Maternal responsiveness predicts child language at ages 3 and 4 in a community-based sample of slow-to-talk toddlers

Parental Input and Its Relationship With Language Outcomes in Children With (Suspected) Developmental Language Disorder: A Systematic Review

PURPOSE

It is widely acknowledged that parental input plays an important role in typical language development. Less is known about the input provided to children with (suspected) developmental language disorder (DLD) or those at risk for DLD. These children may not benefit from parental input in the same way as their typically developing peers, and different aspects of parental input may be more important for them. The present systematic literature review aimed to uncover (a) how parental input has been assessed in the context of DLD, (b) which aspects of parental input have been studied, and (c) what the reported associations are with language outcomes in children with DLD (age 0-6 years).

METHOD

A systematic literature review of 67 articles was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Parental input was coded based on Rowe and Snow's (2020) categorization of input, divided into interactive, linguistic, and conceptual aspects of parental input.

RESULTS

The majority of studies used audio or video recordings of naturalistic parent-child interaction during play. Aspects within the interactive dimension (parental responsiveness and turn-taking) were most often assessed, followed by the linguistic and conceptual dimensions. Thirty-eight studies investigated the relationship between parental input and child language outcomes. Findings show that aspects within the interactive dimension are positively associated with language outcomes in children with DLD. Additionally, the sheer quantity of language input was not associated with language outcomes, although replication of this observation is necessary.

CONCLUSIONS

The results of this review highlight the importance of parents' responsive behaviors as well as the child's involvement in parent-child interaction. The findings also signal gaps in the existing literature and provide associated directions for future research on effects of parental input in children with DLD.

A comparative study of how teachers communicate in deaf education classrooms

This study investigates the communication practices of four teachers in 3rd to 6th grade classrooms with 9 deaf students with limited language proficiency and in stages of emergent writing development. Analyzing language modalities, utterance types, and class interactivity, we found that teachers using American sign language used student-centered approaches, generating a greater number of directives and responsive utterances. They persevered in increasing students' engagement and were successful in clarifying misunderstandings. Teachers using spoken English used teacher-centered approaches, making general comments directed at the whole class, which consequently reduced student participation and responsiveness. They also largely avoided repairing communication breakdowns with emergent writers, focusing instead on those with greater auditory and speaking abilities. These patterns reveal disparities in classroom communication that can affect student learning. Our findings highlight the need for teacher preparation programs to equip teachers with skill sets to employ accessible and effective communication during instruction, especially with deaf students who are still developing foundational language and writing skills.

Child and family characteristics associated with verbal communication difficulties in adolescents with autism and other developmental disabilities

BACKGROUND

Verbal communication difficulties are associated with a range of adolescent and adult outcomes in individuals with autism spectrum disorder (ASD). Yet there is limited information about contextual factors associated with verbal communication difficulties beyond early childhood, and how youth with ASD compare to youth with other developmental disabilities (DD).

AIMS

The current study examined verbal communication difficulties among adolescents with ASD and other DD, and child and family characteristics associated with these difficulties in later in life.

METHODS AND PROCEDURES

Children were classified as ASD or other DD between 2 and 5 years old. Caregivers of these same children reported verbal communication difficulties between 12 and 16 years old. Chi square tests examined group differences in adolescent verbal communication difficulties; Poisson regression examined child and family characteristics associated with adolescent verbal communication difficulties.

OUTCOMES AND RESULTS

Adolescents with ASD had significantly more verbal communication difficulties (47.4 %) than adolescents with other DD (14.6 %). Factors that predicted verbal communication difficulties in adolescents with ASD and other DD were expressive language abilities and internalizing symptoms in early childhood, having a mother of non-Hispanic Black compared to White race, and having a mother with some college compared to an advanced degree.

CONCLUSIONS AND IMPLICATIONS

Almost half of adolescents with ASD had verbal communication difficulties, which was significantly higher than those with other DD. Early childhood and socio-demographic factors like race, education, and insurance were associated with verbal language outcomes. These factors may be useful in identifying and supporting those most likely to benefit from targeted communication services. WHAT THIS PAPER ADDS?: Verbal communication difficulties are common among adolescents with autism. Early childhood and socio-demographic characteristics like race and education are associated with these difficulties. These findings could help better identify and support adolescents with communication difficulties.

