The role of gestures in the transition from one- to two-word speech in a variety of children with intellectual disabilities

Can Gestures Give us Access to Thought? A Systematic Literature Review on the Role of Co-thought and Co-speech Gestures in Children with Intellectual Disabilities

This systematic review analyzes the differential use of gestures in learning by children with intellectual disability (ID) compared to typically developing ones (TD). Eleven studies published between 2000 and 2020 fulfilled the inclusion criteria (N = 364 participants). The results identify three key elements: (1) Children with ID accompany their spoken language with more gestures than TD children; (2) Specifically, they produce more iconic gestures that provide access to the conceptualization process and understanding in students with ID; (3) Children with ID rely on gesture more than TD children to carry meaning (i.e., produce unimodal gestural utterances without accompanying speech). Possible implications for teaching and guidelines for future research are proposed.

Influence of gestures on the intelligibility and comprehensibility of utterances with stuttering events in individuals with Down syndrome

INTRODUCTION

Individuals with Down syndrome (DS) often stutter, which can affect their speech intelligibility. Previous research has shown that manual signs can enhance speech intelligibility and comprehensibility. It remains unclear to what extent spontaneous hand gestures, such as iconic and beat gestures, may enhance intelligibility and/or comprehensibility during utterances with stuttering events.

METHODS

Eleven individuals with DS who stutter provided video-recorded speech samples. From these samples, 60 utterances containing a stuttering event were selected. In half of them, the stuttering events were accompanied by gestures; in the other half, the stuttering events were not accompanied by gestures. The samples were shown to 250 assessors who were blind to the study's goals. Each sample was shown in three visibility conditions: 1) video-with-audio, 2) video-with-audio but with the speaker's mouth covered and 3) audio-only. The assessors rated speech intelligibility on a 7-point Likert scale and transcribed the speech sample. The effect of gesture production, gesture type and the visibility conditions on comprehensibility and intelligibility was examined with a hierarchical multiple linear regression.

RESULTS

When a speaker had used a gesture during a stuttering event, the Likert scale score increased with 0.47 and the accuracy of transcription with 9.07%. There was no difference in effect between the different gesture types. Despite the effect from gesture use, there was no effect of the visibility conditions on the Likert scale or transcription score.

CONCLUSIONS

Gestures positively affect intelligibility and comprehensibility of utterances with stuttering events in individuals with DS by altering the speech production. The possibility of beat gestures as a therapy method should be examined, with caution for the development of maladaptive behaviours.

Exploring Expressive Communication Skills in a Cross-Sectional Sample of Individuals With a Dual Diagnosis of Autism Spectrum Disorder and Down Syndrome

Individuals with a comorbid diagnosis of Down syndrome (DS) and autism spectrum disorder (ASD) have been found to exhibit greater deficits in expressive communication than individuals with DS only. We hypothesized that individuals with a comorbid diagnosis (n = 430) would have significantly lower Communication Matrix scores and specifically social communication scores than individuals with DS alone (n = 4,352). In a sample of 4,782 individuals with DS, scores for individuals with a comorbid diagnosis were on average 18.01 points and 7.26 points lower for total score and social score respectively as compared to individuals with DS. Comorbid diagnosis accounted for 10.5% of the variance in communication scores. Between-group differences in referential gestures and symbolic communication behaviors were also observed.

Maternal input to children with sex chromosome trisomies

BACKGROUND

Although language difficulties are one of the most distinctive characteristics of the neuropsychological profile of children with sex chromosome trisomies (SCT), the analysis of the maternal input addressed to them is a neglected topic.

AIMS

The present study aims to analyse the lexical, morphosyntactic, and functional features of the input addressed to children with SCT comparing them with those of the input directed to typically developing children (TD).

METHODS & PROCEDURES

Participants were 38 mothers and their 8-month-old children, 19 with SCT and 19 TD children. Maternal utterances, collected during video-recorded play sessions, have been transcribed and coded.

OUTCOMES & RESULTS

No significant differences between groups have been found in the lexical and syntactic characteristics of maternal input. However, considering the input functional features, the proportion of directives and questions was significantly higher in the maternal input addressed to children with SCT than in the input addressed to TD children whereas the opposite pattern was found in the proportion of affect-salient speech.

