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Importance of Parent Talk in the NICU – An Article Review

As neonatal therapists, we are always glad to see parents visiting their babies in the NICU.

Parents are seen quietly holding their babies, providing kangaroo care, or sitting in a bedside chair in their son/daughter’s room. Have you ever paid attention to how much parents are talking to their babies during these interactions? Often times little talking is occurring. Sometimes this is a good thing. We know that preterm infants can become easily overwhelmed by too much sensory stimuli in the environment, and that sometimes being held is all that the baby’s underdeveloped systems can tolerate at a given time. NICUs across the country are aiming to decrease the noise levels in their units for this very reason. Parents aren’t always sure how much talking is good versus overstimulating.

As it turns out, we may not know either.

We know that preterm infants are prone to speech and language delays later in childhood. Is it possible that these infants could actually benefit from hearing their parents’ voices more often during their hospital stay? Researchers at Women and Infants Hospital, Providence, Rhode Island sought to analyze the sound environment in the NICU, and to see if preterm infants exposed to more adult language would make more vocalizations, even prior to term equivalent.

Not surprisingly, this study found that language accounted for only a small percentage of noise that an infant is exposed to in the NICU. Interestingly, this study also found that infant vocalizations occur as early as 32 weeks, and that infants had more conversational turns (vocal sounds from the infant such as a coo or squeal followed by a response from an adult within 5 seconds or an adult word followed by a child vocalization within 5 seconds) when parents were visiting than during the times they heard language from only other adults.

Although more research is needed to determine the optimal sound environment for preterm infants and its effects of later outcome, we know that human voice is different from other noise, and that infants were more vocally responsive when parents visited.

Many of the therapeutic interventions we provide to preterm infants are based on mimicking the intrauterine environment. Because the mother’s voice is prominent to the baby in utero, parents talking to their babies prior to term may help mimic that experience. Perhaps we should consider encouraging parents to talk or read to their infants more, while also explaining how to interpret the baby’s response to this stimuli. Below is the full abstract for this study, as well as a link for accessing the full text article.


Importance of Parent Talk on the Development of Preterm Infant Vocalizations

Melinda Caskey, MD, Bonnie Stephens, MD, Richard Tucker, BA, Betty Vohr, MD

Objective: To determine the sound environment of preterm infants cared for in the NICU and to test the hypothesis that infants exposed to more adult language will make more vocalizations.

Methods: This was a prospective cohort study of 36 infants who had a birth weight of ≤1250 g. Sixteen-hour recordings of the infant sound environment were made in the NICU from a digital language processor at 32 and 36 weeks’ postmenstrual age. Adult word counts, infant vocalizations, and conversational turns were analyzed.

Results: Infant vocalizations are present as early as 32 weeks. Both adult word counts per hour and infant vocalizations per hour increase significantly between 32 and 36 weeks. Infant exposure to language as a percentage of time was small but increased significantly. When a parent was present, infants had significantly more conversational turns per hour than when a parent was not present at both 32 and 36 weeks (P < .0001).

Conclusions: Preterm infants begin to make vocalizations at least 8 weeks before their projected due date and significantly increase their number of vocalizations over time. Although infant exposure to language increased over time, adult language accounted for only a small percentage of the sounds to which an infant is exposed in the NICU. Exposure to parental talk was a significantly stronger predictor of infant vocalizations at 32 weeks and conversational turns at 32 and 36 weeks than language from other adults. These findings highlight the powerful impact that parent talk has on the appearance and increment of vocalizations in preterm infants in the NICU.

Link is to abstract & full text link is available on that page: