Preemie Development - a quick look

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Keeping an eye on your preemies development can help you determine when a little help might be necessary.


Preemies aren't just small...

Sometimes preterm children can develop at different rates to a child born full term. In this way it is important to know the key developmental milestones and timeline so that you are able to give your preemie any help if required.

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Language Development

Keeping an eye on your preemie's development can help you determine when a little help might be necessary

It’s amazing how quickly babies grow and develop! The table below highlights some important milestones. Although the table gives an average age at which milestones are achieved it is important to realize that even babies born at term achieve these milestones at varying ages. For preemies, you should always correct for their prematurity.

Language Development in Preemies

Have a look at the following information for typical development of aspects of language. You should talk to your pediatrician if you have any concerns about your preemie's development.

language development milestones and preterm birth


Age Phonology Semantics Grammar Pragmatics Metalinguistic Awareness
Birth – 1 month
  • Categorical speech perception is present (e.g. a giraffe is an animal)
  • Speech sounds become organised into phonemic categories of native language. An example of phoneme is the /a/ sound in the words apple and ape)
  • Variation in tone when speaking and sound patterns of babbling begin to resemble those of native language
  • Shows increased sensitivity to stress patterns and phoneme sequences in words of native language develops
  • Demonstrates preference for sound patterns of native tongue
  • Preverbal gestures develop
  • Understanding of natural sentence structure begins to develop
  • Can return attention to caregiver
  • Begin to engage in vocal exchanges and turn-taking games
1-2 years
  • Start to apply strategies to simplify word pronunciation
  • Produce their first words – increases to several hundred words
  • Object words are used first, followed soon after by action and state words
  • Simple two-word utterances of speech appear (e.g. “give ball”)
  • Start using grammatical morphemes (e.g. adding “ness” to “sad” to make “sadness”)
  • Become more skillful in conversational turn-taking and maintaining topic
3-5 years
  • Large improvement in pronunciation
  • Use of new words increase
  • Begin using simple metaphors that are based on concrete and sensory comparisons (e.g. steer clear of dad today)
  • Sentences begin to reflect an appreciation of adult grammatical categories
  • Increased use of grammatical morphemes
  • Many complex grammatical structures are added
  • Conversational strategies, such as the turnabout, appear
  • Can understand illocutionary intent in speech (e.g. asking “Is there any pepper?” at the dinner table means the person would like the pepper, rather than literally interested if there is any pepper)
  • Can be more flexible with speech to adjust for social expectations
  • The beginnings of metalinguistic awareness appears (i.e. can think about language and its relationship to culture and society)
6-10 years
  • Pronunciations that indicate subtle differences in meaning are mastered
  • By school age vocabulary includes about 10,000 words
  • Meanings of words are understood on the basis of definitions
  • Can understand the multiple meanings of a word and can use to improve understanding of metaphors and humour
  • Complex grammatical structures continue to be refined
  • Advanced conversational strategies develop
  • Improved understanding of illocutionary intent
  • Demanding contexts improve
  • Metalinguistic awareness develops rapidly
  • 11years- adulthood
    • Changes in syllabic stress after certain difficult words take on endings are mastered
  • Large improvement in vocabulary, including many abstract terms; building to over 40,000 words
  • Improvement in understanding of subtle, nonliteral word meanings, such as in irony and sarcasm
    • Continued refinement of complex grammatical structures
  • Referential communication, such as giving and following directions, asking questions, giving explanations, and detecting unclear messages continues to improve
  • Metalinguistic awareness continues to be refined
  • These milestones represent overall age trends. There are individual differences in the exact age at which each milestone is attained (Berk, 2008).


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