TYPE Original Research

PUBLISHED 11 September 2024

DOI 10.3389/fpsyg.2024.1394346

Music and reading activities in

OPEN ACCESS early childhood associated with
improved language development
EDITED BY
Fabrizio Stasolla,
Giustino Fortunato University, Italy

REVIEWED BY
Elena Escolano-Pérez,
in preterm infants at 2–3 years of
University of Zaragoza, Spain
Aslı Aktan-Erciyes,
Kadir Has University, Türkiye
age
*CORRESPONDENCE
Kaisamari Kostilainen Kaisamari Kostilainen 1,2*, Noora Fontell 1, Kaija Mikkola 3,4,
[email protected] Satu Pakarinen 1, Paula Virtala 1,2, Minna Huotilainen 1,2,
RECEIVED 01 March 2024
ACCEPTED 08 July 2024
Vineta Fellman 5,6 and Eino Partanen 1,2
PUBLISHED 11 September 2024 1
Cognitive Brain Research Unit, Faculty of Medicine and Faculty of Educational Sciences, University of
CITATION Helsinki, Helsinki, Finland, 2 Centre of Excellence in Music, Mind, Body and Brain, Faculty of Medicine
Kostilainen K, Fontell N, Mikkola K, and Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland, 3 Department of
Pakarinen S, Virtala P, Huotilainen M, Pediatrics, Pediatric Research Center, Neonatology, New Children’s Hospital, University of Helsinki,
Fellman V and Partanen E (2024) Music and Helsinki, Finland, 4 Helsinki University Hospital, Helsinki, Finland, 5 Department of Clinical Sciences,
reading activities in early childhood Pediatrics, Lund University, Lund, Sweden, 6 Children’s Hospital, University of Helsinki, Helsinki, Finland
associated with improved language
development in preterm infants at 2–3 years
of age.
Front. Psychol. 15:1394346.
doi: 10.3389/fpsyg.2024.1394346
Introduction: Children born preterm are at increased risk for adverse
neurodevelopmental outcomes. Music and reading activities in childhood could
COPYRIGHT
© 2024 Kostilainen, Fontell, Mikkola, ameliorate these difficulties, as they have shown benefits on both neural and
Pakarinen, Virtala, Huotilainen, Fellman and behavioral levels. However, only a few studies have assessed these potential
Partanen. This is an open-access article benefits in preterm-born children. We investigated whether music and language
distributed under the terms of the Creative
Commons Attribution License (CC BY). The activities in early childhood are associated with improved developmental
use, distribution or reproduction in other outcomes of preterm-born children.
forums is permitted, provided the original
author(s) and the copyright owner(s) are Methods: The cognitive, language, and motor skills of 45 children, born between
credited and that the original publication in 24 and 34 gestational weeks, were tested at 23–38 months of corrected age with
this journal is cited, in accordance with the Bayley Scales of Infant and Toddler Development, Third Edition. Background
accepted academic practice. No use,
distribution or reproduction is permitted information, including parental education, and the weekly amount of music and
which does not comply with these terms. language-related activities was collected using parental questionnaires.
Results: The amount of singing, playing musical instruments and reading
aloud was associated with better language skills. Moreover, children who had
participated in a music playschool had better language skills when compared
to those children who had not participated in a music playschool. Maternal
education was associated with music playschool participation and better
language and motor skills in children attending music playschool.
Discussion: Interactive music and language activities in early childhood may
improve language skills in preterm-born children. Informing and guiding parents
at an early stage to integrate these activities into their daily lives could be a one
way of supporting the development of preterm-born children.

