# Predicting language processing efficiency in preterm children: Social-environmental and neuro-biological factors

> **NIH NIH R01** · STANFORD UNIVERSITY · 2020 · $651,139

## Abstract

Each year in the U.S., more than one in 10 children are born preterm (PT). Approximately half of very
preterm survivors, born at < 32 weeks’ gestation, develop language-based learning impairments that may be
discovered late and put children at substantial risk for poor outcomes throughout their lives. Our previous grant
(HD069150) convincingly demonstrated that language processing efficiency, assessed at 18 months in an eye-
tracking paradigm, called looking-while-listening (LWL), was more predictive of long-term outcomes than
standardized tests and parent reports. PT children who were faster at language processing at 18 months
showed advantages in both verbal and non-verbal skills at 54 months. Our next step is to understand early
predictors of language processing efficiency in PT children. In this renewal, we enroll PT neonates (n = 140)
from two language groups, primarily English- and primarily Spanish families, to increase the diversity of our
sample and to improve generalizability. We assess social-environmental predictors at 12 months (infant
environment) and 18 months (toddler environment) using day-long audio recordings of the child’s language
environment and naturalistic laboratory observations of caregiver-child interactions. We assess neurobiological
predictors, focusing on white matter microstructure, in the neonatal period (neonatal scans) and at 12 months
(infant scans). We use two complementary types of MRI scans to assess white matter axonal properties and
myelin content. At 18 months, the primary outcome measure is language processing speed in the LWL task,
the time it takes the child to shift eye gaze to the picture of an object that was just named. Parent reports of
vocabulary and scores on a standardized test of language development are secondary measures. Our aims
are to: (1) determine if properties of the infant and/or toddler environments predict language processing speed
and secondary outcomes in PT children from the two language-groups; (2) determine if properties of white
matter pathways, assessed from neonatal and/or infant MRI scans, predict language processing speed and
secondary outcomes, after consideration of language group, clinical variables, and other covariates; and (3)
investigate the contributions of social-environmental factors and white matter development on language
processing speed in this diverse sample of children born PT. Our main hypothesis is that relations between
language learning environments and language processing speed are mediated by changes in white matter
development, suggesting that supportive learning environments impact language outcomes because learning
environments advance the development of white matter microstructure. The demonstration that white matter
change mediates the association of social-environmental factors on language outcomes provides a clear
example of experience-dependent plasticity in the human brain. This finding would represent a theoretical
contribution to models of l...

## Key facts

- **NIH application ID:** 10120535
- **Project number:** 2R01HD069150-06A1
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Heidi M. Feldman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $651,139
- **Award type:** 2
- **Project period:** 2011-04-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10120535

## Citation

> US National Institutes of Health, RePORTER application 10120535, Predicting language processing efficiency in preterm children: Social-environmental and neuro-biological factors (2R01HD069150-06A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10120535. Licensed CC0.

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