Identification of children with language impairment: investigating the classification accuracy of the MacArthur-Bates Communicative Development Inventories, Level III

Screening versions of the European Portuguese MacArthur-Bates Communicative Development Inventories Short Forms: development and preliminary validation

This study aimed to develop and validate the screening versions of the European Portuguese MacArthur-Bates Communicative Development Inventories Short Forms (EP CDI-SFs), intended to guide referrals for comprehensive language assessments in infants and toddlers. The first cohort, aged 8-18 months, included 1,293 typically developing children (M age = 12.23, SD = 3.12, 50.2% male), 170 children at-risk for language impairments (M age = 11.76, SD = 2.81, 45.9% male), and 39 children with Down syndrome (M age = 12.28, SD = 3.40, 56.4% male), assessed using the EP CDI-SF Level I. The second cohort, aged 16-30 months, included 1,155 typically developing children (M age = 23.45, SD = 4.07, 51.2% male), 181 children at-risk for language impairments (M age = 23.23, SD = 4.31, 47% male), and 46 children with Down syndrome (M age = 23.09, SD = 3.93, 69.6% male), assessed with the EP CDI-SF Level II. Through factor analysis, the 20 most psychometrically robust items from each form were identified and used to develop the new screening versions (EP CDI-Scr). Strong correlations between the EP CDI-SFs and EP CDI-Scr results for typically developing children, along with excellent internal consistency, supported the validity and reliability of the new tools. Furthermore, the EP CDI-Scr versions demonstrated excellent sensitivity and moderate specificity. They effectively distinguished between typically developing children, those at-risk for language impairments, and those with Down syndrome, confirming strong discriminant validity. These findings establish the preliminary validity, reliability, and effectiveness of the EP CDI-Scr, supporting timely referrals for comprehensive language evaluations.

Development and norming of the Hungarian CDI-III: A screening tool for language delay

BACKGROUND

Difficulties in language development are related to social and emotional problems, lower academic outcomes, and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. The introduction of systematic screening for language delay (LD) in 3-year-old children in Hungary was based on the recent adaptation of the MacArthur-Bates CDI-III (HCDI-III).

AIMS

To explore the relevant psychometric properties of the HCDI-III; to identify factors characteristic of the families and children influencing language development at the age group under investigation; and to evaluate the adequacy of the tool for the purpose of screening LD in kindergarten at the age of 3 years.

METHODS & PROCEDURES

The norming study of the HCDI-III was conducted in a collaborative research project with the Metropolitan Pedagogical Services in Budapest. HCDI-III parent report forms along with a demographic survey form were distributed to parents of all Hungarian-speaking children between the ages of 2;0 and 4;2 without special education needs. The normative sample comprised data from 1424 children aged 2;0-4;2 with 51.1% boys and 48.9% girls. The data set contained information including language skills, basic demographics, birth conditions, health issues and socio-economic status (SES).

OUTCOMES & RESULTS

In the HCDI-III form, six outcome variables were created to cover the domains of expressive vocabulary, morphosyntax and language use. Statistical analyses revealed appropriate psychometric properties of five outcome variables that showed a normal distribution and were strongly correlated to age. Outcomes of girls were slightly (but significantly) higher on scales corresponding to vocabulary, syntax, language use and productivity. Most variables were highly correlated with one another even with age partialled out. Multiple regression analyses revealed significant effect of age, gender and parental education on all main outcome variables. Neither one of the other eight predictors, including familial and birth-related factors, affected linguistic outcomes in our sample.

CONCLUSIONS & IMPLICATIONS

The results are consistent with the majority of Communicative Development Inventory (CDI) studies, and support the psychometric eligibility of the instrument for screening purposes between 30 and 50 months. As certain regions of Hungary are characterised by a high prevalence of low-SES families, more research is needed to adapt the screening procedure and subsequent measures to their needs.

WHAT THIS PAPER ADDS

What is already known on the subject Difficulties in language development are related to lower social and academic outcomes and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. Structured parent report forms such as the MacArthur-Bates CDI are widely accepted methods for screening children with LD. What this paper adds to existing knowledge This study reports the Hungarian adaptation and norming of the CDI-III form. Statistical analyses revealed appropriate psychometric properties of most of its sections. Language outcomes were affected by age, gender and parental education on all main outcome variables in children between 2 and 4 years of age. What are the potential or actual clinical implications of this work? The results support the psychometric eligibility of the HCDI-III instrument for screening purposes. The introduction of the screening procedure in clinical practice is expected to improve early support of children with language difficulties and reduce risks of developmental problems related to language disorders.