CONCLUSIONS & IMPLICATIONS

The awareness of a possible delay in their children's language development could influence the way the mothers speak to them. In particular, the functional features of maternal input could be affected. Support groups for parents of children with SCT at the preverbal stage could be useful to reassure the mothers about their role in their children's language development. What this paper adds What is already known on the subject Studies in the literature identified a high percentage of language delays or impairments in children with SCT. To date, according to our knowledge, there are no studies that analyse the linguistic input addressed to these children. What this study adds The lexical and syntactic features of maternal input addressed to 8-month-old children with SCT are adequate to the children's communicative skills. However, the mothers of children with SCT seem to provide additional scaffolding in their verbal input, using a lower proportion of affect-salient speech and a higher proportion of questions. In addition, a higher proportion of directives suggests the use of a more demanding style. Clinical implications of this study The awareness of possible language delays could influence the functional features of input leading mothers to use a more supportive and demanding input. Support groups for parents of children with SCT at the preverbal stage could be useful to reassure the mothers about their role in their children's language development.

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

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

Key Word Signing Usage of Adults With Intellectual Disabilities: Influence of Communication Partners' Sign Usage and Responsivity

PURPOSE

In services for adults with intellectual disabilities, various staff members may have different key word signing (KWS) skills and conversational style. Little is known about how these clients use KWS with different staff members. Therefore, we observed staff-client conversations and examined how clients' KWS usage was shaped by staff members' KWS usage and conversational style.

METHOD

Three 10-min dyadic conversations between an adult with moderate or severe intellectual disabilities (N = 15) and three familiar staff members were filmed and transcribed. The KWS usage and conversational responsivity in the transcriptions was analyzed at group (using generalized estimating equations), subgroup, and individual levels.

RESULTS

Clients appeared to produce significantly more KWS as partners imitated more signs and as partners were more responsive. There was a negative interaction between these two factors. Subgroup analyses showed that spontaneity of clients' KWS usage was a continuum.

CONCLUSION

Findings suggest that staff can encourage clients' KWS usage by imitating manual signs but that clients' response efficiency should also be taken into account.

Beliefs and habits: staff experiences with key word signing in special schools and group residential homes

Even though use of aided augmentative and alternative communication (AAC) by staff has been extensively researched, few studies relate to unaided AAC strategies such as key word signing (KWS). We explored the KWS views of two groups: direct support staff in group residential homes and teachers from special education secondary schools. We examined transcripts from individual semi-structured interviews with five direct support staff and five teachers using thematic analysis. Participants discussed consistency of KWS use and reasons for implementing KWS. Compared to direct support staff, teachers described more use of KWS throughout the day with more individuals with intellectual disability. Teachers discussed use of KWS to facilitate students' present and future interactions, while direct support staff primarily discussed immediate effects. Participants experienced KWS implementation as a learning process and aimed to turn the use of manual signs into a routine habit. This required considerable self-monitoring, and the effort that this continuous self-feedback required, combined with environmental factors, could hinder KWS implementation. These preliminary findings suggest that preservice KWS training and on-site KWS assistance may need to be enhanced.

The development of co-speech gesture in the communication of children with autism spectrum disorders

Co-speech gestures have a close semantic relationship to speech in adult conversation. In typically developing children co-speech gestures which give additional information to speech facilitate the emergence of multi-word speech. A difficulty with integrating audio-visual information is known to exist for individuals with Autism Spectrum Disorder (ASD), which may affect development of the speech-gesture system. A longitudinal observational study was conducted with four children with ASD, aged 2;4 to 3;5 years. Participants were video-recorded for 20 min every 2 weeks during their attendance on an intervention programme. Recording continued for up to 8 months, thus affording a rich analysis of gestural practices from pre-verbal to multi-word speech across the group. All participants combined gesture with either speech or vocalisations. Co-speech gestures providing additional information to speech were observed to be either absent or rare. Findings suggest that children with ASD do not make use of the facilitating communicative effects of gesture in the same way as typically developing children.

Howard W, McCune L, Anderson R. Evidence of a Continuum in Foundational Expressive Communication Skills

Progress monitoring measurement is increasingly needed in early childhood to inform practitioners when an intervention change is needed and as a tool for accomplishing individualization and improving results for individual children. The Early Communication Indicator (ECI) is such a measure for infants and toddlers, 6 to 42 months of age. A greater understanding of the ECI key skills (i.e., gestures, vocalizations, single- and multiple-word utterances) could lead to further improvements in the sensitivity and utility of the decisions made compared to ECIs composite total communication score. Thus, we examined the pattern of growth within and between the ECI's four foundational skills in a large sample of children served in Early Head Start. Results confirmed a unique pattern of growth and change within each skill trajectory in terms of (a) age at skill onset and (b) peaks in each trajectory defining an inflection point or change from acceleration to deceleration. Analyses using these inflection points as intercepts with before and after trajectory slopes in a test of an adjacent skills temporal ordering growth model indicated good fit. Implications of a continuum of foundational ECI skills to future validation and decision making utility of the measure are discussed.