Évaluation électrophysiologique auditive et examen du langage et de l’attention chez l’enfant né prématurément et l’enfant né à terme

The aim of this thesis is to investigate early auditory attention and language development in full-term and preterm children. The last months of pregnancy are particularly important for the child’s cerebral development, and the impacts of a premature birth on his/her neurodevelopment can be substantial. Prematurely born children are at higher risk of developing a variety of neurodevelopmental disorders compared to full-terms. Even without visible brain injury, many premature children are at risk of presenting disorders such as language delays and attentional difficulties. In this thesis, we suggest an approach to investigate pre-attentional processes and early language discrimination abilities in infants using high-density electrophysiology and auditory event-related potentials (AERPs). We conducted two studies. The first one aimed at establishing a paradigm to evaluate auditory attention and language discrimination development in healthy full-term children, over different developmental stages (3 to 7 years, 8 to 13 years, adults; N = 40). To do so, we analyzed the Mismatch Negativity (MMN) component in response to speech (spoken syllables /Ba/ and /Da/) and non-speech stimuli (frequency-synthesized tones, Ba: 1578 Hz/2800 Hz; Da: 1788 Hz/2932 Hz). Distinct patterns of activation were revealed according to stimulus type and age. In all groups, non-speech stimuli elicited an MMN of larger amplitude and earlier latency than did the presentation of speech stimuli. Moreover, in response to speech stimuli, both children groups (3 to 7 years, 8 to 13 years) showed a significantly delayed MMN response compared to the adults group. In contrast, in response to non-speech stimuli, only the youngest group (3 to 7 years) showed a significantly delayed MMN compared to the adults. Age-related differences for tone discrimination therefore appear to occur earlier in children’s development than do the discriminative processes for speech sounds. In the second study, we aimed at identifying the electrophysiological markers of auditory attention and language deficits often incurred by a premature birth. We thus presented this paradigm to 74 infants born preterm (before 34 gestational weeks) or full-term (at least 37 gestational weeks), aged 3, 12 and 36 months old. Our results indicated that preterm children of all age groups showed a significantly delayed MMN and P150 responses to speech stimuli compared to full-terms. Moreover, significant correlations were found between the delayed MMN and P150 responses to speech sounds and lower language scores on a neurodevelopmental assessment. However, no significant differences were found between full-term and preterm children for the MMN in response to non-speech stimuli, suggesting preserved pre-attentional auditory discrimination abilities in these children. Altogether, the findings from this thesis indicate that the neurodevelopmental processes associated with auditory pre-attentional skills occur earlier in childhood compared to language discrimination processes. Cerebral networks involved in speech discrimination are still immature in late childhood. Furthermore, neural networks involved in speech discrimination and language development also appear to be particularly vulnerable to the impacts of prematurity. The use of AERPs and the MMN response to speech stimuli in infancy can thus provide predictive markers of language difficulties commonly seen in premature infants.

Keyphrases: Mismatch Negativity (MMN), Prematurity, Electroencephalography (EEG), Auditory Evoked Potential (AERP), Language development, Neurodevelopment