The Danish Communicative Developmental Inventories: validity and main developmental trends

Lexical development in Kuwaiti Arabic in typically developing children and late talkers

INTRODUCTION

This study explored vocabulary development and lexical composition in young typically developing (TD) Kuwaiti children and late talkers (LT) using the Kuwaiti Arabic Communicative Development Inventory-Words and Sentences (KACDI-WS) Abdalla et al., 2016). The sample included 161 children aged 20 to 37 months: 127 TD and 34 children who were late talkers (LT group). The late talkers were first identified based on a background questionnaire answered by the parents. All the caregivers completed a 698-item web-based KACDI expressive vocabulary inventory by selecting non-imitative words that their children produced.

RESULTS

Lexical size and composition (nouns, predicates, and closed-class words) were analyzed. Across the TD age groups (20-26, 27-31, 32-37 months), a significant age effect for vocabulary size and composition was found in favor of the older groups. Nouns were more prevalent than predicates or closed-class words in within-group comparisons. The vocabulary size of the TD (M= 263.8) was significantly larger than that of the LT group (M= 69.2). The development of their lexical composition followed a similar pattern.

CONCLUSIONS

The results suggested that the KACDI parent report instrument has the potential for measuring vocabulary development in TD children and could serve as an initial screening tool to identify late talkers.

An examination of measures of young children's interest in natural object categories

Developmental research utilizes various different methodologies and measures to study the cognitive development of young children; however, the reliability and validity of such measures have been a critical issue in all areas of research practices. To address this problem, particularly in the area of research on infants' interests, we examined the convergent validity of previously reported measures of children's interests in natural object categories, as indexed by (1) parents' estimation of their child's interest in the categories, (2) extrinsic (overt choices in a task), (3) intrinsic (looking time toward objects), and (4) physiological (pupil dilation) responses to objects of different categories. Additionally, we also examined the discriminant validity of all the aforementioned measures against the well-established and validated measure of parents' estimations of children's vocabulary knowledge. Children completed two tasks: (a) an eye-tracking task, where they were presented with images from a range of defined categories, which collected indices of looking time and pupillary activity; (b) a sticker-choice task, where they were asked to choose between two sticker-images from two different categories belonging to the range of categories assessed in the previous task. Parents completed two questionnaires to estimate (i) their child's interests and (ii) vocabulary knowledge in the categories presented. We first analyzed the discriminant validity between the two parent measures, and found a significant positive association between them. Our successive analyses showed no strong or significant associations between any of our measures, apart from a significant positive association between children's looking time and parents' estimations of children's vocabulary knowledge. From our findings, we conclude that measures of infants' interests thus far may not have sufficient reliability to adequately capture any potential relationship between these measures, or index different components of interest in young children. We suggest next steps for further validation studies in infant research.

Genome-Wide Analyses of Vocabulary Size in Infancy and Toddlerhood: Associations With Attention-Deficit/Hyperactivity Disorder, Literacy, and Cognition-Related Traits

BACKGROUND

The number of words children produce (expressive vocabulary) and understand (receptive vocabulary) changes rapidly during early development, partially due to genetic factors. Here, we performed a meta-genome-wide association study of vocabulary acquisition and investigated polygenic overlap with literacy, cognition, developmental phenotypes, and neurodevelopmental conditions, including attention-deficit/hyperactivity disorder (ADHD).

METHODS

We studied 37,913 parent-reported vocabulary size measures (English, Dutch, Danish) for 17,298 children of European descent. Meta-analyses were performed for early-phase expressive (infancy, 15-18 months), late-phase expressive (toddlerhood, 24-38 months), and late-phase receptive (toddlerhood, 24-38 months) vocabulary. Subsequently, we estimated single nucleotide polymorphism-based heritability (SNP-h2) and genetic correlations (rg) and modeled underlying factor structures with multivariate models.

RESULTS

Early-life vocabulary size was modestly heritable (SNP-h2 = 0.08-0.24). Genetic overlap between infant expressive and toddler receptive vocabulary was negligible (rg = 0.07), although each measure was moderately related to toddler expressive vocabulary (rg = 0.69 and rg = 0.67, respectively), suggesting a multifactorial genetic architecture. Both infant and toddler expressive vocabulary were genetically linked to literacy (e.g., spelling: rg = 0.58 and rg = 0.79, respectively), underlining genetic similarity. However, a genetic association of early-life vocabulary with educational attainment and intelligence emerged only during toddlerhood (e.g., receptive vocabulary and intelligence: rg = 0.36). Increased ADHD risk was genetically associated with larger infant expressive vocabulary (rg = 0.23). Multivariate genetic models in the ALSPAC (Avon Longitudinal Study of Parents and Children) cohort confirmed this finding for ADHD symptoms (e.g., at age 13; rg = 0.54) but showed that the association effect reversed for toddler receptive vocabulary (rg = -0.74), highlighting developmental heterogeneity.

CONCLUSIONS

The genetic architecture of early-life vocabulary changes during development, shaping polygenic association patterns with later-life ADHD, literacy, and cognition-related traits.

Infant-directed speech does not always involve exaggerated vowel distinctions: Evidence from Danish

This study compared the acoustic properties of 26 (100% female, 100% monolingual) Danish caregivers' spontaneous speech addressed to their 11- to 24-month-old infants (infant-directed speech, IDS) and an adult experimenter (adult-directed speech, ADS). The data were collected between 2016 and 2018 in Aarhus, Denmark. Prosodic properties of Danish IDS conformed to cross-linguistic patterns, with a higher pitch, greater pitch variability, and slower articulation rate than ADS. However, an acoustic analysis of vocalic properties revealed that Danish IDS had a reduced or similar vowel space, higher within-vowel variability, raised formants, and lower degree of vowel discriminability compared to ADS. None of the measures, except articulation rate, showed age-related differences. These results push for future research to conduct theory-driven comparisons across languages with distinct phonological systems.

Phonological discrimination and contrast detection in pupillometry

Introduction

The perception of phonemes is guided by both low-level acoustic cues and high-level linguistic context. However, differentiating between these two types of processing can be challenging. In this study, we explore the utility of pupillometry as a tool to investigate both low- and high-level processing of phonological stimuli, with a particular focus on its ability to capture novelty detection and cognitive processing during speech perception.

Methods

Pupillometric traces were recorded from a sample of 22 Danish-speaking adults, with self-reported normal hearing, while performing two phonological-contrast perception tasks: a nonword discrimination task, which included minimal-pair combinations specific to the Danish language, and a nonword detection task involving the detection of phonologically modified words within sentences. The study explored the perception of contrasts in both unprocessed speech and degraded speech input, processed with a vocoder.

Results

No difference in peak pupil dilation was observed when the contrast occurred between two isolated nonwords in the nonword discrimination task. For unprocessed speech, higher peak pupil dilations were measured when phonologically modified words were detected within a sentence compared to sentences without the nonwords. For vocoded speech, higher peak pupil dilation was observed for sentence stimuli, but not for the isolated nonwords, although performance decreased similarly for both tasks.

Conclusion

Our findings demonstrate the complexity of pupil dynamics in the presence of acoustic and phonological manipulation. Pupil responses seemed to reflect higher-level cognitive and lexical processing related to phonological perception rather than low-level perception of acoustic cues. However, the incorporation of multiple talkers in the stimuli, coupled with the relatively low task complexity, may have affected the pupil dilation.

