The impact of child maltreatment on expressive syntax at 60 months

Inferential Comprehension Abilities in French-Speaking Preschoolers Exposed to Neglect in the Early Longitudinal Language and Neglect Study

PURPOSE

Using a longitudinal design, this study aimed to describe inferential comprehension abilities of neglected French-speaking preschool children from 42 to 66 months of age in comparison to non-neglected peers, to examine the association with receptive vocabulary, and to determine whether rates of change in inferential abilities over time was stable between the two group conditions.

METHOD

An inferential comprehension task and the French version of the Peabody Picture Vocabulary Test-Fourth Edition were administered to a group of neglected children (n = 37-40) and to a group of same-age non-neglected children (n = 71-91) at 42, 54, and 66 months old, as part of the Early Longitudinal Language and Neglect study.

RESULTS

Results show that children exposed to neglect obtain significantly lower scores compared to their same-age peers on inferential comprehension and receptive vocabulary measures at all three time points (p < .001) with large to very large effect sizes and indicate moderate to strong correlations between the two variables. Children from the neglected group present difficulties in inferencing compared to same-age non-neglected peers, a disadvantage that remains stable over time.

CONCLUSIONS

This study demonstrates the significant gap in inferential comprehension abilities between neglected and non-neglected preschool children. These results reiterate the importance of early detection of language comprehension difficulties in young children coming from vulnerable environments.

Trajectories of resilience among young children involved with child protective services

Although child maltreatment is associated with short- and long-term maladaptive outcomes, some children are still able to display resilience. Currently, there is a limited understanding of how children's resilience changes over time after experiencing maltreatment, especially for young children. Therefore, the current study used a longitudinal, multidimensional approach to examine trajectories of resilience among very young children involved in child protective services and determine whether placement setting and caregiving behaviors are associated with resilience trajectories. This study used data from National Survey of Child and Adolescent Well-Being I and conducted repeated measures latent class analysis, focusing on children under 2 years old at baseline (n = 1,699). Results suggested that there were three trajectories of resilience: increasing resilience, decreasing resilience, and stable, low resilience. Caregiver cognitive stimulation was related to increasing trajectories of resilience compared to both decreasing and stable, low resilience. These findings illustrate the importance of caregiving behaviors for promoting resilience among a particularly vulnerable population.

Developmental trajectories of speech and language in neglected children aged 3 to 5 years: Results of the ELLAN study

BACKGROUND

Neglected children are at high risk for significant difficulties in speech and language development. Because no longitudinal study has been conducted to date, the dynamic description of development during the preschool period is unknown.

OBJECTIVES

Establish the developmental trajectories of speech sounds, receptive and expressive vocabulary, and morphosyntax among neglected children during the preschool years and compare them with those of non-neglected children.

PARTICIPANTS AND SETTING

Participants are 69 neglected children and 99 same age non-neglected peers (37 and 46 males respectively) recruited at 36 months of age. Data were collected at home.

METHODS

Data were collected at six-month intervals between the ages of 3 and 5.5 years using psychometrically robust tools. Neglected and control groups were compared according to age using repeated measures ANOVAs on all variables. A discrete mixture model for clustering longitudinal data was used for testing the heterogeneity of the language trajectories among neglected children.

RESULTS

The language development of the neglected children as a whole group is lower than that of the control group for all variables. Two subgroups are identified within the neglected group: one with a developmental trajectory similar to that of the non-neglected children, and another whose trajectory is far below that of the control group. The effect sizes of these differences vary between 1.4 and 3 standard deviations under the mean.

CONCLUSIONS

A large proportion of neglected children present significant speech and language difficulties from the age of 3, but some of them catch up and develop similarly to non-neglected children.

Early detection of risk for maltreatment within Dutch preventive child health care: A proxy-based evaluation of the long-term predictive validity of the SPARK method

BACKGROUND

For effective prevention of child maltreatment, it is crucial that risk factors for child maltreatment are identified as early as possible. In the Dutch preventive child healthcare, the SPARK-method is used for this purpose.

OBJECTIVE

The current study investigated the predictive validity of the SPARK-method for predicting child protection activities, as a proxy for child maltreatment, and whether the estimation can be improved with an actuarial module.

PARTICIPANTS AND SETTING

Participants included a community sample of 1582 children of approximately 18-months-old for whom the SPARK was administered during well-child visits at home (51 %) or at the well-baby clinic (49 %).

METHODS

SPARK measurements were linked to data on child protection orders and residential youth care over a 10-year follow-up period. The predictive validity was evaluated using Area Under the receiver operating characteristic Curve (AUC) values.

RESULTS

Results showed good predictive validity for the SPARK clinical risk assessment (AUC = 0.723; large effect). The actuarial module led to a significant improvement in predictive validity (AUC = 0.802; large effect), z = 2.05, p = .04.

CONCLUSION

These results show that the SPARK is suitable for estimating the risk of child protection activities and that the actuarial module is a valuable addition. The SPARK can be used to support professionals in preventive child healthcare with their decision on appropriate follow-up actions.

Maltreated and non-maltreated children's truthful and dishonest reports: Linguistic and syntactic differences

Introduction

Adults are typically poor judges of the veracity of statements, requiring the need for alternative methods for detecting lies. One alternative method to human lie-detectors is using computer-based linguistic analysis which may present a more reliable method for detecting dishonesty. Moreover, while previous research has examined linguistic differences between typically developing children's and adults' truthful and dishonest reports, no study to date has examined whether maltreated children exhibit different linguistic cues to dishonesty. Thus, the current study examined maltreated and nonmaltreated children's linguistic and syntactic cues to children's truthful and dishonest reports.

Methods

Nine- to 12-year-olds, half of whom were maltreated, played a computer game with a confederate: half of the children experienced a transgression (i.e., playing a forbidden game and crashing the computer) and were coached to conceal it, and half of the children experienced no transgression (i.e., simply played a computer game). All children were then interviewed about the event. The current study utilized automated linguistic and syntactic analysis software to compare children's truthful reports (no transgression occurred) with dishonest reports.

Results and Discussion

Results indicated that maltreated and non-maltreated children did not differ in their indicators of dishonesty. Dishonest reporters used more first-person plural pronouns and cognitive mechanism terms and had less syntactically complex reports compared to truthful reporters. Finally, first-personal plural pronouns, cognitive mechanism terms, and syntactic complexity accurately classified (74.2%) the veracity of children's reports. The current findings present a new indicator of dishonesty (syntactic complexity) and suggest that indicators from typically developing populations may apply to maltreated children when coaching occurred.

