Precursors to language development in typically and atypically developing infants and toddlers: the importance of embracing complexity

The Feasibility of an Online Language Program Delivered Through Music and the Impact of Dosage on Vocabulary Outcomes in Young Children With Down Syndrome

BACKGROUND

Few studies have explored the feasibility of online language interventions for young children with Down syndrome. Additionally, none have manipulated dose frequency or reported on the use of music as a medium through which language and sign can be learned.

PURPOSE

The purpose of this study was to (a) examine the feasibility and acceptability of an online language through music intervention for young children (1-3;6 years) with Down syndrome and (b) compare effectiveness at two intervention dose frequencies.

METHOD

The study was carried out in two phases using a mixed-methods design. Phase 1: Qualitative data were gathered from parents to examine feasibility when implementing a video-based language intervention. Phase 2: Seventy-six families participated in an online language intervention at home. Effectiveness was examined comparing two groups, randomly assigned to a high and low dose frequency. The Down Syndrome Education (DSE) checklists (combined) were the primary outcome measure. Process data were gathered to determine intervention acceptability in practice and to identify factors that would improve successful future implementation. Acceptability data were analyzed with reference to the theoretical framework of acceptability (Version 2).

RESULTS

Forty-three parents completed the Phase 1 scoping questionnaire, five of whom took part in focus groups. Once weekly morning sessions were indicated as the preferred scheduling choice. Phase 2 quantitative data were analyzed using beta regression adjusted for baseline scores and indicated no additional benefit to receiving the higher dose. However, exploratory interaction models suggested that the efficacy of the high-dose intervention was higher (than low-dose intervention) in participants with higher baseline DSE performance. Parents perceived the intervention to be effective and positive for the family.

CONCLUSION

The results add to our knowledge of real-world effective online interventions and suggest that a critical minimum language level is required for children with Down syndrome to benefit optimally from a higher intervention dose frequency.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25979704.

Stop trying to carve Nature at its joints! The importance of a process-based developmental science for understanding neurodiversity

Nature is dynamic and interdependent. Yet we typically study and understand it as a hierarchy of independent static things (objects, factors, capacities, traits, attributes) with well-defined boundaries. Hence, since Plato, the dominant research practice has been to 'carve Nature at its joints' (Phaedrus 265e), rooted in the view that the world comes to us pre-divided - into static forms or essences - and that the goal of science is to simply discover (identify and classify) them. This things-based approach dominates developmental science, and especially the study of neurodevelopmental conditions. The goal of this paper is to amplify the marginalised process-based approach: that Nature has no joints. It is a hierarchy of interacting processes from which emerging functions (with fuzzy boundaries) softly assemble, become actively maintained, and dissipate over various timescales. We further argue (with a specific focus on children with Down syndrome) that the prevailing focus on identifying, isolating, and analysing things rather than understanding dynamic interdependent processes is obstructing progress in developmental science and particularly our understanding of neurodiversity. We explain how re-examining the very foundation of traditional Western thought is necessary to progress our research on neurodiversity, and we provide specific recommendations on how to steer developmental science towards the process-based approach.

Neurodevelopmental Outcomes following Preterm Birth and the Association with Postmenstrual Age at Discharge

OBJECTIVE

This study aimed to (1) define the prevalence of motor, cognitive, and language delays in preterm infants born <32 weeks estimated gestational age (EGA); and (2) identify the relationship between the timing of discharge from the neonatal intensive care unit (NICU) and neurodevelopmental outcome in early childhood.

STUDY DESIGN

This retrospective study of 172 preterm infants born <32 weeks EGA and hospitalized in a level-IV NICU captured medical factors, including timing of discharge, from the NICU stay. Standardized developmental testing at 1 to 2 years corrected age was conducted in the newborn follow-up clinic.

RESULTS

At 1 to 2 years corrected age, the sample had an average Bayley Scales of Infant and Toddler Development (Bayley-III) cognitive composite score of 91.5 ± 17.4, language composite score of 84.5 ± 17.3, and motor composite score of 88.9 ± 18.4. Lower EGA at birth, necrotizing enterocolitis, patent ductus arteriosus, and oxygen requirement for >28 days were independently associated with higher postmenstrual age (PMA) at NICU discharge. Higher PMA at discharge was associated with poorer cognitive outcome [p < 0.001, β = -1.1 (-1.6, -0.7)], poorer language outcome [p = 0.049, β = -0.5 (-0.9, -0.003)], and poorer motor outcome [p <0.001, β = -1.0 (-1.5, -0.5)]. For every additional week of hospitalization, scores were an average of 1.1 points lower in cognitive, 1.0 point lower in motor, and 0.5 points lower in language domains of the Bayley-III assessment.

