Clinical Evaluation Of Language Fundamentals-Preschool Research Articles

Fentanyl Exposure in Preterm Infants: Five-Year Neurodevelopmental and Socioemotional Assessment.

ObjectiveTo evaluate the association between cumulative fentanyl dose during neonatal intensive care and 5-year neurodevelopmental and socioemotional outcomes in very preterm infants.Materials and MethodsPatient demographics and clinical factors during the perinatal and neonatal course were collected in 84 patients born between 23- and 30-weeks gestational age (GA). Cumulative fentanyl dose during neonatal intensive care was calculated. Developmental testing at age 5 years included the Wechsler Preschool and Primary Scale of Intelligence Full-Scale Intelligence Quotient, Third Edition, Clinical Evaluation of Language Fundamentals-Preschool, Second Edition, Movement Assessment Battery for Children, Second Edition (MABC-2), and Shape School Assessment. Socioemotional outcomes were assessed via caregiver's responses on the Child Behavior Checklist/1.5-5 (CBCL/1.5-5.5) and Social Responsiveness Scale, Second Edition (SRS-2). Covariates were identified on bivariate analysis (p < 0.1). Linear regression models related outcome measures to the log of cumulative fentanyl dose adjusted for covariates.ResultsHigher cumulative fentanyl dose was associated with lower composite motor scores on bivariate analysis (p < 0.01). Cumulative fentanyl dose did not correlate with composite intelligence quotient, language, or executive function. The Clinical Risk Index for Babies score, log of mechanical ventilation, inotrope, and anesthesia duration, and log of cumulative midazolam and hydrocortisone dose were also associated with MABC-2 scores (p < 0.1). Cumulative fentanyl dose was not associated with composite MABC-2 scores on multiple linear regression. Higher cumulative fentanyl dose was associated with decreased socioemotional problems based on caregiver's response on CBCL/1.5-5.5 t-scores driven by fewer symptoms of depression. The McMaster Family Assessment Device general functioning scale score, maternal age, GA, log of total parenteral nutrition days, patent ductus arteriosus requiring treatment, and log of inotrope hours were also associated with CBCL/1.5-5.5 t-scores (p < 0.1). Cumulative fentanyl dose (p = 0.039) and family dysfunction score (p = 0.002) remained significant after controlling for covariates on multiple linear regression.ConclusionCumulative fentanyl dose during neonatal intensive care did not correlate with 5-year motor, cognitive, or language outcomes after controlling for other variables. Fentanyl dose was associated with caregiver reported total socioemotional problems on the CBCL/1.5-5.5 on multivariate modeling. Additional long-term studies are needed to fully elucidate the safety of fentanyl in very preterm neonates.

The Conversation Compass© Communication Screener-Revised

During classroom conversations all aspects of children’s developing oral language skills, particularly their discourse and social communication (pragmatic) skills, combine with communicative interpersonal skills to foster school success. Few tools exist for teachers to assess children’s conversation skills in the classroom, but the Conversation Compass© Communication Screener (CCCS) was created to fill this void. This study examined the factor structure of an adapted version of the CCCS, the Conversation Compass© Communication Screener-Revised (CCCS-R). Factor analytic results indicated a four-factor structure that fits the data well. The study also investigated the CCCS-R’s convergent validity with the Clinical Evaluation of Language Fundamentals—Preschool (CELF-P) Descriptive Pragmatics Profiles subtest and predictive validity with the CELF-P Pre-Literacy Scale subtest. Results indicated the CCCS-R showed both convergent and predictive validity with those subscales. The CCCS-R aims to provide teachers, researchers, and clinicians with insights into preschoolers’ classroom conversation skills.

Psychometric Properties of Language Assessments for Children Aged 4-12 Years: A Systematic Review.

