Joint attention development and the association with language skills at 3 years in preterm born children

Preterm born children (preterms) are at elevated likelihood for social-communicative and language difficulties. No study before has investigated the longitudinal development of early joint attention (JA) behaviours in preterms. We examined early JA development and the relation with later language abilities in preterms. This prospective longitudinal study examined the early JA development in 51 preterms with a gestational age below 30 weeks. The Early Social Communication Scales (ESCS) were administered at the corrected ages of 10, 18 and 24 months, and coded for infants' JA behaviours and coordinated vocalisations. At 36 months, receptive and expressive language abilities were evaluated by the Mullen Scales of Early Learning. Most JA behaviours (basic or advanced, with or without coordinated vocalisations) developed between 10 and 18 months, while basic initiating JA behaviours showed a decrease during this age period. Responding to JA (RJA) was the only skill with a continued increase in frequency between 18 and 24 months. Advanced IJA behaviours at 10 months and increases towards 24 months emerged as predictor of both language skills. Initial level and increases in RJA predicted receptive language. JA development in preterms, as measured with the ESCS, mainly occurs between 10 and 18 months, but there was substantial inter-individual heterogeneity in JA development. Frequency of advanced IJA behaviours appears to contribute more to later language than initiating behavioural requests, possibly because these behaviours elicit more language learning opportunities. Initial level and improvements in RJA and advanced IJA throughout the second year of life may benefit language development.