Sex differences in language first appear in gesture

Early gesture development as a predictor of autism spectrum disorder in elevated-likelihood infants of ASD

BACKGROUND

Gesture difficulties have been reported in later-born siblings of children with autism spectrum disorder (ASD). Careful observation of gesture development during the first two years of children at elevated likelihood (EL) of developing ASD may identify behavioral indicators that facilitate early diagnosis.

METHODS

This study enrolled 47 EL infants and 27 low-likelihood (LL) infants to explore gesture developmental trajectories and the predictive value of gesture to expedite the early detection of core characteristics of ASD. Gesture frequency, communication function, and integration ability were observed and coded from a semi-structured assessment administered longitudinally across 9-19 months of age. We conducted the Autism Diagnostic Observation Schedule assessment at 18-19 months for ASD's core characteristics.

RESULTS

The development of joint attention (JA) gestures was slower in the EL than in the LL group. The trajectories of the two groups began to diverge at 14-18 months. Children who reached the diagnostic cutoff point for ASD showed reductions in social interaction gestures at 12-13 months, in gestures integrated with any two communication skills (G-M) at 15-16 months; and in gestures integrated with eye contact (G-E) at 18-19 months. Overall gesture and G-M integration were associated with an overall ADOS communication and social interaction score.

CONCLUSIONS

The developmental trajectories of JA gestures of EL and LL children differed. G-M gestures represent early indicators that may be a predictor of ASD.

The Growing Little Brain: Cerebellar Functional Development from Cradle to School

Despite the cerebellum's crucial role in brain functions, its early development, particularly in relation to the cerebrum, remains poorly understood. Here, we examine cerebellocortical connectivity using over 1,000 high-quality resting-state functional MRI scans of children from birth to 60 months. By mapping cerebellar topography with fine temporal detail for the first time, we show the hierarchical and contralateral organization of cerebellocortical connectivity from birth. We observe dynamic shifts in cerebellar network gradients, which become more focal with age while maintaining stable anchor points similar to adults, highlighting the cerebellum's evolving yet stable role in functional integration during early development. Our findings provide the first evidence of cerebellar connections to higher-order networks at birth, which generally strengthen with age, emphasizing the cerebellum's early role in cognitive processing beyond sensory and motor functions. Our study provides insights into early cerebellocortical interactions, reveals functional asymmetry and sexual dimorphism in cerebellar development, and lays the groundwork for future research on cerebellum-related disorders in children.

Does Gestural Communication Influence Later Spoken Language Ability in Minimally Verbal Autistic Children?

PURPOSE

The current study examined the predictive role of gestures and gesture-speech combinations on later spoken language outcomes in minimally verbal (MV) autistic children enrolled in a blended naturalistic developmental/behavioral intervention (Joint Attention, Symbolic Play, Engagement, and Regulation [JASPER] + Enhanced Milieu Teaching [EMT]).

METHOD

Participants were 50 MV autistic children (40 boys), ages 54-105 months (M = 75.54, SD = 16.45). MV was defined as producing fewer than 20 spontaneous, unique, and socially communicative words. Autism symptom severity (Autism Diagnostic Observation Schedule-Second Edition) and nonverbal cognitive skills (Leiter-R Brief IQ) were assessed at entry. A natural language sample (NLS), a 20-min examiner-child interaction with specified toys, was collected at entry (Week 1) and exit (Week 18) from JASPER + EMT intervention. The NLS was coded for gestures (deictic, conventional, and representational) and gesture-speech combinations (reinforcing, disambiguating, supplementary, other) at entry and spoken language outcomes: speech quantity (rate of speech utterances) and speech quality (number of different words [NDW] and mean length of utterance in words [MLUw]) at exit using European Distributed Corpora Project Linguistic Annotator and Systematic Analysis of Language Transcripts.

RESULTS

Controlling for nonverbal IQ and autism symptom severity at entry, rate of gesture-speech combinations (but not gestures alone) at entry was a significant predictor of rate of speech utterances and MLUw at exit. The rate of supplementary gesture-speech combinations, in particular, significantly predicted rate of speech utterances and NDW at exit.

CONCLUSION

These findings highlight the critical importance of gestural communication, particularly gesture-speech (supplementary) combinations in supporting spoken language development in MV autistic children.

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 Emergence and Development of Palestinian Arabic Lexicon and Morphosyntax From 18 to 36 Months: A Communicative Development Inventory Study

PURPOSE

This study presents a comprehensive exploration of lexical and grammatical development in Palestinian Arabic (PA). The study aims to test the validity of the Palestinian Arabic Communicative Development Inventory (PA-CDI) as well as generate growth curves for lexical and morphosyntactic development, examine the order of emergence of both lexical and morphosyntactic categories, and explore the contribution of demographic and developmental factors to language development.