Patterns of lexical and syntactic adjustment in early infant-directed speech related to language development in Hungarian

Infant-directed speech (IDS) is known to be characterised by phonetic and prosodic cues along with reduced vocabulary and syntax compared to adult-directed speech (ADS). However, there is considerable variation between mothers in the degree of lexical and syntactic reduction of their IDS. The present study aims to investigate the correspondences of the inter-individual variation of maternal IDS at 6 and 18 months with infants' language development at 18 months. 109 dyads of mothers and their firstborn infants participated in the study. Mothers' ID and AD storytelling based on standard picture stimuli were recorded at 6 and 18 months of their infants' age. We analysed measures of speech quantity (number of utterances and words), syntactic complexity (mean length of utterance), and lexical diversity (type-token ratio). Language growth was measured bimonthly using the Hungarian adaptation of the MacArthur-Bates CDI W&G form. The results did not reveal any association between characteristics of mothers' ID narratives and their infants' concurrent language skills at 18 months. However, we found a longitudinal link between a distinct pattern of linguistic simplification in maternal ID storytelling at 6 months and the development of expressive vocabulary in infants at 18 months. Infants whose mother tends to reduce both lexical and syntactic complexity of ID narratives the most are more likely to exhibit higher language outcomes. Further research is warranted to explore the background factors and longer-term effects of this maternal strategy.

Creating the conditions for robust early language development for all: Part two: Evidence informed public health framework for child language in the early years

BACKGROUND

One of the most significant developmental accomplishments is the emergence of language in early childhood. Whilst this process is effortless for most children, others can face significant hurdles. Identifying, in the early years, which children will go on to have developmental language disorder is, however, fraught with several well-documented challenges. In the preceding paper we described and linked new research evidence about factors that influence language development in the early years, noting that exposure to some may be time sensitive and that these influences cluster together and can accumulate over time. We demonstrated that risk profiles were associated with and characterised low language trajectories, and we considered how this information could be integrated into a concept that moves beyond screening at single time points in the early years. We argue that this evidence might be used to build an improved early years framework for language thereby creating a more equitable surveillance system that does not leave children living in less advantageous circumstances behind. Underpinning this thinking was a bioecological framework that incorporates the social, environmental and family factors in the child's ecosystem known to influence language development in the early years.

AIMS

To develop a proposal for the design and implementation of an early language public health framework based on current best evidence METHODS: We synthesised the findings from the companion paper (Reilly & McKean 2023) regarding early language trajectories, inequalities and clustering of risks with key public health concepts, relevant intervention evidence and implementation theories to develop a new framework for language surveillance and preventative interventions in the early years.

MAIN CONTRIBUTION

An evidence informed early language public health framework is presented. Describing in turn (1) essential components; (2) relevant interventions; (3) essential qualities for implementation ((i) probabilistic, (ii) proportionate, (iii) developmental and sustained and (iv) codesigned); (4) system-level structures and (5) processes required to adopt and embed an early language public health framework in an existing Local Government Area's child health surveillance and early prevention-intervention systems.

CONCLUSIONS

Children's language development influences their life chances across the life course and language difficulties are unfairly distributed across society. Current evidence points to the need for whole systems approaches to early child language and enables a blueprint for such a framework to be described.

WHAT THIS PAPER ADDS

What is already known on the subject Early child language development sets the stage for a child's life chances and language difficulties can have profound long-term consequences. Such difficulties are unfairly distributed across society and the reach of preventative services is not universal or equitable.

WHAT THIS STUDY ADDS

Several effective primary and secondary preventative interventions exist but their successful implementation is not straightforward. An early language public health framework of surveillance and intervention is described to provide equitable and effective early interventions to children from 0-4 years. We detail the essential components, interventions and qualities of that framework and describe system-level structures and processes required to adopt and embed an early language public health framework in a given locality. WHAT ARE THE CLINICAL IMPLICATIONS OF THIS WORK?: A whole systems approach to early child language is required and should be co-designed through local collaboration with family, community and children's services stakeholders. A public health speech and language therapist role could catalyse the implementation of such approaches and support continuous improvement.

Evaluating the dose-response relationship of the number of sessions of "It Takes Two to Talk®" in young children with language delay

PURPOSE

To evaluate the dose-response relationship between the number of It Takes Two to Talk® (ITTT) sessions attended and the language outcomes of young children with language delay and their parent's responsivity in a multicultural clinical population.

METHOD

A clinical caseload of 273 early language delayed children (mean age 29.2 months, SD 7.8) and their families participated in parent group workshops and individual coaching sessions of the parent responsivity program ITTT. The children's vocabulary and early syntax, collected using the MacArthur-Bates Communicative Development Inventories and mean length of the three longest utterances respectively, were collated from pre- and post-intervention from pre-existing clinical data. Parental responsivity was evaluated utilising the Parent-Child Interaction checklist at three time points. Multilevel regression was used to determine the relationship between the number of sessions attended and outcomes, while accounting for covariates such as age and language spoken.