Introduction: Standardized assessments are widely used by speech pathologists in clinical and research settings to evaluate the language abilities of school-aged children and inform decisions about diagnosis, eligibility for services and intervention. Given the significance of these decisions, it is important that assessments have sound psychometric properties.Objective: The aim of this systematic review was to examine the psychometric quality of currently available comprehensive language assessments for school-aged children and identify assessments with the best evidence for use.Methods: Using the PRISMA framework as a guideline, a search of five databases and a review of websites and textbooks was undertaken to identify language assessments and published material on the reliability and validity of these assessments. The methodological quality of selected studies was evaluated using the COSMIN taxonomy and checklist.Results: Fifteen assessments were evaluated. For most assessments evidence of hypothesis testing (convergent and discriminant validity) was identified; with a smaller number of assessments having some evidence of reliability and content validity. No assessments presented with evidence of structural validity, internal consistency or error measurement. Overall, all assessments were identified as having limitations with regards to evidence of psychometric quality.Conclusions: Further research is required to provide good evidence of psychometric quality for currently available language assessments. Of the assessments evaluated, the Assessment of Literacy and Language, the Clinical Evaluation of Language Fundamentals-5th Edition, the Clinical Evaluation of Language Fundamentals-Preschool: 2nd Edition and the Preschool Language Scales-5th Edition presented with most evidence and are thus recommended for use.

An Observational Study to Evaluate Associations Between Low-Level Gestational Exposure to Organophosphate Pesticides and Cognition During Early Childhood.

Prenatal exposure to organophosphate pesticides, which is ubiquitous, may be detrimental to neurological development. We examined 327 mother/infant pairs in Cincinnati, Ohio, between 2003 and 2006 to determine associations between prenatal exposure to organophosphate pesticides and neurodevelopment. Twice during pregnancy urinary concentrations of 6 common dialkylphosphates, nonspecific metabolites of organophosphate pesticides, were measured. Aggregate concentrations of diethylphosphates, dimethylphosphates, and total dialkylphosphates were calculated. Bayley Scales of Infant Development, Second Edition-Mental and Psychomotor Developmental indices were administered at ages 1, 2, and 3 years, the Clinical Evaluation of Language Fundamentals-Preschool, Second Edition, at age 4, and the Wechsler Preschool and Primary Scale of Intelligence, Third Edition, at age 5. Mothers with higher urinary total dialkylphosphate concentrations reported higher levels of socioeconomic status and increased fresh fruit and vegetable intake. We found no associations between prenatal exposure to organophosphate pesticides and cognition at 1-5 years of age. In our cohort, exposure to organophosphate pesticides during pregnancy was not associated with cognition during early childhood. It is possible that a higher socioeconomic status and healthier diet may protect the fetus from potential adverse associations with gestational organophosphate pesticide exposure, or that dietary exposure to the metabolites is innocuous and not an ideal measure of exposure to the parent compound.

FMRI as a Preimplant Objective Tool to Predict Postimplant Oral Language Outcomes in Children with Cochlear Implants.

Despite the positive effects of cochlear implantation, postimplant variability in speech perception and oral language outcomes is still difficult to predict. The aim of this study was to identify neuroimaging biomarkers of postimplant speech perception and oral language performance in children with hearing loss who receive a cochlear implant. The authors hypothesized positive correlations between blood oxygen level-dependent functional magnetic resonance imaging (fMRI) activation in brain regions related to auditory language processing and attention and scores on the Clinical Evaluation of Language Fundamentals-Preschool, Second Edition (CELF-P2) and the Early Speech Perception Test for Profoundly Hearing-Impaired Children (ESP), in children with congenital hearing loss. Eleven children with congenital hearing loss were recruited for the present study based on referral for clinical MRI and other inclusion criteria. All participants were <24 months at fMRI scanning and <36 months at first implantation. A silent background fMRI acquisition method was performed to acquire fMRI during auditory stimulation. A voxel-based analysis technique was utilized to generate z maps showing significant contrast in brain activation between auditory stimulation conditions (spoken narratives and narrow band noise). CELF-P2 and ESP were administered 2 years after implantation. Because most participants reached a ceiling on ESP, a voxel-wise regression analysis was performed between preimplant fMRI activation and postimplant CELF-P2 scores alone. Age at implantation and preimplant hearing thresholds were controlled in this regression analysis. Four brain regions were found to be significantly correlated with CELF-P2 scores. These clusters of positive correlation encompassed the temporo-parieto-occipital junction, areas in the prefrontal cortex and the cingulate gyrus. For the story versus silence contrast, CELF-P2 core language score demonstrated significant positive correlation with activation in the right angular gyrus (r = 0.95), left medial frontal gyrus (r = 0.94), and left cingulate gyrus (r = 0.96). For the narrow band noise versus silence contrast, the CELF-P2 core language score exhibited significant positive correlation with activation in the left angular gyrus (r = 0.89; for all clusters, corrected p < 0.05). Four brain regions related to language function and attention were identified that correlated with CELF-P2. Children with better oral language performance postimplant displayed greater activation in these regions preimplant. The results suggest that despite auditory deprivation, these regions are more receptive to gains in oral language development performance of children with hearing loss who receive early intervention via cochlear implantation. The present study suggests that oral language outcome following cochlear implant may be predicted by preimplant fMRI with auditory stimulation using natural speech.

