Foetal growth restriction is associated with problems in neurocognitive development. In the present study, prospectively collected cohorts of foetal growth restricted (FGR) and appropriate for gestational age grown (AGA) children were examined at early school-age by using the Children's Communication Checklist-2 (CCC-2) to test the hypothesis that FGR children demonstrate poorer communication skills than AGA children. Furthermore, potential differences between FGR children born prematurely and at term were evaluated, as well as the effect of assessment age on CCC-2 performance. The FGR-children demonstrated poorer language structure and language use than the AGA group. Nineteen percent of the FGR children scored below the 15th percentile threshold value in General Communication Composite, compared to 7% of the AGA children, indicating clinically significant problems in communication skills. Furthermore, impaired communication skills became more evident as the FGR children reached ? 9 years of age. Prematurity was associated with low CCC-2 scores. We conclude that FGR, especially in combination with prematurity, is associated with reduced communication skills. With advancing age and increased academic demands the problems become more evident, indicating a need for early recognition, timely interventions and continuous linguistic evaluations of FGR children in order to optimize their long-term outcome in academic and communication skills.