KEYWORDS

Bayley scales of infant and toddler development, language development, music

playschool, preterm infant, reading, singing

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1 Introduction cognitive skills at 2 years of age. Also, a more recent study by Neri et al.
(2021) suggested that parental book-reading implemented already
Preterm birth is a global health problem covering 4–12% of during the neonatal intensive care can support language development
births worldwide (Vogel et al., 2018; Ohuma et al., 2023). Depending of preterm-born infants in the first 2 years of life. Shared reading
on the gestational weeks (GW) at birth, an infant can be born either activities improve language skills also generally in typically developing
as moderate to late premature (32–37 GW), very premature (28–32 children as a meta-analysis showed that shared storybook reading
GW), or extremely premature (<28 GW; World Health offers a rich linguistic experience for the child, as well as promotes the
Organization, 2020). Preterm birth increases the risk for adverse development of vocabulary and supports later reading skills (Flack
neurodevelopmental outcome and cognitive deficits in the et al., 2018).
development of speech and language, including delays in vocabulary Taken together, research indicates that informal music and reading
and grammatical development, phonological processing, and activities promote cognitive development in typically developing full-
language comprehension are relatively common in this population term-born children. However, no studies to date have investigated the
(McGowan and Vohr, 2019). While the risk for neurodevelopmental associations between informal music activities and development of
deficits is the highest in very or extremely preterm-born infants preterm infant, and studies regarding the effects of reading activities on
(Anderson et al., 2003; Løhaugen et al., 2013; Chung et al., 2020), their development is still scarce. In the current study, we examined
developmental delays have been increasingly reported also in whether informal music and language-related activities during infancy
moderate to late preterm infants, especially in the language domain and early childhood were associated with improved cognitive
(Cheong et al., 2017). development in preterm-born children at 2–3 years of age.
Finding means to improve the developmental trajectories of
preterm infants is paramount. Formal and informal music activities
in childhood may influence brain development in full-term-born 2 Materials and methods
children, as there is evidence of the favorable effects of formal
musical training (e.g., instrumental lessons) on brain structure and 2.1 Participants
function in children (e.g., Putkinen et al., 2015; Tervaniemi et al.,
2018). Informal music activities, i.e., when there is no direct Forty-five preterm-born children at 22.9–38.2 months corrected
intention to learn specific musical skills, such as music playschool age (mean 28.4 months, SD 4.7) participated in this study. The children
that consists of different musical activities in a small group guided were born between 24 and 34 gestational weeks to Finnish-speaking
by a trained music educator (e.g., singing, playing, moving with the parents and were initially recruited to a longitudinal Singing Kangaroo
music, and listening to music), have also been demonstrated to study while receiving medical care in the neonatal wards of the
improve auditory processing and linguistic skills in children. For Helsinki University Central Hospital, Finland (Kostilainen et al.,
example, Putkinen et al. (2019), demonstrated in their longitudinal 2021a,b, 2023). As the neonatal parental singing intervention showed
study that attendance in a music playschool was connected to no association with Bayley-III scores (Kostilainen et al., 2023), and the
improved sound processing in preschool-aged children. Linnavalli music and language-related activities in early childhood between the
et al. (2018), in turn, showed that weekly attendance in a music intervention and control groups did not differ, these groups were
playschool improved phoneme processing and vocabulary skills in combined in this study. During enrollment, the infants were in stable
5–6-year-old children. medical condition, with no cerebral hemorrhage stages III-IV, nor
Even informal music activities conducted at home, such as singing congenital central nervous system abnormalities. For the Singing
and playing, have been associated with improved sound processing Kangaroo study, only infants born between 24 and 34 gestational
and attention in 2–3-year-old children (Putkinen et al., 2013). Many weeks were recruited so that the postnatal singing intervention could
researchers now consider that musical interventions or musical be conducted for several weeks before term age (Kostilainen et al.,
activities benefit development, however, not all studies have shown 2021a). The participant demographics are presented in Table 1. The
support for the broad benefits of musical activities in child study was approved by the Ethics Committee of the Hospital District
development. The general conclusion in the field is that musical of Helsinki (Ethics Committee for gynecology and obstetrics,
activities provide specific benefits for children’s development although pediatrics, and psychiatry 65/13/03/03/2012). The parents gave their
the effects may be narrow (Dumont et al., 2017) and dependent on written informed consent to participate after receiving both oral and
mediating factors (Schellenberg et al., 2015). However, some recent written information about the study.
meta-analyses suggest that the transfer effects of music on cognition
are extremely weak (Sala and Gobet, 2020).
Shared reading activities may also influence language 2.2 Data collection
development, as it requires both exposure to language and active use
or practice of it. Parental interaction may be especially relevant, as the 2.2.1 Bayley Scales of Infant and Toddler
parent focuses the attention of the infant on language while providing Development, Third Edition
support and emotional care (Virtala and Partanen, 2018). Consistent At 2–3 years of corrected age, the children were assessed with
with this, the seminal study of Braid and Bernstein (2015) investigated the Bayley Scales of Infant and Toddler Development, Third
the impact of book reading on cognitive development in preterm- Edition (Bayley-III; Bayley, 2006). Bayley-III is an extensively used
born children with a large sample size of 1,400 preterm infants born tool for the assessment of early childhood development and early
at 22–36 weeks of gestation. Their study demonstrated that reading detection of developmental delays. It includes the assessment of
aloud at least two times per week was associated with improved five domains: cognition, language, motor, socio-emotional, and

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TABLE 1 Demographics of participants.

