ABSTRACT
Objective. To examine the relationship between cumulative biological and environmental risk factors and the language development of children less than 3 years. Methods. A sample of 253 children aged 2 to 35 months, from an urban centre in north India were evaluated for language development. The main outcome measure was the language quotient (LQ) of the child as evaluated by the Clinical Linguistic Auditory Milestone Scale (CLAMS). Twelve possible risk factors, 4 biological and 8 environmental, were selected. Biological risk factors included preterm birth, low birth weight, history of birth asphyxia, and history of neonatal jaundice. The environmental risk factors included low income, large family size, minimal father’s and mother’s education, disadvantaged caste, low level of occupation of head of the household, absence of father, and higher birth order. A multiple risk score was created and categorized into 3 groups: low risk (0 to1), moderate risk (2 to 3) and high risk (4 and above). Results. There was a significant (F=4.80, p<.000) general downward linear trend in the LQ of the child as the number of risk factors increased. The difference in the LQ of the children with no risk factor and those with 8 risk factors was 21.21 LQ points and each risk factor reduced the LQ of the children by 2.63 points. Conclusion. Children experience many risk factors but the most detrimental effects on language development are caused when multiple biological and environmental risk factors act on a single child.