CONCLUSION

Poorer cognitive, language, and motor outcomes were associated with longer hospitalization, even after controlling for medical risk factors known to be associated with poorer outcome. This provides further evidence for the potential role of the environment in impacting developmental outcomes of infants hospitalized in the NICU.

KEY POINTS

· There are high rates of developmental impairment among preterm infants born <32 weeks at 1 year to 2 years.. · The longer the infant is exposed to the NICU environment, the higher the risk of neurodevelopmental challenges.. · These findings provide increased motivation for optimizing the early NICU environment..

The development of a parent report instrument of early communication and language skills of infants and toddlers in mainland China

OBJECTIVE

This study was designed to produce a new parent-report measure, the Diagnostic Receptive Expressive Assessment of Mandarin-Infant Toddler Assessment of Communication and Language (DREAM-IT) in order to provide norms for the developmental skills of children aged 0-36 months in four areas: expressive language, receptive language, cognitive play and social skills.

METHODOLOGY

The scale was designed to be both broader and deeper than existing instruments that neglect one or more of these significant domains involved in early language. Items were chosen by a group of specialists with clinical experience working with the age group and with attention to the developmental literature. Caregivers were tested individually by a trained person who asked the questions and provided examples. In addition to an extensive health questionnaire, caregivers answered questions in Mandarin about their child's behaviour using a scale of 'not yet', 'sometimes' or 'always' or listing out words and/or sounds understood or said by the child. The 476 participating caregivers were recruited at maternal and child healthcare clinics centred in Chengdu, China, 191 of whom were tested a second time seven months later. The children were sampled in three-month age-bands from 0 to 36 months. The sample was balanced for child gender by age band, and parental education was balanced. Caregivers of 0-24-month-old children and caregivers of 12-36 months were each asked a different set of questions, to determine the appropriate age range and cutoff points for each question, requiring the sample size to be doubled for children aged 12-24 months.

RESULTS

The results were subject to item-response theory analysis to remove outlying items, and the resulting internal reliability was high for each domain (average Cronbach's alpha=0.87). The final instrument (between 67 and 113 questions in total) was refined to include the least redundant questions that had the highest intercorrelations, with attention paid to coverage of all domains across the age range. Two scales were developed: one for children 0-18 months, the second for children aged 18-36 months. The longitudinal design permitted the creation of growth curves and norms for each domain for six-month intervals from 0 to 36 months. A small sample of 32 parents of children with Down syndrome aged 18-36 months provided validation that the scales are highly sensitive to developmental delay.

CONCLUSION

The instrument shows considerable promise for detecting early communication problems in children in China.

WHAT THIS PAPER ADDS

What is already known on the subject In China, efforts were made in recent years to develop language assessments for infants and toddlers, but limitations existed with the domains included and number of items included per age group. Many clinical practitioners also continued to rely on language subtests of general developmental scales, which were limited in depth and breadth of language skills tested and were never intended for diagnosis of language delay. What this paper adds to existing knowledge This paper discusses the development of a valid caregiver report instrument for early communication and language skills of infants and toddlers in mainland China. The Diagnostic Receptive Expressive Assessment of Mandarin-Infant Toddler (DREAM-IT) includes foundational domains necessary for language and communication development in young children (receptive language, expressive language, cognitive play and social communication domains). The results show strong internal reliability (Cronbach's alpha) for each domain on a sample of 716 children sampled in three-month age bands from 0 to 36 months. The external validity proved strong when tested on a group of 32 young children with Down syndrome. What are the potential or actual clinical implications of this work? Besides helping to inform the diagnosis of language delays in infants and toddlers in China, the caregiver report instrument has special features to support clinical practitioners in a field that is just emerging in China. The unique support features include the automatic generation of a profile of relative strengths and weaknesses of the child on the report and the recommendation of child-specific caregiver coaching videos on a companion app.