Methodological inconsistencies confound understanding of language measurement in the child maltreatment population: A systematic review

BACKGROUND

While researchers have found a link between childhood maltreatment and language difficulties, the underlying mechanisms remain unclear and replication across the literature is inconsistent.

OBJECTIVE

To conduct a systematic review examining the methodological inconsistencies related to studies' samples construction, maltreatment measurement, and language outcomes using a language acquisition theory-based approach.

METHODS

Using the PRISMA framework, a literature search was conducted across five databases to identify studies that have investigated the effects of maltreatment on the language dimensions of vocabulary and grammar. Data were extracted for participant and maltreatment characteristics.

RESULTS

Fifty articles were reviewed. The results revealed: 1) maltreated children performed consistently below peers on grammar but not vocabulary assessments, 2) disproportionate use of vocabulary assessments, 3) considerable variability on participant characteristics and limited multidimensional measurement of maltreatment exposure, and 4) only nine studies analyzed the relationship between a maltreatment dimension (e.g., type, severity) and language.

CONCLUSIONS

Based on the results of this review, we propose three calls to action: 1) more language acquisition research in the child maltreatment field, 2) specificity when constructing samples with maltreated children, and 3) comprehensive and multidimensional maltreatment measurement. Implications for education were examined.

Adversity Exposure, Syntax, and Specific Language Impairment: An Exploratory Study

PURPOSE

Children exposed to adversity (e.g., chronic poverty, traumatic events, and maltreatment) are at increased risk for performing below age expectations on norm-referenced language assessments, but it is unknown whether the risk is higher for specific language impairment (SLI). This exploratory study investigated whether adversity exposure is associated with reduced grammar knowledge and SLI.

METHOD

The syntax subtest of the Diagnostic Evaluation of Language Variation-Norm-Referenced (DELV-NR) assessment was administered to 30 school-age children with known histories of adversity exposure. Their primary caregiver also completed a comprehensive adversity exposure measure, which captured adverse event type, frequency, chronicity, and severity. Analyses included t tests, correlations, Mann-Whitney U tests, and chi-square.

RESULTS

Overall, the sample performed below age expectations on the DELV-NR Syntax subtest, and a higher percentage of participants (20%) met diagnostic criteria for SLI than expected. The SLI and typical language (TL) groups did not significantly differ in adversity dosage, frequency, chronicity, or severity; however, participants in the SLI group were 1.46 times more likely to have experienced physical trauma than the participants in the TL group.

CONCLUSIONS

Children with known histories of adversity exposure presented with grammatical deficits and SLI more often than expected based on the DELV-NR normative sample; however, features of the adverse event did not associate with SLI status except for exposure to physical trauma (e.g., physical abuse and victimization). Future research is needed to investigate the prevalence and potential causal pathways of SLI in this population.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20483706.

Early Attachment and the Development of Social Communication: A Neuropsychological Approach

Social communication forms the foundation of human relationships. Social communication, i.e., the appropriate understanding and use of verbal and non-verbal communication within a social context, profoundly impacts mental health across the lifespan and is also highly vulnerable to neurodevelopmental threats and social adversities. There exists a strong interconnection between the development of language and other higher cognitive skills, mediated, in part, through the early attachment relationship. Consideration of how attachment links to brain development can help us understand individuals with social communication difficulties across the lifespan. The early attachment relationship supports the development of the foundational constructs of social communication. In this paper, a neuropsychological perspective was applied to social communication, which integrated evidence from early attachment theory, examining the underpinnings of social communication components identified by the SoCom model, namely socio-cognitive, socio-emotional, and socio-linguistic constructs. A neuropsychological perspective underscores the importance of interdisciplinary collaboration. This should also inform approaches to prevention, policy, intervention, and advocacy for individuals with or at risk for social communication impairments, as well as their families.

The Childhood Trauma and Attachment Gap in Speech-Language Pathology: Practitioner's Knowledge, Practice, and Needs

PURPOSE

Previous research demonstrates the relevance of childhood trauma and attachment to communication development. This study aimed to understand speech-language pathology (SLP) practitioners' knowledge, beliefs, training, and current practices regarding developmental trauma and attachment.

METHOD

An online survey was administered to SLP practitioners (N = 97) who work primarily with children from birth to age 6 years in Canada. Quantitative (univariate and bivariate) analysis was performed with SPSS. Qualitative responses were coded by two reviewers using thematic analysis to identify key themes.

RESULTS

SLP practitioners are working with children who have experienced trauma and adapt their practice when they are aware of this history. Practitioners also indicated, however, that they lack training with respect to trauma and attachment, their understanding of the concepts is narrow, they do not have standardized practices for obtaining trauma history, and they do not adapt their practice in consistent ways. The results show there is interest in understanding how trauma affects communication development, the relevance to their work, and that additional training is needed to support practitioners to identify and respond to trauma in early childhood.

CONCLUSIONS

Findings from this study support SLP practitioners' involvement in early identification of trauma and the development of best practices regarding trauma-informed SLP assessment and intervention. The results also inform how systems and areas of service need to be adjusted to be more accessible, flexible, and collaborative in order to support children and families whose lives have been impacted by trauma and indicate additional areas of research in the area.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.16968097.

The Index of Productive Syntax: Psychometric Properties and Suggested Modifications

PURPOSE

The Index of Productive Syntax (IPSyn) is a well-known language sample analysis tool. However, its psychometric properties have not been assessed across a wide sample of typically developing preschool-age children and children with language disorders. We sought to determine the profile of IPSyn scores by age over early childhood. We additionally explored whether the IPSyn could be shortened to fewer items without loss of information and whether the required language sample could be shortened from a current required number of 100 utterances to 50.

METHOD

We used transcripts from the Child Language Data Exchange System, including 1,051 samples of adult-child conversational play with toys within the theoretical framework of item response theory. Samples included those from typically developing children as well as children with hearing loss, Down syndrome, and late language emergence.

RESULTS

The Verb Phrase and Sentence Structure subscales showed more stable developmental trajectories over the preschool years and greater differentiation between typical and atypical cohorts than did the Noun Phrase and Question/Negation subscales. A number of current IPSyn scoring items can be dropped without loss of information, and 50-utterance samples demonstrate most of the same psychometric properties of longer samples.

DISCUSSION

Our findings suggest ways in which the IPSyn can be automated and streamlined (proposed IPSyn-C) so as to provide useful clinical guidance with fewer items and a shorter required language sample. Reference values for the IPSyn-C are provided. Trajectories for one subscale (Question/Negation) appear inherently unstable and may require structured elicitation. Potential limitations, ramifications, and future directions are discussed.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.16915690.