RESULT

ITTT dosage did not predict child language outcomes. Rather, vocabulary and early syntax outcomes were predicted by age, pre-scores and parent responsivity at the beginning of treatment. A higher dosage of ITTT did however positively predict parent responsivity, as did speaking only English at home. Socioeconomic status, gender and presence of receptive language difficulties did not contribute significantly to either child or parent outcomes.

CONCLUSION

A lower dosage of the intervention may be considered for parents and children with fewer known risk factors without significant implications.

Effects of maternal depression on maternal responsiveness and infants' expressive language abilities

High levels of maternal responsiveness are associated with healthy cognitive and emotional development in infants. However, depression and anxiety can negatively impact individual mothers' responsiveness levels and infants' expressive language abilities. Australian mother-infant dyads (N = 48) participated in a longitudinal study examining the effect of maternal responsiveness (when infants were 9- and 12-months), and maternal depression and anxiety symptoms on infant vocabulary size at 18-months. Global maternal responsiveness ratings were stronger predictors of infants' vocabulary size than levels of depression and anxiety symptoms. However, depression levels moderated the effect of maternal responsiveness on vocabulary size. These results highlight the importance of screening for maternal responsiveness-in addition to depression-to identify infants who may be at developmental risk. Also, mothers with elevated depression need support to first reduce their symptoms so that improvements in their responsiveness have the potential to be protective for their infant's language acquisition.

The Role of Social and Emotional Adjustment in Mediating the Relationship Between Early Experiences and Different Language Outcomes

Background: Studies have highlighted the relationship between early childhood experiences and later language and communication skills on the one hand and social and emotional adjustment on the other. Less is known about this relationship between different types of early experiences and their relationship to different communication skills over time. Equally important is the extent to which the child's behaviour is related to later outcomes affecting the relationship between the child's environment and aspects of their communication development. Method: Drawing on data from 5,000 children in Growing Up in Scotland, a representative sample of children born in 2003. This paper looks are the differential relationships between home learning environment (HLE) (reads books/storeys, engages in painting or drawing, reads nursery rhymes and teaches letter/shapes and parental mental health (PMH) (Depression, Anxiety and Stress Scale (DASS) in the first year of life and both structural language skills ("Listening Comprehension" and "Expressive Vocabulary" subtests of The Wechsler Individual Achievement Tests) and pragmatic competence (The Children's Communication Checklist) at 11 years and explores the extent to which they are mediated by social and emotional adjustment at school entry. Results: PMH was associated with pragmatics but not listening comprehension or vocabulary. By contrast HLE was associated with all three measures of communication. In the final mediated model social and emotional adjustment mediated the relationship between PMH and all three measures of communication. The mediation was statistically significant for the relationship between HLE and both pragmatics and listening comprehension but not for expressive vocabulary. The results are discussed in terms of the relationships concerned and what they tell us about the potential for targeted early interventions. Conclusions: The mediating role of socio-emotional adjustment at school entry points to the need for careful monitoring of children's social and emotional development in primary and middle childhood. Services and policy aimed at improving child outcomes through improving home learning environments must work hand in hand with those responsible for offering support for the mental health, social-emotional adjustment and wellbeing of parents and children from birth and into the school years.

Validation of the Parental Responsiveness Scale

BACKGROUND

Parental responsiveness is a parent's predisposition to react to their child's verbal and non-verbal cues promptly and adequately. There is no self-report scale that measures this type of behavior. The aim of this study was to construct a valid and useful scale to measure this construct as subjectively reported by parents of young children.

PARTICIPANTS AND PROCEDURE

Two hundred and fifty parents (including 186 mothers) of young children aged from 1 to 18 months (Mage = 8.60, SDage = 4.06) took part in the study. To confirm the external validity of the tool, participants filled in the following questionnaires: the Parental Responsiveness Scale, the Empathic Sensitivity Scale, and the Experience in Close Relationships-Revised Scale - short version.

RESULTS

The confirmatory analysis verified the one-dimensional structure and that the model has a good fit. Moreover, the results of external validation indicated satisfactory correlations between parental responsiveness and empathic concern (r = .30, p < .01), perspective-taking (r = .31, p < .01), and avoidance (r = .23, p < .01) in relationships.