Reason-Based Recommendations From a Developmental Systems Approach for Students With Needs Across Functional Domains

PURPOSE

This tutorial aims to introduce school-based speech-language pathologists (SLPs) to developmental systems theory as a framework for considering interactions across functional domains, such as language, vision, and motor, for students with complex needs.

METHOD

This tutorial summarizes the current literature on developmental systems theory in its application to working with students who have needs in multiple domains of functioning in addition to communication. A hypothetical case of a student, James, with cerebral palsy, cortical visual impairment, and complex communication needs, is presented to illustrate the primary tenets of the theory.

RESULTS

Specific reason-based recommendations are presented that SLPs can put to practice with their own caseload in direct response to the three tenets of developmental systems theory.

CONCLUSIONS

A developmental systems approach will be useful in expanding SLP knowledge of where to begin and how to best serve children with language, motor, vision, and other concomitant needs. The tenets, including sampling, context dependency, and interdependency, and the application of developmental systems theory can be instrumental in providing a way forward for SLPs struggling with the assessment and intervention of students with complex needs.

Using the Social Skills Improvement System (SSiS) Rating Scales to assess social skills in youth with Down syndrome

Introduction and Methods

This study provides preliminary data on the Social Skills Improvement System (SSiS) Rating Scales Parent Form to measure social skills in a sample of 124 children and adolescents with Down syndrome (DS) ages 6–17 years.

Results

Overall, participants demonstrated relatively mild symptoms, with the sample’s average standard score falling within 1 standard deviation from the mean of the normative sample for the social skills (M = 92, SD = 15) and problem behaviors (M = 104, SD = 12) domains (normative sample M = 100, SD = 15 for both domains). However, a wide range of scores was observed across the sample for the composite and subscale scores. Differential patterns were also observed by subscale. For some subscales (i.e., Cooperation, Assertion, Responsibility, Engagement, Externalizing, Hyperactivity/Inattention, and Autism Spectrum), a disproportionate number of participants scored in the below average (i.e., lower levels of social skills) or above average (i.e., more symptomatic in problem behaviors or autism spectrum) range relative to the normative sample; for other subscales (i.e., Communication, Empathy, Self-Control, Bullying, and Internalizing), participants’ score distribution aligned more closely to that of the normative sample. SSiS composite scores correlated in the expected directions with standardized measures of autism characteristics, executive function, and expressive language.

Discussion

This study provides some of the first evidence validating the use of the SSiS in youth with DS, filling a gap in standardized measures of social functioning in this population.

A Prospective Evaluation of Infant Cerebellar-Cerebral Functional Connectivity in Relation to Behavioral Development in Autism Spectrum Disorder

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder diagnosed based on social impairment, restricted interests, and repetitive behaviors. Contemporary theories posit that cerebellar pathology contributes causally to ASD by disrupting error-based learning (EBL) during infancy. The present study represents the first test of this theory in a prospective infant sample, with potential implications for ASD detection.

Methods

Data from the Infant Brain Imaging Study (n = 94, 68 male) were used to examine 6-month cerebellar functional connectivity magnetic resonance imaging in relation to later (12/24-month) ASD-associated behaviors and outcomes. Hypothesis-driven univariate analyses and machine learning-based predictive tests examined cerebellar-frontoparietal network (FPN; subserves error signaling in support of EBL) and cerebellar-default mode network (DMN; broadly implicated in ASD) connections. Cerebellar-FPN functional connectivity was used as a proxy for EBL, and cerebellar-DMN functional connectivity provided a comparative foil. Data-driven functional connectivity magnetic resonance imaging enrichment examined brain-wide behavioral associations, with post hoc tests of cerebellar connections.

Results

Cerebellar-FPN and cerebellar-DMN connections did not demonstrate associations with ASD. Functional connectivity magnetic resonance imaging enrichment identified 6-month correlates of later ASD-associated behaviors in networks of a priori interest (FPN, DMN), as well as in cingulo-opercular (also implicated in error signaling) and medial visual networks. Post hoc tests did not suggest a role for cerebellar connections.

Conclusions

We failed to identify cerebellar functional connectivity-based contributions to ASD. However, we observed prospective correlates of ASD-associated behaviors in networks that support EBL. Future studies may replicate and extend network-level positive results, and tests of the cerebellum may investigate brain-behavior associations at different developmental stages and/or using different neuroimaging modalities.