Brief Report: An Independent Replication and Extension of Psychometric Evidence Supporting the Theory of Mind Inventory.

This study presents an independent replication and extension of psychometric evidence supporting the Theory of Mind Inventory (ToMI). Parents of 20 children with ASD (4; 1-6; 7years; months) and 20 with typical development (3; 1-6; 5), rated their child's theory of mind abilities in everyday situations. Other parent report and child behavioral assessments included the Social Responsiveness Scale-2, Vineland Adaptive Behavior Scales-2, Peabody Picture Vocabulary Test-4, and Clinical Evaluation of Language Fundamentals-Preschool, 2. Results revealed high internal consistency, expected developmental changes in children with typical development, expected group differences between children with and without ASD, and strong correlations with other measures of social and communication abilities. The ToMI demonstrates strong psychometrics, suggesting considerable utility in identifying theory of mind deficits in children with ASD.

A semi-supervised Support Vector Machine model for predicting the language outcomes following cochlear implantation based on pre-implant brain fMRI imaging.

We developed a machine learning model to predict whether or not a cochlear implant (CI) candidate will develop effective language skills within 2years after the CI surgery by using the pre-implant brain fMRI data from the candidate. The language performance was measured 2years after the CI surgery by the Clinical Evaluation of Language Fundamentals-Preschool, Second Edition (CELF-P2). Based on the CELF-P2 scores, the CI recipients were designated as either effective or ineffective CI users. For feature extraction from the fMRI data, we constructed contrast maps using the general linear model, and then utilized the Bag-of-Words (BoW) approach that we previously published to convert the contrast maps into feature vectors. We trained both supervised models and semi-supervised models to classify CI users as effective or ineffective. Compared with the conventional feature extraction approach, which used each single voxel as a feature, our BoW approach gave rise to much better performance for the classification of effective versus ineffective CI users. The semi-supervised model with the feature set extracted by the BoW approach from the contrast of speech versus silence achieved a leave-one-out cross-validation AUC as high as 0.97. Recursive feature elimination unexpectedly revealed that two features were sufficient to provide highly accurate classification of effective versus ineffective CI users based on our current dataset. We have validated the hypothesis that pre-implant cortical activation patterns revealed by fMRI during infancy correlate with language performance 2years after cochlear implantation. The two brain regions highlighted by our classifier are potential biomarkers for the prediction of CI outcomes. Our study also demonstrated the superiority of the semi-supervised model over the supervised model. It is always worthwhile to try a semi-supervised model when unlabeled data are available.

Standardized Versus Naturalized: An Evaluation of Child Morphological and Syntactic Assessments

Speech-language pathologists may choose to evaluate children’s language using standardized or naturalized assessments. This study investigated if the Clinical Evaluation of Language Fundamentals-Preschool 2 (CELF-P 2), a standardized assessment, and language sampling, a naturalized assessment, reveal the same information about children’s linguistic competence and performance. Children ages 3.0-7.0 were assessed with specific focus on morphology and syntax. The participants completed four morphosyntactic-based subtests of the CELF-P 2. Additionally, play-based interactions, used to elicit natural language, were video-recorded. The CELF-P 2 was scored and language samples were transcribed and analyzed. Mean length of utterance (MLU) scores showed a slightly more variable trend around the mean than CELF-P 2 scores and there were no significant correlations between the two assessments. Furthermore, the two forms of assessment produced incongruous age equivalents for 66% of the participants (four out of six) and participants produced different morphosyntactic structures during each type of assessment. Thus, results indicated limitations and successes of the different assessment approaches. When used alone, either form of assessment did not provide a completely accurate representation of children’s language acquisition. However, when used in conjunction, the two assessments may represent the linguistic competence and performance of children more accurately.

Internationally adopted children in the early school years: relative strengths and weaknesses in language abilities.

