The Power of Language Nutrition for Children's Brain Development, Health, and Future Academic Achievement

Language development, linguistic input, and linguistic racism

Language development is both remarkable and unremarkable. It is remarkable because children learn the language(s) around them, signed or spoken, without explicit instruction or correction. It is unremarkable because children have done this for thousands of years without worldwide incident or catastrophe. Yet, much research on this organic developmental phenomenon relies on an empirical falsehood: "quality" linguistic input is necessary to facilitate language development. "Quality" is a value judgment, not a structural feature of any human language. I argue selectively legitimizing some linguistic input as "quality" is possible only through mischaracterizing what language is. This falsehood is also linguistic racism because it is based on a deficit perspective of the early linguistic experiences of a subset of children, specifically racialized children. I explore how linguistic racism stalls our collective understanding of language development and promotes an environment of bad science. This article is categorized under: Linguistics > Language Acquisition Psychology > Language Neuroscience > Development.

Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Support Principles

This article is the sixth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The Support Principles article is the second of three articles that describe the 10 Principles of FCEI-DHH, preceded by the Foundation Principles, and followed by the Structure Principles, all in this special issue. The Support Principles are composed of four Principles (Principles 3, 4, 5, and 6) that highlight (a) the importance of a variety of supports for families raising children who are DHH; (b) the need to attend to and ensure the well-being of all children who are DHH; (c) the necessity of building the language and communication abilities of children who are DHH and their family members; and (d) the importance of considering the family's strengths, needs, and values in decision-making.

Mothers used wider vocabulary and talked to their six-month-old infants more during shared book reading than when they played with toys

AIM

We compared mothers reading books to six-month-old infants or playing with toys and measured whether the maternal language input influenced the children's spoken vocabulary at 18 months of age.

METHOD

This Taiwanese study recruited 46 dyads and video recorded them while the mothers read books to their infants and played with them with toys at 6 months of age. The mothers' lexical diversity, which is the ratio of different unique words to the total number of words, was measured. We then assessed the children's spoken vocabulary at 18 months.

RESULTS

The mother used more diverse vocabulary and a higher number of words when they were reading books than playing with toys with their children (p = 0.001). Maternal lexical diversity at 6 months of age accounted for 14.4% of the unique variance in the number of different words used by the child at 18 months. We believe that this is a novel finding.

CONCLUSION

Mothers used wider vocabulary and talked to their infants more during book reading than when they played with toys. Diverse maternal vocabulary at 6 months of age positively influenced the number of different words their children used at 18 months of age.

Parent and staff perspectives on the benefits and barriers to communication with infants in the neonatal intensive care unit

Exposure to high quantity and quality of language in the neonatal period is critical to neurocognitive development; however, Neonatal Intensive Care Unit (NICU) environments may contribute to language deprivation. Using qualitative thematic content analysis, this study aimed to characterize the knowledge and attitudes of NICU staff and patient families toward the importance of early language experience, the current NICU language environment, and the benefits and barriers of communication in the NICU. Results revealed that all respondents recognized the importance of communication for optimal cognitive development, though few understood why. Staff and family members alike recognized the role of nurses as coaches and role models in promoting communication at the bedside. Nurses generally felt that family members communicate less with their babies than family members themselves perceived, and that cell phone use has fewer communicative advantages than parents perceive. Respondents reported that patient illness, lack of time, and intimidating equipment all raise barriers to communication. These findings yield important considerations for developing educational interventions to improve NICU language environments, including a synergistic, dual focus on both staff and families. Communication in the NICU is a low cost, feasible, and accessible target with aims of ensuring optimal neurocognitive development for at-risk children.

Early language outcomes in Argentinean toddlers: Associations with home literacy, screen exposure and joint media engagement

This study aimed to analyse the contribution of mothers' home literacy beliefs and practices and the quantity and quality of screen media exposure on Argentinean toddler's language. In addition, we considered parent-child joint engagement, as well as adult scaffolding behaviours during the use of electronic devices. A total of 465 mothers of 18-36 months old children completed an online survey including: the MacArthur Bates CDI, home literacy, screen exposure, joint engagement and scaffolding questionnaires. We observed positive effects of literacy beliefs, PC times and verbal scaffolding on language outcomes. TV exposure contributed negatively to vocabulary and, along with educational content, to sentence use. Shared reading and screen media experiences can be an opportunity for language stimulation, provided there is dialogue and joint engagement. Passive screen exposure and inadequate content may be detrimental for toddlers' language outcomes, probably by displacement of socially significant interactions.

