Directed Language as a Useful Predictor of Speech Processing Efficiency and Vocabulary Development in Preterm Infants

摘要 在子宫内，听觉结构和神经通路发育的有组织和预定模式 15极低出生体重（VLBW）早产儿，出生于24-26岁 怀孕10周是在一个次优的结构和功能的听觉发展的关键阶段， 新生儿重症监护室（NICU）与受保护的子宫 环境中充满了高音警报，救生呼吸设备发出刺耳的机械声 定位在靠近发展中的听觉结构。8环境NICU条件已经 与压力增加和全身炎症相关，导致神经发育不良 结果3，21与VLBW中言语和语言延迟或损伤相关的已识别因素 早产人群包括低出生体重、低胎龄、社会经济危险因素、 然而，很少有针对极低出生体重早产儿的干预措施， 在新生儿重症监护病房住院的患者显示出神经发育的改善，特别是在语言方面 采集因此，本研究的目的之一是探讨新生儿压力的测量是否受到 极低出生体重早产儿的定向语言发作。 早期和频繁的定向言语可能有助于减轻一些可改变的短期和长期的 早产的负面影响，但缺乏这种联系的证据。通过纵向设计，语言 将在NICU住院期间和住院后的4个时间间隔记录输入 使用语言增强分析（LENA）进行放电。语言发展将在12岁时进行测量 18个月在婴儿语言和感知学习实验室。我们的目标是确定 在听觉发展的关键时期，直接语言接触的频率与 (1)改善住院期间新生儿应激的生物物理标志物，（2） 家庭，和（3）提高语音处理效率和词汇量的大小，在这个危险的人口。这 信息将提供新的科学知识，以支持干预措施，包括早期和经常的人类干预措施。 在早产儿群体中的声音作为改善神经发育结果的方法。 研究生和本科生在护理和心理学是至关重要的实施这一点 项目护理专业的学生将有机会在语言发展中实习一个学期 实验室和NICU环境中的心理学学生。因此，除了作出重大贡献， 科学和通知临床实践，这个跨学科的机会将丰富护理研究培训 心理学学生。

ABSTRACT In utero, organized and predetermined patterns of auditory structural and neural pathway development set the stage for early language acquisition.15 The very low birth weight (VLBW) preterm infant, born at 24-26 weeks of gestation is at a critical stage of structural and functional auditory development in a suboptimal environment.3, 15 The Neonatal Intensive Care Unit (NICU), vastly different from the protected uterine environment is full of high pitched alarms, harsh mechanical sounds from lifesaving respiratory equipment positioned in close proximity to developing auditory structures.8 Environmental NICU conditions have been correlated with increased stress and systemic inflammation resulting in negative neurodevelopmental outcomes.3, 21 Identified factors associated with speech and language delay or impairment in the VLBW preterm population include low birth weight, low gestational age, socio-economic risk factors, prolonged hospitalization and increased illness.4, 9 Yet, few interventions directed toward the VLBW preterm infant while hospitalized in the NICU have shown neurodevelopmental improvements especially in the area of language acquisition. Thus, one of the aims of this study is to explore whether measures of neonatal stress is affected by bouts of directed language in the VLBW preterm infant. Early and frequent directed speech may be useful to mitigate some of the modifiable short and longterm negative effects of preterm birth, yet evidence for this link is missing. Through longitudinal design, language input will be recorded at 4-time intervals during NICU hospitalization and at 4 time intervals following hospital discharge using the Language ENvironment Analysis (LENA). Language development will be measured at 12 and 18 months in the Infant Language and Perceptual Learning Lab. Our goals are to determine if the timing and frequency of direct language exposure during critical periods of auditory development are associated with (1) improved biophysical markers of neonatal stress during hospitalization, (2) continued language exposure in the home, and (3) improved speech processing efficiency and vocabulary size in this at-risk population. This information will provide new scientific knowledge to support interventions including early and frequent human voice in the preterm population as a method to improve neurodevelopmental outcomes. Graduate and undergraduate students in Nursing and Psychology are critical to the implementation of this project. Nursing students will have the opportunity to spend a semester interning in a language development lab, and Psychology students in the NICU environment. Thus, in addition to making significant contributions to science and informing clinical practice, this interdisciplinary opportunity will enrich research training of Nursing and Psychology students.