Supplement - Earliest Predictors of Language Outcomes in High-risk Infants

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Project Summary One in every nine babies in the US is born preterm. Speech, language and hearing disorders (SLD) are among the most prevalent neurodevelopmental disorders in children, especially among very preterm survivors. About 40% of very preterm infants (≤32 weeks gestational age) develop speech-language disorders while 10% have permanent hearing loss, increasing the impact on communication difficulties. Currently, it is not possible to accurately predict in the first several years of life which children will develop speech-language disorders, and speech- language therapy is the most delayed of any intervention provided to preterm infants. Such an advance would facilitate early intervention and research therapies during critical windows of optimal neuroplasticity. Our central hypothesis is that prediction of speech-language disorders is possible by 3 m corrected age (CA) with combined innovative measures of structural and functional brain connectivity with magnetic resonance imaging, evoked response measures of speech processing, and novel, sensitized hearing measures. Primary aims are to (1) Identify biomarkers of brain connectivity deficits in very preterm infants that predict SLD; (2) Identify impaired speech processing and all degrees of hearing loss in very preterm infants; and (3) Develop predictive models using advanced biomarkers in preterm infants for adverse speech, language and pre-literacy outcomes at 2 and 3 years CA. This proposal will enroll very preterm infants in a prospective study that will complete comprehensive speech-language and pre- literacy assessments at 2 and 3 years CA. and 36 m CA. The overarching goal is to develop a robust prediction model using innovative measures to enable early identification of children at high risk for SLD.