Association of proximal elements of social disadvantage with children's language development at 2 years: an analysis of data from the Children in Focus (CiF) sample from the ALSPAC birth cohort

The influence of temperament and perinatal factors on language development: a longitudinal study

Early language development is characterized by large individual variation. Several factors were proposed to contribute to individual pathways of language acquisition in infancy and childhood. One of the biologically based explaining factors is temperament, however, the exact contributions and the timing of the effects merits further research. Pre-term status, infant sex, and environmental factors such as maternal education and maternal language are also involved. Our study aimed to investigate the longitudinal relationship between infant temperament and early language development, also considering infant gender, gestational age, and birthweight. Early temperament was assessed at 6, 9, 18, 24, and 30 months with the Very Short Form of Infant Behavior Questionnaire (IBQ-R) and the Very Short Form of Early Childhood Behavior Questionnaire (ECBQ). Early nonverbal communication skills, receptive and expressive vocabulary were evaluated with the Hungarian version of The MacArthur Communicative Development Inventory (HCDI). Our study adds further evidence to the contribution of infant temperament to early language development. Temperament, infant gender, and gestational age were associated with language development in infancy. Infants and toddlers with higher Surgency might enter communicative situations more readily and show more engagement with adult social partners, which is favorable for communication development. Gestational age was previously identified as a predictor for language in preterm infants. Our results extend this association to the later and narrower gestational age time window of term deliveries. Infants born after longer gestation develop better expressive vocabulary in toddlerhood. Gestational age may mark prenatal developmental processes that may exert influence on the development of verbal communication at later ages.

The Association Between Family Resources and Language Among Young Children Who are Deaf and Hard of Hearing

OBJECTIVE

Our study (1) examined demographic factors in families with children with bilateral hearing loss and how they relate to Family Resource Scale (FRS) questionnaire data and (2) examined correlations between FRS data and measures of language.

METHODS

Children aged 6 months to 10 years with bilateral hearing loss were enrolled. Parents completed the FRS questionnaire to assess their access to socioeconomic resources at the first language measurement visit. Assessments measured receptive and expressive language, nonverbal intelligence quotient, and adaptive functioning.

RESULTS

Among the 85 children included in the analysis, approximately 40% had hearing loss classified as mild to moderate and 25% had a cochlear implant. Participants' mean FRS score was 130 (SD 16.6) (with the highest possible score of 150 and indicating better access to resources). Significant positive correlations ( p -value ≤ 0.05) were found between maternal education, paternal education, and family income and several FRS subscales (Growth and Support, Necessities in Health, Childcare, Personal Resources). Significant positive correlations were found between the Necessities in Health subscale and all the language measurements.

CONCLUSION

Children whose parents reported better access to socioeconomic resources related to health care had higher language performance scores. Although early access to intervention services has improved for deaf or hard-of-hearing children, there are other variables contributing to language development, including access to socioeconomic resources. This study highlights the need for further research addressing more specific and modifiable resources to improve language performance for deaf or hard-of-hearing children.

Creating the conditions for robust early language development for all-Part 1: Evidence-informed child language surveillance in the early years

BACKGROUND

The emergence of language in the early years is a major developmental accomplishment that underpins learning, enables social interaction and, later, is an indicator of well-being. Learning language is an effortless process for most, but can be challenging for others. There is a need to act early. First, because there are several social, environmental and family factors known to influence how language develops during the critical early years. Second, there is a robust association between a child's socio-economic circumstances and language outcomes. Put simply, children living in less advantaged circumstance have poorer language outcomes, which are apparent very early and persist across the lifespan. Third, children with demonstrated weaknesses in language learning in early childhood have poorer educational, employment, mental health and quality-of-life outcomes across the lifespan. Acting early to counter these impacts is important; however, there are several well-documented challenges in accurately identifying in the early years children who are at later risk of developmental language disorder (DLD) and to deliver prevention and intervention programmes to scale. This is critical because many services do not currently reach those who need them most; as many as 50% of children in need may not be receiving support.