CONCLUSIONS

The Parental Responsiveness Scale is valid and reliable. This scale could be useful in research on family and child development, and on individual differences between parents, but can also be of use in practice.

Parental Responsiveness During Musical and Non-Musical Engagement in Preschoolers with ASD

BACKGROUND

Parent-child play interactions offer an important avenue for supporting social development in children with autism spectrum disorder (ASD). Musical play is a natural and ubiquitous form of parent-child play. As a familiar, reinforcing, and predictable activity, musical play may support parent-child interactions by scaffolding children's attention to the play activities, while also providing parents with a familiar and accessible context to promote parental responsiveness. However, musical play may also impede interactions due to its sensory and repetitive components.

METHOD

12 parent-child dyads of preschoolers with ASD were video-recorded during a ten-minute play session that included musical and non-musical toys. Interactions were coded for parent and child musical engagement, as well as parental responsiveness.

RESULTS

Parent-child dyads varied in their amount of musical engagement during play, which was not related to children's language level. Overall, parents showed similar levels of responsiveness to children's play across musical and non-musical activities, but type of parental responsiveness differed depending on the play context. Parents provided significantly more physical play responses and significantly fewer verbal responses during musical vs. non-musical engagement with their child.

CONCLUSIONS

There are substantial individual differences in children with ASD's musical engagement during a parent-child free play. Children's musical engagement impacted type of parental responsiveness, which may relate to the familiarity, accessibility, and sensory nature of musical play/toys. Results suggest that musical play/toys can both support and hinder different types of parental responsiveness with implications for incorporation of musical activities into interventions.

Sequential Associations Between Communication Acts of Children With and Without Autism Spectrum Disorder and Maternal Verbal Responses

In this study, the sequential associations between child communication acts, including spontaneous communication (SC) and elicited communication (EC), and the types of verbal responses of Iranian mothers (follow-in nondirective, follow-in directive, and redirective responses) were compared between children with autism spectrum disorder (ASD) and young typically developing (TD) children. Participants were 29 children with ASD aged 3-6 years and 40 TD children aged 13-18 months, matched on expressive vocabulary. Using time-window sequential analysis, maternal verbal responses within a time interval of 3 sec following child communication were examined during 15 min of video-recorded mother-child free play interaction. Mothers in the two groups had broadly similar patterns of response to child communication acts, but some differences in responding to child EC. Across both groups, sequential associations were stronger for maternal follow-in nondirective responses to child SC than for this type of response to child EC, and were stronger for follow-in directive responses to child EC than for follow-in directive responses to child SC. Child EC and SC acts were less likely to be followed by redirective responses than other maternal responses, again across both groups. Finally, mothers of children with ASD were more likely than mothers of TD children to follow-in to child EC with both nondirective and directive responses. Our findings suggest that mothers of children with ASD synchronize their responses with their child's SC acts to the same extent as mothers of TD children, and are more synchronous in responding to their child's EC acts. LAY SUMMARY: This observational study examined how Iranian mothers verbally responded to their children's communication acts, based on whether the children's communication was spontaneous (unprompted) or elicited (prompted by the mother). Mothers of children with autism spectrum disorder or typical development responded to their children's spontaneous communication acts in similar ways, but showed some differences in responding to children's elicited communication. By prompting their children to communicate, mothers create opportunities to give additional verbal responses to their children, which may help to support children's further language development.

Measurement of child-directed speech: A survey of clinical practice

Purpose: Clear correlations exist between the quality and quantity of child-directed speech (CDS) and children's language development. Interventions for children with poor language skills involve manipulation of the quality and/or quantity of CDS in a child's daily experience. Assessment of CDS is therefore important. There are a range of CDS measures reported in the literature, however no data exist on the use of these in clinical practice. The aim of this study was to identify current clinical practices in measurement of CDS.Method: An online survey was developed using the Qualtrics platform. Brief study information and a link to the survey were distributed to speech-language pathologists working in New Zealand and Australia.Result: Responses from 116 clinicians were analysed. Participants mainly reported using informal analysis of adult-child observations, checklists and informal discussion with adults to measure CDS. The barriers to measuring CDS reported were time, teaming with adults and psychometric properties of informal methods.Conclusion: There are few psychometrically validated clinical tools which are "fit for purpose" to measure qualitative aspects of CDS. Automated speech analysis technology appears to have potential as a quantitative measure of CDS to support clinical practice.