ON Time Mobility: Advocating for Mobility Equity

Mobility is a human right. The traditional definition of mobility in physical therapy practice is centered on translocation and, while accurate, is not comprehensive. In this article, we propose the ON Time Mobility framework: that all children have the right to be mobile throughout their development to explore, engage in relationships, and develop agency to cocreate their lives. This perspective highlights interconnected principles of timing, urgency, multimodal, frequency, and sociability to begin discussions on supporting the right to hours of active mobility each day for all children. We propose critical evaluation and discussion of these principles followed by a call to action to shift our conceptualization and enactment of mobility. This mobility rights perspective challenges current medical systems, industry, and government to collaborate with children with disabilities, their families and communities to support mobility as a source of physical and social interactions that define and develop individuals (see Supplemental Digital Content 1, the Video Abstract, available at: http://links.lww.com/PPT/A398 ).

Visual Implicit Learning Abilities in Infants at Familial Risk for Language and Learning Impairments

The ability of infants to track transitional probabilities (Statistical Learning—SL) and to extract and generalize high-order rules (Rule Learning—RL) from sequences of items have been proposed as being pivotal for the acquisition of language and reading skills. Although there is ample evidence of specific associations between SL and RL abilities and, respectively, vocabulary and grammar skills, research exploring SL and RL as early markers of language and learning (dis)abilities is still scarce. Here we investigated the efficiency of visual SL and RL skills in typically developing (TD) seven-month-old infants and in seven-month-old infants at high risk (HR) for language learning impairment. Infants were tested in two visual-habituation tasks aimed to measure their ability to extract transitional probabilities (SL task) or high-order, repetition-based rules (RL task) from sequences of visual shapes. Post-habituation looking time preferences revealed that both TD and HR infants succeeded in learning the statistical structure (SL task), while only TD infants, but not HR infants, were able to learn and generalize the high-order rule (RL task). These findings suggest that SL and RL may contribute differently to the emergence of language learning impairment and support the hypothesis that a mechanism linked to the extraction of grammar structures may contribute to the disorder.

Promoting Language Skills in Children With Neuromotor and Intellectual Disorders: Telepractice at the Time of SARS-CoV-2

Purpose The aim of this pilot study is to gather preliminary results on the effectiveness of intensive, parent-oriented, telepractice-based intervention to improve language skills in preschool children with neuromotor and intellectual disorders. Method Nine preschool children (M = 63 months, SD = 8.7 months) underwent a telepractice program 4 times a week designed to promote speech, lexical, and syntactic skills. Families were remotely connected from home with the therapists, who controlled the rehabilitation procedures from the hospital. The number of stable phonemes, of understood and repeated words, and of understood and repeated sentences were evaluated as outcome measures 3 months (prebaseline) and 1 week (baseline) before the intervention, immediately after the intervention (T1) and at a 3-month follow-up (T2). Results An increase in the number of stable phonemes was detected after the treatment, even if it was not statistically significant. After the intervention program, there was a significant increase in the number of understood words (ratio T1 vs. baseline: 1.33; 95% CI [1.03, 1.71]) and repeated words (ratio T1 vs. baseline: 1.39; 95% CI [1.00, 1.92]), as well as of understood sentences (ratio T1 vs. baseline: 1.80; 95% CI [1.24, 2.35]) and repeated sentences (ratio T1 vs. baseline: 4.23; 95% CI [1.96, 9.12]). No significant differences were found when comparing all the outcome measures at prebaseline and at baseline. Conclusion An intensive, parent-oriented, telepractice-based intervention has the potential to increase scores of lexical and syntactic tasks in children with neuromotor and intellectual disorders.

Toward a Precision Science of Word Learning: Understanding Individual Vocabulary Pathways

Toddlers vary widely in the rate at which they develop vocabulary. This variation predicts later language development and school success at the group level; however, we cannot determine which children with slower vocabulary development in the second year will continue to have difficulty. In this article, I argue that this is because we lack theoretical understanding of how multiple processes operate as a system to create individual children's pathways to word learning. I discuss the difficulties children face when learning even a single concrete noun, the multiple general cognitive processes that support word learning, and some evidence of rapid development in the second year. I present work toward a formal model of the word learning system and how this system changes over time. The long-term goal of this work is to understand how individual children's strengths and weaknesses create unique vocabulary pathways that enable us to predict outcomes and identify effective interventions.

