Do Parents Model Gestures Differently When Children's Gestures Differ?

Does Gestural Communication Influence Later Spoken Language Ability in Minimally Verbal Autistic Children?

PURPOSE

The current study examined the predictive role of gestures and gesture-speech combinations on later spoken language outcomes in minimally verbal (MV) autistic children enrolled in a blended naturalistic developmental/behavioral intervention (Joint Attention, Symbolic Play, Engagement, and Regulation [JASPER] + Enhanced Milieu Teaching [EMT]).

METHOD

Participants were 50 MV autistic children (40 boys), ages 54-105 months (M = 75.54, SD = 16.45). MV was defined as producing fewer than 20 spontaneous, unique, and socially communicative words. Autism symptom severity (Autism Diagnostic Observation Schedule-Second Edition) and nonverbal cognitive skills (Leiter-R Brief IQ) were assessed at entry. A natural language sample (NLS), a 20-min examiner-child interaction with specified toys, was collected at entry (Week 1) and exit (Week 18) from JASPER + EMT intervention. The NLS was coded for gestures (deictic, conventional, and representational) and gesture-speech combinations (reinforcing, disambiguating, supplementary, other) at entry and spoken language outcomes: speech quantity (rate of speech utterances) and speech quality (number of different words [NDW] and mean length of utterance in words [MLUw]) at exit using European Distributed Corpora Project Linguistic Annotator and Systematic Analysis of Language Transcripts.

RESULTS

Controlling for nonverbal IQ and autism symptom severity at entry, rate of gesture-speech combinations (but not gestures alone) at entry was a significant predictor of rate of speech utterances and MLUw at exit. The rate of supplementary gesture-speech combinations, in particular, significantly predicted rate of speech utterances and NDW at exit.

CONCLUSION

These findings highlight the critical importance of gestural communication, particularly gesture-speech (supplementary) combinations in supporting spoken language development in MV autistic children.

Scoping review of behavioral coding measures used to evaluate parent responsiveness of children with autism or elevated risk of autism

LAY ABSTRACT

The topic of how parents react (e.g., how they talk and act) to their child with autism or elevated likelihood of autism, often called parent responsiveness, has been studied by researchers for over 50 years. Many methods for measuring behaviors around parent responsiveness have been created depending on what researchers were interested in discovering. For example, some include only the behaviors that the parent does/says in reacting to something the child does/says. Other systems look at all behaviors in a period of time between child and parent (e.g., who talked/acted first, how much the child or parent said/did). The purpose of this article was to provide a summary of how and what researchers looked at around parent responsiveness, describe the strengths and barriers of these approaches, and suggest a "best practices" method of looking at parent responsiveness. The model suggested could make it more possible to look across studies to compare study methods and results. The model could be used in the future by researchers, clinicians, and policymakers to provide more effective services to children and their families.

Whose Gestures are More Predictive of Expressive Language Abilities among Chinese-Speaking Children with Autism? A Comparison of Caregivers' and Children's Gestures

In spite of the close relationship between gestures and expressive language, little research has examined the roles of the parents' and children's gestures in the development of expressive language abilities in autistic children. Previous findings are also inconclusive. In the present study, we coded the gestures produced by the parents and their autistic children in parent-child interactions and compared the influence of their gestures on the children's expressive language abilities (N = 35; M = 4;10). Autistic children's deictic gestures positively predicted their Mean Length Utterance (MLU), word types, and word tokens whereas parents' deictic gesture inputs negatively predicted MLU and word types. The findings shed light on the importance of the gestures made by autistic children, which may trigger parents' gesture-to-word translation.

What affects gestural learning in children with and without Autism? The role of prior knowledge and imitation

The present study examined whether prior knowledge to the learning target and imitation during learning affected learning outcomes in preschool children with autism spectrum disorder (ASD, N = 22) compared to their typically developing (TD, N = 15) peers. Children's gestural skills in recognizing and producing the target gestures before and after the training, as well as their imitative behavior during the training were coded. Results showed that consistent prior knowledge benefited gestural learning in both groups. Besides, only children with ASD were hindered by inconsistent prior knowledge. Notably, the effect of imitation was not significant in the ASD group. In conclusion, the learning process in children with ASD may differ from those with typical development, suggesting special-designed interventions are required.