Longitudinal links between maternal directives, children's engagement in family conversations, and child linguistic skills

Background

Research on mother-child verbal interaction is largely inspired by Vygotsky. The results align with his view that children acquire language and culture-specific ways of using language through actively participating in daily conversations with adults. Supporting Vygotsky's concept of the Zone of Proximal Development, the facilitative features of such conversations have been found to depend on age, the level of the child's language skills, and the interactional context. Most previous studies in the field have been conducted in English-speaking Western families with a focus on the first years of children's lives. As Estonian middle-class mothers have been found to put greater emphasis on controlling children than mothers from other cultural contexts, we included the frequency of using directives as one of the features of mothers' speech that might have an impact on child language development.

Aim

Accordingly, the current study explored the relative impact of various aspects of mother-child interaction (e.g., mothers' vocabulary diversity, use of attentional and behavioral directives, wh-questions, and the amount of children's talk) on children's language skills using data collected from Estonian middle-class families at two timepoints, 1 year apart. As a novel approach to this topic, the study also examined the correlation between mothers' input features and children's participation in the parent-child conversation.

Method

A total of 87 children aged 3;0 and 4;0 and their mothers participated in the study. We observed the mother-child interactions during a semistructured videotaped game played at home. Mothers reported their children's language skills via the ECDI-III. Children's language comprehension and production were measured using the examiner-administered NRDLS.

Results and conclusion

Although the results showed somewhat differential effects of various aspects of mothers' speech on different measures of child language skills at two timepoints, the diversity of mothers' speech was positively, and mothers' frequent use of directives negatively related to children's language skills. At both ages, the diversity of mothers' speech predicted the amount of children's verbal contribution to conversations. The findings will be discussed in light of Vygotskian and his followers' theoretical views and theories about child language development.

A Qualitative Assessment of Community Acceptability and Use of a Locally Developed Children's Book to Increase Shared Reading and Parent-Child Interactions in Rural Zambia

Introduction

Early reading interventions hold promise for increasing language and literacy development in young children and improving caregiver-child interactions. To engage rural caregivers and young children in home reading, Zambian child psychologists and education specialists developed a culturally representative, local language children's book targeted at pre-grade 1 children.

Objectives

We qualitatively assessed community acceptability and use of the book distributed to households with young children in two provinces of Zambia.

Methods

We conducted 15 focus group discussions (FGDs) with women (n=117) who received the "Zambian folktales adapted stories for young children" book. A codebook was created a priori, based on established themes in the guide; content analysis was conducted in Nvivo v12. Data were interpreted against the Theoretical Framework on Acceptability.

Findings

Respondents described wide acceptability of the children's book across multiple framework constructs. Respondents believed the book was culturally appropriate for its folktale structure and appreciated the morals and lessons provided by the stories. Respondents described using the book in multiple ways including reading in one-on-one or group settings, asking the child questions about the narrative or pictures, and providing additional commentary on the actions or figures in the pictures. Respondents believed the books were helping children grow their vocabulary and early literacy skills. The book's simple vocabulary facilitated use by less educated caregivers. The primary concern voiced was the ability of low literacy caregivers to utilize the book for reading.

Discussion

The children's book was widely considered acceptable by rural Zambian communities. It provided a platform for an additional method of caregiver-child interactions in these households for reading, dialogue, and oral storytelling. Shared reading experiences have potentially substantial benefits for the language development and emergent literacy of young children. Programs to develop and deliver culturally acceptable books to households with limited access should be considered by governments and funders.

Randomised controlled trial of maternal infant-directed reading among hospitalised preterm infants

AIM

A randomised trial to study the impact of a maternal-driven, infant-directed reading intervention on preterm infant language compared with matched controls.