Expanding Echo: Coordinated Head Articulations as Nonmanual Enhancements in Sign Language Phonology

Echo phonology was originally proposed to account for obligatory coordination of manual and mouth articulations observed in several sign languages. However, previous research into the phenomenon lacks clear criteria for which components of movement can or must be copied when the articulators are so different. Nor is there discussion of which nonmanual articulators can echo manual movement. Given the prosodic properties of echoes (coordination of onset/offset and of dynamics such as speed) as well as general motoric coordination of various articulators in the human body, we expect that the mouth is not the only nonmanual articulator involved in echo phonology. In this study, we look at a fixed set of lexical items across 36 sign languages and establish that the head can echo manual movement with respect to timing and to the axis/axes of manual movement. We propose that what matters in echo phonology is the visual percept of temporally coordinated movement that repeats a salient movement property in such a way as to give the visual impression of a copy. Our findings suggest that echoes are not obligatory motor couplings of two or more articulators but may enhance phonological distinctions that are otherwise difficult to see.

Selective Auditory Attention Associated With Language Skills but Not With Executive Functions in Swedish Preschoolers

Associations between language and executive functions (EFs) are well-established but previous work has often focused more on EFs than on language. To further clarify the language-EF relationship, we assessed several aspects of language and EFs in 431 Swedish children aged 4-6, including selective auditory attention which was measured in an event-related potential paradigm. We also investigated potential associations to age, socioeconomic status (SES), bi-/multilingualism, sex and aspects of preschool attendance and quality. Language and EFs correlated weakly to moderately, indicating that relying on measures of vocabulary alone may overestimate the strength of the language-EF relationship. Contrary to predictions, we found no correlations between selective attention and EFs. There were however correlations between morphosyntactic accuracy and selective auditory attention which is in line with previous work and suggests a specific link between morphosyntax and the ability to suppress irrelevant stimuli. In Sweden, socioeconomic differences are rather small and preschool is universally available, but nevertheless, aspects of parental SES predicted children's performance on all measures. Bi-/multilingual children performed lower on language also when controlling for SES, highlighting the need for interventions to reduce inequalities in educational outcomes already in preschool. A female advantage was found for both language and EFs, whereas preschool attendance and quality were not significantly related to outcome measures. Future work should include longitudinal studies of language and EF development, include children from diverse SES backgrounds and contribute toward a theoretical framework that further clarifies the language-EF relationship.

Early bilingual experience is associated with change detection ability in adults

To adapt to their more varied and unpredictable (language) environments, infants from bilingual homes may gather more information (sample more of their environment) by shifting their visual attention more frequently. However, it is not known whether this early adaptation is age-specific or lasts into adulthood. If the latter, we would expect to observe it in adults who acquired their second language early, not late, in life. Here we show that early bilingual adults are faster at disengaging attention to shift attention, and at noticing changes between visual stimuli, than late bilingual adults. In one experiment, participants were presented with the same two visual stimuli; one changed (almost imperceptibly), the other remained the same. Initially, participants looked at both stimuli equally; eventually, they fixated more on the changing stimulus. This shift in looking occurred in the early but not late bilinguals. It suggests that cognitive processes adapt to early bilingual experiences.

Down syndrome and parental depression: A double hit on early expressive language development

BACKGROUND AND AIMS

Down syndrome (DS) is often characterised by intellectual disability with particular difficulties in expressive language. However, large individual differences exist in expressive language across development in DS. In the general population, one of the factors associated with variability in this domain is parental depression. We investigated whether this is also the case in young children with DS.

METHODS

Thirty-eight children with DS between 8 and 48 months of age participated in this study. Their parents reported on the children's receptive and expressive vocabularies (MacArthur-Bates Communicative Development Inventory) and on parental depression. Furthermore, an experimenter-led standardized developmental assessment (Mullen Scales of Early Learning) was administered to the children to test five domains: gross motor, fine motor, visual reception, receptive language, and expressive language.