Gesture Development in Chinese-Speaking Preschool Children With Autism and the Roles of Parental Input and Child-Based Factors

PURPOSE

Children with autism are found to have delayed and heterogeneous gesture abilities. It is important to understand the growth of gesture abilities and the underlying factors affecting its growth. Addressing these issues can help to design effective intervention programs.

METHOD

Thirty-five Chinese-speaking preschoolers with autism spectrum disorder (M _age = 4.89 years, SD = 0.91; four girls) participated in four play sessions with their parents over 9 months. Their child-based factors including autism severity, intellectual functioning, and expressive language abilities were assessed. The gestures (deictic, iconic, and conventional) of the children and their parents were coded. Growth curve analyses were conducted to examine individual growth trajectories and the roles of child-based factors and parental input in shaping the children's gesture development.

RESULTS

Child-based factors and parental input predicted gesture development differently. Parents' gestures positively predicted their children's gestures of the same type. Autism severity negatively predicted iconic and conventional gestures. Overall growth was found in deictic rather than iconic and conventional gestures. Subgroup variation was also found. Specifically, children with better expressive language ability showed a decrease in deictic gestures. An increase in iconic and conventional gestures was found in children with more severe autism and those with poorer expressive language ability and intellectual functioning, respectively.

CONCLUSIONS

Different types of gestures may have different growth trajectories and be predicted by different child-based factors. Particular attention should be given to children who never produced iconic gestures, which is more challenging and may not develop over a short period, and hence require direct instruction.

Identifying Patterns of Similarities and Differences between Gesture Production and Comprehension in Autism and Typical Development

Production and comprehension of gesture emerge early and are key to subsequent language development in typical development. Compared to typically developing (TD) children, children with autism spectrum disorders (ASD) exhibit difficulties and/or differences in gesture production. However, we do not yet know if gesture production either shows similar patterns to gesture comprehension across different ages and learners, or alternatively, lags behind gesture comprehension, thus mimicking a pattern akin to speech comprehension and production. In this study, we focus on the gestures produced and comprehended by a group of young TD children and children with ASD—comparable in language ability—with the goal to identify whether gesture production and comprehension follow similar patterns between ages and between learners. We elicited production of gesture in a semi-structured parent–child play and comprehension of gesture in a structured experimenter-child play across two studies. We tested whether young TD children (ages 2–4) follow a similar trajectory in their production and comprehension of gesture (Study 1) across ages, and if so, whether this alignment remains similar for verbal children with ASD (M_age = 5 years), comparable to TD children in language ability (Study 2). Our results provided evidence for similarities between gesture production and comprehension across ages and across learners, suggesting that comprehension and production of gesture form a largely integrated system of communication.

The role of caregiver gestures and gesture-related responses of toddlers with autism spectrum disorder

Autism spectrum disorder (ASD) is characterized by social communicative abnormalities. Deficits and delays in gestural communication are among the early deficits of ASD and also a major social modality in early caregiver-toddler interaction. Caregiver gestures have an important role in the cognitive and social development of children with ASD. Thus, it is urgent to further explore the role of caregiver gestures in early caregiver-toddler interaction. In this cross-sectional study, we observed the caregivers' gestures and responses of toddlers aged between 18 and 24 months during play (ASD = 44, TD = 29) and dining activities (ASD = 34, TD = 27). By observing the different frequencies and patterns of gestures by the caregiver-child interaction and the different proportions of children's responses to the caregiver's gestures, we found that, compared to caregivers of typically developing toddlers, caregivers of toddlers with ASD had fewer synchronized gestures and more unsynchronized gestures in the play activity and more supplementary gestures in dining activity. Toddlers with ASD produced more social responses to caregivers' synchronized gestures, whereas the use of synchronized gestures by the caregivers in caregiver-toddler interaction had a positive influence on social responses to toddlers with ASD. The findings suggest that effective use of gestures by caregivers during caregiver-toddler activities can improve children's social responses.

Coordinated social communication in toddlers with and without autism spectrum disorder during a home observation

BACKGROUND & AIMS

Social communication and language skills have been found to be important predictors of long-term outcomes in individuals with autism spectrum disorder (ASD). However, the development of coordinated social communication (i.e., gestures and sounds or words) remains relatively understudied in young children with ASD and developmental delays (DD). This study used a prospective, longitudinal design and granular observational coding to document the coordination of gestures, sounds, and words in a large, heterogeneous sample of toddlers identified with ASD, DD, or typical development (TD) during a naturalistic home observation. Specific aims were: (1) to compare rates per minute and proportions of coordinated child communicative acts across groups; (2) to examine concurrent relationships between coordinated communication and measures of social communication and autism symptoms; and (3) to examine prospective relationships between coordinated communication, receptive and expressive language skills, and autism symptoms collected at 3 years of age.