Danish 20-month-olds' recognition of familiar words with and without consonant and vowel mispronunciations

Although several studies initially supported the proposal by Nespor et al. (Nespor, Marina, Marcela Peña & Jacques Mehler. 2003. On the different roles of vowels and consonants in speech processing and language acquisition. Lingue e Linguaggio 2. 221-247) that consonants are more informative than vowels in lexical processing, a more complex picture has emerged from recent research. Current evidence suggests that infants initially show a vowel bias in lexical processing and later transition to a consonant bias, possibly depending on the characteristics of the ambient language. Danish infants have shown a vowel bias in word learning at 20 months-an age at which infants learning French or Italian no longer show a vowel bias but rather a consonant bias, and infants learning English show no bias. The present study tested whether Danish 20-month-olds also have a vowel bias when recognizing familiar words. Specifically, using the Intermodal Preferential Looking paradigm, we tested whether Danish infants were more likely to ignore or accept consonant than vowel mispronunciations when matching familiar words with pictures. The infants successfully matched correctly pronounced familiar words with pictures but showed no vowel or consonant bias when matching mispronounced words with pictures. The lack of a bias for Danish vowels or consonants in familiar word recognition adds to evidence that lexical processing biases are language-specific and may additionally depend on developmental age and perhaps task difficulty.

Sex/Gender Differences in the Language Profiles of Italian Children with Autism Spectrum Disorder: A Retrospective Study

Sex/gender (S/G) differences in ASD language profiles have been poorly investigated. The present study aims to explore whether male (M) and female (F) children with ASD and with normal non-verbal cognitive abilities differ in their linguistic profiles. A sample of 76 Italian children with ASD (range: 4.9-8 years), including 50 Ms and 26 Fs, was retrospectively recruited. Language profiles were analyzed using standardized tests for the evaluation of receptive and expressive vocabulary as well as grammar. Grammatical comprehension was the most impaired domain compared to the other language measures in both M and F children. Comparing language profiles between S/G, Fs showed significantly better scores than Ms in grammatical production (p = 0.002), and Ms showed better active negative sentence comprehension (p = 0.035). Moreover, comparing the language profiles between Ms and Fs with a receptive disorder, Fs had significantly worse grammatical comprehension and better grammatical production than Ms. Even among children without a receptive disorder, Fs had significantly higher grammatical production scores. The S/G differences in language profile, particularly better expressive language in Fs than Ms, can partially contribute to the delayed ASD diagnosis or underdiagnosis of Fs without intellectual disability. Finally, the results document the importance of accurately investigating both expressive and receptive abilities in children with ASD.

Association between prenatal or early postnatal exposure to perfluoroalkyl substances and language development in 18 to 36-month-old children from the Odense Child Cohort

BACKGROUND

Perfluoroalkyl substances (PFAS) are persistent chemicals used in everyday consumer products leading to ubiquitous human exposure. Findings of impaired neurodevelopment after prenatal exposure to PFAS are contradictory and few studies have assessed the impact of postnatal PFAS exposure. Language development is a good early marker of neurodevelopment but only few studies have investigated this outcome separately. We therefore investigated the association between prenatal and early postnatal PFAS exposure and delayed language development in 18 to 36-month-old Danish children.

METHODS

The Odense Child Cohort is a large prospective cohort. From 2010 to 2012 all newly pregnant women residing in the Municipality of Odense, Denmark was invited to participate. Concentration of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were assessed in maternal serum collected in the 1st trimester of pregnancy and in child serum at 18 months. Parents responded to the Danish adaption of the MacArthur-Bates Communicative Development Inventories (MB-CDI) when their child was between 18 and 36 months. Language scores were converted into sex and age specific percentile scores and dichotomized to represent language scores above or below the 15th percentile. We applied Multiple Imputation by Chained Equation and conducted logistic regressions investigating the association between prenatal and early postnatal PFAS exposure and language development adjusting for maternal age, pre-pregnancy BMI, education and respectively fish intake in pregnancy or childhood and duration of breastfeeding in early postnatal PFAS exposure models.

RESULTS

We found no significant associations between neither prenatal nor early postnatal PFAS exposure and language development among 999 mother-child pairs.

CONCLUSION

In this low-exposed cohort the finding of no association between early postnatal PFAS exposure and language development should be interpreted with caution as we were unable to separate the potential adverse effect of PFAS exposure from the well documented positive effect of breastfeeding on neurodevelopment. We, therefore, recommend assessment of child serum PFAS at an older age as development of the brain proceeds through childhood and even a small impact of PFAS on neurodevelopment would be of public health concern at population level due to the ubiquitous human exposure.

Cross-Cultural Sex/Gender Differences in Produced Word Content Before the Age of 3 Years

Does sex/gender matter for language acquisition? Small advantages in vocabulary size for females are well documented. In this study, however, we found that children's early vocabulary composition was a significantly better predictor of sex/gender than their vocabulary size. We conducted classification analysis on word-production data from children (12-36 months old, n = 39,553) acquiring 26 different languages. Children's sex/gender was classified at above-chance levels in 22 of 26 languages. Classification accuracy was significantly higher than for models based on vocabulary size and increased as a function of sample size. Boys produced more words for vehicles and outdoor scenes, whereas girls produced more words for clothing and body parts. Classification accuracy also increased as a function of age and peaked at 30 months, reaching accuracy levels observed in studies of adult word use. These differences in vocabulary are indicative of differences in the lifeworld of children and may themselves cause further differences in development.

Middle ear effusion, ventilation tubes and neurological development in childhood

BACKGROUND

Otitis media with middle ear effusion (MEE) can be treated with ventilation tubes (VT) insertion, and it has been speculated that prolonged MEE in childhood can affect neurological development, which in turn may be important for later academic achievements.

OBJECTIVE

To investigate the association between middle ear effusion (MEE), treatment with ventilation tubes (VT) and childhood neurological development.

STUDY DESIGN

We examined 663 children from the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) unselected mother-child cohort study. Children were followed by study pediatricians with regular visits from pregnancy until 3 years of age. MEE was diagnosed using tympanometry at age 1, 2 and 3 years. Information regarding VT from age 0-3 years was obtained from national registries. We assessed age at achievement of gross motor milestones from birth, language scores at 1 and 2 years, cognitive score at 2.5 years and general development score at age 3 years using standardized quantitative tests.

RESULTS

Children with MEE had a lower 1-year word production vs. children with no disease: (median 2, IQR [0-6] vs. 4, IQR [1-7]; p = 0.017), and a lower 1-year word comprehension (median 36; IQR [21-63] vs. 47, IQR [27-84]; p = 0.03). Children with VT had a lower 2-5-year cognitive score vs. children with no disease; estimate -2.34; 95% CI [-4.56;-0.12]; p = 0.039. No differences were found between children with vs. without middle ear disease regarding age at achievement of gross motor milestones, word production at 2 years or the general developmental score at 3 years.

CONCLUSION

Our study supports the previous findings of an association between MEE and concurrent early language development, but not later neurological endpoints up to the age of 3. As VT can be a treatment of those with symptoms of delayed development, we cannot conclude whether treatment with VT had positive or negative effects on neurodevelopment.