AIM

To determine whether an improved surveillance system, based on best evidence, could be developed for the early years.

METHODS & PROCEDURES

We summarised findings from longitudinal, population or community studies that: (1) adopted bioecological models, (2) repeatedly measured language (including the early years) and (3) adopted similar methodologies, to identify factors that influence language outcomes.

MAIN CONTRIBUTION

The evidence confirmed that language development is not always stable but is characterized by distinct trajectories and each has distinguishing social, environmental features. Children in the change or fluctuating groups tend to live in less advantageous circumstances that may not always support and enable language development. Risk factors tend to cluster and accumulate across the early years and beyond, thereby markedly increasing the likelihood of poorer language outcomes later in life.

CONCLUSIONS & IMPLICATIONS

In this the first of two papers, designed to be read together, we integrate research on the social determinants of child language and propose they be embedded into surveillance models. This has the potential to reach more children and those living in disadvantaged circumstances. In the accompanying paper we combine this information with evidence-informed early prevention/intervention approaches and propose the design and implementation of an early language public health framework.

WHAT THIS PAPER ADDS

What is already known on the subject There are several well-documented challenges in accurately identifying in the early years children who are at later risk of DLD and reaching those most in need of language support. What this study adds to existing knowledge A combination of child, family and environmental determinants, collectively and cumulatively, play out over time and dramatically increase the risk of later language problems, in particular those children living in disadvantaged circumstances. We propose an improved surveillance system that incorporates these determinants be developed and that this be part of a whole of system approach to child language in the early years. What are the potential or actual clinical implications of this work? Clinicians intuitively act to prioritize children with multiple features or risks; however, they can only do so for those who present or are identified to be at risk. Given many children with language problems are not being reached by many early language services, it is reasonable to ask if this knowledge can be integrated to improve reach. Or is a different surveillance model required?

Risk factors for early language delay in children within a minority ethnic, bilingual, deprived environment (Born in Bradford's Better Start): a UK community birth cohort study

BACKGROUND

Preschool language skills and language delay predict academic and socioemotional outcomes. Children from deprived environments are at a higher risk of language delay, and both minority ethnic and bilingual children can experience a gap in language skills at school entry. However, research that examines late talking (preschool language delay) in an ethnically diverse, bilingual, deprived environment at age 2 is scarce.

METHODS

Data from Born in Bradford's Better Start birth cohort were used to identify rates of late talking (≤10th percentile on the Oxford-Communicative Development Inventory: Short) in 2-year-old children within an ethnically diverse, predominantly bilingual, deprived UK region (N=712). The relations between known demographic, maternal, distal and proximal child risk factors, and language skills and language delay were tested using hierarchical linear and logistic regression.

RESULTS

A total of 24.86% of children were classified as late talkers. Maternal demographic factors (ethnicity, born in UK, education, financial security, employment, household size, age) predicted 3.12% of the variance in children's expressive vocabulary. Adding maternal language factors (maternal native language, home languages) and perinatal factors (birth weight, gestation) to the model predicted 3.76% of the variance. Adding distal child factors (child sex, child age) predicted 11.06%, and adding proximal child factors (receptive vocabulary, hearing concerns) predicted 49.51%. Significant risk factors for late talking were male sex (OR 2.07, 95% CI 1.38 to 3.09), receptive vocabulary delay (OR 8.40, 95% CI 4.99 to 14.11) and parent-reported hearing concerns (OR 7.85, 95% CI 1.90 to 32.47). Protective factors were increased household size (OR 0.85, 95% CI 0.77 to 0.95) and age (OR 0.82, 95% CI 0.70 to 0.96).

CONCLUSIONS

Almost one in four children living in an ethnically diverse and deprived UK area have early language delay. Demographic factors explained little variance in early vocabulary, whereas proximal child factors held more predictive value. The results indicate further research on early language delay is warranted for vulnerable groups.