Validity and reliability of the Dutch version of the displaced aggression questionnaire

BACKGROUND

Displaced aggression occurs when a person encounters a provoking situation, is unable or unwilling to retaliate against the original provocateur, and subsequently aggresses against a target that is not the source of the initial provocation. The displaced aggression questionnaire (DAQ) was developed to measure individual differences in the tendency to displace aggression.

AIM

To develop a Dutch version of the DAQ and examine relationships between the DAQ and novel individual differences.

METHODS

The Dutch version of the DAQ was created using a back-translation procedure. Undergraduate students (n = 413) participated in the current study. The questionnaires were administered online.

RESULTS

The results confirmed the original three-factor structure and showed good reliability and validity. We also found differential relationships between trait displaced aggression, social anxiety and cognitive distortions.

CONCLUSION

The results may indicate that distinct patterns exist in the development of the different dimensions of trait displaced aggression. This study adds to the growing cross-cultural literature showing the robustness of trait displaced aggression in several different cultures.

Parenting stress in autism spectrum disorder may account for discrepancies in parent and clinician ratings of child functioning

LAY ABSTRACT

Elevated parenting stress among parents of children with autism spectrum disorder is well-documented; however, there is limited information about differences in parenting stress and potential relationships with parent ratings of child functioning. The aim of this study was to explore profiles of parenting stress among 100 parents of young children with autism spectrum disorder enrolled in two clinical trials and to explore relationships between parenting stress level and parent ratings of child functioning before treatment. Secondary aims examined differential patterns of association between parenting stress profiles and parent versus clinician ratings of child functioning. We show that stress may influence parent ratings of certain child behaviors (e.g. problem behaviors) and not others (e.g. language), yet clinician ratings of these same children do not differ. This new understanding of parenting stress has implications for parent-rated measures, tracking treatment outcome, and the design of clinical trials.

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

This systematic review is one of the three which sought to identify measures commonly implemented in parenting program research, and to assess the level of psychometric evidence available for their use with this age group. This review focuses specifically on measures of child social-emotional and behavioral outcomes. Two separate searches of the same databases were conducted; firstly to identify eligible instruments, and secondly to identify studies reporting on the psychometric properties of the identified measures. Five commercial platforms hosting 19 electronic databases were searched from their inception to conducted search dates. Twenty-four measures were identified from Search 1: a systematic search of randomized controlled trial evaluations of parenting programs. For Search 2, inclusion/exclusion criteria were applied to 21,329 articles that described the development and/or validation of the 24 measures identified in Search 1. Thirty articles met the inclusion criteria. resulting in 11 parent report questionnaires and three developmental assessment measures for review. Data were extracted and synthesized to describe the methodological quality of each article using the COSMIN checklist alongside the overall quality rating of the psychometric property reported for each measure. Measure reliability was categorized into four domains (internal consistency, test-re-test, inter-rater, and intra-rater). Measure validity was categorized into four domains (content, structural, convergent/divergent, and discriminant). Results indicated that supporting evidence for included measures is weak. Further work is required to improve the evidence base for those measures designed to assess children's social-emotional and behavioral development in this age group. PROSPERO Registration number: CRD42016039600.

Perceptual and acoustic evaluation of speech production in Down syndrome: A case series

People with Down syndrome (DS) can experience difficulties with speech production that can impact on speech intelligibility. In previous research, both perceptual and acoustic analysis has shown that people with DS can have difficulties with speech production in the areas of respiration, phonation, articulation, resonance and prosody. However, these studies have investigated various aspects of speech production separately. No study has examined all components of speech production in one single study and considered how these components, if impaired, may impact on speech intelligibility in DS. This paper presents the data of three male speakers with DS and three age- and gender-matched controls as a case series. The participants' speech samples were analysed using a number of perceptual and acoustic parameters, across the major components of speech production - respiration, phonation, articulation, resonance, and prosody. Results showed that different areas of speech production were affected in each participant, to different extents. The main perceptual difficulties included poor voice quality, monopitch, and monoloudness. Acoustic findings showed a higher mean F0, lower harmonics-to-noise ratio and longer voice onset times. These preliminary findings show that people with DS can present with mixed profiles of speech production that can affect speech intelligibility. When assessing speech production in DS, clinicians need to evaluate all components of speech production and consider how they may be impacting intelligibility.