Psychological Distress Symptoms and Resilience Assets in Adolescents in Residential Care

Most studies with institutionalised children and adolescents focus on evaluating the impact of negative life events on emotional development. However, few have investigated the relationship between resilience assets and the teenagers’ psychopathological problems. The purpose of the present study was to investigate differences in psychological distress symptoms and in resilience assets in institutionalised and non-institutionalised adolescents. A total of 266 adolescents aged between 12 and 19 years old took part in the study (60.5% female): 125 lived in residential care and 144 resided with their families. Results found a significant and inverse relation between psychopathology and the perception of individual resilience assets, specifically with self-efficacy and self-awareness in the community sample, and with empathy in the institutionalised sample. Overall, and regardless of the age group, adolescents in residential care tend to perceive themselves as significantly less resilient in perceived self-efficacy and empathy, and they report fewer goals and aspirations for the future. The importance of promoting mental health and resilience assets in adolescents, particularly in those in residential care, is discussed. This can be achieved through early interventions that may prevent emotional suffering and deviant life paths, with transgenerational repercussions.

Developmental Language Disorder (DLD) in Young People Leaving Care in England: A Study Profiling the Language, Literacy and Communication Abilities of Young People Transitioning from Care to Independence

Research indicates children and young people in care have a high prevalence of Developmental Language Disorder (DLD) as part of a complex set of vulnerabilities. This study describes the profile of language, literacy and communication abilities of a cohort of care leavers. The language, literacy and communication abilities of 44 young people leaving care between the ages of 16 and 26 years were assessed using standardized measures. Demographic data about the young people was collected along with a survey to key staff to capture their perceptions and experiences of the language and communication abilities of these young people. Ninety percent of the care leavers' language abilities were below average and over 60% met criteria for DLD in combination with literacy difficulties, developmental disorders and social, emotional and mental health difficulties (SEMH). The implications of unidentified DLD on the lives of young people leaving care is discussed. Earlier identification of DLD is advocated to enable services to intervene to facilitate more positive outcomes and life chances for this very vulnerable population.

Autobiographical Memory in Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, Hearing Loss, and Childhood Trauma: Implications for Social Communication Intervention

Purpose Speech-language pathologists (SLPs) work with a variety of populations at risk for poor autobiographical and episodic memory. The purpose of this tutorial is to describe autobiographical memory and how it is affected in children with autism spectrum disorder, attention-deficit/hyperactivity disorder, hearing loss, and childhood trauma, as well as provide clinicians with practical strategies for supporting autobiographical memory in each of these clinical populations. Method This tutorial reviews the literature on (a) autobiographical and episodic memory in typical development; (b) its relation to theory of mind, personal narrative skills, and executive functions; (c) elaborative reminiscing in typical development; (d) how autobiographical memory is impaired in children with autism spectrum disorder, attention-deficit/hyperactivity disorder, hearing loss, and childhood trauma; and (e) strategies for supporting autobiographical memory in each clinical population. Conclusions When adequately prepared, SLPs are uniquely situated to address autobiographical and episodic memory in their work with children, families, and related professionals. This is a long-overdue focus of such great clinical import that justifies its inclusion in the traditional training and preparation of SLPs. Adapting elaborative reminiscing strategies for use with various clinical populations is promising for facilitating healthy EM development and related cognitive functions.

Elaborative Reminiscing and Child Receptive Language in the Context of Maltreatment: The Moderating Role of Maternal Sensitivity

This study investigated whether the effect of maternal elaborative reminiscing on child language is moderated by maternal sensitivity and whether this association depends on children's experience of maltreatment. A total of 236 mothers and their 3- to 7-year-old children (mean age = 5 years) were observed interacting with experimenter-provided toys in the lab and at home, and maternal sensitivity was coded from these interactions. Of that, 155 of the children had a history of maltreatment with the mother being named a perpetrator, and the remaining dyads were demographically matched with no history of maltreatment. Dyads were also asked to discuss four past emotional events, and these conversations were coded for maternal elaborative reminiscing. Children and mothers participated in an assessment of receptive language. Findings revealed an unqualified positive main effect of elaborative reminiscing on children's receptive language in the nonmaltreating families. However, for maltreated children, elaborative reminiscing was only associated with higher child receptive language when mothers were also more sensitive. These findings indicate that, in the context of maltreatment, both elaborative reminiscing and more general aspects of the quality of the parent-child relationship are important for facilitating child receptive language.

Inter-agency collaboration factors affecting multidisciplinary workers' ability to identify child maltreatment

OBJECTIVES

This study aimed to clarify the factors of successful inter-agency collaboration that affect multidisciplinary workers' abilities to identify child maltreatment. A questionnaire-based survey was conducted; the contents of the questionnaire included the Collaboration Evaluation Scale we developed and the workers' abilities to identify child maltreatment. In total, 277 individuals from various agencies in Japan participated in this study. To examine the factors of successful inter-agency collaboration affecting workers' awareness of child maltreatment, we used hierarchical multiple regression analysis.

RESULTS

The analysis showed the positive effect of "commitment with loyalty" on the workers' awareness of child maltreatment-related information in all fields (β = .18-.31, p < .05), the effect of "strong leadership" on information about maltreated children and the home environment (β = .18, p < .05; β = .16, p < .05, respectively), and the effect of "resources" on the information about mothers' information during pregnancy and of fathers' feelings towards their children during the perinatal period (β = .17, p < .05; β = .22, p < .01, respectively). In conclusion, commitment with loyalty, strong leadership, and resources are factors of successful inter-agency collaboration that affects the ability of multidisciplinary workers to recognize signs of child maltreatment.

Emotion Socialization and Developmental Risk: Interactive Effects of Receptive Language and Maltreatment on Reminiscing

OBJECTIVES

Emotional reminiscing, or mother-child discussion of past emotional experiences, is a critical aspect of emotion socialization that predicts a range of child outcomes and is central to parent-child interventions. Thus, understanding individual differences in emotional reminiscing will advance our ability to identify families at-risk for poor emotion dialogues and to adapt interventions for diverse populations, such as families affected by maltreatment and mothers and children with low language abilities. The present study examined associations among maternal and child receptive language with emotional reminiscing and the moderating role of maltreatment.

METHODS

Two hundred and twenty three underserved, racially diverse mothers (144 maltreating) and their preschool aged children completed measures of receptive language (PPVT-4). Emotional reminiscing was comprehensively measured using maternal report and observations of emotion dialogues, including ratings of elaborations, maternal sensitive guidance, and child cooperative exploration.