METHODS

At a mean age of 20.3 months (SD = 2.0), 211 children (n_ASD = 121; n_DD = 46; n_TD = 44) participated in everyday activities with a parent during an hourlong home observation. Rates per minute and proportions of gestures, sounds and words, as well as temporally overlapping gesture + sound, gesture + word, and gesture + phrase combinations, were compared using one-way ANOVA. Pearson product moment correlations between coordinated communicative acts and measures of social communication, language, and autism symptoms were examined.

RESULTS

On average, children with ASD used sounds and gesture + sounds at significantly lower rates than DD and TD groups, who did not differ. Children with ASD and DD coordinated gesture + single words and gesture + phrases at significantly lower rates than the TD group. Groups did not differ with respect to the rate per minute at which they used gestures alone. Children with TD used a smaller proportion of sounds alone and higher proportions of words and phrases, with and without coordinated gestures, than ASD and DD groups. Children with ASD and DD used a significantly higher proportion of gestures alone than children with TD. Rates per minute and proportions of single words and gesture + words had significant correlations with measures of social communication, language skills, and autism symptoms.

CONCLUSIONS

Results suggest that a significantly lower rate per minute of sounds and gesture + sound combinations was a distinguishing feature of ASD in our sample. Further, limited use of single words and gesture + single words was observed in children ASD and DD. Significant prospective relationships between single words and gesture + words with language skills measured over a year later underscores the importance of acquiring these forms.

IMPLICATIONS

Results support the idea that clinicians should include opportunities to observe and encourage coordinated social communication while screening and assessing young children for DD and ASD in the home environment. The significant associations between rate of single words and gesture + word combinations with language development over a year later have implications for incorporating intervention targets that encourage the use of gesture-speech combinations.

Effect of sex and dyad composition on speech and gesture development of singleton and twin children

Children's early vocabulary shows sex differences - with boys having smaller vocabularies than age-comparable girls - a pattern that becomes evident in both singletons and twins. Twins also use fewer words than their singleton peers. However, we know relatively less about sex differences in early gesturing in singletons or twins, and also how singletons and twins might differ in their early gesture use. We examine the patterns of speech and gesture production of singleton and twin children, ages 0;10-to-3;4, during structured parent-child play. Boys and girls - singleton or twin - were similar in speech and gesture production, but singletons used a greater amount and diversity of speech and gestures than twins. There was no effect of twin dyad type (boy-boy, girl-girl, boy-girl) on either speech or gesture production. These results confirm earlier research showing close integration between gesture and speech in singletons in early language development, and further extend these patterns to twin children.

Show, give, and point gestures across infancy differentially predict language development

It is well established that deictic gestures, especially pointing, play an important role in children's language development. However, recent evidence suggests that other types of deictic gestures, specifically show and give gestures, emerge before pointing and are associated with later pointing. In the present study, we examined the development of show, give, and point gestures in a sample of 47 infants followed longitudinally from 10 to 16 months of age and asked whether there are certain ages during which different gestures are more or less predictive of language skills at 18 months. We also explored whether parents' responses vary as a function of child gesture types. Child gestures and parent responses were reliably coded from videotaped sessions of parent-child interactions. Language skills were measured at 18 months using standardized (Mullen Scales of Early Learning) and parent report (MacArthur-Bates Communicative Development Inventory) measures. We found that at 10 months, show+give gestures were a better predictor of 18-month language skills than pointing gestures were, yet at 14 months, pointing gestures were a better predictor of 18-month language skills than show+give gestures. By 16 months, children's use of speech in the interaction, not gesture, best predicted 18-month language skills. Parents responded to a higher proportion of shows+gives than to points at 10 months. These results demonstrate that different types of deictic gestures provide a window into language development at different points across infancy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Longitudinal Study of Parent Gestures, Infant Responsiveness, and Vocabulary Development in Infants at Risk for Autism Spectrum Disorder

We investigated gestures that parents used with 12-, 18-, and 24-month-old infants at high or low risk for autism spectrum disorder (ASD; high-risk diagnosed with ASD: n = 21; high-risk classified as no ASD: n = 34; low-risk classified as no ASD: n = 34). We also examined infant responses to parent gestures and assessed the extent to which parent gesture relates to vocabulary development. Parents of three groups gestured in similar frequencies and proportions. Infants, in turn, responded similarly to parent gestures regardless of the infant's ASD risk and later diagnosis. Finally, parents who gestured more at 12 months had children with better vocabulary at 36 months than parents who gestured less. These findings highlight the importance of examining parent gestures when predicting language development.