Mean SD Range
N = 45 (female 42%)

Gestational age at birth (weeks), n = 44 30.3 2.1 24.7–34.1

Weight at birth (g), n = 43 1459.5 398.8 900–2800

Maternal education (years), n = 43 17.5 3.1 11–25

Paternal education (years), n = 42 15.5 3.4 9–25.3

TABLE 2 The six main factors from the self-report questionnaires used in the analyses.

Factors
1. Mother’s education (years in total)

2. Father’s education (years in total)

3. Attendance in a music playschool (yes/no) If yes:

a. at what age (e.g., 6–12 months)

b. for how long (e.g., 6 months)

c. how often (e.g., 1 h/week)

4. Music and language-related activities in the same space with the child currently (hours per week, music playschool activities excluded)

a. playing live music

b. singing

c. listening to music

d. reading aloud

5. Language-related activities together with the child currently (rated 1–4*, music playschool activities excluded)

a. singing

b. reading nursery rhymes or books

6. Music activities currently (1–4*, music playschool activities excluded)

a. playing instruments together with the child

b. the child playing instruments alone

*1 = almost never, 2 = once a month at most, 3 = several times per month, 4 = several times per week.

adaptive behavior in infants aged from 1 to 42 months. In this 2.2.2 Self-report questionnaire
study, three major areas of development were evaluated in the Background information was collected using self-report
following order: cognition, language (including receptive and questionnaires, filled in by the parents (n = 44) during the child’s
expressive communication), and motor (including fine and gross Bayley-III test. In addition to questions concerning basic information
motor). The cognitive part included tasks related to sensorimotor (e.g., parental education), parents were asked to evaluate how much
development, memory, and concept formation. The language part children were currently exposed to music and language activities
included word comprehension, the ability to respond to words, weekly, and whether children had participated in a music playschool.
preverbal communication, vocabulary, and syntactic development. According to our hypotheses, six main factors from the questionnaire
Motor development was measured with tasks related to functional were chosen for the analyses (Table 2).
hand skills, manipulation of objects, static positioning, and
movement of limbs and balance.
The Bayley-III assessments were conducted by a research assistant, 2.3 Statistical analyses
a student of psychology, under the supervision of a licensed
psychologist (EP). The assessments were carried out during one The statistical analyses were conducted using SPSS 28 (IBM
approximately 3-h session (including breaks) in a quiet test room in Corporation, NY, United States). Bayley-III age-standardized index
the Department of Psychology and Logopedics, Faculty of Medicine, scores were used in the analyses. Missing values were not replaced.
University of Helsinki, Finland. In line with the Bayley-III instructions, To reduce the number of multiple comparisons, sum and mean
the parents were permitted to be present, however, they were not scores of theoretically related background variables; music and
allowed to assist the child during the test. In some children, the language-related activities in the same space with the child,
assessment of all three domains (cognition, language, motor) was not language-related activities together with the child, and music
possible, reducing the sample size in those analyses involving all activities were used instead of scores from several individual items
domains (See section Statistical Analyses). (Table 3). Multiple linear regression was used to examine the

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TABLE 3 Variables generated from the background questionnaire and used in the analyses.

Variable changes
Music and language-related activities in the same space with the child currently (hours per week)
Sum variable:
1. playing live music + listening to music
2. singing + reading aloud

Language-related activities together with the child currently (1–4*)

Mean variable:
3. singing + reading nursery rhymes or books

Music activities currently (mean from 1 to 4*)

Mean variable:
4. playing instruments together with the child + the child playing instruments alone
*1 = almost never, 2 = once a month at most, 3 = several times per month, 4 = several times per week.

TABLE 4 The mean Bayley-III index and subtest scores for all participants (not all participants completed all the subtests).

