Does early object exploration support gesture and language development in extremely preterm infants and full-term infants?

Vocal Characteristics of Infants at Risk for Speech Motor Involvement: A Scoping Review

PURPOSE

The purpose of this scoping review was to (a) summarize methodological characteristics of studies examining vocal characteristics of infants at high risk for neurological speech motor involvement and (b) report the state of the high-quality evidence on vocal characteristic trends of infants diagnosed or at high risk for cerebral palsy (CP).

METHOD

The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) extension for scoping reviews was followed for reporting our review. Studies measured prelinguistic vocal characteristics of infants under 24 months with birth risk or genetic conditions known to commonly present with speech motor involvement. Fifty-five studies met criteria for Part 1. Eleven studies met criteria for synthesis in Part 2.

RESULTS

A smaller percentage of studies examined infants with or at risk for CP compared to studies examining genetic conditions such as Down syndrome. The median year of publication was 1999, with a median sample size of nine participants. Most studies were conducted in laboratory settings and used human coding of vocalizations produced during caregiver-child interactions. Substantial methodological differences were noted across all studies. A small number of high-quality studies of infants with or at risk for CP revealed high rates of marginal babbling, low rates of canonical babbling, and limited consonant diversity under 24 months. Mixed findings were noted across studies of general birth risk factors.

CONCLUSIONS

There is limited evidence available to support the early detection of speech motor involvement. Large methodological differences currently impact the ability to synthesize findings across studies. There is a critical need to conduct longitudinal research with larger sample sizes and advanced, modern technologies to detect vocal precursors of speech impairment to support the accurate diagnosis and prognosis of speech development in infants with CP and other clinical populations.

Early triadic interactions in the first year of life: a systematic review on object-mediated shared encounters

Infants' early interactions with adults and everyday objects are key to socio-communicative development, but their emergence and development are still under debate. Aiming at describing the diversity of theoretical and methodological approaches on triadicity during the first year of life, we conducted a systematic and qualitative review of recent literature. Following PRISMA 2020 guidelines, we explored the scientific production of recent decades on triadic interactions up to 12 months of age. We initially screened 1943 items from which we obtained a final sample of 51 publications. Studies are usually conducted in laboratory settings, while ecological research is becoming increasingly common, especially in home settings. According to a thematic analysis of the data, we discussed the different perspectives on the origin and conceptualization of triadic interactions, and how they contribute to structuring and facilitating other developmental phenomena, such as the children's communicative gestures and uses of objects. Prior to the origin of intentional communication, adults facilitate early forms of triadicity based on fostering opportunities for infants' communication and engagement with both adults and materiality. However, there is a need for further research that explore the potential of early triadic interactions for parenting and early childhood education practises.

A model for using developmental science to create effective early intervention programs and technologies to improve children's developmental outcomes

Children born with a variety of environmental or medical risk factors may exhibit delays in global development. Very often, such delays are identified at preschool or school age, when children are severely overdue for effective early interventions that can alleviate the delays. This chapter proposes a conceptual model of child development to inform the creation of interventions and rehabilitative technologies that can be provided very early in development, throughout the first year of life, to optimize children's future developmental outcomes. The model suggests that early sensorimotor skills are antecedent and foundational for future motor, cognitive, language, and social development. As an example, this chapter describes how children's early postural control and exploratory movements facilitate the development of future object exploration behaviors that provide enhanced opportunities for learning and advance children's motor, cognitive, language, and social development. An understanding of the developmental pathways in the model can enable the design of effective intervention programs and rehabilitative technologies that target sensorimotor skills in the first year of life with the goal of minimizing or ameliorating the delays that are typically identified at preschool or school age. Specific examples of early interventions and rehabilitative technologies that have effectively advanced children's motor and cognitive development by targeting early sensorimotor skills and behaviors are provided.

Language Profiles and Their Relation to Cognitive and Motor Skills at 30 Months of Age: An Online Investigation of Low-Risk Preterm and Full-Term Children

Purpose Wide interindividual variability characterizes language development in the general and at-risk populations of up to 3 years of age. We adopted a complex approach that considers multiple aspects of lexical and grammatical skills to identify language profiles in low-risk preterm and full-term children. We also investigated biological and environmental predictors and relations between language profiles and cognitive and motor skills. Method We enrolled 200 thirty-month-old Italian-speaking children-consisting of 100 low-risk preterm and 100 comparable full-term children. Parents filled out the Italian version of the MacArthur-Bates Communicative Development Inventories Infant and Toddler Short Forms (word comprehension, word production, and incomplete and complete sentence production), Parent Report of Children's Abilities-Revised (cognitive score), and Early Motor Questionnaire (fine motor, gross motor, perception-action, and total motor scores) questionnaires. Results A latent profile analysis identified four profiles: poor (21%), with lowest receptive and expressive vocabulary and absent or limited word combination and phonological accuracy; weak (22.5%), with average receptive but limited expressive vocabulary, incomplete sentences, and absent or limited phonological accuracy; average (25%), with average receptive and expressive vocabulary, use of incomplete and complete sentences, and partial phonological accuracy; and advanced (31.5%), with highest expressive vocabulary, complete sentence production, and phonological accuracy. Lower cognitive and motor scores characterized the poor profile, and lower cognitive and perception-action scores characterized the weak profile. Having a nonworking mother and a father with lower education increased the probability of a child's assignment to the poor profile, whereas being small for gestational age at birth increased it for the weak profile. Conclusions These findings suggest a need for a person-centered and cross-domain approach to identifying children with language weaknesses and implementing timely interventions. An online procedure for data collection and data-driven analyses based on multiple lexical and grammatical skills appear to be promising methodological innovations. Supplemental Material https://doi.org/10.23641/asha.14818179.

