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We conducted a six-center, prospective, randomized, open-label trial to assess whether an early standardized educational protocol provided from 42 to 48 months of age improved the progression of oral language and phonological development in children born preterm. A total of 552 children with phonological fragility were included in this study. The children were randomized to receive the educational protocol (guided arm, n  = 87) or not (non-guided arm, n  = 78). In the guided arm, the oral language development used a short "say and do" type educational protocol designed to maintain visual attention and train the developmental phonology/lexicon/morphosyntax structural links. In contrast, a conservative approach was used in the non-guided arm. A total of 70 guided and 73 non-guided children completed the study. After 6 months, the educated children showed a non-significant increase in their phonology score ( p  = 0.37), while the variations in the scores of the expressive lexicon (secondary endpoints) were significantly improved ( p  = 0.0008). We conclude that the short, standardized stimulation of the sensorimotor aspects of language in children born very preterm increased the expressive lexicon. This protocol improved the language of the premature children, especially those with minimal motor skills, with more significant improvement in the phonological scores., Clinical Trial Registration: clinicaltrials.gov, identifier NCT01426659., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Charollais, Laudenbach, Stumpf, Delaporte, Datin-Dorriere, Debillon, De Barace, Flechelles and Farmer.)

Background: Anaesthesia is neurotoxic in developing primates. Retrospective clinical studies show a correlation between exposure to anaesthesia during infancy and the occurrence of learning disorders (LD). Prospective studies failed to detect any influence of a single exposure to anaesthesia on neurodevelopment. We hypothesised that some specific populations of children were electively sensitive to anaesthesia-related neurotoxicity., Methods: Using a case-control design, we analysed the medical histories of children with LD, compared to those of their normally reading siblings. Interviews were conducted and medical records were reviewed. The numbers of hospitalisations and anaesthesia exposures before the age of five years were determined., Results: Four hundred fourteen dyslexic children were screened over a one-year period. Two hundred and seventy patients were excluded due to confounding variables (single child, all siblings showing LD or any condition placing the neurological prognosis at risk (N = 107/414 for the latter)) or inability to accurately collect evaluation criteria. In the 144 case-control pairs studied, the mean number of hospitalisations was significantly different (N = 1.097 ± 0 .135/case versus 0.667 ± 0.097/control, p = 0.0052), as was the proportion of hospitalised patients (54.2% versus 38.9%, p = 0.0031). The mean number of anaesthesia exposures per individual was not statistically different (N = 0.958 ± 0.183/case versus 0.569 ± 0.107/control, p =  0.0732), but the proportion of children anaesthetised at least once was (43.8% (cases) versus 33.3% (controls), p =  0.0301)., Discussion: One or more hospitalisation(s) may reflect a health status and/or have an iatrogenic effect disrupting the normal setting up of learning abilities. Anaesthesia may play a role, but a correlation between LD and anaesthesia is of a lower magnitude than between LD and hospitalisation., (Copyright © 2020 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)

Clinical and radiological knowledge of language development in the former premature infant compared to the newborn allows us to argue for exploration of the sensorimotor co-factors required for proper language development. There are early representations of the maternal language in the infant's visual, auditory, and sensorimotor areas, activated or stabilized by orofacial and articulatory movements. The functional architecture of language is different for vulnerable children such as premature infants. We have already mentioned the impact of early dysfunction of the facial praxis fine motor skills in this population presenting comprehension disorders. A recent meta-analysis confirms the increasing difficulty of understanding between 3 and 12 years, questioning the quality of the initial linguistic processes. A precise analysis of language, referenced from 3 years of age, should be completed by sensorimotor tests to assess possible constraints in automating neurolinguistic foundations. The usual assessment at this age can exclude sensory disturbances and communication and offers guidance and socialization. However, a recent study shows the ineffectiveness of "language-reinforced immersion" at 2 and 3 years in a population of vulnerable children. The LAMOPRESCO study of language and motor skills in the premature infant (National PHRC 2010) has assessed language and sensorimotor skills of preterm-born (<33 weeks) 3.5-year-old children without cerebral palsy. Fragile children were randomized into 2 groups, 1 stimulated by a specific individual protocol, the other given guidance. The primary endpoint was phonology, assuming that it is composed of very early good-quality sensorimotor integration stabilized by the child's oral facial motor skills before 5 years of age. This developmental integrative dynamic validates the "motor theory of speech perception." Early and accurate assessment of language and the patient's constraints should differentiate and specify management strategies for all children, whatever their background and pathologies., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: Very premature birth carries a high risk of neurocognitive disabilities and learning disorders. Acquiring sufficient speech skills is crucial to good school performance., Methods: A prospective study was conducted in 2006 to evaluate speech development in 55 children born very prematurely in 2000 at the Rouen Teaching Hospital (Rouen, France), free of cerebral palsy, compared to 6-year-old born at full term. A computerized speech assessment tool was used (Bilan Informatisé du Langage Oral, BILO II)., Results: In the premature-birth group, 49 % of 6-year-old had at least 1 score below the 25th percentile on 1 of the 8 BILO II tests. Significant speech impairments were noted for 2 components of speech, namely, comprehension and phonology. Oral comprehension scores no higher than the 10th percentile were obtained by 23 % of prematurely born children (P<0.02 vs controls). On word repetition tasks used to test phonology, 21 % of prematurely born children obtained scores no higher than the 10th percentile (P<0.01 vs controls). An evaluation of sensorimotor language prerequisites (constraints) in 30 of the 55 prematurely born children showed significant differences with the controls for word memory, visual attention, and buccofacial praxis., Conclusion: The speech development impairments found in 6-year-old born very prematurely suggest a distinctive pattern of neurodevelopmental dysfunction that is consistent with the motor theory of speech perception., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)