Mean SD Range
Bayley-III index score

Cognitive, n = 45 101.9 10 85–125

Language, n = 43 107.6 11.3 83–132

Motor, n = 40 104 11.8 79–136

Bayley-III subtest score

Cognitive 10.4 2.0 7–15

Receptive language 12.1 2.1 7–16

Expressive language 10.3 2.9 4–15

Fine motor 10.7 2.0 7–16

Gross motor 10.5 2.6 5–18

associations between the Bayley-III scores, music/language 3 Results

activities, and mother’s education years. In the models, the
dependent variable (cognitive, language and motor scores) was The mean index and subtest scores of all participants on Bayley-III
regressed on predicting variables of music and language activities scales are presented in Table 4 and the amount of weekly music and
and mothers’ education years. Furthermore, the impact of music language-related activities is reported in Table 5. No associations
playschool on the Bayley performance was tested using the between the mothers’ and fathers’ education years in total and the
repeated-measures Analysis of variance (rmANOVA) with music children’s Bayley scores were found (p > 0.08). The gestational age at
playschool participation as a between-group factor and Bayley birth was not associated with the Bayley scores, respectively. Also, no
scores (cognitive, language, and motor) as within-group factors. sex differences were found in the Bayley scores.
Only those children who had all Bayley scores measured (cognitive, Twenty-six children (58%, one child’s data missing) had participated
language, and motor) were included in the analysis (n = 37). The or were currently still attending a music playschool. The families had
data were further analyzed with repeated-measures Analysis of started the activity when their infants were on average 8.5 months of age
covariance (rmANCOVA) to assess the possible effect of maternal (range 1–24 months), and music playschool was attended on average
education on Bayley scores in children that had attended 52 min per week (range 30–90 min) for an overall period of 12.3 months
music playschool. (range 2–30 months). When comparing the background information of
The possible effect of sex on the Bayley scores was tested using the divided groups (children in music playschool vs. children not in
sex (male, female) as a between-group factor and Bayley scores music playschool), no differences were found (p > 0.319 for all
(cognitive, language, and motor) as within-group factors. A comparisons) except for maternal education, U = 94.50, z = −3.225,
Greenhouse–Geisser correction was used if the assumption of p = 0.001, as the mothers of the children in the music playschool had
sphericity was not met, and Bonferroni correction was used in the more education years (Md = 18.00, n = 25) than those mothers of the
post hoc tests. Partial eta squared (η2) is used when reporting effect children that had not participated in a music playschool (Md = 15.66,
sizes for rmANOVA analyses. Non-parametric Mann–Whitney n = 18). There were no statistically significant differences in the amount
U-tests were used when comparing the background information of of weekly music and language-related activities between the children
the divided groups (children in music playschool vs. children not in who participated in music playschool and who did not participate in
music playschool). music playschool (Supplementary Table 1).

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TABLE 5 The questionnaire results regarding the amount of weekly music and language-related exposure in the families.

Mean SD Range
Music and language-related activities in the same space with the child (hours per week)

a. playing live music 0.7 1.3 0–7

b. singing 3.3 3.1 0–10

c. listening to music 5.5 3.8 0–15

d. reading aloud 4.3 3.2 1–15

FIGURE 1
Scatterplot illustrating the association between Bayley-III language score and the amount of singing and reading aloud in the same space with the
child (p = 0.012).

3.1 The associations between the Bayley-III 70) = 3.433, p = 0.038, η2 = 0.089. This result was due to children who had
scores and the music and reading activities participated in a music playschool having statistically higher Bayley
language scores than those children who did not participate in a music
The multiple regression analysis showed that the music and language- playschool, p = 0.03 (Figure 3). However, as the results showed a group
related activities and mother’s education years did not predict Bayley-III difference in maternal education, an additional analysis was conducted
cognitive (p = 0.356) nor motor scores (p = 0.318). However, the multiple while adjusting for maternal education. The analysis revealed a main
regression model with music and language-related activities and mother’s effect of the covariate ‘Maternal education’ F(1, 33) = 5.138, p = 0.03,
education years predicting Bayley-III language scores resulted in a η2 = 0.135, meaning that maternal education was positively associated with
significant model F(5, 34) = 3.724, p = 0.009, R2 = 0.354. When examining the Bayley scores. Also, when controlling for the confounding factor
the individual predictors, we found that singing and reading aloud in the ‘Maternal education’, the group difference did not remain statistically
same space with the child (t = 2.647, p = 0.012; Figure 1) as well as playing significant, F(2, 66) = 2.769, p = 0.07, η2 = 0.077. After a more detailed
instruments together with the child or child on their own (t = 2.611, correlation analysis, the results revealed that higher maternal education
p = 0.013; Figure 2) were significant predictors for Bayley-III language was positively associated with higher Bayley language scores, rs = 0.436,
scores. On the contrary, mother’s education years did not predict children’s n = 23, p = 0.037, and motor scores, rs = 0.472, n = 22, p = 0.026, in the music
language scores (t = 1.346, p = 0.187). The regression table of the significant playschool group children. Also, after evaluating the correlation between
model is presented in Table 6. maternal education and the amount of the music and language-related
When examining the effect of music playschool participation on activities in general, higher maternal education was found to be positively
Bayley cognitive, language, and motor scores, rmANOVA showed an associated with how much there was reading aloud in the same space with
interaction effect of music playschool participation and Bayley scores, F(2, the child, rs = 0.305, n = 43, p = 0.47.