Parental behaviors associated with the level of pragmatic language ability among 42-month-old neglected children

BACKGROUND

Exposure to neglect can severely compromise children's pragmatic skills (social language use). The disruptions of parent-child interactions that typically occur in context of neglect may compromise several parental behaviors which are known to foster language skills such as pragmatics.

OBJECTIVES

1- Compare the behaviors of neglectful and non-neglectful parents in four domains which are of interest for pragmatic language development, namely, responsive, supportive, affective, and control behaviors, and 2- Identify parental behaviors associated with the levels of pragmatic ability of 42-month-old neglected children.

PARTICIPANTS

Study sample consisted of 21 neglected children living in their biological family, recruited in four Youth Centers in the province of Québec (Canada) and 95 non-neglected children recruited in child-care centers.

METHOD

Parental behaviors were video recorded in context of free-play with the child at the participants' homes between 2015 and 2017, and subsequently analyzed using the Coding Observations of Parent-Child Interactions (COPI), developed to observe ten parental behaviors associated with early language development. The level of pragmatic ability of children was established using the Language Use Inventory: French, a standardized questionnaire completed with parents of both groups.

RESULTS

Parents in situation of neglect scored lower than parents in the control group on eight of the ten behaviors (p < .001). Parental reciprocity was associated with the level of pragmatic ability of 42-month-old neglected children (p = .04).

CONCLUSIONS

The results of this exploratory study provide insight on the associations between parental behaviors and the level of pragmatic language skills of children experiencing neglect.

Maternal depression, anxiety, psychoticism and paranoid ideation have effects on developmental delay types of infants: A study with clinical infant-mother dyads

BACKGROUND

Developmental delay in infancy includes cognitive-language delay, fine motor delay, gross motor delay, and social-self help delay. Delay in one intellectual domain frequently effects the other areas of development; therefore, determining risk factors are essential. In this study, we evaluated the relationship between maternal psychiatric symptoms and developmental delay types of infants who have not a known risk factor and are expected to show healthy development but have some behavioral and developmental problems.

METHODS

The sample consisted of 79 infant-mother (26 girls, 53 boys) dyads who had been admitted to the Department of Child and Adolescent Psychiatry at Gulhane Research and Training Hospital over a one year period. Brief Infant-Toddler Social and Emotional Assessment Scale, Brief Symptom Inventory and Ankara Developmental Screening Inventory were used.

RESULTS

The most frequent developmental delay types were fine motor and social -self-help delay in this sample. For all developmentally delayed infants, maternal interpersonal sensitivity, and depression scores were higher than healthy developed ones. Logistic regression analyses revealed the risk factors: Higher maternal paranoid ideation increases the language-cognitive delay; maternal hostility and anxiety increase the gross motor delay; maternal psychoticism increases the social and self-help delay, and maternal depression increases the total development delay of infants.

CONCLUSION

Maternal depression, anxiety, psychoticism, and paranoid ideation are important risk factors for infants' developmental delay types and should be addressed while evaluating infant-mother dyads in clinical practice.

Training community health nurses to measure parent-child interaction: a mixed-methods study

BACKGROUND

This study aims to determine whether the Parental Responsiveness Rating Scale (PaRRiS) completed at child age 24-30 months can be used by community child health nurses (CCHNs) to reliably measure the quality of parent-child interactions in practice.

METHODS

A mixed-methods design was used involving CCHNs working in public health settings. Five CCHNs recruited from the North-East of England were trained to use PaRRiS. Thirty parent-child dyads attending their routine 24-30-month check were observed. Nurses rated parent-child dyads during 5 min of free-play using PaRRiS. The free-play sessions were video recorded and rated blind by the first author to the nurse observation. Semi-structured phone interviews were conducted with the five CCHNs once observations of parent-child interactions were complete. Interviews were audio-recorded, transcribed, anonymized and thematically analyzed.

RESULTS

Two-thirds of participating parents were mothers. Half the families (15/30) were from the 10% most deprived areas based on the English Index of Multiple Deprivation. The average PaRRiS score was 3.03 [standard deviation (SD) = 0.8; all ratings were <5.0]. Reliability between the first author ('gold standard') and CCHNs was excellent [Intra-class correlation coefficient (ICC): 0.85; 95% confidence interval (CI): 0.67-0.93]. CCHNs found PaRRiS aligned well with current practice and was acceptable to parents. There was no evidence of a relationship between social disadvantage and PaRRiS scores.

CONCLUSIONS

With further development and evaluation work, PaRRiS could potentially be incorporated into existing universal health services to provide child health nurses with an additional tool for identifying families most likely to be in need of parent-child interaction interventions.