RESULTS

A cross-sectional developmental trajectories analysis demonstrated that expressive language developed at a slower rate in children with DS whose parent reported depression than in those whose parent did not. No differences between groups were found in any other domain.

CONCLUSION

Parental depression is associated with slower rate of expressive language development in young children with DS. These findings suggest that DS and parental depression may constitute a double hit leading to increased difficulties in the development of expressive language.

Do Infants With Down Syndrome Show an Early Receptive Language Advantage?

Purpose The study explored longitudinally the course of vocabulary and general language development in a group of infants with Down syndrome (DS) compared to a group of typically developing (TD) infants matched on nonverbal mental ability (NVMA). Method We compared the vocabulary and general language trajectories of the two groups in two ways: (a) at three time points during a 12-month period and (b) at two time points when the groups had made equal progress in NVMA (a period of 6 months for the TD infants vs. 12 months for the infants with DS). Results The TD group had overtaken the DS group on all general language and vocabulary measures by the end of the 12-month period. However, expressive communication and expressive vocabulary were developing at the same rate and level in the two groups when examined over a period in which the two groups were matched in gains in NVMA. Furthermore, the infants with DS showed a receptive language advantage over the TD group; this group's auditory comprehension and receptive vocabulary scores were superior to those of the TD group at both time points when NVMA was accounted for. Conclusion The results shed light on the widely reported discrepancy between expressive and receptive language in individuals with DS. Although infants with DS appear to be developing language skills more slowly than chronological age TD peers, when NVMA is taken into account, infants with DS do not have expressive language delays, and they seem to show a receptive language advantage.

Sleep is atypical across neurodevelopmental disorders in infants and toddlers: A cross-syndrome study

This cross-syndrome study focuses on sleep and its relationship with language development. Children with neurodevelopmental disorders present with language delay. Typical language development is constrained by numerous factors including sleep. Sleep is often disrupted in adolescents/adults with neurodevelopmental disorders. We therefore hypothesised that sleep may be disrupted, and correlate with language development, in infants/toddlers with neurodevelopmental disorders. To test our hypothesis, we obtained sleep and vocabulary size data from 75 infants/toddlers with one of three neurodevelopmental disorders (Down syndrome [DS], fragile X syndrome [FXS], Williams syndrome [WS]). Sleep was indeed disrupted in these children. It was also positively associated with receptive vocabulary size in the infants/toddlers with DS and WS (we could not test the relationship between sleep and language in FXS due to lack of power). We argue that disrupted sleep may be a common occurrence in very young children with neurodevelopmental disorders, and it may relate to their ability to acquire their first language.

Is mere exposure enough? The effects of bilingual environments on infant cognitive development

Bilinguals purportedly outperform monolinguals in non-verbal tasks of cognitive control (the 'bilingual advantage'). The most common explanation is that managing two languages during language production constantly draws upon, and thus strengthens, domain-general inhibitory mechanisms (Green 1998 Biling. Lang. Cogn. 1, 67-81. (doi:10.1017/S1366728998000133)). However, this theory cannot explain why a bilingual advantage has been found in preverbal infants (Kovacs & Mehler 2009 Proc. Natl Acad. Sci. USA 106, 6556-6560. (doi:10.1073/pnas.0811323106)). An alternative explanation is needed. We propose that exposure to more varied, less predictable (language) environments drive infants to sample more by placing less weight on consolidating familiar information in order to orient sooner to (and explore) new stimuli. To confirm the bilingual advantage in infants and test our proposal, we administered four gaze-contingent eye-tracking tasks to seven- to nine-month-old infants who were being raised in either bilingual (n = 51) or monolingual (n = 51) homes. We could not replicate the finding by Kovacs and Mehler that bilingual but not monolingual infants inhibit learned behaviour (experiment 1). However, we found that infants exposed to bilingual environments do indeed explore more than those exposed to monolingual environments, by potentially disengaging attention faster from one stimulus in order to shift attention to another (experiment 3) and by switching attention more frequently between stimuli (experiment 4). These data suggest that experience-driven adaptations may indeed result in infants exposed to bilingual environments switching attention more frequently than infants exposed to a monolingual environment.

