Stability of core language skill from infancy to adolescence in typical and atypical development

oREV: An item response theory-based open receptive vocabulary task for 3- to 8-year-old children

Individual differences in early language abilities are an important predictor of later life outcomes. High-quality, easy-access measures of language abilities are rare, especially in the preschool and primary school years. The present study describes the construction of a new receptive vocabulary task for children between 3 and 8 years of age. The task was implemented as a browser-based web application, allowing for both in-person and remote data collection via the internet. Based on data from N = 581 German-speaking children, we estimated the psychometric properties of each item in a larger initial item pool via item response modeling. We then applied an automated item selection procedure to select an optimal subset of items based on item difficulty and discrimination. The so-constructed task has 22 items and shows excellent psychometric properties with respect to reliability, stability, and convergent and discriminant validity. The construction, implementation, and item selection process described here makes it easy to extend the task or adapt it to different languages. All materials and code are freely accessible to interested researchers. The task can be used via the following website: https://ccp-odc.eva.mpg.de/orev-demo .

Impaired communication ability in SOX11 syndrome

BACKGROUND

Speech and language skills are important for social interaction and learning. This study characterised the communication abilities of verbal individuals with SOX11 syndrome using a standardised parent/carer questionnaire, the Children's Communication Checklist (CCC-2).

METHOD

Thirteen parent/carers of verbal individuals (aged 5-19 years) diagnosed with SOX11 syndrome completed the CCC-2. In order to contextualise findings, responses were compared to norms and to data from Noonan syndrome, a relatively well-known genetic diagnosis associated with communication impairment.

RESULTS

For all individuals, the CCC-2 composite score indicated significant communication difficulties. Language structure (speech, syntax, semantics and coherence), pragmatic language (inappropriate initiation, stereotyped language use of context and non-verbal communication) and autistic features (social relations and interests) scores were lower than typically developing norms. Subscale comparisons revealed relative difference in use of context compared to other pragmatic domains (stereotyped language and inappropriate initiation). Individual scores showed substantial variation, particularly in regard to language structure profile. Differences were more pronounced than for Noonan syndrome, specifically in domains of speech, syntax, non-verbal communication and social relations.

CONCLUSIONS

SOX11 syndrome is associated with communication impairment. It is important to assess communication abilities as part of the management of individuals with SOX11 syndrome and understand individual strengths and difficulties in order to provide targeted support.

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.

Stability of language difficulties among a clinical sample of preschoolers

BACKGROUND

Some data call into question the persistence of developmental language disorders (DLDs) identified during the preschool period. For this reason, speech-language pathologists (SLPs) often reassess children. However, it is unclear if the instability of the profiles documented in community sample studies is present in children referred to specialized clinics. Given the scarcity of SLP resources, is re-evaluating the language skills of these children a good use of clinical time?

AIM

To examine the stability of the findings from two SLP assessments in a sample of Canadian preschool children referred to a tertiary clinic between the ages of 2 and 6 years. It was hypothesized that children under the age of 4 years at first assessment and children with less severe initial deficits would show less stability of DLD diagnosis.

METHODS & PROCEDURES

The clinical files of children referred to an early childhood psychiatric clinic in Canada were reviewed. For 149 children with two SLPs assessment reports, persistence of language deficits was documented and tested with McNemar's statistics. Differences between preschoolers under the age of 4 versus 4 years and over, as well as between mildly and severely impaired children, were examined.

OUTCOMES & RESULTS

High level of agreement (94%) and McNemar's test (p = 0.180) supported the stability of initial diagnosis. The stability for children assessed before the age of 4 (n = 64) was 100%, and was significantly different from older children's (n = 85) stability of 89% (Fisher's exact test, p = 0.01; bilateral). The stability for children with mild impairments (n = 18) was 78%, which was significantly lower than the stability (97%) in children with severe impairments (n = 114) (Fisher's exact test, p = 0.007; bilateral).

CONCLUSIONS & IMPLICATIONS

No instability of language status was observed in children assessed before 4 years of age, which could be related to the significant severity of the difficulties that children in this age group presented and be specific to this type of clinical sample. The great stability of language status observed in preschoolers referred to a specialized clinic suggests that clinicians should limit reassessments to devote available resources to intervention efforts.

WHAT THIS PAPER ADDS

What is already known on this subject? Previous research that has demonstrated important instability in the classification of language impairment before 4 years of age gathered data mainly by screening the general population or was not based on a comprehensive clinical assessment. What this paper adds to existing knowledge? This study investigated the classification stability of DLD between two comprehensive SLP assessments in a clinical sample of Canadian preschoolers. The results indicate great stability of language status assessed before 4 years old in this population, suggesting that severity of impairments may trump the age factor in this group. What are the potential or actual clinical implications of this work? In the case of children referred to a specialized clinic, clinicians and policymakers should be aware that DLD diagnosis made before 4 years of age remains stable during preschool age, and that a best practice with this population would be to abandon unnecessary testing in favour of early intervention.