How do minimally verbal children and adolescents with autism spectrum disorder use communicative gestures to complement their spoken language abilities?

BACKGROUND AND AIMS

Prior work has examined how children and adolescents with autism spectrum disorder who are minimally verbal use their spoken language abilities during interactions with others. However, social communication includes other aspects beyond speech. To our knowledge, no studies have examined how minimally verbal children and adolescents with autism spectrum disorder are using their gestural communication during social interactions. Such work can provide important insights into how gestures may complement their spoken language abilities.

METHODS

Fifty minimally verbal children and adolescents with autism spectrum disorder participated (M _age = 12.41 years; 38 males). Gestural communication was coded from the Autism Diagnostic Observation Schedule. Children (n = 25) and adolescents (n = 25) were compared on their production of gestures, gesture-speech combinations, and communicative functions. Communicative functions were also assessed by the type of communication modality: gesture, speech, and gesture-speech to examine the range of communicative functions across different modalities of communication. To explore the role gestures may play the relation between speech utterances and gestural production was investigated.

RESULTS

Analyses revealed that (1) minimally verbal children and adolescents with autism spectrum disorder did not differ in their total number of gestures. The most frequently produced gesture across children and adolescents was a reach gesture, followed by a point gesture (deictic gesture), and then conventional gestures. However, adolescents produced more gesture-speech combinations (reinforcing gesture-speech combinations) and displayed a wider range of communicative functions. (2) Overlap was found in the types of communicative functions expressed across different communication modalities. However, requests were conveyed via gesture more frequently compared to speech or gesture-speech. In contrast, dis/agree/acknowledging and responding to a question posed by the conversational partner was expressed more frequently via speech compared to gesture or gesture-speech. (3) The total number of gestures was negatively associated with total speech utterances after controlling for chronological age, receptive communication ability, and nonverbal IQ.

CONCLUSIONS

Adolescents may be employing different communication strategies to maintain the conversational exchange and to further clarify the message they want to convey to the conversational partner. Although overlap occurred in communicative functions across gesture, speech, and gesture-speech, nuanced differences emerged in how often they were expressed across different modalities of communication. Given their speech production abilities, gestures may play a compensatory role for some individuals with autism spectrum disorder who are minimally verbal.

IMPLICATIONS

Findings underscore the importance of assessing multiple modalities of communication to provide a fuller picture of their social communication abilities. Our results identified specific communicative strengths and areas for growth that can be targeted and expanded upon within gesture and speech to optimize social communication development.

Gesture Use and Processing: A Review on Individual Differences in Cognitive Resources

Speakers use spontaneous hand gestures as they speak and think. These gestures serve many functions for speakers who produce them as well as for listeners who observe them. To date, studies in the gesture literature mostly focused on group-comparisons or the external sources of variation to examine when people use, process, and benefit from using and observing gestures. However, there are also internal sources of variation in gesture use and processing. People differ in how frequently they use gestures, how salient their gestures are, for what purposes they produce gestures, and how much they benefit from using and seeing gestures during comprehension and learning depending on their cognitive dispositions. This review addresses how individual differences in different cognitive skills relate to how people employ gestures in production and comprehension across different ages (from infancy through adulthood to healthy aging) from a functionalist perspective. We conclude that speakers and listeners can use gestures as a compensation tool during communication and thinking that interacts with individuals' cognitive dispositions.

Gesture Development, Caregiver Responsiveness, and Language and Diagnostic Outcomes in Infants at High and Low Risk for Autism

We investigated gesture production in infants at high and low risk for autism spectrum disorder (ASD) and caregiver responsiveness between 12 and 24 months of age and assessed the extent to which early gesture predicts later language and ASD outcomes. Participants included 55 high-risk infants, 21 of whom later met criteria for ASD, 34 low-risk infants, and their caregivers. Results indicated that (a) infants with ASD outcomes used fewer gestures and a lower proportion of developmentally advanced gesture-speech combinations; (b) caregivers of all the infants provided similar rates of contingent responses to their infants' gestures; and (c) gesture production at 12 months predicted subsequent receptive language and ASD outcomes within the high-risk group.