Language input in late infancy scaffolds emergent literacy skills and predicts reading related white matter development

Longitudinal studies provide the unique opportunity to test whether early language provides a scaffolding for the acquisition of the ability to read. This study tests the hypothesis that parental language input during the first 2 years of life predicts emergent literacy skills at 5 years of age, and that white matter development observed early in the 3rd year (at 26 months) may help to account for these effects. We collected naturalistic recordings of parent and child language at 6, 10, 14, 18, and 24 months using the Language ENvironment Analysis system (LENA) in a group of typically developing infants. We then examined the relationship between language measures during infancy and follow-up measures of reading related skills at age 5 years, in the same group of participants (N = 53). A subset of these children also completed diffusion and quantitative MRI scans at age 2 years (N = 20). Within this subgroup, diffusion tractography was used to identify white matter pathways that are considered critical to language and reading development, namely, the arcuate fasciculus (AF), superior and inferior longitudinal fasciculi, and inferior occipital-frontal fasciculus. Quantitative macromolecular proton fraction (MPF) mapping was used to characterize myelin density within these separately defined regions of interest. The longitudinal data were then used to test correlations between early language input and output, white matter measures at age 2 years, and pre-literacy skills at age 5 years. Parental language input, child speech output, and parent-child conversational turns correlated with pre-literacy skills, as well as myelin density estimates within the left arcuate and superior longitudinal fasciculus. Mediation analyses indicated that the left AF accounted for longitudinal relationships between infant home language measures and 5-year letter identification and letter-sound knowledge, suggesting that the left AF myelination at 2 years may serve as a mechanism by which early language experience supports emergent literacy.

Associations between sociodemographic and behavioural parameters and child development depending on age and sex: a cross-sectional analysis

OBJECTIVES

To explore environmental and individual factors that are associated with child development and to investigate whether the strength of these associations differs according to the age of the children.

DESIGN

Cross-sectional study.

SETTING

This study was part of the LIFE Child study, a large cohort study conducted in Leipzig, Germany.

PARTICIPANTS

778 children aged between 0.5 and 6 years (48.6% girls, mean age=2.67 years).

OUTCOME MEASURES

The outcomes were cognitive development, language development, body and hand motor skills, social-emotional development, and tracing skills, measured with a standardised development test. We analysed the associations between development and gestational age, socioeconomic status (SES), sex, behavioural difficulties, siblings, sleep duration, breastfeeding duration and overweight/obesity. We also tested for interactions between these variables and child age or sex.

RESULTS

Higher gestational age (b ranging between 0.12 and 0.26) and higher SES (b ranging between 0.08 and 0.21) were associated with better outcomes in almost all developmental domains (all p<0.019). Children with older siblings had improved body and hand motor skills compared with children without older siblings (both b=0.55, all p<0.029). Boys had poorer scores than girls in body and hand motor skills and tracing (b=-0.45, -0.68 and -1.5, all p<0.019). Children with behavioural difficulties had significantly poorer outcomes in most developmental domains. Some of the associations with SES and sex were stronger in older than in younger children. Associations between gestational age and motor development were weaker in older children. We did not find significant associations between child development and sleep duration, breastfeeding duration or overweight/obesity.

CONCLUSION

Some factors had a protective, others an adverse effect on development of children under 6 years of age. The effect of SES and sex increased, while the effect of gestational age decreased with age.

TRIAL REGISTRATION NUMBER

NCT02550236.

Measuring disadvantage in the early years in the UK: A systematic scoping review

Background

The relationship between disadvantage and child health in the early years is well established. For this evidence base to most helpfully inform services, we need to better understand how disadvantage is conceptualised and measured in the literature. We aimed to conceptualise disadvantage measured in child health literature and explore the associations between disadvantage and child health using these measures.