Prediction from early childhood vocabulary to academic achievement at the end of compulsory schooling in Denmark

Prediction from early development to later achievement has the potential to improve clinical and educational service delivery as well as to inform developmental theory. In this longitudinal study, we asked how well can educational achievement measured in the final year (Grade 9, age 15) of compulsory education—both overall and for outcomes in the lowest 20%—be predicted from information available in the first 3 years of life, particularly early expressive vocabulary? Measures for 2,767 children (1,345 males, 1,422 females) aged 16 to 30 months on early expressive vocabulary, along with family socioeconomic status (parental education, occupation, and household income), other demographic information (gender, birth order, parental age, social benefits, etc.), timing and nature of early child care, and early home literacy experience, were used to predict performance on Danish Upper Secondary School Leaving Exam (USSLE) in Danish, English, Math, and Science. A cross-validated combination of Lasso (Least absolute shrinkage and selection operator) and ordinary least squares regression was the primary analysis for continuous outcomes and cross-validated Lasso and logistic regression for categorical outcomes. With respect to continuous outcome measures, the patterns of prediction varied with specific domain; R2 ranged from 9.4% to 21.4%. With respect to low USSLE performance, area under the curve statistics ranged from 64.1% to 72.2%. In all domains, early childhood expressive vocabulary made a significant unique contribution to the outcome when measured over the full range. The prediction was also significant for vocabulary to low Danish and English scores although not for Math and Science. Although the predictions were not strong enough for clinical diagnosis on their own, they demonstrate that low early vocabulary is an important and measurable risk condition that can direct early intervention and thus contribute to later educational attainment.

A short-form version of the Australian English Communicative Development Inventory

Purpose: The Australian English Communicative Development Inventory (OZI) is a 558-item parent report tool for assessing language development at 12-30 months. Here, we introduce the short form (OZI-SF), a 100-item, picture-supported, online instrument with substantially lower time and literacy demands.Method: In tool development (Study 1), 95 items were drawn from the OZI to match its item distribution by age of acquisition and semantic categories. Five items were added from four other semantic categories, plus 12 gestures and six games/routines. Simulations computed OZI-SF scores from existing long-form OZI norm data, and OZI and projected OZI-SF scores were correlated. In an independent norming sample (Study 2), parents (n = 230) completed the OZI-SF for their children aged 12-30 months. Child scores were analysed by age and sex.Result: OZI-SF and OZI scores correlate highly across age and language development levels. Vocabulary scores (receptive, expressive) correlate with age and the median for girls is higher until 24 months. By 24 months, 50% of the sample combine words "often". The median time to OZI-SF completion was 12 minutes.Conclusion: Fitted percentiles permit working guidelines for typical (median) performance and lower cut-offs for children who may be behind on age-based expectations and/or at risk for a communication difficulty. The OZI-SF is a short-form of the OZI that has promise for research and clinical/educational use with Australian families.

Effects of prenatal nutrient supplementation and early life exposures on neurodevelopment at age 10: a randomised controlled trial - the COPSYCH study protocol

INTRODUCTION

Nutrient deficiency and immune and inflammatory disturbances in early life may compromise neurodevelopment and be implicated in the aetiology of psychiatric disorders. However, current evidence is limited by its predominantly observational nature. COpenhagen Prospective Study on Neuro-PSYCHiatric Development (COPSYCH) is a research alliance between Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research with the overall aim to investigate effects of prenatal and early life exposures on neurodevelopment at 10 years. COPSYCH will investigate the impact of prenatal n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) and high-dose vitamin D supplementation on neurodevelopment reflected by brain development, neurocognition and psychopathology. Moreover, the neurodevelopmental impact of early life exposures such as infections, low grade inflammation and the gut microbiome will be scrutinised.

METHODS AND ANALYSIS

COPSYCH is based on the prospective and ongoing COPSAC2010 birth cohort of 700 mother-child pairs. Randomised controlled trials of supplementation with n-3 LCPUFA and/or high-dose vitamin D or placebo in the third trimester were embedded in a factorial 2×2 design (ClinicalTrials.gov: NCT01233297 and NCT00856947). This unique cohort provides deep phenotyping data from 14 previous clinical follow-up visits and exposure assessments since birth. The ongoing 10-year visit is a 2-day visit. Day 1 includes a comprehensive neurocognitive examination, and assessment of psychopathological dimensions, and assessment of categorical psychopathology. Day 2 includes acquisition of brain structural, diffusion and functional sequences using 3 Tesla MRI. Study outcomes are neurocognitive, psychopathological and MRI measures.

ETHICS AND DISSEMINATION

This study has been approved by the Danish National Committee on Health Research Ethics and The Danish Data Protection Agency. The study is conducted in accordance with the guiding principles of the Declaration of Helsinki. Parents gave written informed consent before enrolment.

A Subtle Profile With a Significant Impact: Language and Communication Difficulties for Autistic Females Without Intellectual Disability

The presentation of autism in females is poorly understood, which is thought to contribute to missed or later- age diagnosis, especially for those without intellectual disability. Dedicated research into social and behavioral differences has indicated a specific female phenotype of autism. However, less has been done to explore language and communication profiles, despite known sex/gender differences in typically developing populations. This article provides a synthesis of recent work from this small but emerging field. It focuses on a series of four preliminary and explorative studies conducted by the authors and embeds this within the wider literature. Findings suggest a specific profile of language and communication strengths and weaknesses for autistic females without intellectual disability (compared to autistic males and typically developing females). Furthermore, despite the relatively subtle presentation of difficulties (compared to autistic males), the impact on functionality, social inter-relations and emotional well-being, appears to be equitable and significant. The discussion highlights the need for further empirical research and proposes areas for investigation. Implications for clinical practice include the need for better recognition, testing and provision of interventions dedicated to the language and communication difficulties for autistic females. This has relevance for diagnostic, mental health and speech and language therapy services.

Parental Reports of Preschoolers' Lexical and Syntactic Development: Validation of the CDI-III for European Portuguese

This study presents the validation analysis of the European Portuguese version of the MacArthur-Bates Communicative Development Inventory III (CDI-III-PT). The CDI-III-PT is a parental report measure allowing researchers to assess expressive vocabulary and the syntactic abilities of children aged 2;6–4;0. In this study, we present a version comprising a lexical subscale which follows the Swedish adaptation and an original syntactic subscale allowing us to include language-specific structures. The reports of 739 children were collected; in addition, a standardized measure of language was also administered to a sub-sample of these children and the reports of preschool teachers were collected for another sub-sample. The results indicate a high internal consistency of the lexical and syntactic subscales. As for sociodemographic variables often found to be predictors of language development, as measured by this type of instrument, the results indicate that age and maternal education are significant predictors of the scores, and that first-born children attain higher scores in vocabulary than later born children, but no significant gender differences were found. The scores of the CDI-III-PT are positively correlated with the ones obtained in the standardized language measure, thus supporting their validity. A high agreement between the reports of parents and teachers was also found. These findings indicate that the CDI-III-PT has adequate psychometric properties and that it can be a useful tool for research and clinical practice. The age-based norms that are now provided can be used to evaluate whether a child is performing poorly compared to their peers.

Sociocultural Factors Affecting Vocabulary Development in Young South African Children

Sociocultural influences on the development of child language skills have been widely studied, but the majority of the research findings were generated in Northern contexts. The current crosslinguistic, multisite study is the first of its kind in South Africa, considering the influence of a range of individual and sociocultural factors on expressive vocabulary size of young children. Caregivers of toddlers aged 16 to 32 months acquiring Afrikaans (n = 110), isiXhosa (n = 115), South African English (n = 105), or Xitsonga (n = 98) as home language completed a family background questionnaire and the MacArthur-Bates Communicative Development Inventory (CDI) about their children. Based on a revised version of Bronfenbrenner’s (1977) ecological systems theory, information was obtained from the family background questionnaire on individual factors (the child’s age and sex), microsystem-related factors (the number of other children and number of adults in the child’s household, maternal level of education, and SES), and exosystem-related factors (home language and geographic area, namely rural or urban). All sociocultural and individual factors combined explained 25% of the variance in expressive vocabulary size. Partial correlations between these sociocultural factors and the toddlers’ expressive vocabulary scores on 10 semantic domains yielded important insights into the impact of geographic area on the nature and size of children’s expressive vocabulary. Unlike in previous studies, maternal level of education and SES did not play a significant role in predicting children’s expressive vocabulary scores. These results indicate that there exists an interplay of sociocultural and individual influences on vocabulary development that requires a more complex ecological model of language development to understand the interaction between various sociocultural factors in diverse contexts.

