Premature births, or births before 37 weeks of gestation, are a growing phenomenon, including in Slovenia, where about approximately 7 % of newborns are born prematurely. Low birth weight (< 2500 g) and feeding and swallowing disorders pose an additional risk for the developmental abnormalities.
The theoretical part of this thesis describes the characteristics of the occurrence of premature birth, the possible consequences of preterm birth for the child's development, the characteristics of hospital care of premature babies and the specifics of subsequent monitoring of their development. We studied the mutual influence of low birth weight, feeding and swallowing disorders, and atypical speech and language development.
In the empirical part, the characteristics of individual preterm infants from the neonatal, toddler, and preschool periods are presented. 117 premature children with birth weight less than 1500 g born in Ljubljana Maternity Hospital between 2013 and 2015 were included in the research. Their development was studied using data from the Neonatal Intensive Care Unit and baseline data from the follow-up examination after the discharge from the maternity hospital at an average age of two years, as well as two questionnaires. With the first questionnaire, we collected the data about the child from their last physical examination at an average age of five and a half years, while the other aimed to obtain the data about the child's speech and language development from their speech and language pathologists (SLP). We received 50 completed questionnaires from the pediatricians and 19 completed questionnaires from SLPs. The study revealed that children with feeding and swallowing disorders were significantly more likely to have deviations in the Denver Developmental Screening Test at the last follow-up visit at the maternity hospital (n = 117) than children without these disorders (p = 0.01). We also observed a correlation between the Denver Developmental Screening Test administered at the age of two, and the pediatricians' assessment of atypical speech and language development at the last physical examination (p = 0.02). The correlation between speech and language deviations in the Denver Developmental Screening Test and low gestational age (p = 0.11) or low birth weight (p = 0.05) was not confirmed. During the follow-up examinations of premature children at an average age of five and a half years (n = 50), pediatricians reported atypical speech and language development in 34% of children, which were correlated to the deviations in general development (p < 0.01), psychological development (p < 0.01), gross (p = 0.04) and fine motor skills (p < 0.01), the presence of neurological disorders (p = 0.04), and activity and attention disorders (p = 0.02). The pediatricians' assessments of atypical speech and language were not related to the child's gender or the characteristics of the child's family, which were asked about in the questionnaire. Data obtained from the SLPs (n = 19) showed that 83.3 % of the children visited a SLP for the first time before the age of five and 44.4 % before the age of three. SLPs reported deviations in expressive language (94.7 %), receptive language (36.8 %), phonological awareness (57.9 %), and sociopragmatic skills (42.1 %) in the treated premature children. Articulation problems exclusively occurred in 26.3 % of premature babies, whereas problems in all four mentioned areas were observed in 42.1 %.
A speech and language pathologist (SLP) participates in the assessment and treatment of premature babies, which requires a deep understanding of their developmental and health specifics. With the help of findings on the development and treatment of premature children with low birth weight and feeding and swallowing disorders, we have contributed to a better understanding of their characteristics and needs, provided a conceptual starting point for further research, and highlighted the importance of including the SLP into the early treatment of feeding and swallowing disorders, and speech and language disorders.
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