Using Infant Non-Nutritive Suck as a Diagnostic Measure of Future Speech Function

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PROJECT SUMMARY Pediatric feeding disorders are on the rise and are present in 20-50% of typically developing children (1-8) and in 33-80% of children with developmental delay (9, 10). Furthermore, infants who are born preterm are particularly at-risk for sucking and feeding difficulties (11, 12). Early non-nutritive suck (NNS) – or sucking without nutrients being delivered – and feeding skills have been shown to be reliable indicators of central nervous system (CNS) integrity (18). In fact, delays in sucking and feeding have been reported in approximately 35-48% of infants with different types of neonatal brain injury (18). Sucking, feeding, speech, and language all develop in parallel in the first year of life and rely heavily on sensorimotor integration. However, the link between sucking and feeding skills, CNS function, and development extends beyond the neonatal period. Emerging retrospective research links neonatal sucking and feeding patterns to subsequent speech (13) and language (14-17) development in early childhood. Although these behaviors emerge on a similar timeline and share neural resources and musculature, they are rarely studied together and the links between them remain unknown. We propose a longitudinal study to sample NNS data at 3, 6, 9, and 12 months of age and speech outcomes at 12, 24, and 36 months of age across full-term (n=85) and moderate to late preterm (32-37 weeks’ gestational age; n=85) infants. The specific goals of the proposed research are as follows: (Aim 1) to establish typical patterns of NNS across infants born full-term and preterm in the first year of life and utilize a functional data analysis to examine infants’ NNS burst waveforms, and (Aim 3) to determine the ability of NNS to predict subsequent speech development across preterm and full-term infants until age three. We hypothesize that infant suck will change significantly across the first year of life with infants born premature performing worse on these measures compared to full-term infants. In addition, we hypothesize that neonatal suck will predict speech development across preterm and full-term infants. This study provides an unprecedented level of power in identifying the connection between neonatal sucking and subsequent speech emergence for several reasons: we will use our (1) innovative, custom and quantitative NNS device to sample suck across (2) two groups of infants and will (3) utilize functional data analyses to better understand NNS development and its implications for speech development later in life. (4) We will use standardized and non- standardized approaches to longitudinally study speech development, which will allow for a more robust and nuanced understanding of how NNS and speech are connected in infants and children. Overall, this project captures three years of in-depth oral motor coordination using state-of-the-art methods and collaborators to answer important theoretical questions. Results generated by this clinically relevant and theoretically driven study will create a paradigm shift in how clinicians approach feeding and speech therapies in early childhood.