Twins' and Singletons' Linguistic Environment: A Systematic Review

Background: Among twins, lower linguistic skills emerged when compared with singletons. Considering the association found between parental linguistic input and children's language development, exploring the differences between twins and singletons' linguistic environments could find variables that are potentially associated with the lower linguistic skills of twins.

Aim: The current systematic review aims to analyze and systematize the existing literature focused on the comparison of twins' and singletons' linguistic environments within their first 3 years of life. Methodological issues (i.e., the procedure used to assess the linguistic environment, the coding of the linguistic environment's features, the computational method employed to assess the parental linguistic input, and participant characteristics) and differences found among twins and singletons regarding their linguistic environment (i.e., linguistic input quantity, linguistic input complexity, linguistic features of child-directed speech, parental responsiveness, and directiveness, joint attention, and book reading) were highlighted.

Method: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement was followed. Eligible studies were searched through EBSCO, PubMed, and Web of Science. From this search, 1,347 study results emerged, and 8 studies were included.

Results: To our knowledge, this is the first systematic review focused on the comparison of twins' and singletons' linguistic environments. Differences between the groups were found in all of the included studies. Data against twins were generally identified regarding all the considered linguistic environment's features. However, conflicting results within and between the included studies emerged, mainly according to the computational method employed (i.e., twin moms value, twin direct dyadic value, twin direct dyadic + both value, and input directed toward both children simultaneously).

Conclusion: The disadvantaged linguistic environment of twins is likely due to limited parental resources and demands associated with the management of two children of the same age. However, the limited and conflicting data found did not allow for a firm conclusion to be drawn on the differences in the twins' and singletons' linguistic environments. Further studies on the topic are needed.

Psychometric Properties of Parent-Child (0-5 years) Interaction Outcome Measures as Used in Randomized Controlled Trials of Parent Programs: A Systematic Review

This systematic review sought to identify observational measures of parent-child interactions commonly implemented in parenting program research, and to assess the level of psychometric evidence available for their use with this age group. Two separate searches of the same databases were conducted; firstly, to identify eligible instruments, and secondly to identify studies reporting on the psychometric properties of the identified measures. Five commercial platforms hosting 19 electronic databases were searched from their inception to conducted search dates. Fourteen measures were identified from Search 1; a systematic search of randomized controlled trial evaluations of parenting programs. For Search 2, inclusion/exclusion criteria were applied to 1327 retrieved papers that described the development and/or validation of the 14 measures identified in Search 1. Seventeen articles met the inclusion criteria, resulting in five observational measures for the final review. Data were extracted and synthesized using the COSMIN rating system to describe the methodological quality of each article alongside the overall quality rating of the psychometric property reported for each measure using the Terwee checklist. Measure reliability was categorized into four domains (internal consistency, test-re-test, inter-rater, and intra-rater). Measure validity was categorized into four domains (content, structural, convergent/divergent, and discriminant). Results indicated that the majority of psychometric evidence related to children aged from birth the three with internal consistency, inter-rater reliability, and structural validity the most commonly reported properties, although this evidence was often weak. The findings suggest further validation of the included measures is required to establish acceptability for the whole target age group.

Paths to language development in at risk children: a qualitative comparative analysis (QCA)

Background

Childhood language development is related to long term educational, employment, health and social outcomes. Previous research identifies a complex range of risk and protective factors which result in good and poor language outcomes for children, however children at risk are an underrepresented group in these studies. Our aim is to investigate the combinations of factors (paths) that result in good and poor language outcomes for a group of 5 year old children of mothers experiencing adversity.

Methods

This mixed methods study utilised longitudinal data from a randomised control trial of sustained home visiting (MECSH) to determine the language outcomes in at risk children. Mothers were randomly assigned to a comparison group at entry to the study (prior to child’s birth). Their children who were retained at entry to school completed language assessments (n = 41) and were participants in this study. Influence of 13 key factors derived from the extant literature that impact language development were explored. Regression was used to determine the six key factors of influence and these were used in the Qualitative Comparative Analysis (QCA). QCA was employed to examine the necessary and sufficient conditions and paths affecting language development linked to good and poor language outcomes. A post hoc analysis of the risk and protective paths to good and poor language outcomes was also conducted.

Results

Thirteen distinct pathways led to good language outcomes and four paths to poor language outcomes in five year old at risk children. A variety of condition combinations resulted in these outcomes, with maternal responsivity, toddler development and number of children in the home being key. High and low maternal education influenced both good and poor language development.