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FIGURE 2
Scatterplot illustrating the association between Bayley-III language score and the amount of playing instruments together with the child or child
playing on their own (p = 0.013). Grey colored symbol indicates mean value.

TABLE 6 The regression coefficients, statistical significances, and R-squared values of mother’s education years and music and reading activities on
Bayley-III language scores.

Variable B SE B β t p
Mother’s education years 0.811 0.603 0.217 1.346 0.187

Playing live music and listening to music in the same space –0.355 0.445 –0.122 –0.797 0.431
with the child

Singing and reading aloud in the same space with the child 0.879 0.332 0.418 2.647 0.012*

Singing and reading nursery rhymes or books together with –5.518 6.008 –0.165 –0.919 0.365
the child

Playing instruments together with the child or the child 5.772 2.211 0.458 2.611 0.013*
playing instruments alone

R2 0.354
* p < 0.05.

4 Discussion and reading in the same space and together with the child were
associated with better Bayley-III language scores unlike passive music
In this study, we examined the association of music and language- activities, such as music listening. Social interaction is known to be an
related activities during early childhood on cognitive development in important factor in speech learning (Kuhl et al., 2003; Kuhl, 2004;
preterm-born children at 2–3 years of age. The results showed that Lytle et al., 2018) and interactive music-making in infancy and early
regular interactive music and language-related activities, such as childhood has been shown to improve language development more
singing and reading aloud as well as playing musical instruments, were efficiently than passive music listening. For example, in a study by
associated with improved Bayley language skills. Hence, interactive Gerry et al. (2012), 6-months-of-age full-term born infants and their
music and language-activities may support language development in parents were randomly assigned either to active music classes
preterm-born children. consisting of movement, singing, and instrument playing or passive
On average, the preterm children in this study performed similarly music classes consisting of music listening once a week for 6 months.
as their age equivalent full-term peers (Serenius et al., 2013). In our After the intervention period, infants in the active music classes
data, interactive music, and language-related activities, such as singing showed better prelinguistic communicative gestures and social

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FIGURE 3
Bayley cognitive, language, and motor mean scores with 95% confidence intervals between children who had not participated in a music playschool
(grey) and children who had participated in a music playschool (grey/white). A statistically significant group difference (p = 0.03) was found in the
Bayley language performance between the two groups when maternal education was not controlled for (cognitive: p = 0.40; motor: p = 0.29).

behavior when compared to infants in the passive music group (Gerry backgrounds did not differ in their verbal ability, but they differed
et al., 2012). Thus, social interaction is an important factor in music in general knowledge of child development and the importance of
activities enhancing both language and social development. child-directed speech. Hence, the parents from high SES
Musical interaction between the caretaker and the child has been backgrounds had more word diversity, they used “parentese”
proposed to have benefits for child development (Virtala and Partanen, (speaking style with exaggerated phonetic patterns) when talking
2018). Consistent with the idea that benefits of musical activities arise to their child and talked more in general (Rowe, 2008). Thus,
from reciprocal activity incorporating music, music playschool parents with higher education levels have more knowledge of child
participation together with the caregiver in our study was associated with development, which affects how they interact with their children.
improved language skills. Music playschool offers moments of musical This likely explains why mothers with more education years placed
interaction in a positive environment. Hence, it may be that both the their children in music playschools in our data. In future studies,
reciprocal nature of music playschool and the positive environment it would be important to examine more thoroughly what different
together improved language skills in our study. However, this result factors, such as music, mother’s education, and interactive behavior
should be handled with extra caution as maternal education affected the contribute to the benefits of music activities.
results and the impact of music playschool on preterm infant development As parents are usually the primary source of language input for
should be assessed more closely in future studies. their children, educating parents of preterm infants from different
As our results indicated, participation in a music playschool with education and socioeconomic backgrounds about the benefits of
their preterm-born child became more likely with increasing maternal developmentally supportive activities, such as reading aloud and using
education. It may be that higher-educated parents have more resources, music activities in early childhood, is recommended. Offering parental
such as money and knowledge, to offer their children developmentally psychoeducation is of value, however, parents from lower education
supportive activities. For example, parents can afford paid activities such level should also be offered resources to support child development,
as music playschool, or parents read more to their children as in this study for example, by increasing their possibilities to attend music
and the study reviewed earlier by Braid and Bernstein (2015), where the playschool. Even if increasing resources would not be possible,
amount of shared reading was associated with enhanced cognitive distributing knowledge can be beneficial as the study by Suskind et al.
development in preterm infants, maternal education was associated with (2015) demonstrated that educating mothers from low SES
how much parents read to their children. In our study, higher maternal backgrounds about the importance of their language input can
education level was also associated with higher Bayley language and increase knowledge, have an impact on mothers’ behavior, and change
motor scores in those children who had participated or were still the home language environment. Parental education, as in educating
participating in a music playschool. parents to behave and interact in a manner that supports child
Maternal education is known to be closely related to child development (McMahon et al., 2012) can also influence parental
development, and overall, the socioeconomic status (SES) of sensitivity, which has been shown to enhance language learning
parents has been shown to impact language development. For (Madigan et al., 2019). Based on these results, future studies examining
example, Rowe (2008) investigated the connections between the the effects of both parent education and music playschool participation
speaking styles of parents from different socioeconomic on cognitive development in preterm infants, especially from low-SES
backgrounds. They found that parents from low and high SES families would be needed.