Prenatal exposure to pyrethroid and organophosphate insecticides and language development at age 20-36 months among children in the Odense Child Cohort

BACKGROUND

Prenatal exposure to organophosphate and pyrethroid insecticides has been associated with impaired neurodevelopment. Few longitudinal studies have investigated associations with early language development in populations with mainly low dietary exposure.

OBJECTIVE

To investigate associations between biomarkers of maternal gestational exposure to organophosphate and pyrethroid insecticides and the child's language development at age 20-36 months in the prospective Odense Child Cohort.

METHODS

Metabolites of organophosphate and pyrethroid insecticides were measured in maternal urine samples collected at gestational week 28. Language development was assessed among 755 singletons at age 20-36 months using the Vocabulary and Complexity scores of the MacArthur-Bates Communicative Development Inventories, standardized into age and sex specific percentile scores according to a Danish reference study. Multiple logistic regression models were used to estimate the odds of scoring below the 15th percentile scores in relation to maternal urinary insecticide metabolite concentrations after adjustment for confounders.

RESULTS

The generic pyrethroid metabolite 3-phenoxybenzoic acid (3-PBA) and the chlorpyrifos metabolite 3,5,6-trichloro-2-pyridinol (TCPY) were detectable in more than 90% of the urine samples analyzed. Likewise, 82.2% had detectable concentrations of diethyl phosphates (DE) and 58.4% of dimethyl phosphates (DM), both of which are common metabolites of organophosphate insecticides. None of the metabolites was associated with higher odds of delayed results below the 15th percentile language scores. In contrast, reduced probability for scoring below the 15th percentile Vocabulary score was seen for the highest tertile of 3-PBA in boys and for the upper tertile of TCPY and DE in girls.

CONCLUSION

In this prospective cohort, with predominantly dietary insecticide exposure, we found no evidence that gestational exposure to organophosphate or pyrethroid insecticides adversely affected early language development in the children. The observed indication of a positive effect of insecticides on language development may be explained by residual and unmeasured confounding from socioeconomic factors and dietary habits. Follow-up of these children should include assessment of more complex cognitive functions in later childhood, as well as associations with their own postnatal insecticide exposure.

Fish Oil Supplementation in Pregnancy and Neurodevelopment in Childhood-A Randomized Clinical Trial

A double-blind randomized controlled trial of n-3 long-chain polyunsaturated fatty acid (n-3 LCPUFA) supplementation or matching placebo during third trimester of pregnancy was conducted within the COPSAC₂₀₁₀ mother-child cohort consisting of 736 women and their children. The objective was to determine if maternal n-3 LCPUFA pregnancy supplementation affects offspring neurodevelopment until 6 years. Neurodevelopment was evaluated in 654 children assessing age of motor milestone achievement, language development, cognitive development, general neurodevelopment, and emotional and behavioral problems. Maternal n-3 LCPUFA supplementation during pregnancy improved early language development and reduced the impact of emotional and behavioral problems. The n-3 LCPUFA supplementation was in boys associated with the earlier achievement of gross motor milestones, improved cognitive development, and a reduced impact of emotional and behavioral problems.

High-Dose Vitamin D Supplementation in Pregnancy and Neurodevelopment in Childhood: A Prespecified Secondary Analysis of a Randomized Clinical Trial

IMPORTANCE

Observational studies have reported an association between high maternal vitamin D levels and improved neurodevelopment in offspring, but no randomized clinical trial (RCT) has investigated these observations.

OBJECTIVE

To determine whether high-dose vitamin D supplementation during pregnancy improves offspring neurodevelopment from birth to age 6 years.

DESIGN, SETTING, AND PARTICIPANTS

This prespecified secondary analysis of a double-blinded, placebo-controlled RCT of high-dose vitamin D3 supplementation vs standard dose during the third trimester of pregnancy was conducted in the unselected prospective mother-child birth cohort at a single-center research unit in Denmark as part of the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC-2010). Participants included pregnant women; women with vitamin D intake greater than 600 IU/d or an endocrine, heart, or kidney disorder, and those who did not speak Danish fluently were excluded. Neurodevelopmental assessments for offspring of these women were performed at ages 0 to 6 years. Children born prematurely (gestational week <37), with low birth weight (<2500 g), or with a neurological disease affecting neurodevelopment were excluded. Data were analyzed from August 2019 to February 2020.

INTERVENTIONS

High-dose (ie, 2800 IU/d) vs standard dose (ie, 400 IU/d) vitamin D3 supplementation from pregnancy week 24 until 1 week after birth.

MAIN OUTCOMES AND MEASURES

The primary outcome of interest was cognitive development assessed at 2.5 years using the Bayley Scales of Infant and Toddler Development. Other neurodevelopmental outcomes included age of motor milestone achievement (Denver Developmental Index and World Health Organization milestone registration), language development (MacArthur-Bates Communicative Development Inventories), general neurodevelopment at age 3 years (Ages and Stages Questionnaire), and emotional and behavioral problems at age 6 years (Strengths and Difficulties Questionnaire).

RESULTS

Among 623 women randomized, 315 were randomized to high-dose vitamin D3 and 308 were randomized to standard dose placebo. A total of 551 children were evaluated from birth to age 6 years, (282 [51.2%] boys; 528 [95.8%] White), with 277 children in the high-dose vitamin D3 group and 274 children in the standard dose group. There was no effect of the high-dose compared with standard dose of vitamin D3 supplementation during pregnancy on offspring achievement of motor milestones (β = 0.08 [95% CI, -0.26 to 0.43]; P = .64), cognitive development (score difference: 0.34 [95% CI, -1.32 to 1.99]; P = .70), general neurodevelopment (median [IQR] communication score: 50 [50-55] vs 50 [50-55]; P = .62), or emotional and behavioral problems (odds ratio, 0.76 [95% CI, 0.53 to 1.09]; P = .14). There was no effect on language development expressed by the word production at 1 year (median [IQR], 2 [0-6] words vs 3 [1-6] words; P = .16), although a decreased word production was apparent at 2 years in children in the high-dose vitamin D3 group (median [IQR], 232 [113-346] words vs 253 [149-382.5] words; P = .02).

CONCLUSIONS AND RELEVANCE

In this prespecified secondary analysis of an RCT, maternal high-dose vitamin D3 supplementation during the third trimester of pregnancy did not improve neurodevelopmental outcomes in the offspring during the first 6 years of life. These findings contribute essential information clarifying the effects of prenatal exposure to vitamin D on neurodevelopment in childhood.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT00856947.

A Bayesian-Inspired Item Response Theory-Based Framework to Produce Very Short Versions of MacArthur-Bates Communicative Development Inventories

Purpose This study introduces a framework to produce very short versions of the MacArthur-Bates Communicative Development Inventories (CDIs) by combining the Bayesian-inspired approach introduced by Mayor and Mani (2019) with an item response theory-based computerized adaptive testing that adapts to the ability of each child, in line with Makransky et al. (2016). Method We evaluated the performance of our approach-dynamically selecting maximally informative words from the CDI and combining parental response with prior vocabulary data-by conducting real-data simulations using four CDI versions having varying sample sizes on Wordbank-the online repository of digitalized CDIs: American English (a very large data set), Danish (a large data set), Beijing Mandarin (a medium-sized data set), and Italian (a small data set). Results Real-data simulations revealed that correlations exceeding .95 with full CDI administrations were reached with as few as 15 test items, with high levels of reliability, even when languages (e.g., Italian) possessed few digitalized administrations on Wordbank. Conclusions The current approach establishes a generic framework that produces very short (less than 20 items) adaptive early vocabulary assessments-hence considerably reducing their administration time. This approach appears to be robust even when CDIs have smaller samples in online repositories, for example, with around 50 samples per month-age.