RESULTS

Child language was positively associated with all observed aspects of child reminiscing, and the association between child language and maternal reminiscing was moderated by maltreatment. For non-maltreating families, child language was positively associated with maternal factual elaborations and sensitive guidance. For the maltreating families, these associations were not significant, demonstrating that maltreatment disrupted the association between child language and reminiscing. Maternal language was significantly associated with maternal report of emotion dismissing behaviors, regardless of maltreatment status.

CONCLUSIONS

Results highlight that language is an essential individual difference factor contributing to variance in emotion dialogues, and that maltreatment influences how child language relates to reminiscing. Future directions and clinical implications for families affected by developmental risk are considered.

Narrative language skills of maltreated children living in out-of-home care

Purpose: Children's narrative accounts of their experiences are central to the prosecution of perpetrators of alleged maltreatment. We describe the narrative language skills of children who were placed in out-of-home care (OOHC) following substantiated maltreatment. It was hypothesised that (i) children with such histories would display narrative language skills that fall significantly below published age-expected norms, (ii) narrative language skills and core language skills would be positively correlated and (iii) narrative language skills would be associated with measures of socio-economic disadvantage.Method: Eighty-three children (40 males and 43 females) aged 5;3 to 12;10 (M = 7.9, SD = 2.3) from English-speaking home backgrounds were assessed using the Test of Narrative Language and the Clinical Evaluation of Language Fundamentals (CELF-4) Core Language Score. The Raven's Coloured Progressive Matrices, a measure of nonverbal intelligence, was employed as a covariate.Result: Forty-two percent of children scored in the below-average range on the Narrative Language Index Ability Index. The same proportion scored at/above age-expected levels on the Narrative Comprehension subtest, and 19% scored at/above age-expected levels on Oral Narration. There was a significant correlation between CELF-4 Core Language Scores and the Narrative Language Index Ability Index. Female carers' education was significantly positively associated with overall narrative language scores; however, household income and index of socio-economic disadvantage were not significantly associated with narrative language scores.Conclusion: Children who are victims of substantiated maltreatment should be considered at-risk for compromised ability to provide a narrative account of their experiences. The heterogeneity and often scant oral narrative language skills of these children highlights the importance of police/human services training on best-practice forensic interviewing. Policy and practice implications for speech-language pathology early intervention to support the needs of at-risk children are also discussed.

A Study on the Mother Education Program for the Prevention of Child Neglect

In the present research, the aim was to develop, implement, and examine the effectiveness of an education program for mothers for the prevention of child neglect. In the study, the “Mother Education Program to Prevent Child Neglect” was initially designed for implementation and a quasi-experimental design involving pretest/posttest, and one-month follow-up test was implemented to examine the effectiveness of the trial procedure. The study group of the research consisted of 24 mothers (12 mothers in the intervention group and 12 mothers in the comparison group) who agreed to participate in the study. In order to collect the sociodemographic information about the children and their mothers, an “Individual Information Form” was administered. In order to assess the neglectful behaviors of the mothers, the Parent Form of the Multidimensional Neglectful Behavior Scale-Parents Form was used. As a result of the study, a significant difference was found between the pretest and posttest scores of the mothers in the intervention group ( p<.05). The cognitive neglect and the total neglect scores of the mothers in the intervention group were found to significantly decrease after the completion of the education program. The results of the follow-up test also revealed that the effect of the education program for mothers was sustained after one month. Resultantly, suggestions related to the prevention of child neglect have been made for parents, professionals, institutions, and researchers working on the subject.

Efficacy of a reminiscing and emotion training intervention on maltreating families with preschool-aged children

The current investigation reports the results of a randomized controlled trial of a brief, relational intervention for maltreated preschool-aged children and their mothers, called Reminiscing and Emotion Training (RET). RET facilitates elaborative and emotionally supportive parent-child communication, which is an essential component of the parent-child relationship and is especially relevant for the preschool age period. Participants were 248 children between the ages of 3- to 6-years-old and their mothers. Following a baseline assessment, 165 maltreating families were randomized into RET or a Community Standard (CS) condition in which families received case management and written parenting information; 83 families participated in the nonmaltreating comparison condition. Results indicated that the key mechanisms targeted by the RET interventions were enhanced, such that mothers who participated in RET were significantly better in elaboration and sensitive guidance during reminiscing at the posttest than were maltreating mothers who did not receive the intervention, with medium to large effect sizes; additionally, mothers in the RET group were more elaborative than mothers from the nonmaltreatment group. Children in the RET condition also contributed significantly more memories and had better emotional knowledge than did children in the CS condition, controlling for baseline values and language, and approximated the functioning of nonmaltreated children. These findings add to a growing literature underscoring the benefits of brief, focused, relational interventions for maltreated children and their caregivers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Morphosyntactic Development and Severe Parental Neglect in 4-Year-Old French-Speaking Children: ELLAN study

Language is the most frequently compromised area of development in English-speaking neglected children, particularly the morphosyntactic component of language. This is very worrisome given its central role in academic success and social participation. No previous study has examined the morphosyntactic skills of French-speaking neglected children, despite the morphological richness of French. This study aimed to fill this gap. Forty-four neglected (mean age = 48.32 months, SD = 0.45) and 92 non-neglected (mean age = 48.07 months, SD = 0.24) French-speaking children participated. Measures of morphosyntactic skills were derived from a sample of spontaneous language collected during standardized semistructured play and analyzed using Systematic Analysis of Language Transcripts software (2012) . Four morphosyntactic indicators were compared using analyses of variance and Kolmogorov-Smirnov tests: the mean length of utterances (MLU), verbal inflections, word-level errors, and omission errors. The results indicate that 25.6% of the neglected children presented clinically significant morphosyntactic difficulties, as evidenced by a significantly shorter MLU (M = 5.60, SD = 1.13; M = 6.90, SD = 1.30), fewer verbal inflections, and more frequent word omission errors compared to their non-neglected peers. The results confirm that French-speaking neglected children present many morphosyntactic difficulties. This study argues for sustained speech-language services for these children.

Timing of the first report and highest level of child protection response in association with early developmental vulnerabilities in an Australian population cohort

BACKGROUND

Childhood maltreatment is associated with early childhood developmental vulnerabilities. However, the extent to which higher levels of child protection responses confer benefit to developmental competencies, and the impact of earlier timing of first reports in relation to early childhood vulnerability remains unclear.

OBJECTIVE

We examined associations between early developmental vulnerabilities and (1) the highest level of child protection response (where OOHC was deemed the highest response among other types of reports/responses), and (2) the developmental timing of the first child protection report.