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4.1 Limitations Author contributions

The children were originally planned to be assessed with KK: Formal analysis, Visualization, Writing – original draft,
Bayley-III at 24 months of corrected age (± 3 months). Due to Writing – review & editing, Funding acquisition, Methodology,
restrictions in assessment schedules due to the COVID-19 Validation. NF: Methodology, Writing – review & editing. KM:
pandemic, some of the children were assessed later than initially Conceptualization, Writing – review & editing, Data curation,
planned. Bayley-III being an age-standardized test, it was possible Project administration, Supervision. SP: Conceptualization,
to conclude the assessments despite part of the children exceeding Writing – review & editing, Methodology, Supervision. PV:
the age limit set for the measurements. In this study, the amount Supervision, Writing – review & editing. MH: Conceptualization,
of music and language-related activities was examined using self- Supervision, Writing – review & editing, Funding acquisition,
report questionnaires answered by the parents. Hence, Methodology, Project administration. VF: Conceptualization,
information about the specific contents and durations of the Funding acquisition, Supervision, Writing – review & editing,
reading and music playschool activities during the first 2 years of Project administration. EP: Conceptualization, Supervision,
age could not be assessed. Also, as no information on the amount Writing – review & editing, Methodology, Project administration.
of parent–child interactions other than music or reading was
collected, we cannot exclude the possibility that other interactive
activities may have affected the results. Moreover, as we studied Funding
infants born extremely and very preterm, we cannot draw further
conclusions from these results regarding infants born moderate The author(s) declare that financial support was received for the
to late preterm. research, authorship, and/or publication of this article. This study was
It should be considered that the number of participants in this funded by the Alfred Kordelin Foundation (KK), Signe and Ane
study was limited and did not include a control group of full-term Gyllenberg Foundation (grant number 5930, VF), Medicinska
children. In addition, parents participating in studies are often highly Understödsföreningen Liv och Hälsa (VF), and Finnish Cultural
educated, as in this study. Therefore, it would be important to find Foundation (MH). The work of author PV was supported by the
ways to involve families from different socioeconomic backgrounds. Academy of Finland (grant number 1346211) and by the Ella and
Future studies should consider the use of more systematic and Georg Ehrnrooth Foundation.
controlled early childhood interventions and outcome measures with
higher number of participants and RCT designs, including the SES of
the family at randomization. Acknowledgments
We are thankful to all the families for participating in the study
5 Conclusion and we address our gratitude to the research assistants Anastasia
Gallen and Ilona Tuomi for their valuable work. We also thank Helmi
Regular interactive music and language-related activities in early Uusitalo for helping with the data visualization.
childhood, such as singing, reading aloud, and playing musical
instruments may improve language skills in preterm-born children.
Informing and guiding parents from early on how to utilize these Conflict of interest
developmentally supportive interactive activities in their daily lives might
be one potential means to support preterm infant’s development. Such The authors declare that the research was conducted in the
instructions could form a basis for early music and language-related absence of any commercial or financial relationships that could
intervention that would be feasible and cost-effective for parents from be construed as a potential conflict of interest.
different educational and SES backgrounds to conduct.