METHODS

Infants born at 22-32 weeks in Women & Infants Neonatal Intensive Care were gestationally stratified to a reading intervention (n = 33) or standard care (n = 34). At 32-, 34- and 36-weeks postmenstrual age, 16-h language recordings were obtained in the hospital. Bivariate group comparisons and regressions adjusting for gestational age and multiples were run to predict word counts and conversational turns. Longitudinal analyses were conducted by negative binomial models containing intervention, randomised gestation group, recording number (1-3), an intervention × recording number interaction term and multiple birth adjustment by generalised estimating equations.

RESULTS

In adjusted analyses, by 36-weeks postmenstrual age, infants in the reading group had twice the number of conversational turns as infants receiving standard care (Rate ratio 1.98, 95% CI 1.33-2.93, p < 0.05). In longitudinal analyses, only infants in the reading group had a significant increase in the conversational turns between 32- and 36-weeks postmenstrual age (Rate ratio 2.45, 95% CI 1.45-4.14, p < 0.05).

CONCLUSIONS

A maternal infant-directed reading curriculum in the hospital demonstrated a positive impact on interactive conversations by 36-weeks postmenstrual age.

Underinsurance in children is associated with worsened quality of life after cochlear implantation

IMPORTANCE

Research has suggested that early cochlear implantation is associated with improved language outcomes. Select studies demonstrate that this translates into a higher quality of life following implantation. Previous work from our group has shown that underinsurance represents a risk factor for worsened auditory and language outcomes for implantees. However, to our knowledge, the effect of insurance status on quality of life outcomes following cochlear implantation has not been evaluated.

OBJECTIVE

To assess quality of life outcomes for children receiving cochlear implants, accounting for age at implantation, insurance status, gender, surgeon, number of implants and duration of follow-up since implantation.

DESIGN

A retrospective study using the Glasgow Children's Benefit Inventory (GCBI), a validated questionnaire measuring quality of life across four domains: learning, emotion, vitality and physical heath. Multivariate linear regression was used to examine the effects of age at implantation, insurance status, number of implants, sex, surgeon, and duration of follow-up on GCBI scores. Age at implantation was assessed as both a continuous and dichotomous variable, comparing children implanted by 12 months of age with those implanted after 12 months.

SETTING

Children's National Health System in Washington, DC, a tertiary academic referral center.

PARTICIPANTS

The GCBI was administered telephonically to parents/guardians of prelingually deaf children aged 2-16 years who received cochlear implants at the center between January 1, 2008 and December 31, 2018.

RESULTS

Of 169 prelingually deafened implantee children who met inclusion criteria, parents/guardians of 64 (37.9%) responded to the questionnaire. After excluding children with late implantation (≥7 years age at CI) and missing GCBI responses, the final analytic sample consisted of 57 children. The mean age (SD) of the children at the time of the study was 3.3 (1.9) years, 63.2% were publicly insured, and 73.7% were implanted after 12 months of age. Average duration of follow-up was 3.9 (2.8) years. On a scale of -100 to +100, GCBI scores ranged from 41.7 to 95.8 (mean (SD), 64.0 (10.3)). Public health insurance (β, -5.8 [95% CI, -10.6 to -0.01]), and older age at the time of implantation (β, -0.1 [95% CI, -0.3 to 0.0]), particularly implantation following 12 months of age (p < 0.05), were significantly associated with lower GCBI scores after implantation.

CONCLUSION

Publicly insured recipients of cochlear implants and children implanted at an older age, particularly after 12 months of age, experienced significantly lower quality of life measures.

A Randomized Controlled Trial Assessing the Effectiveness of the Háblame Bebé Mobile Application With Spanish-Speaking Mothers Experiencing Economic Hardship

PURPOSE

This study examined the effectiveness of a standalone mobile application (app), Háblame Bebé, for use in real-world settings without supplemental human interaction to promote Spanish-speaking mothers' language interactions with their young children and associated child bilingual (Spanish-English) language development.

METHOD

Thirty-seven Spanish-speaking Latina mothers with lower incomes and their children were randomly assigned to experimental and wait-list control groups for 12 weeks. The experimental group was introduced to the app to learn how to provide language-promoting strategies in the home language and encouraged to use the app to track child vocabulary growth and overall development. Mother and child outcomes were measured before and after intervention via standardized assessments, direct observations, and parent report. Engagement and social validity data were also gathered.