Fine Motor Skills and Lexical Processing in Children and Adults

Children’s fine motor skills (FMS) link to cognitive development, however, research on their involvement in language processing, also with adults, is scarce. Lexical items are processed differently depending on the degree of sensorimotor information inherent in the words’ meanings, such as whether these imply a body-object interaction (BOI) or a body-part association (i.e., hand, arm, mouth, foot). Accordingly, three studies examined whether lexical processing was affected by FMS, BOIness, and body-part associations in children (study 1, n = 77) and adults (study 2, n = 80; study 3, n = 71). Analyses showed a differential link between FMS and lexical processing as a function of age. Whereas response latencies indicated that children’s FMS were associated with “hand” words, adults’ FMS linked to the broader concept of BOI. Findings have implications for shared activation theories positing that FMS support lexical processing.

Visualizing 3D imagery by mouth using candy-like models

Handheld models help students visualize three-dimensional (3D) objects, especially students with blindness who use large 3D models to visualize imagery by hand. The mouth has finer tactile sensors than hand, which could improve visualization using microscopic models that are portable, inexpensive, and disposable. The mouth remains unused in tactile learning. Here, we created bite-size 3D models of protein molecules from "gummy bear" gelatin or nontoxic resin. Models were made as small as rice grain and could be coded with flavor and packaged like candy. Mouth, hands, and eyesight were tested at identifying specific structures. Students recognized structures by mouth at 85.59% accuracy, similar to recognition by eyesight using computer animation. Recall accuracy of structures was higher by mouth than hand for 40.91% of students, equal for 31.82%, and lower for 27.27%. The convenient use of entire packs of tiny, cheap, portable models can make 3D imagery more accessible to students.

Object play as a mediator of the role of exploration in communication skills development

In this study, we investigated exploration and language development, particularly whether preliminary object play mediates the role of exploration in gesture and speech production. We followed 27 infants, aged 8-17 months, and gathered data on the frequency of their exploration, preliminary functional acts with single or multiple objects, and communicative behaviors (e.g., gesturing and single-word utterances). The results of our path analysis indicated that exploration had a direct effect on single-object play, which, in turn, affected gesturing and advanced object play. Gesturing as well as single and multi-object play affected speech production. These findings suggest that exploration is associated with language development. This association may be facilitated by object play milestones in which infants recall the object's function, which strengthens their memory and representation skills. Further, recalling the usage of an object by the caregivers may encourage an infant's overall imitation tendency, which is important for learning how to communicate with gestures and words.

Do 6-Month Motor Skills Have Cascading Effects on 12-Month Motor and Cognitive Development in Extremely Preterm and Full-Term Infants?

In this study, we analyzed whether 6-month gross and fine motor skills were related to 12-month gross and fine motor skills and cognitive development, controlling for 6-month cognitive skills, and neonatal status (extremely low gestational age ELGA ≤ 28 weeks vs. full-term FT ≥ 37 weeks). We also investigated, at 6 months, predictive indexes for motor and cognitive delay at 12-months. We assessed 40 infants (20 ELGA and 20 FT) at 6 and 12 months (corrected age for the ELGA infants). Six-month gross motor skills were related to 12-month gross motor, fine motor, and cognitive skills and predicted 12-month gross motor delay. Six-month cognitive skills explained an additional amount of variance of 12-month gross motor skills, whereas neonatal status explained an additional amount of variance of 12-month cognitive skills. Considering the intradomain and cross-domain cascading effects of early gross motor skills on later motor and cognitive development, these skills should be repeatedly assessed in ELGA infants in the first year of life for early identification of infants with delayed gross motor skills and implementation of customized interventions.

Reaching skills of infants born very preterm predict neurodevelopment at 2.5 years

The purpose was to investigate associations between quality of reaching for moving objects at 8 months corrected age and neurodevelopment at 2.5 years in children born very preterm (gestational age (GA), 24-31 weeks). Thirtysix infants were assessed while reaching for moving objects. The movements were recorded by a 3D motion capture system. Reaching parameters included aiming, relative length of the reach, number of movement units, proportion of bimanual coupled reaches and number of hits. Neurodevelopment was assessed at 2.5 years by the Bayley Scales of Infant Development III. There were strong associations between infant reaching kinematics and neurodevelopment of cognition and language but the patterns differed: in children born extremely preterm (GA < 28 weeks), planning and control of reaching was strongly related to outcome, while in children born very preterm (GA 28-31 weeks) number of hits and bimanual strategies were of greater relevance. In conclusion, for extremely preterm infants, basic problems on how motion information is incorporated with action planning prevail, while in very preterm infants the coordination of bimanual reaches is more at the focus. We conclude that the results reflect GA related differences in neural vulnerability and that early motor coordination deficits have a cascading effect on neurodevelopment.