Children's Dental Anxiety during the COVID-19 Pandemic: Polish Experience

Dental fear and anxiety is a significant issue that affects pediatric patients and creates challenges in oral health management. Considering that the coronavirus disease 2019 (COVID-19) pandemic, along with its associated sanitary regime, social distancing measures and nationwide quarantines, could itself induce public fears, including in children, it is of great interest to explore whether this situation and the necessity of reorganizing dental care could potentially affect the emotional state of pediatric patients facing a need for urgent dental intervention. The present study assessed the emotional state of children ≤ seven years old (n = 25) requiring dental healthcare during a nationwide quarantine in Poland, as well as the anxiety levels of their caregivers. The Faces Anxiety Scale was adopted, and the evaluation was independently performed by the dentist, caregivers and children themselves. The level of anxiety in caregivers was also measured. As demonstrated, children requiring dental intervention during the nationwide quarantine did not reveal a significantly higher anxiety level as compared to the age- and indication-matched pre-pandemic control group (n = 20), regardless of whether their emotional state was evaluated by the dentist, caregivers, or by themselves. However, the share of children scoring the lowest anxiety level in all assessments was smaller in the pandemic group. Boys in the pandemic group had a higher anxiety level, as indicated by a caregiver assessment, and displayed a negative correlation with age in all three types of evaluation. Moreover, caregiver anxiety levels were higher in the pandemic group as compared to the pre-pandemic subset and revealed stronger correlations with the dental anxiety in children. The results suggest that the reorganization of oral healthcare under the pandemic scenario did not have a profound effect on children’s dental anxiety. Nevertheless, findings in young boys highlight that they may be more vulnerable and require special care to mitigate their anxiety and decrease the risk of dentophobia in the future—these observations must be, however, treated with caution due to the small sample size and require further confirmation. Moreover, it is important to reassure caregivers of the safety of the dental visit during the pandemic to minimize the effect of their own anxiety on dental fears in children.

Consistency and Variability in Children's Word Learning Across Languages

Why do children learn some words earlier than others? The order in which words are acquired can provide clues about the mechanisms of word learning. In a large-scale corpus analysis, we use parent-report data from over 32,000 children to estimate the acquisition trajectories of around 400 words in each of 10 languages, predicting them on the basis of independently derived properties of the words’ linguistic environment (from corpora) and meaning (from adult judgments). We examine the consistency and variability of these predictors across languages, by lexical category, and over development. The patterning of predictors across languages is quite similar, suggesting similar processes in operation. In contrast, the patterning of predictors across different lexical categories is distinct, in line with theories that posit different factors at play in the acquisition of content words and function words. By leveraging data at a significantly larger scale than previous work, our analyses identify candidate generalizations about the processes underlying word learning across languages.

Determinants of neurodevelopment in early childhood - results from the Copenhagen prospective studies on asthma in childhood (COPSAC2010 ) mother-child cohort

AIM

The objective of this study was to identify possible pre- and postnatal factors influencing neurodevelopment of the young child.

METHODS

We used data from the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC₂₀₁₀ ) mother-child cohort, but excluded those with a neurological diagnosis, born <37 weeks of gestation and birthweights <2500 g, resulting in 650 children analysed. Neurodevelopment was assessed as age of achievement of early milestones, language scores at 1 and 2 years and cognitive score at 2 ½ years of age.

RESULTS

Neurodevelopmental scores were not associated with breastfeeding, persistent wheeze, eczema and number of sick days (p > 0.05 in all tests). Early age at milestone achievement was associated with male sex (p = 0.05), lower maternal age (p = 0.02), higher gestational age (p < 0.001) and paternity leave (p = 0.01). A higher 1-year language score was associated with female sex (p = 0.02) and maternal smoking during pregnancy (p = 0.01) and a higher 2-year language score with female sex (p < 0.001) and being first born (p = 0.01). A higher cognitive score was associated with female sex (p = 0.02).

CONCLUSION

Neurodevelopmental scores were unrelated to breastfeeding, persistent wheeze, eczema and number of sick days. Neurodevelopment in early childhood was mostly associated with gender.

The development of vocabulary and grammar: a longitudinal study of European Portuguese-speaking toddlers

The goals of this study were to analyze the growth and stability of vocabulary, mean length of the three longest utterances (MLLUw), and sentence complexity in European Portuguese-speaking children aged 1;4-2;6, to explore differences in growth as a function of personal and family-related variables, and to investigate the inter-relationships among the three language dimensions. Fifty-one European Portuguese-speaking toddlers were longitudinally assessed at 1;4, 1;9, 2;1, and 2;6, through parent reports. Exponential growth models best described acquisition patterns during this period, but the vocabulary growth accelerated across the full age-range, whereas the growth of grammar dimensions accelerated mainly after 1;9. High variability was observed in the scores, but the toddlers' relative positions were mostly stable over time. Gender approached significance as a predictor of vocabulary growth. Maternal educational level did not predict the growth of any of the three language dimensions. Both vocabulary and MLLUw predicted sentence complexity.

The Italian Words and Sentences MB-CDI: normative data and concordance between complete and short forms

One of the most popular and widely used parent report instruments for assessing early language acquisition is the MacArthur-Bates Communicative Development Inventories (MB-CDI). This study compares normative data of the Italian Words and Sentences complete form (WS-CF) and short form (WS-SF). The samples included 752 children for the WS-CF and 816 children for the WS-SF designed for children aged 18-36 months. The concordance between WS-SF and WS-CF is analyzed in a subgroup of 65 children. The results revealed strong correlations between WS-CF and WS-SF in both lexical and grammar skills as well as strong relationship between lexical and grammar skills. There was a high percentage agreement (97%) between the two forms for scores below the 10th percentile, suggesting that the two forms may be used interchangeably in order to describe vocabulary and grammatical development.

Prenatal bisphenol A exposure is associated with language development but not with ADHD-related behavior in toddlers from the Odense Child Cohort

Bisphenol A (BPA) is a non-persistent chemical with endocrine disrupting abilities widely used in a variety of consumer products. The fetal brain is particularly sensitive to chemical exposures due to its rapid growth and complexity. Some studies have reported associationbetween maternal BPA exposure and behavior but few have assessed impact on cognitive development, and to our knowledge no studies have specifically assessed the impact on language development. We therefore assessed whether maternal urinary BPA concentration during pregnancy was associated with language development and attention-deficit and hyperactivity disorder (ADHD) symptoms in offspring aged 18-36 months in the prospective Odense Child Cohort. BPA was analyzed in 3rd trimester maternal fasting urine spot samples. Language development was addressed among 535 children using the Danish adaptation of the MacArthur-Bates Communicative Development Inventories at median age 21 months; ADHD traits were assessed by parents of 658 children using the Child Behavior Checklist for ages 1½-5 years at mean age 2.7 years. Associations were assessed using logistic regression models comparing children below the 15th percentile score for language and above the 85 percentiles score for ADHD with the other children while stratifying by sex and adjusting for maternal education, duration of breastfeeding and maternal urine phthalates. BPA was detected in 85.3% of the urine samples (median 1.2 ng/ml). Boys of mothers with BPA exposure in the highest tertile had an odds ratio of 3.70 (95% CI 1.34-10.21) of being in the lowest 15th percentile of vocabulary score compared to boys of mothers within the lowest tertile of BPA exposure after adjustment, whereas no association was found in girls. No clear dose-response relationship between maternal BPA and ADHD scores above the 85th percentile was found for either sex. Since early language development is a predictor of future reading skills and educational success, more epidemiological studies assessing BPA exposure and language skills are needed to confirm our findings.