RESULTS

No statistically significant differences were identified between experimental and control groups. However, looking at the magnitude of the difference between groups, child outcomes consistently favored the experimental group (d = 0.2-0.4). Mothers reported high levels of acceptance of the intervention.

CONCLUSIONS

Culturally and linguistically responsive app-based interventions have the potential to serve as a unique delivery model for speech-language pathologists and other professionals to share critical information on bilingual language development with parents of young children who are learning in a bilingual context. Clinical and research implications are discussed, including the consideration that low-intensity interventions may need to be paired with ongoing parent coaching.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.18461585.

Nutrition education incorporation into mainstream primary school curriculum in Ghana: Stakeholders' sources of nutrition information and perceived barriers

Introduction

Nutrition literacy has been cited as a crucial life skill. Nutrition education as a primary school subject has been treated inconsequentially when compared to other subjects. We investigated an aspect of the current state of nutrition education in Ghana by engaging stakeholders about their sources of nutrition information and the perceived barriers in implementing nutrition education in mainstream primary schools.

Methods

Three hundred and fifty one (351) primary school children, 121 homebased caregivers, six schoolteachers, two headteachers, two Ghana Education Service (GES) officials, and six school cooks were involved in the study. Surveys were used to collect data on nutrition information acquisition behaviors and to record perceived barriers. Key Informant Interviews were conducted among GES officials, headteachers, schoolteachers and school cooks, while Focus Group Discussions were used among homebased caregivers and children to gather qualitative information.

Results

Only 36.3% of the primary school children had heard about nutrition, and 71% of those got nutrition information from their family members. About 70% of homebased caregivers had heard or seen nutrition messages, and their source of nutrition information was predominantly traditional media. Schoolteachers mostly received their nutrition information from non-governmental organizations and the Internet, while most of the school cooks stated their main source of nutrition information was hospital visits. Perceived barriers included schoolteachers’ knowledge insufficiency, and lack of resources to adequately deliver nutrition education. Lack of a clear policy appeared to be an additional barrier.

Conclusion

The barriers to the implementation of nutrition education in the mainstream curriculum at the primary school level that were identified in this study can be resolved by: providing schoolteachers with learning opportunities and adequate nutrition education resources for practical delivery, having specific national policy framework, and including family members and school cooks in the nutrition education knowledge and information dissemination process.

Progress Toward a Multisectoral Community Intervention Approach to Prevention of the Word Gap

Children learn language through the interactions they have with their parents/caregivers beginning at birth. Hart and Risley (1995) discovered an inequity in the home language input children received from parents/caregivers. Children reared in low-income families received less input (conversations, turns) from parents than did children reared in more advantaged families. Less language input was linked to a disparity in children's vocabulary learning by age 3. The long-term result of this social determinant of early language/literacy learning is a life trajectory of poor educational, economic, and health attainment for many children in families with limited resources, at vast cost to individuals, communities, and the nation. What is needed is an approach to word-gap prevention that is capable of achieving positive individual, community, and population outcomes. Translating research into practice, we developed the Bridging the Word Gap Community Action Planning Guide (BWG-CAPG) using a combined behavior-analytic, community psychology, and public health framework for this purpose (Greenwood et al., 2017). We also developed a progress-monitoring measure, the online BWG Community Check Box Evaluation System, to provide feedback on a community's actions and progress in implementing their plan. Results from an initial pilot investigation within and across three community sectors in a large urban city were promising. BWG Community Check Box results indicated a number of desired outcomes: (a) capacity development and mobilization, (b) community implementation actions, and (c) community changes in practices, programs, and policies. Implications are discussed.

Parents' linguistic strategies in interaction with their children with history of cleft lip and/or palate

BACKGROUND

Cleft lip and/or palate (CL/P) presents a rather complex challenge that requires understanding beyond biological or clinical perspective. Even though inaccuracies in speech articulation are the common consequences of CL/P, individuals with repaired CL/P are likely to experience other language-associated issues. Studies on social interaction have generally reported the children to be passive interlocutors, despite having their surgical treatment at the early stages of life.

AIMS

This study aims to describe the linguistic strategies that parents employ when interacting with their repaired CL/P child. How parents allocate the next turn of speaking to their repaired CL/P child will be specifically examined.