PARTICIPANTS AND SETTING

Participants included 67,027 children from the New South Wales Child Development Study, of whom 10,944 were reported to child protection services up to age 5 years.

METHODS

A series of Multinomial Logistic Regressions were conducted to examine focal associations.

RESULTS

Children with substantiated maltreatment reports showed the strongest odds of vulnerability on three or more developmental domains (adjusted OR = 4.90; 95% CI = 4.13-5.80); children placed in OOHC showed slightly better physical, cognitive and communication competencies (adjusted ORs from 1.83 to 2.65) than those with substantiated reports that did not result in OOHC placements (adjusted OR from 2.77 to 3.67), when each group was compared to children with no child protection reports. Children with first maltreatment reports occurring in the first 18 months of life showed the strongest likelihood of developmental vulnerabilities on three or more developmental domains (adjusted OR = 3.56; 95% CI = 3.15-4.01) relative to children with no child protection reports.

CONCLUSION

Earlier reports of maltreatment may signal the need for targeted remediation of early developmental competencies to mitigate early developmental difficulties.

Receptive Vocabulary Development of Children Placed in Foster Care and Children Who Remained With Birth Parents After Involvement With Child Protective Services

Children who experience maltreatment are more likely than nonmaltreated children to demonstrate deficits in early receptive language skills that negatively impact their later academic achievement, social competence, and behavioral adjustment. It remains unclear whether placement in foster care affects children's early receptive language skills. In the current study, we examined whether children with Child Protective Services (CPS) involvement who were in foster care ( n = 176) had more advanced receptive vocabulary than children with CPS involvement who resided with their birth parents ( n = 144). Results demonstrated that children in foster care had higher receptive vocabulary scores at ages 36 and 48 months than children who stayed with their birth parents. Group differences were not significant after controlling for caregiver education level, marital status, and household income. These findings suggest that placement in foster care may be associated with meaningful improvements in children's receptive vocabulary among children with experiences of CPS involvement, and birth parents might benefit from increased supports to promote parent-child interactions that facilitate language development.

Developmental delay in communication among toddlers and its relationship to caregiving behavior among violence-exposed, posttraumatically stressed mothers

OBJECTIVES

This study aimed to understand if maternal interpersonal violence-related posttraumatic stress disorder (IPV-PTSD) is associated with delayed language development among very young children ("toddlers").

METHODS

Data were collected from 61 mothers and toddlers (ages 12-42 months, mean age = 25.6 months SD = 8.70). Child expressive and receptive language development was assessed by the Ages and Stages Questionnaire (ASQ) communication subscale (ASQCS) that measures language acquisition. Observed maternal caregiving behavior was coded from videos of 10-min free-play interactions via the CARE-Index. Correlations, Mann-Whitney tests, and multiple linear regression were performed.

RESULTS

There was no significant association between maternal IPV-PTSD severity and the ASQCS. Maternal IPV-PTSD severity was associated with continuous maternal behavior variables (i.e. sensitive and controlling behavior on the CARE-Index) across the entire sample and regardless of child gender. Maternal sensitivity was positively and significantly associated with the ASQCS. Controlling behavior was negatively and significantly associated with the ASQCS.

CONCLUSIONS

Results are consistent with the literature that while maternal IPV-PTSD severity is not associated with child language delays, the quality of maternal interactive behavior is associated both with child language development and with maternal IPV-PTSD severity. Further study is needed to understand if the level of child language development contributes to intergenerational risk or resilience for relational violence and/or victimization.

Latent profiles of early developmental vulnerabilities in a New South Wales child population at age 5 years

OBJECTIVE

Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study.

METHODS

Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census-defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models.

RESULTS

Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled 'misconduct risk' ( N = 4368; 6.5%); (2) 'pervasive risk' ( N = 2668; 4.0%); (3) 'mild generalised risk' ( N = 7822; 11.6%); and (4) 'no risk' ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates.

CONCLUSION

Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.

A role for epistemic trust in speech-language pathology: A tutorial paper

This paper provides an introduction to epistemic trust for speech-language pathologists (SLPs). 'Epistemic trust' describes a specific form of trust that an individual places in others when learning about the world, particularly the social world. To date, the relevance of epistemic trust to SLP clinical practice has received little theoretical or empirical attention. The aim of this paper is to define epistemic trust and explain its relationship with parent-child attachment and mentalization which have, in turn, been linked with language development and use. Suggestions are made for ways in which SLPs may encourage epistemic trust in clients, emphasizing the need to establish strong therapeutic alliances. The authors conclude that epistemic trust is an important consideration for SLPs and that further research exploring the relationship between epistemic trust and language skills is needed to better understand the interplay of these variables and inform clinical practice.

School readiness of maltreated preschoolers and later school achievement: The role of emotion regulation, language, and context

Guided by bio-ecological theory, this study aimed to: (1) identify heterogeneity in the developmental patterns of emotion regulation for maltreated preschool-aged children; (2) examine the role of gender, language, placement instability, cognitive stimulation, and emotional support on patterns of stability and change of emotion regulation over time; and (3) elucidate the role of emotion regulation/dysregulation patterns on later academic achievement. This study utilized data from the first cohort of the National Survey of Child and Adolescent Well-Being. Results using LCA and LTA models indicated stability and change in emotionally regulated vs. emotionally dysregulated latent classes across 4, 5, and 6 ½ years of age. Placement instability significantly increased the likelihood of being classified as emotionally dysregulated at wave 1. Moreover, children classified as emotionally dysregulated by age 6 ½ scored significantly lower than children who were classified as emotionally regulated on measures of reading and math achievement by age 10. Based on these findings, placement stability at first contact with CPS should be promoted in order to prevent cascading negative effects on emotion regulation. Additionally, children who are more emotionally dysregulated by the time they transition to formal schooling should receive increased socioemotional and socioemotional learning supports.

Maltreated Children Use More Grammatical Negations

Many studies reveal a strong impact of childhood maltreatment on language development, mainly resulting in shorter utterances, less rich vocabulary, or a delay in grammatical complexity. However, different theories suggest the possibility for resilience-a positive adaptation to an otherwise adverse environment-in children who experienced childhood maltreatment. Here, we investigated different measures for language development in spontaneous speech, examining whether childhood maltreatment leads to a language deficit only or whether it can also result in differences in language use due to a possible adaptation to a toxic environment. We compared spontaneous speech during therapeutic peer-play sessions of 32 maltreated and 32 non-maltreated children from the same preschool and equivalent in gender, age (2 to 5 years), home neighborhood, ethnicity, and family income. Maltreatment status was reported by formal child protection reports, and corroborated by independent social service reports. We investigated general language sophistication (i.e., vocabulary, talkativeness, mean length of utterance), as well as grammatical development (i.e., use of plurals, tense, grammatical negations). We found that maltreated and non-maltreated children showed similar sophistication across all linguistic measures, except for the use of grammatical negations. Maltreated children used twice as many grammatical negations as non-maltreated children. The use of this highly complex grammatical structure shows an advanced linguistic skill, which shows that childhood maltreatment does not necessarily lead to a language deficit. The result might indicate the development of a negativity bias in the structure of spontaneous language due to an adaptation to their experiences.