Sex differences in post-stroke aphasia rates are caused by age. A meta-analysis and database query

BACKGROUND

Studies have suggested that aphasia rates are different in men and women following stroke. One hypothesis says that men have more lateralized language function than women. Given unilateral stroke, this would lead to a prediction of men having higher aphasia rates than women. Another line of observations suggest that women are more severely affected by stroke, which could lead to a higher aphasia rate among women. An additional potential confounding variable could be age, given that women are typically older at the time of stroke.

METHODS & PROCEDURES

This study consists of two parts. First, a meta-analysis of the available reports of aphasia rates in the two sexes was conducted. A comprehensive literature search yielded 25 studies with sufficient information about both aphasia and gender. These studies included a total of 48,362 stroke patients for which aphasia rates were calculated. Second, data were extracted from an American health database (with 1,967,038 stroke patients), in order to include age and stroke severity into a regression analysis of sex differences in aphasia rates.

OUTCOMES & RESULTS

Both analyses revealed significantly larger aphasia rates in women than in men (1.1-1.14 ratio). This speaks against the idea that men should be more lateralized in their language function. When age and stroke severity were included as covariates, sex failed to explain any aphasia rate sex difference above and beyond that which is explained by age differences at time of stroke.

Self-reported parental vocabulary input frequency for young children

Vocabulary input frequency influences age of acquisition, and is also an essential control for investigating the influence of other factors. We propose a new method of frequency estimation, self-report. 918 Danish-speaking parents of 12-36-month-old children estimated their frequency of use of 725 words. Self-report was substantially correlated with both language sample based frequencies (0.67) and frequencies of a large written corpus of Danish (0.58). Correlations within vocabulary categories between frequency and age of acquisition, restricted to words occurring in the language samples, were comparable for the two estimates. Overall, self-report based frequency estimates appear to have a promising degree of validity, which reflects their greatest strength, independence of the situation.

From melody to words: The role of sex hormones in early language development

Contribution to Special Issue on Fast effects of steroids. Human infants are the most proficient of the few vocal learner species. Sharing similar principles in terms of the generation and modification of complex sounds, cross-vocal learner comparisons are a suitable strategy when it comes to better understanding the evolution and mechanisms of auditory-vocal learning in human infants. This approach will also help us to understand sex differences in relation to vocal development towards language, the underlying brain mechanisms thereof and sex-specific hormonal effects. Although we are still far from being capable of discovering the "fast effects of steroids" in human infants, we have identified that peripheral hormones (blood serum) are important regulators of vocal behaviour towards language during a transitory hormone surge ("mini-puberty") that is comparable in its extent to puberty. This new area of research in human infants provides a promising opportunity to not only better understand early language acquisition from an ontogenetic and phylogenetic perspective, but to also identify reliable clinical risk-markers in infants for the development of later language disorders.

An educator-administered measure of language development in young children

An increasing number of infants and toddlers in many countries are enrolled in early childhood education (ECE) programs, and educators thus play a central role in stimulating language development in these young children. A valid, brief educator-completed measure of language development in young children has important uses both for the identification and monitoring of language development and for the guidance and evaluation of intentional instruction and targeted interventions for children who need it. We present such a measure here for Danish, the CDI: Educator (CDI-Edu) version, which is based on well-developed and validated parent report measures, adapted for the early childhood education setting. It requires approximately 10 min per child on the part of the educator. It includes a 70-item vocabulary checklist, as well as questions concerning the child's use of decontextualized language with respect to objects and actions distant from the here and now. The test has been standardized on a total of 5097 children aged 18-34 months. Test-retest and internal consistency measures demonstrate reliability. Validation is established through correlations with age, maternal education, the Danish One-Word Picture Vocabulary Test, and the Social Emotional Assessment Measure.

Te Reo Māori: indigenous language acquisition in the context of New Zealand English

This study assessed the status of te reo Māori, the indigenous language of New Zealand, in the context of New Zealand English. From a broadly representative sample of 6327 two-year-olds (Growing Up in New Zealand), 6090 mothers (96%) reported their children understood English, and 763 mothers (12%) reported their children understood Māori. Parents completed the new MacArthur-Bates Communicative Development Inventory short forms for te reo Māori (NZM: CDI sf) and New Zealand English (NZE: CDI sf). Mothers with higher education levels had children with larger vocabularies in both te reo Māori and NZ English. For English speakers, vocabulary advantages also existed for girls, first-borns, monolinguals, those living in areas of lower deprivation, and those whose mothers had no concerns about their speech and language. Because more than 99% of Māori speakers were bilingual, te reo Māori acquisition appears to be occurring in the context of the acquisition of New Zealand English.

Prenatal phthalate exposure and language development in toddlers from the Odense Child Cohort

BACKGROUND

Phthalates are a group of chemicals found in a variety of consumer products. They have anti-androgenic properties and human studies have reported associations between prenatal phthalate exposure and neuropsychological development in the offspring despite different cognitive tests, different ages and varying timing of exposure.

OBJECTIVES

To investigate the association between prenatal phthalate exposure and language development in children aged 20-36months.

METHODS

In the Odense Child Cohort, we analyzed 3rd trimester urine samples of 518 pregnant women for content of metabolites of diethyl, di-n-butyl, diisobutyl, butylbenzyl, di(2-ethylhexyl), and diisononyl phthalate, adjusted for osmolality. Language development was addressed using the Danish version of the MacArthur-Bates Communicative Development Inventories "Words and Sentences". Associations were assessed using logistic regression models comparing children below and above the 15th percentile while stratifying by sex and adjusting for maternal age and educational level.

RESULTS

Phthalate metabolites were detectable in all samples although in lower levels than previous studies. Among boys, increased prenatal phthalate exposure was associated with lower scores in language development; odds ratios for vocabulary score below the 15th percentile with doubling in monoethyl phthalate, and summed di-(2-ethylhexyl) phthalate metabolites were respectively 1.24 (95% confidence interval: 1.05,1.46), and 1.33 (1.01,1.75). Similar associations were found for language complexity. No associations were found for girls.

CONCLUSIONS

Our findings are notable, as adverse associations were suggested even in this low-level exposed population, with only one spot urine sample for exposure assessment and control for confounders. Lower scores in early language development are of relevance to health as this test predicts later educational success.

Does sound structure affect word learning? An eye-tracking study of Danish learning toddlers

Previous research has shown that Danish-learning children lag behind in early lexical acquisition compared with children learning a number of other languages. This delay has been ascribed to the opaque phonetic structure of Danish, which appears to have fewer reliable segmentation cues than other closely related languages. In support of this hypothesis, recent work has shown that the phonetic properties of Danish negatively affect online language processing in young Danish children. In this study, we used eye-tracking to investigate whether the challenges associated with processing Danish also affect how Danish-learning children between 24 and 35 months of age establish and learn novel label-object mappings. The children were presented with a series of novel mappings, either ostensively (one novel object presented alone on the screen) or ambiguously (one novel object presented together with a familiar one), through carrier phrases with different phonetic structures (more vs less opaque). Our results showed two main trends. First, Danish-learning children performed poorly on the task of mapping novel labels onto novel objects. Second, when learning did occur, accuracy was affected by the phonetic opacity of the speech stimuli. We suggest that this finding results from the interplay of a perceptually challenging speech input and a slower onset of early vocabulary experience, which in turn may delay the onset of word learning skills in Danish-learning children.