METHODS & PROCEDURES

Three parent-child pairs with each child having repaired CL/P were selected to participate in the study. Guided by the principles of Conversation Analysis, their everyday interactions in their homes were video-recorded and transcribed according to the Jefferson System of Transcription Notation (2004). The transcriptions were subsequently analysed in order to highlight the linguistic strategies.

OUTCOMES & RESULTS

Three main linguistic strategies are identified in the parents' turns when they allocate the next turn of speaking to their repaired CL/P child. Specifically, parents' turns are constructed through interrogative sentences in addition to using emphasis words and repeated elicitation of responses from their child.

CONCLUSION & IMPLICATIONS

Parents' linguistic strategies are found to be restrictive as they limit children's active participation. Consequently, the interaction becomes asynchronous rather than synchronous, which could otherwise benefit children's language development. Findings provide information on how parents can be supported in order to foster a positive growth of the children's language development through everyday interactions.

WHAT THIS PAPER ADDS

What is already known on the subject Even after repair surgery, children with CL/P may experience poor language performance that is not limited to inaccuracies in speech articulation. Studies within the area of pragmatics have consistently shown the CL/P children to be passive interlocutors. What this paper adds to existing knowledge This study describes the linguistic strategies employed by parents when they allocate the next turn of speaking to their repaired CL/P child. Parents are found to employ three main strategies: framing the turn into an interrogative sentence, deploying emphasis words and repeatedly eliciting responses. The findings suggest that such strategies limit the interactions, making them asynchronous and potentially unconducive to the positive growth of the child's language development. What are the potential or actual clinical implications of this work? In addition to providing speech treatment to children affected with CL/P, parents, especially those belonging to collectivist groups that are sympathetic to authoritarian parenting styles, can also be informed or trained on other ways to communicate with such individuals.

Integrating Early Brain Science and Skills Into Prelicensure Nursing Curriculum to Promote Parent-Child Interaction

BACKGROUND

Research shows that the number of loving words children hear in their first 3 years of life has a tremendous impact on their health, developmental, and literacy outcomes. Early language transactions should be rich in engagement, quantity, quality, and context-a term called language nutrition.

PROBLEM

The curriculum in most nursing programs does not emphasize the importance of early language exposure and ways to empower families to talk with their babies.

APPROACH

The Talk With Me Baby Curriculum for Nurses, which includes techniques to empower families to better engage conversationally with their babies, was integrated into the prelicensure nursing curriculum.

OUTCOMES

More than 1,300 nursing students have received knowledge and skills on early language exposure and ways nurses can promote parent-child interactions.

CONCLUSION

Nurses have the opportunity to empower families to engage with their babies socially, emotionally, and linguistically as a means of promoting healthy brain development.

Toddlers' Early Communicative Skills as Assessed by the Short Form Version of the Estonian MacArthur-Bates Communicative Development Inventory II

Purpose The purpose of the current study is to develop a valid and reliable screening tool to identify children with risk of developing language difficulties for Estonian-speaking 2- to 3-year-old children. Method Nine hundred ninety parents of children ages 1;8-3;1 (years;months) filled in the Estonian MacArthur-Bates Communicative Development Inventory II (ECDI-II SF)-containing a 100-word vocabulary checklist, questions about decontextualized language use, and sentence production. A subset of parents filled in the long form of the MacArthur-Bates Communicative Development Inventory: Words and Sentences (n = 131). We examined the results of 31 children with language problems on the ECDI-II SF to assess the accuracy of the instrument. Results The concordance of scores on the ECDI-II long form and ECDI-II SF is high. Toddlers' results on the ECDI-II SF are related to their gender, with girls outscoring boys on the expressive vocabulary and sentence complexity subscales. We also found that children of highly educated mothers outperform others in the acquisition of grammatical skills. The sensitivity and specificity of the ECDI-II SF vocabulary section supported the implementation of this screening tool in order to identify toddlers with difficulties in their language development. Conclusions ECDI-II SF vocabulary scores are the most informative for determining whether a 2- or 3-year-old is following typical developmental patterns or should be referred to a speech and language specialist for a direct assessment. We provide a discussion on early language screening process and its implications for public health policies.