METHOD

Data were collected from 1,399 parents of PA children aged 18-36 months using an online PA-CDI.

RESULTS

The results show that as age increased, so did lexical and morphosyntactic production, along with considerable variability across individuals. While lexical development in PA resembles the order observed in other languages with nouns preceding verbs and adjectives, morphosyntactic development indicates early emergence of verbal inflectional morphology prior to noun pluralization or negation. Age of word combination and health problems are predictive of lexical and morphosyntactic development, and so are parental concerns.

CONCLUSIONS

Our findings indicate the potential of the PA-CDI as an assessment tool for lexical and morphosyntactic development among PA-speaking children in Israel. Our developmental growth curves may also be used to identify children at risk for developmental language disorder, particularly those falling below the 10th percentile, thus allowing for early identification and early intervention. The use of background variables, specifically parental concerns, health issues, and word combinations, along with the PA-CDI, could potentially enhance the precision of language delay assessment.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26026777.

Sex differences during development in cortical temporal processing and event related potentials in wild-type and fragile X syndrome model mice

BACKGROUND

Autism spectrum disorder (ASD) is currently diagnosed in approximately 1 in 44 children in the United States, based on a wide array of symptoms, including sensory dysfunction and abnormal language development. Boys are diagnosed ~ 3.8 times more frequently than girls. Auditory temporal processing is crucial for speech recognition and language development. Abnormal development of temporal processing may account for ASD language impairments. Sex differences in the development of temporal processing may underlie the differences in language outcomes in male and female children with ASD. To understand mechanisms of potential sex differences in temporal processing requires a preclinical model. However, there are no studies that have addressed sex differences in temporal processing across development in any animal model of ASD.

METHODS

To fill this major gap, we compared the development of auditory temporal processing in male and female wildtype (WT) and Fmr1 knock-out (KO) mice, a model of Fragile X Syndrome (FXS), a leading genetic cause of ASD-associated behaviors. Using epidural screw electrodes, we recorded auditory event related potentials (ERP) and auditory temporal processing with a gap-in-noise auditory steady state response (ASSR) paradigm at young (postnatal (p)21 and p30) and adult (p60) ages from both auditory and frontal cortices of awake, freely moving mice.

RESULTS

The results show that ERP amplitudes were enhanced in both sexes of Fmr1 KO mice across development compared to WT counterparts, with greater enhancement in adult female than adult male KO mice. Gap-ASSR deficits were seen in the frontal, but not auditory, cortex in early development (p21) in female KO mice. Unlike male KO mice, female KO mice show WT-like temporal processing at p30. There were no temporal processing deficits in the adult mice of both sexes.

CONCLUSIONS

These results show a sex difference in the developmental trajectories of temporal processing and hypersensitive responses in Fmr1 KO mice. Male KO mice show slower maturation of temporal processing than females. Female KO mice show stronger hypersensitive responses than males later in development. The differences in maturation rates of temporal processing and hypersensitive responses during various critical periods of development may lead to sex differences in language function, arousal and anxiety in FXS.

Developmental Language Differences in Children with Autism Spectrum Disorders and Possible Sex Difference

Developmental difference is a common characteristic of autism spectrum disorder (ASD) with unclear sex differences. The current study included 610 children with ASD, aged between 2 and 7 years, with completed language profiles. We used a nonparametric item response theory model called Mokken scale analysis to examine the order of acquisition of developmental language milestones in children with ASD. Our results demonstrated the developmental language differences in the expressive and receptive language dimensions in children with ASD compared with typical developmental sequences. Furthermore, The acquisition of gestures and pragmatics was more impaired in the female subgroup than in the male subgroup. The identified developmental language sequence could help provide a more comprehensive ASD developmental profile.

The breadth and specificity of 18-month-old's infant-initiated interactions in naturalistic home settings

