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

Purpose: Preterm born children (preterms) are at elevated likelihood for socio-communicative and language difficulties. No study before has investigated the longitudinal development of early joint attention (JA) behaviours in preterms. The current study examined the growth of early JA behaviours and the relation with later language skills in preterms.Methods: This prospective longitudinal study examined the development of early JA skills between 10 and 24 months in 51 preterms. The Early Social Communication Scales (ESCS) were administered at the corrected ages of 10, 18 and 24 months. At each age, infants’ JA behaviours and coordinated vocalisations were coded. At 36 months, language skills were evaluated by the Mullen Scales of Early Learning.Results: We found that most JA behaviours (basic or advanced, regardless of coordinated vocalisations were considered) developed between 10 and 18 months in preterms. Only basic initiating behaviours did not seem to increase, with even a decrease for basic initiating JA (IJA). Response to JA behaviour was the only skill with a continued increase in frequency between 18 and 24 months. When investigating JA behaviours (at 10 months, and growth between 10-18 and 18-24 months) as predictors of language, only 10-months advanced IJA behaviours emerged as predictor of receptive language.Conclusion: JA development in preterms mainly occurs between 10 and 18 months, but we emphasise the large observed inter-individual heterogeneity in JA development. Frequency of (advanced) IJA behaviours seem to contribute more to later language than initiating behavioural requests, possibly because these behaviours elicit more language learning opportunities.