Research Roundup: NICU interventions enhance interactive talk with premature babies


Research Roundup

Led by Dr. Betty Vohr, researchers at the Women & Infants Hospital of Rhode Island have been shaping our understanding of preterm infants’ language environments in neonatal intensive care unit (NICU) settings for over a decade. Infants born prematurely are deprived of hearing their mother’s voice in the womb and may also encounter less language in their first weeks of life in the NICU, contributing to their increased risk of developmental delays.

Two recent publications, summarized below, highlight the promise of interventions aimed at increasing preterm infants’ exposure to adult interaction in the NICU.

A reading intervention to boost conversational turns

A study published in the journal Acta Paediatrica is the first randomized trial to show the benefits of participating in a mother-to-child reading intervention for preterm infants in the NICU. A group of 33 infants born at 22-32 weeks received the intervention, while a group of 34 preterm infants did not. At 36 weeks postmenstrual age, the children in the reading group engaged in twice as many conversational turns as children receiving standard care, as measured by LENA technology. The authors used LENA SP to complete the study.

Both groups received information about the importance of talking to their babies. However, the mothers in the reading group received additional resources, including: 

  • A demonstration of prosodic reading.
  • A supplemental curriculum highlighting the benefits of infant-directed speech, joint attention, and ways to read, talk, and sing with the baby.
  • LENA feedback reports and donated books during coaching sessions at 32, 34, and 36 weeks postmenstrual age. (The standard-care group received their book donations and a summary of their LENA data after the study’s completion.)

It’s in the third and final LENA recording that the pronounced difference in conversational turns arose. Daily conversational turn totals ranged from 17-63 in the reading group and 5-33 in the standard care group. The median in the reading group was 30, compared to 20 in the control group. In addition, only the reading group showed a significant increase in conversational turns (+145%) over the course of the four weeks.  

A neonatal Cuddler program to enhance NICU language environments

The Women and Infants Hospital launched a Cuddler program in 2013 to increase direct human contact for high-risk infants in the NICU. In a study published in the Journal of Perinatology, the authors assessed how a language intervention for the Cuddler volunteers may impact babies’ language environments.

One group consisted of infants who were visited at least three times per week by a parent, while a second group consisted of infants who were visited once weekly for 1-2 hours by a Cuddler volunteer. Following an initial 16-hour LENA recording, both the Cuddlers and the parents received feedback on the LENA data, as well as a series of lessons on how to talk with infants, including such topics as “Reading Aloud” and “Copying First Sounds.” One week later, a second LENA recording was completed.

The second, post-intervention recording revealed comparable levels of increased conversational turns for both groups, though the increases were not significant. A comparison group, consisting of infants whose parents did not receive the lessons or the feedback on LENA reports, experienced a decrease in interaction. Looking only at the Cuddler group, we see that conversational turns were higher during Cuddler time than they were during the time the infants were in the care of a nurse. Likewise, infants whose parents received the language intervention and LENA feedback experienced more conversational turns than infants whose parents did not take the lessons or see their LENA reports.

These promising results support the researchers’ view that “all families and healthcare providers may benefit from training in providing language-rich environments for infants in the NICU.”

Video: Using LENA to support healthy development of premature infants

Dr. Betty Vohr is on the LENA Scientific Advisory Board and has spent many years researching the language environments of preterm infants. In the video below, she describes her previous research:


The LENA Team is a dedicated group of professionals who are passionate about increasing awareness of the importance of early interactive talk. We are statisticians, speech-language pathologists, curriculum specialists, engineers, and linguists.

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