Publisher’s note
Data availability statement
All claims expressed in this article are solely those of the authors
The raw data supporting the conclusions of this article will and do not necessarily represent those of their affiliated organizations,
be made available by the authors, without undue reservation. or those of the publisher, the editors and the reviewers. Any product
that may be evaluated in this article, or claim that may be made by its
manufacturer, is not guaranteed or endorsed by the publisher.
Ethics statement
The studies involving humans were approved by Ethics Committee Supplementary material
of the Hospital District of Helsinki. The studies were conducted in
accordance with the local legislation and institutional requirements. The Supplementary material for this article can be found online
Written informed consent for participation in this study was provided at: https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1394346/
by the participants’ legal guardians/next of kin. full#supplementary-material

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References
Anderson, P., and Doyle, L. W.Victorian Infant Collaborative Study Group (2003). Madigan, S., Prime, H., Graham, S. A., Rodrigues, M., Anderson, N., Khoury, J., et al.
Neurobehavioral outcomes of school-age children born extremely low birth weight or (2019). Parenting behavior and child language: a Meta-analysis. Pediatrics
very preterm in the 1990s. JAMA 289, 3264–3272. doi: 10.1001/jama.289.24.3264 144:e20183556. doi: 10.1542/peds.2018-3556
Bayley, N. (2006). Bayley scales of infant and toddler development. San Antonio, TX: McGowan, E. C., and Vohr, B. R. (2019). Neurodevelopmental follow-up of preterm
Harcourt Assessment. infants: what is new? Pediatr. Clin. N. Am. 66, 509–523. doi: 10.1016/j.pcl.2018.12.015
Braid, S., and Bernstein, J. (2015). Improved cognitive development in preterm McMahon, E., Wintermark, P., and Lahav, A. (2012). Auditory brain development in
infants with shared book reading. Neonatal Netw. 34, 10–17. doi: 10.1891/ premature infants: the importance of early experience. Ann. N. Y. Acad. Sci. 1252, 17–24.
0730-0832.34.1.10 doi: 10.1111/j.1749-6632.2012.06445.x
Cheong, J. L., Doyle, L. W., Burnett, A. C., Lee, K. J., Walsh, J. M., Potter, et al. (2017). Neri, E., De Pascalis, L., Agostini, F., Genova, F., Biasini, A., Stella, M., et al. (2021).
Association between moderate and late preterm birth and neurodevelopment and Parental book-Reading to preterm born infants in NICU: the effects on language
social–emotional development at age 2 years. JAMA Pediatr. 171:e164805. doi: 10.1001/ development in the first two years. Int. J. Environ. Res. Public Health 18:11361. doi:
jamapediatrics.2016.4805 10.3390/ijerph182111361
Chung, E. H., Chou, J., and Brown, K. A. (2020). Neurodevelopmental outcomes of Ohuma, E. O., Moller, A. B., Bradley, E., Chakwera, S., Hussain-Alkhateeb, L.,
preterm infants: a recent literature review. Transl. Pediat. 9, S3–S8. doi: 10.21037/ Lewin, A., et al. (2023). National, regional, and global estimates of preterm birth in 2020,
tp.2019.09.10 with trends from 2010: a systematic analysis. Lancet 402, 1261–1271. doi: 10.1016/
S0140-6736(23)00878-4
Dumont, E., Syurina, E. V., Feron, F. J. M., and van Hooren, S. (2017). Music
interventions and child development: a critical review and further directions. Front. Putkinen, V., Tervaniemi, M., and Huotilainen, M. (2013). Informal musical activities
Psychol. 8:1694. doi: 10.3389/fpsyg.2017.01694 are linked to auditory discrimination and attention in 2–3-year-old children: an event-
related potential study. Eur. J. Neurosci. 37, 654–661. doi: 10.1111/ejn.12049
Flack, Z. M., Field, A. P., and Horst, J. S. (2018). The effects of shared storybook
reading on word learning: a meta-analysis. Dev. Psychol. 54, 1334–1346. doi: 10.1037/ Putkinen, V., Tervaniemi, M., and Huotilainen, M. (2019). Music playschool activities
dev0000512 are linked to faster auditory development during preschool-age: a longitudinal ERP
Gerry, D., Unrau, A., and Trainor, L. J. (2012). Active music classes in infancy enhance study. Sci. Rep. 9:11310. doi: 10.1038/s41598-019-47467-z