Childhood Maltreatment and Early Developmental Vulnerabilities at Age 5 Years

This study examined associations between maltreatment and early developmental vulnerabilities in a population sample of 68,459 children (M_age  = 5.62 years, SD = .37) drawn from the Australian state of New South Wales, using linked administrative data for the children and their parents (collected 2001-2009). Associations were estimated between (a) any maltreatment, (b) the number of maltreatment types, and (c) the timing of first reported maltreatment and vulnerability and risk status on multiple developmental domains (i.e., physical, social, emotional, cognitive, and communication). Pervasive associations were revealed between maltreatment and all developmental domains; children exposed to two or more maltreatment types, and with first maltreatment reported after 3 years of age, showed greater likelihood of vulnerability on multiple domains, relative to nonmaltreated children.

Screening for potential child maltreatment in parents of a newborn baby: The predictive validity of an Instrument for early identification of Parents At Risk for child Abuse and Neglect (IPARAN)

For preventive purposes it is important to be able to identify families with a high risk of child maltreatment at an early stage. Therefore we developed an actuarial instrument for screening families with a newborn baby, the Instrument for identification of Parents At Risk for child Abuse and Neglect (IPARAN). The aim of this study was to assess the predictive validity of the IPARAN and to examine whether combining actuarial and clinical methods leads to an improvement of the predictive validity. We examined the predictive validity by calculating several performance indicators (i.e., sensitivity, specificity and the Area Under the receiver operating characteristic Curve [AUC]) in a sample of 4692 Dutch families with newborns. The outcome measure was a report of child maltreatment at Child Protection Services during a follow-up of 3 years. For 17 children (.4%) a report of maltreatment was registered. The predictive validity of the IPARAN was significantly better than chance (AUC=.700, 95% CI [.567-.832]), in contrast to a low value for clinical judgement of nurses of the Youth Health Care Centers (AUC=.591, 95% CI [.422-.759]). The combination of the IPARAN and clinical judgement resulted in the highest predictive validity (AUC=.720, 95% CI [.593-.847]), however, the difference between the methods did not reach statistical significance. The good predictive validity of the IPARAN in combination with clinical judgment of the nurse enables professionals to assess risks at an early stage and to make referrals to early intervention programs.

Effects of the ABC Intervention on Foster Children's Receptive Vocabulary: Follow-Up Results From a Randomized Clinical Trial

Children with histories of maltreatment and disruptions in care are at elevated risk for impairments in early language development, which contribute to difficulties in other developmental domains across childhood. Given research demonstrating associations between parent responsiveness and children's early language development, we examined whether a parenting intervention administered in infancy improved preschool receptive language skills in children involved with the child welfare system. Attachment and Biobehavioral Catch-up (ABC) is a 10-session intervention that aims to enhance parent-child interactions. The follow-up results of this randomized clinical trial demonstrated that infants who received the ABC intervention ( n = 24) scored significantly higher on a test of receptive vocabulary at age 36 months than infants who received a control intervention ( n = 28). These results provide evidence of the critical role of parental responsiveness in supporting optimal language development among young children with histories of child welfare involvement.

Maternal elaborative reminiscing mediates the effect of child maltreatment on behavioral and physiological functioning

Theoretical and empirical evidence suggest that the way in which parents discuss everyday emotional experiences with their young children (i.e., elaborative reminiscing) has significant implications for child cognitive and socioemotional functioning, and that maltreating parents have a particularly difficult time in engaging in this type of dialogue. This dyadic interactional exchange, therefore, has the potential to be an important process variable linking child maltreatment to developmental outcomes at multiple levels of analysis. The current investigation evaluated the role of maternal elaborative reminiscing in associations between maltreatment and child cognitive, emotional, and physiological functioning. Participants included 43 maltreated and 49 nonmaltreated children (aged 3-6) and their mothers. Dyads participated in a joint reminiscing task about four past emotional events, and children participated in assessments of receptive language and emotion knowledge. Child salivary cortisol was also collected from children three times a day (waking, midday, and bedtime) on 2 consecutive days to assess daily levels and diurnal decline. Results indicated that maltreating mothers engaged in significantly less elaborative reminiscing than did nonmaltreating mothers. Maternal elaborative reminiscing mediated associations between child maltreatment and child receptive language and child emotion knowledge. In addition, there was support for an indirect pathway between child maltreatment and child cortisol diurnal decline through maternal elaborative reminiscing. Directions for future research are discussed, and potential clinical implications are addressed.

Co-occurrence of communication disorder and psychiatric disorders in maltreated children and adolescents: relationship with global functioning

OBJECTIVE

To study the co-occurrence of psychiatric disorders (PD) and communication disorders (CD) and their relationship with global functioning in maltreated children and adolescents.

METHODS

The sample comprised 143 maltreated children and adolescents (55.8% male). All underwent clinical communication and psychiatric evaluations, as well as global functioning assessment using the Children's Global Assessment Scale (C-GAS).

RESULTS

Four groups emerged from evaluation: Group 1 (n=7, 4.9%) did not exhibit any disorders; Group 2 (n=26, 18.2%) exhibited PD; Group 3 (n=34, 23.8%) exhibited CD; and Group 4 (n=76, 53.1%) exhibited both PD and CD on evaluation. Significant differences in global functioning scores were found between G1 and G2, G1 and G4, G2 and G4, and G3 and G4, with the highest C-GAS scores found in G1 and the lowest in G4.

CONCLUSION

Rates of PD and CD are high in this maltreated population. The presence of PD has a major impact on C-GAS score, and the simultaneous presence of CD increases the already impaired function of PD. Demonstration of the additive effects of PD and CD on youth functioning suggests that professionals should be alert to the presence of both disorders to better act preventively and therapeutically in a high-risk population.