Method

We conducted a scoping review using systematic methods to identify key concepts of disadvantage used in empirical child health literature. We searched MEDLINE, Scopus, and grey literature for studies exploring the association between disadvantage and child health outcomes for children aged 0–5 in the United Kingdom. We extracted and analysed data from 86 studies.

Results

We developed a framework describing two domains, each with two attributes conceptualising disadvantage: level of disadvantage indicator (individual and area) and content of disadvantage indicator (social and economic). Individual-level measures of disadvantage tended to identify stronger associations between disadvantage and child health compared with area-level measures.

Conclusion

The choice of disadvantage indicators, particularly whether individual- or area-level, can affect the inferences made about the relationship between disadvantage and child health. Better access to individual-level disadvantage indicators in administrative data could support development and implementation of interventions aimed at reducing child health inequalities in the early years.

•

Measurement of disadvantage in child health is wide-ranging and multi-dimensional.

•

Social, economic, individual, and area-level are key concepts of disadvantage.

•

Area-level measures underestimate the association between disadvantage and child health.

•

Individual-level disadvantage indicators are needed in administrative data.

•

Policymakers planning child health interventions should measure disadvantage carefully.

Screening for Language Difficulties in Disadvantaged Populations on Entry to Early Years Education: Challenges and Opportunities

Children aged 3-4 years (n = 876) were recruited from deprived areas in England, and a significant minority of the sample were second language learners. Oral language ability was assessed using child administered standardized measures, and parents reported on children's language. We adapted the Language Use Inventory [LUI; (1)] to capture carer's reports of the children's structural language in the language of instruction and their home language (where appropriate). The final measure included six subscales from the original: use of simple words, requests for help, gaining attention, talking about activities/actions, interactions with others, and building sentences. Children's language abilities and non-verbal abilities were below norms on all standardized tests administered except non-word repetition. Factor analysis indicated that all the six scales of the adapted parent completed measure loaded on one language factor. The revised total scale score correlated significantly (p < 0.0005) with child assessed language measures, specifically expressive vocabulary and grammar. Different patterns across gender, language status and parental education were examined. Sensitivity and specificity of the scale to identify children with the greatest delays were evaluated. These preliminary data indicated that parent-reported information on children's language skills at 3 years of age has the potential to provide a reliable indicator to inform pedagogy and practice at the start of nursery school. Study limitations are examined and avenues for future development explored.

Early temperament as a predictor of language skills at 40 months

Background

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

Methods

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

Results

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

Conclusions

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

Supplementary Information

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

Parent responsiveness mediates the association between hyporeactivity at age 1 year and communication at age 2 years in children at elevated likelihood of ASD

Studies suggest that higher parent responsiveness is associated with higher child language abilities. Infants and toddlers later diagnosed with autism spectrum disorder (ASD) often display hyporeactivity to sensory stimuli, which has also been associated with lower child communication abilities and lower parent responsiveness. Yet, whether parent responsiveness mediates the relationship between child hyporeactivity and later communication outcomes remains unexplored. This study is a secondary data analysis which includes children (n = 83; 56 males) identified as at elevated likelihood of later ASD. Children completed an observational measure of sensory reactivity and a standard developmental assessment at 14 (Time 1) and 23 months old (Time 2). At each time point, parents reported on the child's adaptive communication behaviors and sensory behaviors, and Parent Verbal Responsiveness (AvgPVR) was coded from parent-child free-play videos. Results indicated that the association between child sensory hyporeactivity at Time 1 (observed and parent-reported) and communication at Time 2 (observed and parent reported) was significantly mediated by AvgPVR. Although child hyporeactivity predicts poorer communication outcomes, increased parent verbal responsiveness may attenuate this negative impact. Parent responsiveness, a focus of many parent-mediated interventions, may be an important mechanism of treatment response that should be directly tested in future research. LAY SUMMARY: Toddlers at elevated likelihood of autism spectrum disorder (ASD) are often under-reactive (hyporeactive) to sensory stimuli. This hyporeactivity slows learning of communication skills and provides parents with fewer opportunities to respond to their children. In this study, children with hyporeactivity at 14 months generally had poorer communication at 23 months; however, the more responsive their parents were, the weaker the relationship between early hyporeactivity and later communication. Thus, increasing parent responsiveness may lead to better communication outcomes for toddlers with the early ASD symptom of hyporeactivity.