The interrelatedness between infants' communicative gestures and lexicon size: A longitudinal study

Research has shown a close relationship between gestures and language development. In this study, we investigate the cross-lagged relationships between different types of gestures and two lexicon dimensions: number of words produced and comprehended. Information about gestures and lexical development was collected from 48 typically developing infants when these were aged 0;9, 1;0 and 1;3. The European Portuguese version of the MacArthur-Bates Communicative Development Inventory: Words and Gestures (PT CDI:WG) was used. The results indicated that the total number of actions and gestures and the number of early gestures produced at 0;9 and at 1;0 year predicted the number of words comprehended three months later. Actions and gestures' predictive power of the number of words produced was limited to the 0;9-1;0 year interval. The opposite relationship was not found: word comprehension and production did not predict action and gestures three months later. These results highlight the importance of non-verbal communicative behavior in language development.

Baby babbling at five months linked to sex hormone levels in early infancy

Gender-dependent differentiation of the brain at morphological, neurochemical and functional levels of organization have been shown to be primarily controlled by sex differences in gonadal hormone concentrations during pre- and early postnatal development. Indeed, previous studies have reported that pre- and perinatal hormonal environments influence brain development and, consequently, affect sex specific long-term language outcomes. Herein, we investigated whether postnatal surges of estrogen (estradiol) and androgen (testosterone) may predict properties of pre-speech babbling at five months. This study is the first attempt to investigate a possible correlation between sex hormones and infants' articulatory skills during the typical postnatal period of extended hormonal activity known as 'mini-puberty.' A hierarchical, multiple regression approach revealed a significant, robust positive relationship between 4-week concentrations of estradiol and individual articulatory skills. In contrast, testosterone concentrations at five months negatively correlated with articulatory skills at the same age in both boys and girls. Our findings reinforce the assumption of the importance of sex hormones for auditory-vocal development towards language in human infants.

An Item Response Theory-Based, Computerized Adaptive Testing Version of the MacArthur-Bates Communicative Development Inventory: Words & Sentences (CDI:WS)

PURPOSE

This study investigated the feasibility and potential validity of an item response theory (IRT)-based computerized adaptive testing (CAT) version of the MacArthur-Bates Communicative Development Inventory: Words & Sentences (CDI:WS; Fenson et al., 2007) vocabulary checklist, with the objective of reducing length while maintaining measurement precision.

METHOD

Parent-reported vocabulary for the American CDI:WS norming sample consisting of 1,461 children between the ages of 16 and 30 months was used to investigate the fit of the items to the 2-parameter logistic IRT model and to simulate CDI-CAT versions with 400, 200, 100, 50, 25, 10, and 5 items.

RESULTS

All but 14 items fit the 2-parameter logistic IRT model, and real data simulations of CDI-CATs with at least 50 items recovered full CDI scores with correlations over .95. Furthermore, the CDI-CATs with at least 50 items had similar correlations with age and socioeconomic status as the full CDI:WS.

CONCLUSION

These results provide strong evidence that a CAT version of the CDI:WS has the potential to reduce length while maintaining the accuracy and precision of the full instrument.

Fundamental Frequency of Crying in Two-month-old Boys and Girls: Do Sex Hormones During Mini-puberty Mediate Differences?

OBJECTIVE

To evaluate whether the puberty-like sex hormone surge during the first months of life (mini-puberty) affects fundamental frequency (fo) in infant crying as one would derive from hormone influences on voice in adults.

STUDY DESIGN

Populational prospective study.

PARTICIPANTS

Twenty healthy normal-hearing infants (nine boys) were recruited for participation.

METHODS

Spontaneously uttered cries were collected from each infant at 8 weeks of age. The cries were acoustically analyzed for mean fo and fo range. The fo properties were correlated to the average serum levels of bioavailable estradiol (E2) (mean E2/sex hormone-binding globulin [SHBG]) and testosterone (T) (mean T/SHBG) across the second month of life.

RESULTS

Whereas no significant hormone effect was found for mean fo, a significant negative correlation (r = -0.55) was found between fo range and mean E2/SHBG. No indication for a T influence on fo features was found at this age. Although girls showed a slightly higher mean E2 concentration than boys did, the observed differences in cry fo range were judged to be reflective of an infant's serum concentration of E2 rather than a sex-based difference.

CONCLUSION

In the absence of laryngeal size differences between female and male infants, the result was interpreted as indicative of an E2 influence on viscoelastic properties of the vocal folds. In our opinion, the investigation of young infants' vocalizations during the early postnatal surge of sex steroids (mini-puberty) may advance our understanding of the mechanisms mediating average sex differences in vocal development and early communication.

Developmental inventories using illiterate parents as informants: Communicative Development Inventory (CDI) adaptation for two Kenyan languages

Communicative Development Inventories (CDIs, parent-completed language development checklists) are a helpful tool to assess language in children who are unused to interaction with unfamiliar adults. Generally, CDIs are completed in written form, but in developing country settings parents may have insufficient literacy to complete them alone. We designed CDIs to assess language development in children aged 0;8 to 2;4 in two languages used in Coastal communities in Kenya. Measures of vocabulary, gestures, and grammatical constructions were developed using both interviews with parents from varying backgrounds, and vocabulary as well as grammatical constructions from recordings of children's spontaneous speech. The CDIs were then administered in interview format to over 300 families. Reliability and validity ranged from acceptable to excellent, supporting the use of CDIs when direct language testing is impractical, even when children have multiple caregivers and where respondents have low literacy levels.

Androgen modulation of Foxp1 and Foxp2 in the developing rat brain: impact on sex specific vocalization

Sex differences in vocal communication are prevalent in both the animals and humans. The mechanism(s) mediating gender differences in human language are unknown, although, sex hormones, principally androgens, play a central role in the development of vocalizations in a wide variety of animal species. The discovery of FOXP2 has added an additional avenue for exploring the origins of language and animal communication. The FOXP2 gene is a member of the forkhead box P (FOXP) family of transcription factors. Prior to the prenatal androgen surge in male fetuses, we observed no sex difference for Foxp2 protein levels in cultured cells. In contrast, 24 hours after the onset of the androgen surge, we found a sex difference for Foxp2 protein levels in cultured cortical cells with males having higher levels than females. Furthermore, we observed the potent nonaromatizable androgen dihydrotestosterone altered not only Foxp2 mRNA and protein levels but also Foxp1. Androgen effects on both Foxp2 and Foxp1 were found to occur in the striatum, cerebellar vermis, and cortex. Immunofluorescence microscopy and coimmunoprecipitation demonstrate Foxp2 and the androgen receptor protein interact. Databases for transcription factor binding sites predict a consensus binding motif for androgen receptor on the Foxp2 promoter regions. We also observed a sex difference in rat pup vocalization with males vocalizing more than females and treatment of females with dihydrotestosterone eliminated the sex difference. We propose that androgens might be an upstream regulator of both Foxp2 and Foxp1 expression and signaling. This has important implications for language and communication as well as neuropsychiatric developmental disorders involving impairments in communication.

Early Lexical Characteristics of Toddlers with Cleft Lip and Palate

Objective

To examine development of early expressive lexicons in toddlers with cleft palate to determine whether they differ from those of noncleft toddlers in terms of size and lexical selectivity.

Design

Retrospective.

Patients

A total of 37 toddlers with cleft palate and 22 noncleft toddlers.

Main Outcome Measures

The groups were compared for size of expressive lexicon reported on the MacArthur Communicative Development Inventory and the percentage of words beginning with obstruents and sonorants produced in a language sample. Differences between groups in the percentage of word initial consonants correct on the language sample were also examined.