Providing Supportive Hospital Environments to Promote the Language Development of Infants and Children Born Prematurely: Insights From Neuroscience

INTRODUCTION

Rapid neural development occurs beginning in utero and extending throughout a child's first years of life, shaped by environmental input, which is essential for language learning. If this development is disrupted by premature birth and/or related repeated hospitalizations, atypical language development may result even in the absence of severe neurologic damage.

METHOD

This narrative review describes typical neurodevelopment associated with language and the atypical neurodevelopment often experienced by children born prematurely that can adversely affect their language development.

RESULTS

We describe evidence-based intervention strategies applicable in the hospital setting that can support the language development of young children who are born prematurely.

DISCUSSION

To promote neurodevelopmental growth that will support language learning, children born prematurely need to engage in supportive interactions with others. Awareness of evidence-based strategies can equip health care staff to provide a supportive hospital environment to promote the language development of children born premature.

Vocalization frequency as a prognostic marker of language development following early cochlear implantation

Despite their potential significance for later linguistic outcomes, early aspects of vocalization had been seriously undervalued in the past, and thus, minimally investigated until relatively recently. The present article sets out to critically examine existing evidence to: i) ascertain whether vocalization frequency (volubility) posits a plausible marker of cochlear implantation success in infancy, and ii) determine the clinical usefulness of post-implementation vocalization frequency data in predicting later language development. Only recent peer-reviewed articles with substantial impact on vocalization growth during the first year of life, examining sound production characteristics of normally hearing (NH) and hearing impaired infants fitted with cochlear implantation (CI) were mentioned. Recorded differences in linguistic performance among NH and CI infants are typically attributed to auditory deprivation. Infants who have undergone late CI, produce fewer syllables (low volubility) and exhibit late-onset babbling, especially those who received their CIs at the age of 12 months or thereafter. Contrarily, early recipients (before the 12-month of age) exhibit higher volubility (more vocalizations), triggered from CI-initiated auditory feedback. In other words, early CI provides infants with early auditory access to speech sounds, leading to advanced forms of babbling and increased post-implementation vocalization frequency. Current findings suggest vocalization frequency as a plausible criterion of the success of early CI. It is argued that vocalization frequency predicts language development and affects habilitation therapy.

Brain lateralization of phonological awareness varies by maternal education

Socioeconomic status (SES) has been shown to influence language skills, with children of lower SES backgrounds performing worse on language assessments compared to their higher SES peers. While there is abundant behavioral research on the effects of SES, whether there are differences in the neural mechanisms used to support language skill is less established. In this study, we examined the relation between maternal education (ME), a component of SES, and neural mechanisms of language. We focused on Kindergarten children, at the beginning of formal reading education, and on a pre-reading skill, phonological awareness-the ability to distinguish or manipulate the sounds of language. We determined ME-related differences in neural activity by examining a skill-matched sample of typically achieving 5-year-old children as they performed a rhyme judgment task. We examined brain lateralization in two language processing regions, the inferior frontal gyrus (IFG) and superior temporal gyrus (STG). In the IFG, lateralization was related to ME but not skill: children with low ME showed bilateral activation compared to children with higher ME who showed leftward lateralization. In the STG, there was a skill by ME interaction on lateralization, such that children with high ME showed a positive relation between rightward lateralization and skill and children with low ME showed a positive relation between leftward lateralization and skill. Thus, we demonstrated ME is related to differences in neural recruitment during language processing, yet this difference in recruitment is not indicative of a deficit in linguistic processing in Kindergarten children.

Research domain criteria from neuroconstructivism: A developmental view on mental disorders

Neuroconstructivism can provide Research Domain Criteria (RDoC) with a developmental framework to understand mental disorders. Neuroconstructivism proposes that mental disorders are the outcome of a developmental trajectory. Based on this assumption, symptoms would reveal the system's adaptation to optimize functioning according to the system's experience of the physical and social contexts. RDoC adopts a translational research approach with the aim of detecting, curing, and preventing mental illness. More specifically this involves to: (a) identify early signs of mental disorders, (b) find the optimal patient-treatment fit, and (c) design efficient interventions to prevent the system's eventual pathological functioning. We propose that meeting RDoC's threefold objective necessarily involves predicting the system's developmental trajectory. Such endeavor requires counting with assessment tools that are sensitive to both the process of development and its different contexts; the measures provided by these tools will allow identifying the risk and protective factors that make the system vulnerable to depart from a typical developmental trajectory. Including vectors relative to time and contexts in a relevant part of the matrix will make of RDoC a truly integrative model, which considers the relationships between behavior and neural circuits throughout the developmental pathway. This article is categorized under: Psychology > Brain Function and Dysfunction Neuroscience > Clinical Neuroscience Neuroscience > Development.