Language Problems Among Abused and Neglected Children: A Meta-Analytic Review

Research data show that exposure to abuse and neglect has detrimental effects on a child's language development. In this meta-analysis, we analyze studies (k = 23), to compare the language skills (receptive language, expressive language, pragmatics) of children who have experienced abuse and/or neglect with the language skills of children who have not experienced abuse and/or neglect and to examine whether age or type of maltreatment moderate the relationship between maltreatment and language skills. Results confirm that the language skills of children who have experienced abuse and/or neglect are delayed when compared to children who have not experienced abuse and/or neglect. Compared to older children, young children seem particularly vulnerable to abuse and neglect. No significant differences were demonstrated concerning the type of maltreatment suffered by the child. These findings support the necessity of early detection of language problems in abused and neglected children as well as early intervention in order to implement interventions that will positively stimulate their development.

Pre-existing adversity, level of child protection involvement, and school attendance predict educational outcomes in a longitudinal study

Maltreatment largely occurs in a multiple-risk context. The few large studies adjusting for confounding factors have raised doubts about whether low educational achievement results from maltreatment or co-occurring risk factors. This study examined prevalence, risk and protective factors for low educational achievement among children involved with the child protection system compared to other children. We conducted a population-based record-linkage study of children born in Western Australia who sat national Year 3 reading achievement tests between 2008 and 2010 (N=46,838). The longitudinal study linked data from the Western Australian Department of Education, Department of Child Protection and Family Support, Department of Health, and the Disability Services Commission. Children with histories of child protection involvement (unsubstantiated maltreatment reports, substantiations or out-of-home care placement) were at three-fold increased risk of low reading scores. Adjusting for socio-demographic adversity partially attenuated the increased risk, however risk remained elevated overall and for substantiated (OR=1.68) and unsubstantiated maltreatment (OR=1.55). Risk of low reading scores in the out-of-home care group was fully attenuated after adjusting for socio-demographic adversity (OR=1.16). Attendance was significantly higher in the out-of-home care group and served a protective role. Neglect, sexual abuse, and physical abuse were associated with low reading scores. Pre-existing adversity was also significantly associated with achievement. Results support policies and practices to engage children and families in regular school attendance, and highlight a need for further strategies to prevent maltreatment and disadvantage from restricting children's opportunities for success.

Physical maltreatment of children with autism in Henan province in China: A cross-sectional study

The aim of this study was to investigate the frequency of child physical maltreatment (CPM) in children with autism aged 2-5 years in Henan province (China), and to explore the risk factors for severe CPM in these children. This cross-sectional study was performed at the Psychology Clinic of the Third Affiliated Hospital of Zhengzhou University between September 2012 and September 2013 with 180 parents of children with autism. Children and parents had no history of any cognitive therapy. The childhood autism rating scale (CARS) was used to evaluate the severity of autism in children. Data on parental CPM during the past 3 months were collected from parental self-reporting. Logistic regression was used to investigate the risk factors of severe CPM. CPM was self-reported by 88% of the parents of children with autism. One hundred and fifty four of these cases were in the minor CPM group (86%) and 64 in the severe CPM group (36%). Most cases of severe CPM were unlikely to have caused injury. Univariate analyses showed that child's age (p=.018), age started to speak (p=.043) and CARS score (p=.048) were associated with severe CPM. Child's age (p=.011) and CARS score (p=.041) were independently associated with severe CPM. The risk of severe CPM increased with age and CARS score. Our findings showed that CPM is widespread in families of children with autism in Central China and more knowledge should be provided to parents of children with autism, particularly in cases of severe autism (those with high CARS scores).

Children neglected: Where cumulative risk theory fails

Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children.

A Meta-Analysis of Cross Sectional Studies Investigating Language in Maltreated Children

PURPOSE

In this review article, meta-analysis was used to summarize research investigating language skills in maltreated children.

METHOD

A systematic search of published studies was undertaken. Studies were included in the meta-analysis if they investigated language skills in groups comprising maltreated and nonmaltreated children. Studies were selected if these 2 groups of children were of comparable age and from a similar socioeconomic background.

RESULTS

A total of 26 studies were identified that met the inclusion criteria. Results from the meta-analysis showed that maltreated children demonstrated consistently poorer language skills with respect to receptive vocabulary (k = 19; standardized mean difference [SMD] = .463; 95% confidence interval [CI; .293, .634]; p < .001), expressive language (k = 4; SMD =.860; 95% CI [.557, 1.163]; p < .001), and receptive language (k = 9; SMD =.528; 95% CI [.220, .837]; p < .001).

CONCLUSION

Together, these results indicate a reliable association between child maltreatment and poor language skills.

Do early care and education services improve language development for maltreated children? Evidence from a national child welfare sample

Young children under 6 years old are over-represented in the U.S. child welfare system (CWS). Due to their exposure to early deprivation and trauma, they are also highly vulnerable to developmental problems, including language delays. High quality early care and education (ECE) programs (e.g. preschool, Head Start) can improve children's development and so policymakers have begun calling for increased enrollment of CWS-supervised children in these programs. However, it is not a given that ECE will benefit all children who experience maltreatment. Some types of maltreatment may result in trauma-related learning and behavior challenges or developmental deficits that cause children to respond to ECE settings differently. The current study uses data from a nationally representative survey of children in the U.S. child welfare system, the National Survey of Child and Adolescent Well-Being II, to assess whether young CWS-supervised children (N=1,652) who were enrolled in ECE had better language development outcomes 18 months later than those not enrolled in ECE. We also explore whether the type of maltreatment that brought children to the CWS' attention moderates the relationship between ECE and children's language development. After controlling for children's initial scores on the Preschool Language Scale (PLS-3), type(s) of maltreatment experienced, and child and caregiver demographics, we found that ECE participation predicted better PLS-3 scores at follow-up, with a positive interaction between ECE participation and supervisory neglect. ECE seems to be beneficial for CWS-involved children's early language development, especially for children referred to the CWS because they lack appropriate parent supervision at home.

The role of maternal input in the development of wh-question comprehension in autism and typical development

Social deficits have been implicated in the language delays and deficits of children with autism (ASD); thus, the extent to which these children use language input in social contexts similarly to typically developing (TD) children is unknown. The current study investigated how caregiver input influenced the development of wh-question comprehension in TD children and language-matched preschoolers with ASD. Children were visited at four-month intervals over 1.5 years; mother-child play sessions at visits 1-2 were coded for maternal wh-question use. At visits 3-5 children watched videos in the Intermodal Preferential Looking paradigm, to assess their comprehension of subject and object wh-questions. Mothers' use of wh-questions with verbs and complex wh-questions positively predicted wh-question comprehension in the TD group; in contrast, mothers' use of wh-questions with 'be' as the main verb negatively predicted wh-question comprehension in the ASD group. Thus, TD children and children with ASD appear to use their linguistic input differently.