Conclusions

The paths to good and poor language outcomes were different and complex. Most paths to a good language outcome involved protective factors, though not always. In addition, paths to poor language more often involved risk factors. The varied patterns of risk and protective factors point to the need for interventions across the first five years of life in both health and education for families which can respond to these risk and protective patterns.

Trial registration

The original RCT was retrospectively registered in the ANCTR: ACTRN12608000473369.

Electronic supplementary material

The online version of this article (10.1186/s12887-019-1449-z) contains supplementary material, which is available to authorized users.

Parent–Child Interaction Therapy as a Behavior and Spoken Language Intervention for Young Children With Hearing Loss

Purpose

The importance of early intervention for fostering language in children with hearing loss has been well documented; those that facilitate parent engagement are particularly effective. Listening and spoken language outcomes among children with hearing loss continue to fall short compared to hearing peers, despite improvements in hearing technologies. The current study evaluated the effectiveness of parent–child interaction therapy (PCIT) as a behavioral intervention for children with hearing loss and its applicability as a language intervention.

Method

PCIT effectiveness was evaluated for children with hearing loss (PCIT treatment group: N = 18). For a subset of the treatment group (matched experimental group: n = 6), pretreatment and posttreatment language samples were compared to a matched control group ( n = 6).

Results

Significant changes were observed in parent skills and child behavior from pretreatment to posttreatment for the PCIT treatment group. A subset of the treatment group (matched experimental group) with available matched controls (matched control group) demonstrated a significant increase in utterances and a trend toward significant increase in receptive vocabulary compared to the control group.

Conclusion

PCIT is a promising intervention for children with hearing loss that empowers parents to engage in optimal indirect language stimulation, improves parent–child interactions, improves child behavior, and promotes spoken language skills.

Do Fathers' Home Reading Practices at Age 2 Predict Child Language and Literacy at Age 4?

BACKGROUND

Maternal shared reading practices predict emergent literacy, but fathers' contributions are less certain. We examined whether fathers' shared home reading activities at 2 years predict language and emergent literacy at age 4 years, when controlling for maternal contributions; and whether this differentially benefits these outcomes in disadvantaged children.

METHODS

Two-parent families were recruited from 5 relatively disadvantaged communities for the universal Let's Read literacy promotion population-based trial (ISRCTN 04602902) in Melbourne, Australia. For exposure at 2 years, home reading practices were recorded via self-reported maternal and paternal StimQ-Toddler questionnaires and dichotomized at study median (high vs low). At 4 years, outcomes assessed included receptive and expressive language (Clinical Evaluation of Language Fundamentals 4) and emergent literacy (Sunderland Phonological Awareness Test-Revised). Linear regression, adjusted for mothers' home reading, was performed to assess 2-year-old vocabulary and communication skills and family disadvantage. Interaction of disadvantage (yes vs no) with high home reading by fathers and at least one parent was assessed.

RESULTS

Data were available for 405 families (64.3%). High father reading at 2 years (reference: low) predicted better expressive (mean difference, 4.7; 95% confidence interval, 1.5 to 8.0) and receptive (mean difference, 5.0; 95% confidence interval, 1.8 to 8.2) language at 4 years (both P < .001), but not emergent literacy skills. Similar patterns were observed in families with at least one parent with high home reading. Fathers' reading did not differentially benefit outcomes in disadvantaged children.

CONCLUSIONS

Fathers' involvement in reading at 2 years predicted better language but not emergent literacy at 4 years, and it did not protect against adverse effects of socioeconomic disadvantage.

The Language Exposure Assessment Tool: Quantifying Language Exposure in Infants and Children

Purpose

The aim of this study was to develop the Language Exposure Assessment Tool (LEAT) and to examine its cross-linguistic validity, reliability, and utility. The LEAT is a computerized interview-style assessment that requests parents to estimate language exposure. The LEAT yields an automatic calculation of relative language exposure and captures qualitative aspects of early language experience.

Method

Relative language exposure as reported on the LEAT and vocabulary size at 17 months of age were measured in a group of bilingual language learners with varying levels of exposure to French and English or Spanish and English.

Results

The LEAT demonstrates high internal consistency and criterion validity. In addition, the LEAT's calculation of relative language exposure explains variability in vocabulary size above a single overall parent estimate.

Conclusions

The LEAT is a valid and efficient tool for characterizing early language experience across cultural settings and levels of language exposure. The LEAT could be a useful tool in clinical contexts to aid in determining whether assessment and intervention should be conducted in one or more languages.