This study aimed to determine the relative strengths and weaknesses in language and verbal short-term memory abilities of school-age children who were adopted from Eastern Europe. Children adopted between 1;0 and 4;11 (years;months) of age were assessed with the Clinical Evaluation of Language Fundamentals-Preschool, Second Edition (CELF-P2) and the Clinical Evaluation of Language Fundamentals, Fourth Edition (CELF-4) at age 5 and ages 6-7. Language composites and subtests were compared across time. All CELF-P2 and CELF-4 mean scores fell in the average range. Receptive composites were 102.74 and 103.86, and expressive composites were 100.58 and 98.42, at age 5 and ages 6-7, respectively. Age of adoption did not correlate to test scores. At ages 6-7, receptive language, sentence formulation, and vocabulary were areas of strength, with subtest scores significantly better than test norms. Verbal short-term memory and expressive grammar subtest scores were within the average range but significantly worse than test norms. A high percentage of children scored 1 standard deviation below the mean on these 2 subtests (27.3%-34.1%). Eastern European adoptees had average scores on a variety of language tests. Vocabulary was a relative strength; enriching the environment substantially improved this language area. Verbal short-term memory and expressive grammar were relative weaknesses. Children learning a language later in life may have difficulty with verbal short-term memory, which leads to weaknesses in expressive syntax and grammar.

Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study

To quantify the contributions of child, family, and environmental predictors to language ability at 4 years. A longitudinal study was performed with a sample of 1910 infants recruited at 8 months in Melbourne, Australia. Predictors were child gender, prematurity, birth weight and order, multiple birth, socioeconomic status, maternal mental health, vocabulary, education, and age at child's birth, non-English-speaking background, and family history of speech/language difficulties. Outcomes were Clinical Evaluation of Language Fundamentals-Preschool, language scores, low language status (scores >1.25 SDs below the mean), and specific language impairment (SLI) (scores >1.25 SDs below the mean for children with normal nonverbal performance). A total of 1596 children provided outcome data. Twelve baseline predictors explained 18.9% and 20.9% of the variation in receptive and expressive scores, respectively, increasing to 23.6% and 30.4% with the addition of late talking status at age 2. A total of 20.6% of children (324 of 1573 children) met the criteria for low language status and 17.2% (251 of 1462 children) for SLI. Family history of speech/language problems and low maternal education levels and socioeconomic status predicted adverse language outcomes. The combined predictors discriminated only moderately between children with and without low language levels or SLIs (area under the curve: 0.72-0.76); this improved with the addition of late talking status (area under the curve: 0.78-0.84). Measures of social disadvantage helped explain more variation in outcomes at 4 years than at 2 years, but ability to predict low language status and SLI status remained limited.

High Prevalence/Low Severity Language Delay in Preschool Children Born Very Preterm

To examine the language development at corrected age 4 years of a regionally representative cohort of children born very preterm (VPT). Of particular interest was the identification of biological and socioenvironmental risk and protective factors that influence VPT children's early language development. Data were collected as part of a prospective longitudinal study of 110 VPT (VPT: ≤ 33 weeks gestation) and 113 full-term children (full term: 37-41 weeks gestation) born in Canterbury, New Zealand from 1998 to 2000. At corrected age 4 years, all children were assessed with the preschool version of the Clinical Evaluation of Language Fundamentals. Extensive information was also collected about children's family social background, perinatal health, childrearing environment, education/intervention exposures, and neurodevelopmental progress from birth to age 4. At the age of 4 years, VPT children were characterized by poorer receptive and expressive language development than full-term children. These differences persisted after exclusion of children with neurosensory impairment as well as statistical adjustment for the effects of social risk. Within the VPT group, the key predictors of children's overall language development were family social risk at birth (p =.05), severity of white matter abnormalities on neonatal magnetic resonance imaging (p =.49), observed parent-child synchrony (p =.001), and concurrent child cognitive ability (p =.001). Together, these factors accounted for 45% of the variance in children's total Clinical Evaluation of Language Fundamentals-Preschool scores. By preschool age, children born VPT show early emerging mild to moderate language delays that are likely to affect their school success and longer-term developmental progress. Findings highlight the importance of potentially modifiable factors such as early brain injury and parenting quality in predicting the language outcomes of children born VPT.