Does early object exploration support gesture and language development in extremely preterm infants and full-term infants?

BACKGROUND

An increasing body of research on typically and atypically developing infants has shown that motor skills play an important role in language development. To date, however, the role of specific object exploration skills for early gesture and vocabulary development has not been investigated in extremely low gestational age infants (ELGA, GA < 28 weeks), who are at greater risk for motor and language delays than full-term (FT) infants.

PURPOSE

This longitudinal study examined relations between 6-month active exploratory behaviors and 12- month word comprehension, gestures and vocal production, controlling for cognitive performance and neonatal condition (ELGA vs FT).

METHODS

Forty infants, 20 ELGA and 20 FT, and their mothers participated in the study. Mother-infant play interaction was video-recorded at 6 and 12 months. Oral and manual object exploration at 6 months and spontaneous gestures and vocal production at 12 months were coded. Word comprehension was evaluated with the Italian version of the MacArthur-Bates CDI parent questionnaire at 12 months. Cognitive performance was examined with the Griffiths Mental Developmental Scales at 6 months and the Bayley-III Scales at 12 months.

RESULTS

Regression analyses showed that after accounting for cognitive performance and neonatal condition, oral exploration was related to word comprehension, and manual exploration to gestures and vocal production in the overall sample.

CONCLUSIONS

Cascading effects of specific object exploration skills on gestures and language comprehension and production in preterm infants and FT infants are discussed. Clinical implications for early assessment of and interventions involving object exploration skills, which may affect language development, are considered for the preterm population.

Early Influence of Musical Abilities and Working Memory on Speech Imitation Abilities: Study with Pre-School Children

Musical aptitude and language talent are highly intertwined when it comes to phonetic language ability. Research on pre-school children’s musical abilities and foreign language abilities are rare but give further insights into the relationship between language and musical aptitude. We tested pre-school children’s abilities to imitate unknown languages, to remember strings of digits, to sing, to discriminate musical statements and their intrinsic (spontaneous) singing behavior (“singing-lovers versus singing nerds”). The findings revealed that having an ear for music is linked to phonetic language abilities. The results of this investigation show that a working memory capacity and phonetic aptitude are linked to high musical perception and production ability already at around the age of 5. This suggests that music and (foreign) language learning capacity may be linked from childhood on. Furthermore, the findings put emphasis on the possibility that early developed abilities may be responsible for individual differences in both linguistic and musical performances.

Developmental trajectories of children with Down syndrome by socio-economic status: the case of Latin America

BACKGROUND

Several studies show that socio-economic status (SES) is related to the developmental trajectories of children with typical development (TD). However, few studies have analysed this relationship regarding children with neurodevelopmental disorders such as Down syndrome (DS). In this paper, we analyse the impact of SES in the neurodevelopmental trajectories of children with DS in comparison with children with TD.

METHOD

Cognitive, language, motor and socio-emotional development were assessed in 31 children with DS between the ages of 15 and 80 months from high to low SES backgrounds. Data from this group were compared with data from a sample of 72 children with TD randomly selected from the Longitudinal Survey of Early Childhood. We analyse and compare these two groups using the developmental trajectories method RESULTS: The results show delayed onsets for the four abilities measured in children with DS compared with children with TD from high to low SES. In the comparison of the developmental trajectories, we found that the differences between the neurodevelopmental trajectories in DS and TD vary according to SES. High SES show differences only in language development, while low SES show significant differences in cognitive, language and socio-emotional development.

CONCLUSIONS

The results indicate that SES is a factor that could impact the developmental trajectories of children with DS. Although the differences between children with DS and with TD are similar at the beginning regardless of SES, the developmental trajectories are slower in children with DS of low SES than in children of high SES. We argue that the differences are related to the complex interaction of several biological and cultural factors associated with SES. Some specific hypotheses about nutrition, health care access, quality of education and parenting practices are presented, but more research in this area is needed to fully understand these results.