Parents' reactions to children's stuttering and style of coping with stress

PURPOSE

The aim of the research was to determine: (a) how parents react to their child's stuttering, (b) what stress coping strategies they utilise, as well as (c) whether stress coping style depends on parents' reaction to their child's stuttering.

METHODS

The research involved 23 mothers and 23 fathers of children who stutter (CWS) at the age of three to six years old. The Reaction to Speech Disfluency Scale (RSDS), developed by the authors, was used in the research. To determine the parents' coping the Coping Inventory in Stressful Situations (CISS) by N.S. Endler and D.A Parker was applied.

RESULTS

The strongest reactions are observed on the cognitive level. Stronger cognitive, emotional and behavioural reactions are observed in the mothers towards their disfluently speaking sons and in the fathers towards their daughters. Having analysed the profiles of coping styles, it can be noticed that the task-oriented coping is most frequently adapted by the fathers. The mothers most often use the avoidance-oriented coping. No relevant correlation was observed between the fathers' coping style and their reactions to the child's disfluent speech. As far as the mothers are concerned, it has been proved that an increase in behavioural reactions correlates with the avoidance-oriented coping.

CONCLUSION

The cognitive reactions of the parents' towards their child's stuttering were most frequent, while the emotional ones were the least frequent. Confronted with a stressful situation, the fathers most often adapt the task-oriented coping, whereas the mothers use the avoidance-oriented coping.

EDUCATIONAL OBJECTIVES

the reader will be able to (1) learn what the key reactions of parents to their children's stuttering are, (2) describe stuttering as a stress factor for the parents, (3) describe the factors which influence parents' reactions to their child's stuttering and their coping style.

More Than “Try This at Home”—Including Parents in Early Intervention

Current state and federal recommendations encourage the delivery of early intervention services in a child's natural environment with typical communication partners (Individuals With Disabilities Education Act [IDEA], 2004). As such, speech-language pathologists (SLPs) often provide intervention services in homes and work closely with parents. However, only 30% of SLPs have early intervention expertise (ASHA, 2014) and 68% of SLPs report low-levels of competence in working with infants and toddlers (Campbell, Chiarello, Wilcox, & Milbourne, 2009). This may be due to the fact that the majority of graduate programs (60%) provide little or no training in early intervention (Bruder & Dunst, 2005). Working in early intervention is a challenging albeit rewarding task for even the most seasoned therapist. Given that the largest percentage of children served under part C of IDEA are children with language delays (Hebbeler et al., 2007), it is essential that SLPs working in early intervention implement effective strategies for both parents and children. The purpose of this paper is to: (a) explain why including parents in intervention is important; (b) discuss ways of including parents in early intervention; (c) examine strategies used to teach parents; (d) describe a method for teaching parents; (e) compare methods of measuring parent progress; and (f) propose future directions for research.

Maternal hypothyroxinaemia in early pregnancy and school performance in 5-year-old offspring

OBJECTIVE

Overt hypothyroidism in pregnant women is associated with a lower intelligence quotient in their children. More recently, subtle decreases in maternal thyroid function have also been associated with neurodevelopmental impairment in offspring. We tested the effect of hypothyroxinaemia during early pregnancy on school performance.

DESIGN

This was a longitudinal study that included the data of 1196 mother-child pairs from the Amsterdam Born Children and Their Development study.

METHODS

Maternal serum free thyroxine (T4) and TSH were obtained at a median gestational age of 12.9 (interquartile range: 11.9-14.3) weeks. School performance was assessed at age 5 years and based on scores obtained in arithmetic and language tests from the national monitoring and evaluation system. Poor school performance was defined as a test result <25th percentile and subnormal school performance as a result <50th percentile of the norm population. To estimate the impact of possible non-response bias, we conducted inverse-probability weighted analyses.

RESULTS

Maternal hypothyroxinaemia (i.e., a maternal free T4 in the lowest 10% of distribution) was associated with a 1.61 (95% CI: 1.05-2.47) -fold increased odds of subnormal arithmetic performance after adjustment for confounders (P=0.03). However, the odds ratio dropped to 1.48 (95% CI: 0.94-2.32) after inverse-probability weighting (P=0.09). No such relations were found with TSH.

CONCLUSIONS

Maternal hypothyroxinaemia at the end of the first trimester was associated with reduced performance in an arithmetic test, but not in a language test, in 5-year-old offspring. However, our results should be interpreted carefully because of possible non-response bias.