Attention and Word Learning (@WL) study: protocol for a longitudinal study examining early predictors of coordinated visual attention and word learning in preterm and full-term infants.

INTRODUCTION: Despite an improved survival rate, preterm birth (PT, <37 weeks of gestation) remains a significant public health concern due to the elevated risks of developing neurocognitive impairments among survivors. Compared with full-term (FT) infants, PT infants show early deficits in visual attention and motor skills as well as language delays. Infant–parent coordinated visual attention (CVA), the coordination of attention to an object with a caregiver, creates critical opportunities for language learning. In FT dyads, CVA emerges from attention-motor coordination, enhances infants’ sustained attention and coincides with parental object naming. Yet, it remains unclear how PT-related differences in attention and motor abilities shape the development of CVA and, in turn, infants’ word learning. To address this gap, the Attention and Word Learning (@WL) study aims to investigate the mechanistic pathway through which PT-related disruptions in basic attention functions and motor abilities impact the moment-to-moment formation of CVA and the associated word learning experience.

METHODS AND ANALYSIS: In this longitudinal study, infant attention and motor abilities are assessed at 12–14 months (T1). Attention subfunctions are measured using three screen-based eye-tracking tasks. Gross and fine motor skills are assessed using a laboratory assessment and a parent-report questionnaire. Six months later, at 18–20 months (T2), mobile eye tracking is used during infant-caregiver free play to examine CVA from a first-person perspective. Dyads play with four novel toys assigned with pseudoword names. Infants’ comprehension of these names is subsequently assessed using an eye-tracking looking-while-listening task. Receptive and expressive vocabulary size are measured by parent reports at T1 and T2. Analyses will test group differences (PT vs FT) in CVA and word learning at T2, and whether birth status moderates the associations between T1 attention and motor abilities and T2 CVA. We will also explore whether CVA mediates associations between early attention and motor abilities and later vocabulary size. Findings will clarify developmental pathways linking PT birth to language acquisition and enhance the ability to identify clinically useful predictors of language difficulties following PT birth.

ETHICS AND DISSEMINATION: Ethical approval was granted by the University of South Carolina (Pro00136706). Study results will be disseminated through academic conferences and journal publications. Study data will be shared on Databrary.