Ratunku! or Just Tunku! Evidence for the Reliability and Concurrent Validity of the Language Use Inventory-Polish

Purpose To date, there is no tool for assessing early pragmatic development of Polish-speaking children. This study aimed to adapt to Polish a standardized parent report measure, the Language Use Inventory (LUI; O'Neill, 2009, in order to enable cross-cultural comparisons and to use the LUI-Polish to screen for pragmatic development in children 18-47 months of age. We concentrated on the sociocultural and functional adaptation of LUI and aimed to demonstrate its reliability, developmental sensitivity, and concurrent validity. Method Parents completed an online version of LUI-Polish, longitudinally at 3 time points (when the child was 20, 32, and 44 months old). In addition, parents completed the Polish adaptations of the Questionnaire for Communication and Early Language at 22 months and the Language Development Survey at 24 months. Children's spontaneous speech was assessed at 24 months, and their expressive and receptive vocabulary was assessed at 36 months. Results All 3 parts of the LUI-Polish (Gestures, Words, and Sentences) showed very good levels of internal consistency at each time point. Significant correlations were observed between all parts of the LUI-Polish at all 3 measurement time points. The expected developmental trajectory was observed for boys and girls providing evidence of its developmental sensitivity for children between the ages of 2 and 4 years: an increase with age in the total score (due to an increase in Words and Sentences) and a decrease in Gestures. Supporting concurrent validity, significant correlations were found between children's performance on (a) the LUI-Polish at 20 months and the Questionnaire for Communication and Early Language at 22 months as well as the Language Development Survey and spontaneous speech measures at 24 months and (b) the LUI-Polish at 32 months and the 2 measures of vocabulary comprehension and production at 36 months. Conclusion The Polish adaptation of the LUI demonstrated good psychometric properties that provide a sound basis for cross-cultural comparisons and further research toward norming of the LUI-Polish. Moreover, the expected developmental trajectory in the pragmatic development of Polish children was observed.

Generalized hostile interpretation bias regarding facial expressions: Characteristic of pathological aggressive behavior

Individuals with aggression regulation disorders tend to attribute hostility to others in socially ambiguous situations. Previous research suggests that this "hostile attribution bias" is a powerful cause of aggression. Facial expressions form important cues in the appreciation of others' intentions. Furthermore, accurate processing of facial expressions is fundamental to normal socialization. However, research on interpretation biases in facial affect is limited. It is asserted that a hostile interpretation bias (HIB) is likely to be displayed by individuals with an antisocial (ASPD) and borderline personality disorder (BPD) and probably also with an intermittent explosive disorder (IED). However, there is little knowledge to what extent this bias is displayed by each of these patient groups. The present study investigated whether a HIB regarding emotional facial expressions was displayed by forensic psychiatric outpatients (FPOs) and whether it was associated with ASPD and BPD in general or, more specifically, with a disposition to react with pathological aggression. Participants of five different groups were recruited: FPOs with ASPD, BPD, or IED, non-forensic patients with BPD (nFPOs-BPD), and healthy, non-aggressive controls (HCs). Results suggest that solely FPOs with ASPD, BPD, or IED exhibit a HIB regarding emotional facial expressions. Moreover, this bias was associated with type and severity of aggression, trait aggression, and cognitive distortions. The results suggest that a HIB regarding facial expressions is an important characteristic of pathological aggressive behavior. Interventions that modify the HIB might help to reduce the recurrence of aggression. Aggr. Behav. 43:386-397, 2017. © 2017 Wiley Periodicals, Inc.

Late Talkers: A Population-Based Study of Risk Factors and School Readiness Consequences

PURPOSE

This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in children's school readiness at 60 months.

METHOD

We analyzed data from the Early Childhood Longitudinal Study, a population-based sample of 9,600 children. Data were gathered when the children were 9, 24, 48, and 60 months old.

RESULTS

The risk of being a late talker at 24 months was significantly associated with being a boy, lower socioeconomic status, being a nonsingleton, older maternal age at birth, moderately low birth weight, lower quality parenting, receipt of day care for less than 10 hr/week, and attention problems. Being a late talker increased children's risk of having low vocabulary at 48 months and low school readiness at 60 months. Family socioeconomic status had the largest and most profound effect on children's school readiness.

CONCLUSIONS

Limited vocabulary knowledge at 24 and 48 months is uniquely predictive of later school readiness. Young children with low vocabularies require additional supports prior to school entry.

Who Receives Speech/Language Services by 5 Years of Age in the United States?