musical, communicative and social development. Dev. Sci. 15, 398–407. doi: Putkinen, V., Tervaniemi, M., Saarikivi, K., and Huotilainen, M. (2015). Promises of
10.1111/j.1467-7687.2012.01142.x formal and informal musical activities in advancing neurocognitive development
Kostilainen, K., Hugoson, P., Haavisto, A., Partanen, E., Mikkola, K., Huotilainen, M., throughout childhood. Ann. N. Y. Acad. Sci. 1337, 153–162. doi: 10.1111/nyas.12656
et al. (2023). No impact of parental singing during the neonatal period on cognition in Rowe, M. L. (2008). Child-directed speech: relation to socioeconomic status,
preterm-born children at 2–3 years. Acta Paediatr. 112, 1471–1477. doi: 10.1111/ knowledge of child development and child vocabulary skill. J. Child Lang. 35, 185–205.
apa.16788 doi: 10.1017/s0305000907008343
Kostilainen, K., Mikkola, K., Erkkilä, J., and Huotilainen, M. (2021b). Effects of Sala, G., and Gobet, F. (2020). Cognitive and academic benefits of music training with
maternal singing during kangaroo care on maternal anxiety, wellbeing and mother- children: a multilevel meta-analysis. Mem. Cogn. 48, 1429–1441. doi: 10.3758/
infant relationship after preterm birth: a mixed methods study. Nord. J. Music. Ther. 30, s13421-020-01060-2
357–376. doi: 10.1080/08098131.2020.1837210
Schellenberg, E. G., Corrigall, K. A., Dys, S. P., and Malti, T. (2015). Group music
Kostilainen, K., Partanen, E., Mikkola, K., Wikström, V., Pakarinen, S., Fellman, V., training and Children’s prosocial skills. PLoS One 10:e0141449. doi: 10.1371/journal.
et al. (2021a). Repeated parental singing during kangaroo care improved neural pone.0141449
processing of speech sound changes in preterm infants at term age. Front. Neurosci.
15:686027. doi: 10.3389/fnins.2021.686027 Serenius, F., Källén, K., Blennow, M., Ewald, U., Fellman, V., Holmström, G., et al.
(2013). Neurodevelopmental outcome in extremely preterm infants at 2.5 years after
Kuhl, P. K. (2004). Early language acquisition: cracking the speech code. Nat. Rev. active perinatal care in Sweden. JAMA 309, 1810–1820. doi: 10.1001/jama.2013.3786
Neurosci. 5, 831–843. doi: 10.1038/nrn1533
Suskind, D. L., Leffel, K. R., Graf, E., Hernandez, M. W., Gunderson, E. A.,
Kuhl, P. K., Tsao, F. M., and Liu, H. M. (2003). Foreign-language experience in infancy: Sapolich, A. G., et al. (2015). A parent-directed language intervention for children of
effects of short-term exposure and social interaction on phonetic learning. Proc. Natl. low socioeconomic status: a randomized controlled pilot study. J. Child Lang. 43,
Acad. Sci. 100, 9096–9101. doi: 10.1073/pnas.1532872100 366–406. doi: 10.1017/S0305000915000033
Linnavalli, T., Putkinen, V., Lipsanen, J., Huotilainen, M., and Tervaniemi, M. (2018). Tervaniemi, M., Tao, S., and Huotilainen, M. (2018). Promises of music in education?
Music playschool enhances children’s linguistic skills. Sci. Rep. 8:8767. doi: 10.1038/ Front. Educ. 3:74. doi: 10.3389/feduc.2018.00074
s41598-018-27126-5
Virtala, P., and Partanen, E. (2018). Can very early music interventions promote at-
Løhaugen, G. C. C., Østgård, H. F., Andreassen, S., Jacobsen, G. W., Vik, T., Brubakk, A.- risk infants’ development? Ann. N. Y. Acad. Sci. 1423, 92–101. doi: 10.1111/nyas.13646
M., et al. (2013). Small for gestational age and intrauterine growth restriction decreases
cognitive function in young adults. J. Pediatr. 163, 447–453.e1. doi: 10.1016/j. Vogel, J. P., Chawanpaiboon, S., Moller, A.-B., Watananirun, K., Bonet, M., and
jpeds.2013.01.060 Lumbiganon, P. (2018). The global epidemiology of preterm birth. Best Pract. Res. Clin.
Obstet. Gynaecol. 52, 3–12. doi: 10.1016/j.bpobgyn.2018.04.003
Lytle, S. R., Garcia-Sierra, A., and Kuhl, P. K. (2018). Two are better than one: infant
language learning from video improves in the presence of peers. PNAS 115, 9859–9866. World Health Organization (2020). Preterm birth. Available at: https://www.who.int/
doi: 10.1073/pnas.1611621115 news-room/fact-sheets/detail/preterm-birth (Accessed May 6, 2024).

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