Auditory-perceptual analysis of voice in abused children and adolescents

INTRODUCTION

Abused children and adolescents are exposed to factors that can trigger vocal changes.

OBJECTIVE

This study aimed to analyze the prevalence of vocal changes in abused children and adolescents, through auditory-perceptual analysis of voice and the study of the association between vocal changes, communication disorders, psychiatric disorders, and global functioning.

METHODS

This was an observational and transversal study of 136 children and adolescents (mean age 10.2 years, 78 male) who were assessed by a multidisciplinary team specializing in abused populations. Speech evaluation was performed (involving the aspects of oral and written communication, as well as auditory-perceptual analysis of voice, through the GRBASI scale). Psychiatric diagnosis was performed in accordance with the DSM-IV diagnostic criteria and by applying the K-SADS; global functioning was evaluated by means of the C-GAS scale.

RESULTS

The prevalence of vocal change was 67.6%; of the patients with vocal changes, 92.3% had other communication disorders. Voice changes were associated with a loss of seven points in global functioning, and there was no association between vocal changes and psychiatric diagnosis.

CONCLUSION

The prevalence of vocal change was greater than that observed in the general population, with significant associations with communication disorders and global functioning. The results demonstrate that the situations these children experience can intensify the triggering of abusive vocal behaviors and consequently, of vocal changes.

Low-SES children's eyewitness memory: the effects of verbal labels and vocabulary skills

This study examined the effects of the verbal labels procedure and vocabulary skills on low-socioeconomic status (SES) preschool children's eyewitness memory. Children (N = 176) aged 3-5 years witnessed a conflict event and were then questioned about it in either a standard or a verbal labels interview. Findings revealed that children with higher rather than lower vocabulary skills produced more complete and accurate memories. Children who were given the verbal labels interview recalled more information, which included both correct and incorrect details. Overall, the verbal labels procedure did not improve children's performance on direct questions, but children with low vocabulary skills answered direct questions more accurately if they were given the verbal labels interview than when they were not. Implications of the findings for memory performance of low-SES children are discussed.

Parenting support needs assessment: screening for child maltreatment risk in young families

OBJECTIVES

The objective of the study was to examine the Parenting Support Needs Assessment (PSNA) for content validity, internal consistency reliability, and clinical usefulness. The PSNA was designed for use by primary care clinicians who care for young children and their families, to identify families with risk factors for child maltreatment.

METHODS

Phase I of the study consisted of the content validity assessment by child maltreatment experts, and phase II was a pilot test of the PSNA and referral algorithm by nurse practitioners (NPs) for clinical usefulness. Data obtained during the pilot testing were used to examine individual PSNA items, establishing an estimate of internal consistency reliability and identify the instrument's clinical usefulness.

RESULTS

The PSNA instrument and referral algorithm was found to have content validity and clinical usefulness. The number of referrals to family support social service agencies increased from 4 to 22 over the pre-PSNA use (with different children) and the instrument exceeded the internal consistency reliability threshold of .80.

CONCLUSIONS

The PSNA instrument was found to be valid, reliable, and clinically useful in the primary care setting. The PSNA represents a significant step forward in screening for child maltreatment risk in families of young children during routine primary care.

Oral Language Competence, Young Speakers, and the Law

Purpose

This paper highlights the forensic implications of language impairment in 2 key (and overlapping) groups of young people: identified victims of maltreatment (abuse and/or neglect) and young offenders.

Method

Two lines of research pertaining to oral language competence and young people’s interface with the law are considered: 1 regarding investigative interviewing with children as victims or witnesses in the context of serious allegations of sexual abuse, and the other pertaining to adolescent offenders as suspects, witnesses, or victims. The linguistic demands that forensic interviewing places on these young people are also considered. Literature concerning the impact of early maltreatment on early language acquisition is briefly reviewed, as is the role of theory of mind in relation to the requirements of investigative interviewing of children and adolescents.

Implications

High-risk young people (i.e., those who are subject to child protection orders because of suspected or confirmed maltreatment, and those who are engaged with the youth justice system) face an elevated risk for suboptimal language development but may need to draw on their language skills in high-stakes forensic interviews. Implications for early intervention policy and practice are identified, and the need for greater speech-language pathology advocacy and engagement in forensic interviewing research is emphasized.

Maternal functional speech to children: a comparison of autism spectrum disorder, Down syndrome, and typical development

Children with developmental disabilities benefit from their language environment as much as, or even more than, typically developing (TD) children, but maternal language directed to developmentally delayed children is an underinvestigated topic. The purposes of the present study were to compare maternal functional language directed to children with two developmental disabilities--autism spectrum disorder (ASD) and Down syndrome (DS)--with TD children and to investigate relations of maternal functional language with child language skills. Participants were 60 mothers and their children with TD (n = 20), DS (n = 20), or ASD (n = 20). Children's mean developmental age was 24.77 months (SD = 8.47) and did not differ across the groups. Mother and child speech were studied during naturalistic play. We found (a) similarities in maternal functional language directed to the two groups of children with developmental disabilities compared to that directed to TD children and (b) a positive association between subcategories of information-salient speech and child mean length of utterance in TD dyads only. The clinical and developmental implications of these findings are discussed.

The Effects of Early Neglect on Cognitive, Language, and Behavioral Functioning in Childhood

OBJECTIVES

Few studies have explored the impact of different types of neglect on children's development. Measures of cognition, language, behavior, and parenting stress were used to explore differences between children experiencing various forms of neglect, as well as to compare children with and without a history of early neglect.

METHODS

Children, ages 3 to 10 years with a history of familial neglect (USN), were compared to children with a history of institutional rearing (IA) and children without a history of neglect using the Differential Abilities Scale, Test of Early Language Development, Child Behavior Checklist, and Parenting Stress Index. Factors predicting child functioning were also explored.

RESULTS

Compared with youth that were not neglected, children with a history of USN and IA demonstrated lower cognitive and language scores and more behavioral problems. Both internalizing and externalizing behavior problems were most common in the USN group. Externalizing behavior problems predicted parenting stress. Higher IQ could be predicted by language scores and an absence of externalizing behavior problems. When comparing the two neglect groups, shorter time spent in a stable environment, lower scores on language skills, and the presence of externalizing behavior predicted lower IQ.

CONCLUSION

These findings emphasize the importance of early stable, permanent placement of children who have been in neglectful and pre-adoptive international settings. While an enriching environment may promote resilience, children who have experienced early neglect are vulnerable to cognitive, language and behavioral deficits and neurodevelopmental and behavioral evaluations are required to identify those in need of intervention.