Early vocabulary development: Relationships with prelinguistic skills and early social-emotional/behavioral problems and competencies

The aim of this longitudinal study was to investigate early vocabulary development and its relationships with prelinguistic communication skills and social-emotional/behavioral (SEB¹) problems and competencies. The participants were 58 healthy Finnish-speaking children (30 girls, 28 boys). First, the concurrent relationships were investigated at the age of 18 months. Second, the relationships between prelinguistic communication skills and SEB problems and competencies at 18 months, and subsequent vocabulary scores at 24 and 30 months, were examined. Parental reports on early vocabulary (MacArthur Communicative Developmental Inventories; MCDI), prelinguistic communication skills (The Infant-Toddler Checklist of the Communication and Symbolic Behavior Scales Developmental Profile; ITC), SEB problems and competencies (Brief Infant-Toddler Social and Emotional Assessment; BITSEA) were gathered. Compared to boys, girls scored significantly higher on ITC Speech Composite at 18 months and expressive vocabulary measures at 18, 24, and 30 months. Vocabulary, as well as prelinguistic communication measures, correlated with SEB competencies at 18 months. Furthermore, vocabulary, as well as ITC Symbolic Composite and Total Score, correlated negatively with externalizing problem and SEB Total Problem scores. With regard to subsequent vocabulary development, all of the prelinguistic communication measures at 18 months correlated with vocabulary at 24 and 30 months. However, when accounted for gender and earlier vocabulary, only the associations with ITC Speech Composite and Total Score at 24 months remained significant. SEB Competencies at 18 months correlated positively, while externalizing problems at 18 months correlated negatively with vocabulary at 24 and 30 months, however, these associations did not remain significant, when accounted for gender and earlier vocabulary.

What Impacts Early Language Skills? Effects of Social Disparities and Different Process Characteristics of the Home Learning Environment in the First 2 Years

It is well documented that the language skills of preschool children differ substantially and that these differences are highly predictive of their later academic success and achievements. Especially in the early phases of children's lives, the importance of different structural and process characteristics of the home learning environment (HLE) has been emphasized and research results have documented that process characteristics such as the quality of parental interaction behavior and the frequency of joint activities vary according to the socio-economic status (SES) of the family. Further, both structural and process characteristics are associated with children's language development. As most of the studies focus on single indicators or didn't take the dynamics of parenting behavior across age into account, the present paper aims to investigate the associations of different characteristics of the home learning environment as well as their potentially changing impact on the language skills of 2-year-old children. Using data of 2.272 families of the infant cohort study of the German National Educational Panel Study (NEPS), longitudinally assessed process characteristics (sensitivity in the sense of maternal responsivity to the child's behavior and signals in mother-child interaction; maternal stimulation behavior which goes beyond the child's actual level of action and development; frequency of joint picture book reading) and structural characteristics (mother's education, equivalised household income, parental occupational status) were considered. Language skills (vocabulary and grammar) of the children at the age of two were measured by a standardized and validated parent report instrument (child language checklist). Results showed that (1) all three process characteristics of the home learning environment (HLE) are associated with the family's SES; (2) across three assessment waves nearly all process characteristics predicted children's vocabulary and grammar skills with some process-specific changes across waves; (3) despite separate direct effects of nearly all HLE-process characteristics in each wave, the amount of explained variance in a joint model including the HLE facets from each wave is hardly higher than in the separate models; and (4) socioeconomic background predicted both language facets of the children in each model even when controlling for the assessed process characteristics of the home learning environment.