Results

Although expressive vocabulary was comparable at 13 months of age for both groups, size of the lexicon for the cleft group was significantly smaller than that for the noncleft group at 21 and 27 months of age. Toddlers with cleft palate produced significantly more words beginning with sonorants and fewer words beginning with obstruents in their spontaneous speech samples. They were also less accurate when producing word initial obstruents compared with the noncleft group.

Conclusions

Toddlers with cleft palate demonstrate a slower rate of lexical development compared with their noncleft peers. The preference that toddlers with cleft palate demonstrate for words beginning with sonorants could suggest they are selecting words that begin with consonants that are easier for them to produce. An alternative explanation might be that because these children are less accurate in the production of obstruent consonants, listeners may not always identify obstruents when they occur.

Deep phenotyping of the unselected COPSAC2010 birth cohort study

Background

We hypothesize that perinatal exposures, in particular the human microbiome and maternal nutrition during pregnancy, interact with the genetic predisposition to cause an abnormal immune modulation in early life towards a trajectory to chronic inflammatory diseases such as asthma and others.

Objective

The aim of this study is to explore these interactions by conducting a longitudinal study in an unselected cohort of pregnant women and their offspring with emphasis on deep clinical phenotyping, exposure assessment, and biobanking. Exposure assessments focus on the human microbiome. Nutritional intervention during pregnancy in randomized controlled trials are included in the study to prevent disease and to be able to establish causal relationships.

Methods

Pregnant women from eastern Denmark were invited during 2008–2010 to a novel unselected ‘COPSAC₂₀₁₀’ cohort. The women visited the clinic during pregnancy weeks 24 and 36. Their children were followed at the clinic with deep phenotyping and collection of biological samples at nine regular visits until the age of 3 and at acute symptoms. Randomized controlled trials of high‐dose vitamin D and fish oil supplements were conducted during pregnancy, and a trial of azithromycin for acute lung symptoms was conducted in the children with recurrent wheeze.

Results

Seven hundred and thirty‐eight mothers were recruited from week 24 of gestation, and 700 of their children were included in the birth cohort. The cohort has an over‐representation of atopic parents. The participant satisfaction was high and the adherence equally high with 685 children (98%) attending the 1 year clinic visit and 667 children (95%) attending the 2 year clinic visit.

Conclusions

The COPSAC₂₀₁₀ birth cohort study provides longitudinal clinical follow‐up with highly specific end‐points, exposure assessments, and biobanking. The cohort has a high adherence rate promising strong data to elucidate the interaction between genomics and the exposome in perinatal life leading to lifestyle‐related chronic inflammatory disorders such as asthma.

Docosahexaenoic acid status at 9 months is inversely associated with communicative skills in 3-year-old girls

The objective of the present observational study was to investigate if the docosahexaenoic acid (DHA) status assessed in infant erythrocytes (RBC) at 9 months was associated with the age when the infants reach developmental milestones and their psychomotor function at 3 years of age. Three hundred eleven healthy Danish children were followed from 9 months to 3 years of age (the SKOT cohort). RBC fatty acid composition was analysed by gas chromatography in 272 of the children. Milestone age was collected by questionnaires at 9 and 18 months and psychomotor development at 3 years of age was assessed by the parents using third edition of the Ages and Stages Questionnaire (ASQ-3). RBC DHA levels ranged from 2.2% to 12.6% of the RBC fatty acids. The age of reaching milestones correlated with psychomotor development, particularly with gross motor function at 3 years. An association between milestones and later personal and social skills was also observed, but only for girls. In girls, RBC-DHA was found to be inversely correlated with communication at 3 years of age (odds ratio = 0.69, 95% confidence interval: 0.56-0.86, P = 0.001), but no other associations with psychomotor development or milestones were found. The results from study indicate that DHA status at 9 months may not have a pronounced beneficial effect on psychomotor development in early childhood and that communicative skills at 3 years of age may even be inversely associated with early RBC-DHA levels in girls.

Children's computation of complex linguistic forms: a study of frequency and imageability effects

This study investigates the storage vs. composition of inflected forms in typically-developing children. Children aged 8–12 were tested on the production of regular and irregular past-tense forms. Storage (vs. composition) was examined by probing for past-tense frequency effects and imageability effects – both of which are diagnostic tests for storage – while controlling for a number of confounding factors. We also examined sex as a factor. Irregular inflected forms, which must depend on stored representations, always showed evidence of storage (frequency and/or imageability effects), not only across all children, but also separately in both sexes. In contrast, for regular forms, which could be either stored or composed, only girls showed evidence of storage. This pattern is similar to that found in previously-acquired adult data from the same task, with the notable exception that development affects which factors influence the storage of regulars in females: imageability plays a larger role in girls, and frequency in women. Overall, the results suggest that irregular inflected forms are always stored (in children and adults, and in both sexes), whereas regulars can be either composed or stored, with their storage a function of various item- and subject-level factors.

Lexical Selectivity in Danish Toddlers with Cleft Palate

Objective

To study if Danish children with cleft palate display lexical selectivity in their early lexicon at 18 months of age.

Design

A cross-sectional study.

Participants

Thirty-four children with unilateral cleft lip and palate and 35 children without cleft palate, matched for gender and age.

Methods

All participants were video recorded at 18 months of age during play interaction with a parent. The video recordings were transcribed according to the International Phonetic Alphabet and an individual consonant inventory was established for each participant. The video recordings were also analyzed with respect to word productions, establishing an observed productive vocabulary size for each participant.

Results

At 18 months of age Danish children with cleft palate showed marked lexical selectivity in their early words. The distribution of consonant classes observed at 11 months of age in a previous study of the children with cleft palate was almost perfectly reflected in their early lexicon at 18 months. The early lexicon of children with cleft palate differed from the early lexicon of their noncleft peers.

Conclusions and Implications

Danish toddlers with cleft palate display lexical selectivity in the early lexicon as it has been described for English-speaking toddlers with and without cleft palate, even though some qualitative differences were found.

The use of the Internet in collecting CDI data--an example from Norway

This article presents the methodology used in a population-based study of early communicative development in Norwegian children using an adaptation of the MacArthur-Bates communicative development inventories (CDI), comprising approximately 6500 children aged between 0.8 and 3.0. To our knowledge, this is the first CDI study collecting data via the Internet. After a short description of the procedures used in adapting the CDI to Norwegian and the selection of participants, we discuss the advantages and potential pitfalls of using web-based forms as a method of data collection. We found that use of web-based forms was far less time-consuming, and therefore also far less expensive than the traditional paper-based forms. The risk of coding errors was virtually eliminated with this method. We conclude that in a society with high access to the Internet, this is a method well worth pursuing.

Foxp2 mediates sex differences in ultrasonic vocalization by rat pups and directs order of maternal retrieval

The FOXP2 gene is central to acquisition of speech and language in humans and vocal production in birds and mammals. Rodents communicate via ultrasonic vocalizations (USVs) and newborn pups emit distress USVs when separated from their dam, thereby facilitating their retrieval. We observed that isolated male rat pups emitted substantially more USV calls and these were characterized by a significantly lower frequency and amplitude compared with female rat pups. Moreover, the dam was more likely to first retrieve male pups back to the nest, then females. The amount of Foxp2 protein was significantly higher in multiple regions of the developing male brain compared with females and a reduction of brain Foxp2 by siRNA eliminated the sex differences in USVs and altered the order of pup retrieval. Our results implicate Foxp2 as a component of the neurobiological basis of sex differences in vocal communication in mammals. We extended these observations to humans, a species reported to have gender differences in language acquisition, and found the amount of FOXP2 protein in the left hemisphere cortex of 4-year-old boys was significantly lower than in age-matched girls.