Safety and Efficacy of Rivastigmine in Adolescents with Down Syndrome: A Preliminary 20-Week, Open-Label Study

Individuals with Down syndrome (DS) exhibit a cholinergic deficiency similar to that found in Alzheimer's disease. Cholinesterase inhibitors, used to treat Alzheimer's disease, may improve cognitive function in individuals with DS. This is the first investigation of the safety and efficacy of rivastigmine (an acetyl and butyryl cholinesterase inhibitor) on specific cognitive domains in pediatric DS. Eleven subjects with DS (ages 10-17 years) were treated with a liquid formulation of rivastigmine. Four subjects experienced no adverse events (AEs). Seven subjects reported AEs that were mild, transient and consistent with adverse events typically noted with cholinesterase inhibitors. Significant improvements were found in overall adaptive function (Vineland Adaptive Behavior Scales and Clinician's Interview-Based Impression of Change), attention (Leiter Attention Sustained tests A and B), memory (NEPSY: Narrative and Immediate Memory for Names subtests) and language (Test of Verbal Expression and Reasoning and Clinical Evaluation of Language Fundamentals-Preschool) domains. Improved language performance was found across all functional levels. These results underscore the need for larger, controlled studies employing a carefully constructed test battery capable of measuring the full scope of performance across multiple domains and a wide range of functional levels.

Performance of children with different types of communication impairment on the Clinical Evaluation of Language Fundamentals (CELF)

Three groups of children with communication disorders were assessed using the CELF (Clinical Evaluation of Language Fundamentals). The results were used to compare the language skills of children with specific language impairment (SLI), autistic spectrum disorder (ASD) and a middle group who shared some characteristics of both SLI and ASD (Shared group). The children were aged between 5 years 10 months and 10 years 7 months. Each child was assessed on either the CELF UK 3 or the CELF Preschool, depending on their age and ability. The overall language profiles were compared and differences were found between the three groups. A more detailed analysis of the individual subtests was made, which showed that all three groups had the least difficulty with 'Listening to Paragraphs' (which involves abstracting and remembering information from two short texts). It also showed that all three groups had difficulty with 'Recalling Sentences' (which involves repeating sentences of increasing length and complexity). This paper discusses the value of using a more comprehensive range of linguistic assessments when considering the similarities and differences between groups of children within this population, it also considers the educational and clinical implications and makes suggestions for future research.

Expressive and receptive language functioning in preschool children with prenatal cocaine exposure.

To estimate the relationship between severity of prenatal cocaine exposure and expressive and receptive language skills in full-term, African American children at age 3 years. Language was assessed at age 3 using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P). The sample included 424 children (226 cocaine exposed, 198 non-cocaine exposed) who received preschool language assessments at age 3, drawn from a cohort of 476 children enrolled prospectively at birth. Structural equation modeling was used to regress expressive and receptive language as intercorrelated response variables on level of prenatal cocaine exposure, measured by a latent construct including maternal self-report of cocaine use and maternal/infant urine toxicology assays and infant meconium. Results indicated a.168 SD decrease in expressive language functioning for every unit increase in exposure level (95% CI = -.320, -.015; p =.031) after consideration for fetal growth and gestational age as correlated response variables. Receptive language was more modestly related to prenatal cocaine exposure and was not statistically significant. Results for expressive language remained stable with inclusion of the McCarthy general cognitive index as a response variable (expressive language beta = -.173, 95% CI = -.330, -.016; p =.031), and with adjustment for maternal age and prenatal exposures to alcohol, tobacco, and marijuana (expressive language beta = -.175, 95% CI = -.347, -.003; p =.046). Additional child and caregiver environmental variables assessed at age 3 were also evaluated in varying statistical models with similar results. The evidence from this study supports a gradient relationship between increased level of prenatal cocaine exposure and decreased expressive language functioning in preschool-aged cocaine-exposed children.

Four-year language outcomes of children exposed to cocaine in utero

A large cohort of children exposed to cocaine in utero ( n=189) were followed prospectively from birth to 4 years of age and compared to nonexposed children ( n=185) on the Clinical Evaluation of Language Fundamentals—Preschool (CELF-P), a measure of receptive and expressive language abilities. Children exposed to cocaine in utero performed more poorly on the expressive and total language measures than nonexposed children after controlling for confounding variables, including prenatal exposure to alcohol, marijuana, and tobacco, as well as medical and sociodemographic variables. Children exposed to cocaine had more mild receptive language delays than nonexposed children and were less likely to have higher expressive abilities. Also, maternal factors such as language ability, performance IQ, race, and education correlated with child language abilities. Prenatal cigarette and marijuana exposure were related to deficits in specific language skills. Children placed in adoptive or foster care who were cocaine exposed demonstrated superior language skills compared to children exposed to cocaine who remained in biological relative or mother's care. These findings support a cocaine-specific effect on language skills in early childhood that may be modified with an enriched environment.