The Language Development Via FOXP2 in Autism Spectrum Disorder: A Review

BACKGROUND

An increasing number of newborn children in numerous nations are enrolled in early childhood education programs, and instructors, in this way, assume a focal job in invigorating language improvement in these youthful kids. Kids with language issues are found to have a higher risk for future scholarly challenges and learning inabilities. Language advancement among kids is an intricate procedure and vital for correspondence. The shortcomings in the utilization of grammatical structures may lessen the useful utilization of language for verbally expressive kids with autism spectrum disorder and exacerbate troubles with academic and social expertise advancement.

RESULTS

FOXP2, the single principal gene connected to a speech and language issue, is significant for the right execution of complex motor behaviors used for speech. In any case, changes in FOXP2 lead to a speech/language issue portrayed by childhood apraxia of speech. These days, language learning is fundamentally required for kids who need to move to different nations to pursue the instructive frameworks and be helpful individuals or residents of those nations.

CONCLUSION

The purpose of this study was to explore the role of FOXP2 in language disorder and its management for children's language and communication development.

Bermúdez M, Campoy C. Influence of a Functional Nutrients-Enriched Infant Formula on Language Development in Healthy Children at Four Years Old

Nutrition during early life is essential for brain development and establishes the basis for cognitive and language skills development. It is well established that breastfeeding, compared to formula feeding, has been traditionally associated with increased neurodevelopmental scores up to early adulthood. We analyzed the long-term effects of a new infant formula enriched with bioactive compounds on healthy children's language development at four years old. In a randomized double-blind COGNIS study, 122 children attended the follow-up call at four years. From them, 89 children were fed a standard infant formula (SF, n = 46) or an experimental infant formula enriched with functional nutrients (EF, n = 43) during their first 18 months of life. As a reference group, 33 exclusively breastfed (BF) were included. Language development was assessed using the Oral Language Task of Navarra-Revised (PLON-R). ANCOVA, chi-square test, and logistic regression models were performed. EF children seemed to show higher scores in use of language and oral spontaneous expression than SF children, and both SF and EF groups did not differ from the BF group. Moreover, it seems that SF children were more frequently categorized into "need to improve and delayed" in the use of language than EF children, and might more frequently present "need to improve and delayed" in the PLON-R total score than BF children. Finally, the results suggest that SF children presented a higher risk of suffering language development than BF children. Secondary analysis also showed a slight trend between low socioeconomic status and poorer language skills. The functional compound-enriched infant formula seems to be associated with beneficial long-term effects in the development of child's language at four years old in a similar way to breastfed infants.

Maternal reading and fluency abilities are associated with diffusion properties of ventral and dorsal white matter tracts in their preschool-age children

Early language exposure and shared parent-child reading, as assessed by maternal reading ability and fluency, affect the child's future language and cognitive abilities. The aim of the current study was to explore the association between maternal reading ability and fluency and diffusion properties of language- and cognition-related white matter tracts in their pre-school age children using diffusion tensor imaging (DTI). DTI data were acquired from fifteen girls (mean age: 3.83 ± 0.49 years). Reading ability and fluency were assessed in their mothers. Effects of hemisphere and node on diffusion properties were measured at 100 points along white matter tracts related to language and cognitive abilities. Significant positive correlations were found between maternal reading ability and fractional anisotropy in left and right dorsal and ventral language and executive functions-related tracts, while maternal reading fluency was associated with higher fractional anisotropy in ventral tracts, mainly in the left hemisphere. Fractional Anisotropy was significantly higher in the left compared to the right arcuate, cingulum cingulate, and inferior longitudinal fasciculus and higher in the right compared to the left superior longitudinal fasciculus. Our results signify the importance of maternal reading as a facilitator of the child's future language and cognitive abilities.