PURPOSE

We sought to identify factors predictive of or associated with receipt of speech/language services during early childhood. We did so by analyzing data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B; Andreassen & Fletcher, 2005), a nationally representative data set maintained by the U.S. Department of Education. We addressed two research questions of particular importance to speech-language pathology practice and policy. First, do early vocabulary delays increase children's likelihood of receiving speech/language services? Second, are minority children systematically less likely to receive these services than otherwise similar White children?

METHOD

Multivariate logistic regression analyses were performed for a population-based sample of 9,600 children and families participating in the ECLS-B.

RESULTS

Expressive vocabulary delays by 24 months of age were strongly associated with and predictive of children's receipt of speech/language services at 24, 48, and 60 months of age (adjusted odds ratio range = 4.32-16.60). Black children were less likely to receive speech/language services than otherwise similar White children at 24, 48, and 60 months of age (adjusted odds ratio range = 0.42-0.55). Lower socioeconomic status children and those whose parental primary language was other than English were also less likely to receive services. Being born with very low birth weight also significantly increased children's receipt of services at 24, 48, and 60 months of age.

CONCLUSION

Expressive vocabulary delays at 24 months of age increase children's risk for later speech/language services. Increased use of culturally and linguistically sensitive practices may help racial/ethnic minority children access needed services.

Who Is At Risk for Persistent Mathematics Difficulties in the United States?

We analyzed two nationally representative, longitudinal data sets of U.S. children to identify risk factors for persistent mathematics difficulties (PMD). Results indicated that children from low socioeconomic households are at elevated risk of PMD at 48 and 60 months of age, as are children with cognitive delays, identified developmental delays or disabilities, and vocabulary difficulties. In contrast, children attending preschool either in Head Start or non-Head Start classrooms are at initially lower risk of PMD. Kindergarten-aged children experiencing either low socioeconomic status or mathematics difficulties are at greatest risk for PMD across third, fifth, and eighth grades. Also at risk for PMD between third and eighth grades are children displaying reading difficulties or inattention and other learning-related behaviors problems, children with identified disabilities, and those who are retained. Educationally relevant and potentially malleable factors for decreasing young children's risk for PMD may include increasing children's access to preschool, decreasing their risk of experiencing vocabulary or reading difficulties, and avoiding use of grade retention.

The Swedish Communicative Development Inventory III: Parent reports on language in preschool children

A revised form of MacArthur-Bates Communicative Development Inventory III (SCDI-III) was presented designed for Swedish speaking children aged 2 years 6 months–4 years 0 months with the objective to give a proxy measure of their language competence. The instrument contains a vocabulary checklist with 100 words, mainly predicates, from four areas; Food words, Body words, Mental words and Emotion words. Two sections assess the child’s grammar skills and a final section appraises the child’s metalinguistic awareness. Assessments from 1,134 parents are reported. Scales with adequate psychometric properties were formed for each section. Monthly median values and spread of score distributions are presented for each scale. Girls scored higher than boys on all scales. The revision, sampling procedures, demographic variables and issues of reliability and validity, are discussed. The general structure of the instrument can well be integrated in similar instruments designed for other languages and cultures.

Parent Reports of Young Spanish–English Bilingual Children's Productive Vocabulary: A Development and Validation Study

Purpose

This 2-phase study aims to extend research on parent report measures of children's productive vocabulary by investigating the development ( n = 38) of the Spanish Vocabulary Extension and validity ( n = 194) of the 100-item Spanish and English MacArthur-Bates Communicative Development Inventories Toddler Short Forms and Upward Extension (Fenson et al., 2000, 2007; Jackson-Maldonado, Marchman, & Fernald, 2013) and the Spanish Vocabulary Extension for use with parents from low-income homes and their 24- to 48-month-old Spanish–English bilingual children.

Method

Study participants were drawn from Early Head Start and Head Start collaborative programs in the Northeastern United States in which English was the primary language used in the classroom. All families reported Spanish or Spanish–English as their home language(s). The MacArthur Communicative Development Inventories as well as the researcher-designed Spanish Vocabulary Extension were used as measures of children's English and Spanish productive vocabularies.

Results

Findings revealed the forms' concurrent and discriminant validity, on the basis of standardized measures of vocabulary, as measures of productive vocabulary for this growing bilingual population.

Conclusion

These findings suggest that parent reports, including our researcher-designed form, represent a valid, cost-effective mechanism for vocabulary monitoring purposes in early childhood education settings.