Early Lateralization of Gestures in Autism: Right-Handed Points Predict Expressive Language

Children with autism spectrum disorder (ASD) produce fewer deictic gestures, accompanied by delays/deviations in speech development, compared to typically-developing (TD) children. We ask whether children with ASD-like TD children-show right-hand preference in gesturing and whether right-handed gestures predict their vocabulary size in speech. Our analysis of handedness in gesturing in children with ASD (n = 23, M_age = 30-months) and with TD (n = 23, M_age = 18-months) during mother-child play showed a right-hand preference for TD children-but not for children with ASD. Nonetheless, right-handed deictic gestures predicted expressive vocabulary 1 year later in both children with ASD and with TD. Handedness for gesture, both hand preference and amount of right-handed pointing, may be an important indicator of language development in autism and typical development.

Language Growth in Young Children with Autism: Interactions Between Language Production and Social Communication

Young children with autism spectrum disorder (ASD) present with a broad range of spoken language abilities, as well as delays in precursor skills such as gesture production and joint attention skills. While standardized assessments describe language strengths, the Communication and Symbolic Behavior Scales (CSBS-DP) is a particularly robust measure as it additionally characterizes precise aspects of social communication. This study provides a unique contribution by assessing the interactional effects of CSBS-DP Social Composite performance with early language samples on later language outcomes. Our results indicate that multiple social communication elements significantly interact with early spoken language to predict later language. Our findings also highlight the transactional relationship between early spoken vocabulary and social communication skills that bolster language development growth.

Rates of Prelinguistic Communication and Early Symbol Use in Young Children With Down Syndrome: Using a Progress-Monitoring Tool to Model Growth

Purpose This study aims to provide descriptive data on rates of expressive communication skill use in young children with Down syndrome (DS) across early childhood. Children with DS are known to have delays in expressive communication, but there are little current data on rates of communication in early skills, such as gestures, vocalizations, words, and word combinations. In addition, few studies use measures that offer a composite or "across-skills" view of early development across time. Method This article used a longitudinal descriptive design to generate growth curves for expected rates of communication in young children with DS in 4 major skill elements as measured by the Individual Growth and Development Indicator-Early Communication Index. Using data from 19 children aged 11-42 months with DS, we used hierarchical linear modeling to generate growth curves for children with DS while comparing them to the benchmarked data available for children who are typically developing. Results Results indicate relative strengths in gesture use, a longer period of vocalizations, and lower rates of growth in single and multiple word combinations across time. Children differed significantly from one another on all parameters. Conclusion These data indicate a need to develop and research interventions to support the transition from gestures to words and that support early word combinations in young children with DS.

Do parents provide a helping hand to vocabulary development in bilingual children?

Monolingual children identify referents uniquely in gesture before they do so with words, and parents translate these gestures into words. Children benefit from these translations, acquiring the words that their parents translated earlier than the ones that are not translated. Are bilingual children as likely as monolingual children to identify referents uniquely in gesture; and do parental translations have the same positive impact on the vocabulary development of bilingual children? Our results showed that the bilingual children - dominant in English or in Spanish - were as likely as monolingual children to identify referents uniquely in gesture. More importantly, the unique gestures, when translated into words by the parents, were as likely to enter bilingual and monolingual children's speech - independent of language dominance. Our results suggest that parental response to child gesture plays as crucial of a role in the vocabulary development of bilingual children as it does in monolingual children.

Do Verbal Children with Autism Comprehend Gesture as Readily as Typically Developing Children?

Gesture comprehension remains understudied, particularly in children with autism spectrum disorder (ASD) who have difficulties in gesture production. Using a novel gesture comprehension task, Study 1 examined how 2- to 4-year-old typically-developing (TD) children comprehend types of gestures and gesture-speech combinations, and showed better comprehension of deictic gestures and reinforcing gesture-speech combinations than iconic/conventional gestures and supplementary gesture-speech combinations at each age. Study 2 compared verbal children with ASD to TD children, comparable in receptive language ability, and showed similar patterns of comprehension in each group. Our results suggest that children comprehend deictic gestures and reinforcing gesture-speech combinations better than iconic/conventional gestures and supplementary combinations-a pattern that remains robust across different ages within TD children and children with ASD.