Severity of Prenatal Cocaine Exposure and Child Language Functioning Through Age Seven Years: A Longitudinal Latent Growth Curve Analysis

The current study estimates the longitudinal effects of severity of prenatal cocaine exposure on language functioning in an urban sample of full-term African-American children (200 cocaine-exposed, 176 noncocaine-exposed) through age 7 years. The Miami Prenatal Cocaine Study sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview and toxicology assays of maternal and infant urine and infant meconium. Language functioning was measured at ages 3 and 5 years using the Clinical Evaluation of Language Fundamentals–Preschool (CELF-P) and at age 7 years using the Core Language Domain of the NEPSY: A Developmental Neuropsychological Assessment. Longitudinal latent growth curve analyses were used to examine two components of language functioning, a more stable aptitude for language performance and a time-varying trajectory of language development, across the three time points and their relationship to varying levels of prenatal cocaine exposure. Severity of prenatal cocaine exposure was characterized using a latent construct combining maternal self-report of cocaine use during pregnancy by trimesters and maternal and infant bioassays, allowing all available information to be taken into account. The association between severity of exposure and language functioning was examined within a model including factors for fetal growth, gestational age, and IQ as intercorrelated response variables and child's age, gender, and prenatal alcohol, tobacco, and marijuana exposure as covariates. Results indicated that greater severity of prenatal cocaine exposure was associated with greater deficits within the more stable aptitude for language performance (D = −0.071, 95% CI = −0.133, −0.009; p = 0.026). There was no relationship between severity of prenatal cocaine exposure and the time-varying trajectory of language development. The observed cocaine-associated deficit was independent of multiple alternative suspected sources of variation in language performance, including other potential responses to prenatal cocaine exposure, such as child's intellectual functioning, and other birth and postnatal influences, including language stimulation in the home environment.

Longitudinal influence of prenatal cocaine exposure on child language functioning

The present study estimates the longitudinal effects of in utero cocaine exposure on language functioning at 3, 5 and 7 years of age in an urban sample of 443 full-term children (236 cocaine-exposed and 207 noncocaine-exposed) participating in the Miami Prenatal Cocaine Study. The sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview and urine and meconium toxicology assays. Language functioning was measured at ages 3 and 5 years using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P) and at age 7 years using the Core Language Domain of the NEPSY: A Developmental Neuropsychological Assessment. Longitudinal Generalized Linear Model and Generalized Estimating Equations (GLM/GEE) analyses revealed an association between prenatal cocaine exposure and deficits in total language functioning after statistically controlling for child sex, visit age, prenatal exposure to alcohol, marijuana and tobacco and over 20 additional medical and sociodemographic covariates drawn from potentially confounding influences assessed at birth and follow-up visits ( D=−0.17; 95% CI=−0.32, −0.03; P=.019). The link from prenatal cocaine exposure to later language deficits does not appear to be mediated by cocaine-associated deficits in birth weight, length or head circumference. Overall, the evidence tends to support an inference of a stable cocaine-specific effect on indicators of language functioning during early childhood through age 7 years.

Parent-Child Interactions, Parenting Stress, and Developmental Outcomes at 4 Years

This study examined the relationship of father-child and mother-child interactions, perceptions of parenting stress, socioeconomic status, and prematurity to development of 44 healthy preterm and 49 full-term Canadian children at 4 years of age. Preterm or full-term birth, infant sex, and parental age accounted for 30-32% of the variance in cognitive and motor scores, respectively, on the McCarthy Scales of Children's Abilities. Parenting stress, father-child interactions at 12 months, and preterm and full-term birth accounted for 19% of the variance for expressive language on the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P). For receptive language on the CELF-P, mother-child interaction at 12 months, mother's spousal relationship, and preterm and full-term birth accounted for 13% of the variance. Addressing early parent-child interaction and perceptions of parenting stress may improve child language development.