Háblame Bebé: A phone application intervention to support Hispanic children's early language environments and bilingualism

The early language environments of low-income Hispanic children can be negatively affected when their Spanish-speaking caregivers face racism, assimilation pressure, and/or misinformed advice based on English-only ideologies. This article reports on the design and efficacy of Háblame Bebé, a language-promoting phone application that encourages low-income Hispanic mothers to talk more to their children in their native Spanish with the goals of (1) improving their children's early language environment, (2) promoting bilingualism, and (3) monitoring developmental milestones. The app was designed and tested across three phases as mandated by the US HRSA Bridging the Word Gap Challenge. In Phase I, we developed a curriculum that promotes high-quality language interactions in Spanish and designed the app components. In Phase II, we tested the app with 20 Hispanic mothers (half high school-educated, half college-educated) in a pretest-posttest design in which we examined their language interactions before and after two months of using the app. Preliminary results indicated that mother-child verbal interactions increased, but not always in their native Spanish, and the difference was not statistically significant. Focus group data revealed that many of the mothers had experienced linguistic racism and that tropes surrounding Spanish-speaking identity in the USA needed to be explicitly addressed within the intervention. In Phase III, a sociolinguistic pride component was added and the app was again tested with 12 additional Hispanic mothers (all high school-educated only). This time, a statistically significant increase in mother-child verbal interactions was found. Mothers also reported feeling prouder to use Spanish with their children. These results suggest that Háblame Bebé may be a viable means to reach low-income Hispanic caregivers who face obstacles in accessing health information and/or home-visiting programs for their children.

Infant-directed language following a brief behavioral parenting intervention: The importance of language quality

Behavioral parenting interventions decrease early childhood behavior problems and increase positive parenting skills. However, few studies have examined the impact of low intensity interventions for infants at risk for behavior problems on changes in parent language. This study examined the effect of a brief parenting intervention, the Infant Behavior Program, on changes in parent linguistic input and its influence on infant language. Participants were 58 mothers and their12- to 15-month-olds, with elevated levels of behavioral problems. Mothers and their infants were from primarily Hispanic and low-income backgrounds. Mother-infant dyads were randomly assigned to receive the Infant Behavior Program or standard pediatric primary care. Mothers receiving the Infant Behavior Program provided more linguistic input, which indirectly influenced infant language, and suggest targeting infants at risk for behavior problems can have a broader impact on language development.

Language nutrition for language health in children with disorders: a scoping review

The quantity and quality of child-directed speech-language nutrition-provided to typically-developing children is associated with language outcomes-language health. Limited information is available about child-directed speech to children at biological risk of language impairments. We conducted a scoping review on caregiver child-directed speech for children with three clinical conditions associated with language impairments-preterm birth, intellectual disability, and autism-addressing three questions: (1) How does child-directed speech to these children differ from speech to typically-developing children? (2) What are the associations between child-directed speech and child language outcomes? (3) How convincing are intervention studies that aim to improve child-directed speech and thereby facilitate children's language development? We identified 635 potential studies and reviewed 57 meeting study criteria. Child-directed speech to children with all conditions was comparable to speech to language-matched children; caregivers were more directive toward children with disorders. Most associations between child-directed speech and outcomes were positive. However, several interventions had minimal effects on child language. Trials with large samples, intensive interventions, and multiple data sources are needed to evaluate child-directed speech as a means to prevent language impairment. Clinicians should counsel caregivers to use high quality child-directed speech and responsive communication styles with children with these conditions.

Determinants of social behavior deficits and recovery after pediatric traumatic brain injury

Traumatic brain injury (TBI) during early childhood is associated with a particularly high risk of developing social behavior impairments, including deficits in social cognition that manifest as reduced social interactions, with profound consequences for the individuals' quality of life. A number of pre-injury, post-injury, and injury-related factors have been identified or hypothesized to determine the extent of social behavior problems after childhood TBI. These include variables associated with the individual themselves (e.g. age, genetics, the injury severity, and extent of white matter damage), proximal environmental factors (e.g. family functioning, parental mental health), and more distal environmental factors (e.g. socioeconomic status, access to resources). In this review, we synthesize the available evidence demonstrating which of these determinants influence risk versus resilience to social behavior deficits after pediatric TBI, drawing upon the available clinical and preclinical literature. Injury-related pathology in neuroanatomical regions associated with social cognition and behaviors will also be described, with a focus on findings from magnetic resonance imaging and diffusion tensor imaging. Finally, study limitations and suggested future directions are highlighted. In summary, while no single variable can alone accurately predict the manifestation of social behavior problems after TBI during early childhood, an increased understanding of how both injury and environmental factors can influence social outcomes provides a useful framework for the development of more effective rehabilitation strategies aiming to optimize recovery for young brain-injured patients.