ACQ Vol 11 no 2 2009

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118 ACQ Volume 11, Number 2 2009 ACQuiring knowledge in speech, language and hearing
There was an interesting pattern of results: in comparison with
their preterm good reader peers, the preterm poor readers
appeared to have global deficits; in contrast, the full-term
poor readers had difficulties only on the literacy measures.
This pattern indicates that the full-term group included a
small group of children with specific reading difficulties, while
the poor readers in the preterm group had more widespread
cognitive, literacy and language processing problems.
Spelling
The preterm group performed poorly in comparison to both
the full-term control group and the standardised assessment
means on the measures of real and non-word spelling. In
addition, more preterm children were identified with speech
difficulties and had a history of receiving speech therapy.
Children who have current speech impairment and those
with a history of speech impairments but currently error-free
speech are both at increased risk of experiencing reading
and spelling difficulties (Holm, Farrier & Dodd, 2008). Studies
investigating the long-term effects of speech difficulties in the
preschool years show that even as adolescents, children
with a history of phonological difficulties are likely to have
literacy difficulties (Leitão & Fletcher, 2004).
Conclusions
The high number of preterm children who were identified
with speech difficulties needs further investigation. Speech
difficulty is a significant risk factor for children’s literacy
development, indicating that preterm children need to be
carefully monitored.
References
Allen, M. (2008). Neurodevelopment outcomes of preterm
infants. Current Opinion in Neurology, 21, 123–128.
Brunssen, S., & Harry, G. (2007). Diffuse white matter injury
and neurologic outcomes of infants born very preterm in the
1990s. Journal of Obstetric, Gynecologic, & Neonatal Nursing,
36, 386–395.
Holm, A., Farrier, F., & Dodd, B. (2008). Phonological
awareness, reading accuracy and spelling ability of children
with inconsistent phonological disorder. International Journal
of Language & Communication Disorders , 43, 300–322.
Leitão, S., & Fletcher, J. (2004). Literacy outcomes for
students with speech impairment: Long-term follow-up.
International Journal of Language & Communication
Disorders, 39, 245–256.
Neale, M. (1999). Neale Analysis of Reading Ability (3rd
ed.). Australian standardisation. Camberwell, Vic.: ACER.
Neilson, R. (2003). Sutherland Phonological Awareness
Test – Revised (SPAT-R). Camberwell, Vic.: ACER.
Alison Holm and Sharon Crosbie are research
speech pathologists based at the Perinatal
Research Centre at the Royal Brisbane and
Women’s Hospital. Over the last four years their
research has focused on the communication
outcomes of children who are born preterm (<33
weeks gestational age). The majority of children
who are born preterm are considered neuro­
logically normal and free of disability. However,
more subtle impairments of attention, executive
function, language, visual-perceptual abilities,
and fine motor function are reported to influence
the ability to function. These “functional deficits”
affecting 50–70% of very preterm children are
often evident when children start attending school
(Allen, 2008; Brunssen & Harry, 2007). One of the
areas Alison and Sharon were interested in
looking at was the literacy of children born pre-
term. This issue of the ACQ provides an excellent
forum for a quick summary of the findings.
The aim of the study was to investigate the
literacy, phonological awareness and language abilities of
preterm children. We assessed 169 preterm and 141
full-term children aged between 5 and 12 years. All children
were attending mainstream schools in south-east
Queensland; had monolingual English language development;
and did not have major physical or sensorineural impairment.
Phonological awareness skills, reading (accuracy and
comprehension) and real word spelling were assessed.
Language and cognitive skills were also assessed.
The results indicate the preterm children achieved poorer
scores across all domains assessed in comparison to their
full-term classmates. However, the results of the preterm
children did not differ significantly from the standardised
assessment populations. That is, while there is a subgroup of
children experiencing difficulty, on most tasks the proportion
of children having difficulty was the same as you would
expect in any normally distributed population.
Phonological awareness
The Sutherland phonological awareness test–revised (SPAT-R;
Neilson, 2003) was used to assess the phonological aware­
ness abilities of the children in year 1 and 2 (5–7 years of
age). Raw scores were obtained and then compared to the
standardised average range. Each child was then allocated a
SPAT category of 1 (below average range), 2 (average range)
or 3 (above average range). While more preterm children (11%
of the sample) fell in the below average category than full-term
children (6%), the proportion of children in this category is
what would be expected in a normally distributed population.
Reading
In order to examine the reading skills of the preterm and
full-term children in more detail, the children were grouped
into good and poor readers based on their Neale Analysis of
Reading Ability (NARA; Neale, 1999) accuracy profile levels.
Literacy skills of children born preterm
University of Queensland Centre for Clinical Research
Alison Holm and Sharon Crosbie
Research updates
Correspondence to:
Dr Sharon Crosbie and Dr Alison Holm
University of Queensland Centre for Clinical Research
Level 4, Building 71/918
Royal Brisbane and Women’s Hospital, Herston, QLD 4029
phone: 07 3346 6013
fax: 07 3346 5594
email: ;