Structural and Pragmatic Language Impairments in Children Evaluated for Autism Spectrum Disorder (ASD)

Pragmatic language impairments are common in neurodevelopmental disorders, especially in autism spectrum disorder (ASD). The relationship between structural language skills and pragmatic competence in children with autistic symptoms, however, is largely unknown. We investigated this relationship based on the Children's Communication Checklist-2 and early language delay among children (N = 177, 19% females) clinically evaluated for ASD, differentiated into ASD (n = 148) and non-ASD (n = 29). Structural language deficits were common and associated with reduced pragmatic competence in both groups. Pragmatic language impairments were most profound in children with ASD. Early language delay and structural language deficits were less common in females. Our findings suggest that assessment of structural language skills should be included in the evaluation of children with suspected ASD.

Early temperament as a predictor of language skills at 40 months

Background

Mastering language involves the development of expressive and receptive skills among children. While it has been speculated that early temperament plays a role in the acquisition of language, the actual mechanism has not yet been explored. We investigated whether temperament at 18 months predicted expressive or receptive language skills at 40 months.

Methods

A representative sample of 901 children and their mothers who were enrolled and followed-up longitudinally in the Hamamatsu Birth Cohort for Mothers and Children study was included in the analysis. Child temperament was measured at 18 months using the Japanese version of the Early Childhood Behavior Questionnaire. Expressive and receptive language skills were measured at 40 months using the Mullen Scales of Early Learning.

Results

The multiple regression analysis, adjusting for potential confounders, suggested that higher motor activation (fidgeting) at 18 months was associated with lower expressive and receptive language skills at 40 months. Higher perceptual sensitivity was associated with higher expressive and receptive language skills at 40 months.

Conclusions

Specific temperament at 18 months of age predicted the development of the child’s expressive and receptive language skills at 40 months.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03116-5.

Neural Speech Encoding in Infancy Predicts Future Language and Communication Difficulties

Purpose This study aimed to construct an objective and cost-effective prognostic tool to forecast the future language and communication abilities of individual infants. Method Speech-evoked electroencephalography (EEG) data were collected from 118 infants during the first year of life during the exposure to speech stimuli that differed principally in fundamental frequency. Language and communication outcomes, namely four subtests of the MacArthur-Bates Communicative Development Inventories (MCDI)-Chinese version, were collected between 3 and 16 months after initial EEG testing. In the two-way classification, children were classified into those with future MCDI scores below the 25th percentile for their age group and those above the same percentile, while the three-way classification classified them into < 25th, 25th-75th, and > 75th percentile groups. Machine learning (support vector machine classification) with cross validation was used for model construction. Statistical significance was assessed. Results Across the four MCDI measures of early gestures, later gestures, vocabulary comprehension, and vocabulary production, the areas under the receiver-operating characteristic curve of the predictive models were respectively .92 ± .031, .91 ± .028, .90 ± .035, and .89 ± .039 for the two-way classification, and .88 ± .041, .89 ± .033, .85 ± .047, and .85 ± .050 for the three-way classification (p < .01 for all models). Conclusions Future language and communication variability can be predicted by an objective EEG method that indicates the function of the auditory neural pathway foundational to spoken language development, with precision sufficient for individual predictions. Longer-term research is needed to assess predictability of categorical diagnostic status. Supplemental Material https://doi.org/10.23641/asha.15138546.

Environmental Tobacco Smoke and Early Language Difficulties among U.S. Children

Objective: Environmental Tobacco Smoke (ETS) is a serious public health concern with the potential to interfere with various components of healthy child development. Even so, there has been limited nationally representative research investigating these connections. The current study examines the relationship between ETS and language difficulties among toddlers and preschool-aged children in the United States. Method: Data are derived from the 2018 National Survey of Children's Health and facilitate strategic comparisons between different forms of ETS-namely, children who live with family members who smoke vs. children whose family members smoke inside the housing unit. Results: The findings reveal a robust association between family members smoking inside the housing unit and both receptive and expressive language difficulties, but only among male children. After adjusting for covariates, smoking inside the housing unit is associated with a 182% increase in the rate of early composite language difficulties among male children. These associations persist even when compared to male children who live with smoking family members who do not smoke inside the housing unit. Conclusions: The findings suggest a need for interventions designed to reduce ETS in households with young children and increase targeted language skill training for vulnerable children in an effort to enhance child development and well-being. To maximize this effort, we advocate for interdisciplinary teams, including medical and public health practitioners, educators, and researchers, to work together to develop and implement evidence-based strategies to limit ETS in homes and facilitate healthy language development among young children.

The epidemiology of cognitive development

The epidemiology of cognitive development is an approach essentially based on large observational studies, which examines individual differences in cognitive abilities throughout childhood and their determinants. Although different in terms of methodology and main interests from developmental psychology, cognitive epidemiology offers complementary viewpoints on cognitive development and addresses fundamental research questions of interest to developmental psychologists. The present paper depicts the contributions of the epidemiological approach to the field of cognitive development and highlights the methodological advances that have made such contributions possible. We discuss the stability and developmental trajectories of cognitive functions, their main predictors, the complex interplay between environmental and genetic predictors, and the relationships between the different domains of cognition from birth to adulthood.