24-Month-Old Children With Larger Oral Vocabularies Display Greater Academic and Behavioral Functioning at Kindergarten Entry

Data were analyzed from a population-based, longitudinal sample of 8,650 U.S. children to (a) identify factors associated with or predictive of oral vocabulary size at 24 months of age and (b) evaluate whether oral vocabulary size is uniquely predictive of academic and behavioral functioning at kindergarten entry. Children from higher socioeconomic status households, females, and those experiencing higher quality parenting had larger oral vocabularies. Children born with very low birth weight or from households where the mother had health problems had smaller oral vocabularies. Even after extensive covariate adjustment, 24-month-old children with larger oral vocabularies displayed greater reading and mathematics achievement, increased behavioral self-regulation, and fewer externalizing and internalizing problem behaviors at kindergarten entry.

Assessment of neurodisability and malnutrition in children in Africa

Neurodevelopmental delay, neurodisability, and malnutrition interact to contribute a significant burden of disease in global settings. Assessments which are well integrated with plans of management or advice are most likely to improve outcomes. Assessment tools used in clinical research and programming to evaluate outcomes include developmental and cognitive tools that vary in complexity, sensitivity, and validity as well as the target age of assessment. Few tools have been used to measure socioemotional outcomes and fewer to assess the disabled child with malnutrition. There is a paucity of tools used clinically which actually provide families and professionals with advice to improve outcomes. Brain imaging, electroencephalography, audiology, and visual assessment can also be used to assess the effect of malnutrition on brain structure and function. The interaction of neurodisability and malnutrition is powerful, and both need to be considered when assessing children. Without an integrated approach to assessment and management, we will not support children and families to reach their best potential outcomes.

Measurement properties and classification accuracy of two spanish parent surveys of language development for preschool-age children

PURPOSE

To describe the concurrent validity and classification accuracy of 2 Spanish parent surveys of language development, the Spanish Ages and Stages Questionnaire (ASQ; Squires, Potter, & Bricker, 1999) and the Pilot Inventario-III (Pilot INV-III; Guiberson, 2008a).

METHOD

Forty-eight Spanish-speaking parents of preschool-age children participated. Twenty-two children had expressive language delays, and 26 had typical language development. The parents completed the Spanish ASQ and the Pilot INV-III at home, and the Preschool Language Scale, Fourth Edition: Spanish Edition (PLS-4 Spanish; Zimmerman, Steiner, & Pond, 2002) was administered to the children at preschool centers.

RESULTS

The Spanish ASQ and Pilot INV-III were significantly correlated with the PLS-4 Spanish, establishing concurrent validity. On both surveys, children with expressive language delays scored significantly lower than children with typical development. The Spanish ASQ demonstrated unacceptably low sensitivity (59%) and good specificity (92%), while the Pilot INV-III demonstrated fair sensitivity (82%) and specificity (81%). Likelihood ratios and posttest probability revealed that the Pilot INV-III may assist in detection of expressive language delays, but viewed alone it is insufficient to make an unconditional screening determination.

CONCLUSIONS

Results suggest that Spanish parent surveys hold promise for screening language delay in Spanish-speaking preschool children; however, further refinement of these tools is needed.

Enalapril in infants with single ventricle: results of a multicenter randomized trial

BACKGROUND

Angiotensin-converting enzyme inhibitor therapy improves clinical outcome and ventricular function in adults with heart failure. Infants with single-ventricle physiology have poor growth and are at risk for abnormalities in ventricular systolic and diastolic function. The ability of angiotensin-converting enzyme inhibitor therapy to preserve ventricular function and improve somatic growth and outcomes in these infants is unknown.

METHODS AND RESULTS

The Pediatric Heart Network conducted a double-blind trial involving 230 infants with single-ventricle physiology randomized to receive enalapril (target dose 0.4 mg . kg(-1) . d(-1)) or placebo who were followed up until 14 months of age. The primary end point was weight-for-age z score at 14 months. The primary analysis was intention to treat. A total of 185 infants completed the study. There were 24 and 21 withdrawals or deaths in the enalapril and placebo groups, respectively (P=0.74). Weight-for-age z score was not different between the enalapril and placebo groups (mean+/-SE -0.62+/-0.13 versus -0.42+/-0.13, P=0.28). There were no significant group differences in height-for-age z score, Ross heart failure class, brain natriuretic peptide concentration, Bayley scores of infant development, or ventricular ejection fraction. The incidence of death or transplantation was 13% and did not differ between groups. Serious adverse events occurred in 88 patients in the enalapril group and 87 in the placebo group.

CONCLUSIONS

Administration of enalapril to infants with single-ventricle physiology in the first year of life did not improve somatic growth, ventricular function, or heart failure severity. The results of this randomized trial do not support the routine use of enalapril in this population.