Preterm birth + social disadvantage = extra at-risk

*Another study on social disadvantage; this time, over 100 infants studied.

We know that babies born pre-term are at a higher risk for developmental delays, including language. We also know that children born into socially disadvantaged environments are at risk for language delay. So what happens when a baby from a socially disadvantaged* background is born early? The most SLP-relevant findings include:

  • full-term infants with fewer social risk factors had the best language scores at age 5

  • but low social risk isn’t enough to make up for prematurity (< 30 week gestation)— that is, preterm infants with low social risk did not experience as much language growth from 2- to 5-years as the full-term children (thus, addressing social risk for preterm kids is good, but may not be enough to close the language gap by 5 years)

  • high social risk was associated with decreasing language scores as developmental demands increased with age (and the authors found this trajectory was associated with maternal affect and maternal intellectual ability, so parent interventions addressing affect and responsiveness may be helpful for these children)

The big picture? Just because everything looks “ok” for a child at 2 years doesn’t mean things will look that way at 5 years when cognitive, linguistic, and motor development gets more demanding. Also, very preterm infants and toddlers, at a social disadvantage or not, need our support. We can start by training parent responsivity, but it looks like some preterm children could need more intensive interventions to close the developmental gap between themselves and their full term peers.

*Their definition of social risk included factors like teen parents, single parents, no high school diploma. Refer back to the previous study, though, that shows how a healthy home environment can reduce the impact of these factors.


Lean, R. E., Paul, R. A., Smyser, T. A., Smyser, C. D., & Rogers, C. E. (2019). Social adversity and cognitive, language, and motor development of very preterm children from 2 to 5 years of age. The Journal of Pediatrics. Advance online publication. doi:10.1016/j.jpeds.2018.07.110.