A Multi-Sectoral Approach Improves Early Child Development in a Disadvantaged Community in Peru: Role of Community Gardens, Nutrition Workshops and Enhanced Caregiver-Child Interaction: Project "Wawa Illari"

Background: Multi-dimensional monitoring evaluation and learning strategies are needed to address the complex set of factors that affect early child development in marginalized populations, but few studies have explored their effectiveness.

Objective: To compare improvement of health and development of children 0–3 years between intervention communities (IC) and control communities (CC) from peripheral settlements of Lima. Sequential interventions included: (1) home and community gardens, (2) conscious nutrition, and (3) parenting workshops following the International Child Development Program (ICDP).

Methods: Interventions were delivered by community health promoters (CHPs) using a “step-by-step” learning system. Both IC and CC were monitored before the interventions began, at 8 and 12 months (n = 113 IC and 127 CC children). Data were collected on household characteristics, diet, food security, health indicators (history of diarrhea and respiratory infections, hemoglobin, intestinal parasites, anthropometry), caregiver-child interactions and stress, and achievement of Pan-American Health Organization age-specific developmental milestones. Stepwise multiple logistic regressions were used to determine if the interventions affected food insecurity, as well as motor, social/cognitive and language delays.

Results: At baseline, 2.6% were categorized as “suspected developmental delay” and 14.2% were on “alert for development delay.” Food insecurity, diarrhea and respiratory infections were lowered following the interventions. Through the “step-by-step” approach, caregivers in IC gained skills in gardening, conscious nutrition and parenting that reduced the risk of food insecurity [Adjusted Risk Ratio = 0.20 (95% CI: 0.08–0.51)] and language delay [0.39 (0.19–0.82)] but not motor or social/cognitive delay. Use of a multiple micronutrient supplement decreased the risk of motor delay [0.12 (0.03–0.56)], but more pets were associated with higher risk of motor [3.24 (1.47–7.14)] and social/cognitive delay [2.72 (1.33–5.55)], and of food insecurity [1.73 (1.13–2.66)].

Conclusion: The combined interventions delivered by CHPs helped to mitigate the impact of adversity on food insecurity and language delay. Additional improvements may have been detected if the interventions had continued for a longer time. Our results indicate that control of infections and pets may be needed to achieve measurable results for motor and social/cognitive development. Continuous monitoring facilitated adjusting implementation strategies and achieving positive developmental outcomes.

Affording autism an early brain development re-definition

The national priority to advance early detection and intervention for children with autism spectrum disorder (ASD) has not reduced the late age of ASD diagnosis in the US over several consecutive Centers for Disease Control and Prevention (CDC) surveillance cohorts, with traditionally under-served populations accessing diagnosis later still. In this review, we explore a potential perceptual barrier to this enterprise which views ASD in terms that are contradicted by current science, and which may have its origins in the current definition of the condition and in its historical associations. To address this perceptual barrier, we propose a re-definition of ASD in early brain development terms, with a view to revisit the world of opportunities afforded by current science to optimize children's outcomes despite the risks that they are born with. This view is presented here to counter outdated notions that potentially devastating disability is determined the moment a child is born, and that these burdens are inevitable, with opportunities for improvement being constrained to only alleviation of symptoms or limited improvements in adaptive skills. The impetus for this piece is the concern that such views of complex neurodevelopmental conditions, such as ASD, can become self-fulfilling science and policy, in ways that are diametrically opposed to what we currently know, and are learning every day, of how genetic risk becomes, or not, instantiated as lifetime disabilities.

The Comprehension Boost in Early Word Learning: Older Infants Are Better Learners

Recent research has revealed that infants begin understanding words at around 6 months. After that, infants' comprehension vocabulary increases gradually in a linear way over 8-18 months, according to data from parental checklists. In contrast, infants' word comprehension improves robustly, qualitatively, and in a nonlinear way just after their first birthday, according to data from studies on spoken word comprehension. In this review, I integrate observational and experimental data to explain these divergent results. I argue that infants' comprehension boost is not well-explained by changes in their language input for common words, but rather by proposing that they learn to take better advantage of relatively stable input data. Next, I propose potentially complementary theoretical accounts of what makes older infants better learners. Finally, I suggest how the research community can expand our empirical base in this understudied area, and why doing so will inform our knowledge about child development.

Stabilities of Infant Behaviors and Maternal Responses to Them

Consistency in the order of individuals in a group across substantial lengths of time-stability-is a central concept in developmental science for several reasons. Stability underscores the meaningfulness of individual differences in psychological phenomena; stability informs about the origins, nature, and overall developmental course of psychological phenomena; stability signals individual status and so affects the environment, experience, and development; stability has both theoretical and clinical implications for individual functioning; and stability helps to establish that a measure constitutes a consequential individual-differences metric. In this three-wave prospective longitudinal study (Ns = 40 infants and mothers), we examined stabilities of individual variation in multiple infant behaviors and maternal responses to them across infant ages 10, 14, and 21 months. Medium to large effect size stabilities in infant behaviors and maternal responses emerged, but both betray substantial amounts of unshared variance. Documenting the ontogenetic trajectories of infant behaviors and maternal responses helps to elucidate the nature and structure of early human development.