Infants actively initiate social interactions aiming to elicit different types of responses from other people. This study aimed to document a variety of communicative interactions initiated by 18-month-old Turkish infants from diverse SES (N = 43) with their caregivers in their natural home settings. The infant-initiated interactions such as use of deictic gestures (e.g., pointing, holdouts), action demonstrations, vocalizations, and non-specific play actions were coded from video recordings and classified into two categories as need-based and non-need-based. Need-based interactions were further classified as a) biological (e.g., feeding); b) socio-emotional (e.g., cuddling), and non-need-based interactions (i.e., communicative intentions) were coded as a) expressive, b) requestive; c) information/help-seeking; d) information-giving. Infant-initiated non-need-based (88%) interactions were more prevalent compared to need-based interactions (12%). Among the non-need-based interactions, 50% aimed at expressing or sharing attention or emotion, 26% aimed at requesting an object or an action, and 12% aimed at seeking information or help. Infant-initiated information-giving events were rare. We further investigated the effects of familial SES and infant sex, finding no effect of either on the number of infant-initiated interactions. These findings suggest that at 18 months, infants actively communicate with their social partners to fulfil their need-based and non-need-based motivations using a wide range of verbal and nonverbal behaviors, regardless of their sex and socio-economic background. This study thoroughly characterizes a wide and detailed range of infant-initiated spontaneous communicative bids in hard-to-access contexts (infants' daily lives at home) and with a traditionally underrepresented non-WEIRD population.

Physical punishment and effective verbal communication in children aged 9-36 months, according to sex: secondary analysis of a national survey

BACKGROUND

A substantial number of children in the world are regularly subjected to physical punishment by their parents as a method of upbringing. Evidence suggests that it has negative effects on the development of brain function. However, evidence regarding its association with verbal communication is limited and heterogeneous. It is also unknown whether the effects are the same in both boys and girls; especially in the contexts of developing countries, where the highest rates of physical punishment are found.

OBJECTIVE

This investigation aimed at analyzing the association between physical punishment administered by both fathers and mothers and effective verbal communication among children aged 9-36 months according to sex.

METHODS

A secondary analytical cross-sectional study was conducted based on the 2018-2019 Peruvian Demographic and Family Health Survey. Physical punishment, based on the mother's report of the use of hitting and/or slapping, was considered as a method to correct children by the father and/or mother. Effective verbal communication (EVC) was measured using the Battle scale which consists of age-appropriate questions included in the early childhood development module. A generalized linear model of the family and Log Poisson link option was used to identify the association between them, using the crude, general adjusted, and sex-stratified models.

RESULTS

Of all the children, 16.31% received physical punishment from their father and/or mother, wherein 16.65% were boys and 15.97% were girls. Moreover, 36.48% exhibited EVC, wherein 32.55% were boys and 40.50% were girls. Adjusting for socioeconomic level, witnessing violence, mother's marital status, age, occupation, education level, language, number of children, and moderate-to-severe depressive symptoms, it was found that boys who received physical punishment from their father and/or mother have a 31% lower probability of EVC (adjusted prevalence ratio (aPR) 0.69, 95% confidence interval (CI) 0.58-0.83, p < 0.001), whereas no association was found in girls who received physical punishment from their father and/or mother and EVC (aPR 0.93, 95% CI 0.81-1.06, p = 0.278).

CONCLUSIONS

An association was found between physical punishment administered by father and/or mother and reduced EVC among boys, whereas no such association was found among girls. It is possible that even though a significant impact has not been observed in girls during this early stage, they may experience consequences in later stages of life, further research is needed.

Child-level factors associated with Spanish-English bilingual toddlers' productive vocabulary growth

This longitudinal study-conducted in the Midwestern United States-examines the child-level factors that promote Spanish-English bilingual toddlers' (n = 47; Mage = 18.80 months; SDage = 0.57) productive vocabulary skills from 18 to 30 months of age. At 6-month intervals, caregivers reported on toddlers' Spanish and English words produced as well as their language exposure at home. Video recordings at child age 18 months yielded estimates of toddlers' speech output (word tokens per minute). In addition, at child age 18 months, caregivers reported on toddlers' linguistic skills (comprehension), demographic background (gender, household income), and nonverbal behaviors (gesture production). Results showed that toddlers were exposed to both English and Spanish and received more Spanish than English from primary caregivers; there were no significant primary caregiver input differences across time. Growth modeling revealed linear growth rates for Spanish and conceptual (Spanish, English combined) vocabulary and a curvilinear trajectory for English vocabulary. Furthermore, toddlers' Spanish and conceptual vocabularies were positively associated with their higher frequencies of token use, greater production of gesture, and greater comprehension skills, even after controlling for input. Moreover, Spanish and conceptual growth rates were positively associated with higher token use. In terms of English, toddlers' vocabulary at child age 18 months was positively associated with their comprehension skills. Toddlers' use of more gestures and tokens as well as gender (boys) influenced their English acceleration rates over time. Findings indicate that unique trajectories exist for each of a bilingual's languages and these trajectories are differentially influenced by child-level factors, including their speech output, not only exposure to language. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sex differences in resting state functional connectivity across the first two years of life

Sex differences in behavior have been reported from infancy through adulthood, but little is known about sex effects on functional circuitry in early infancy. Moreover, the relationship between early sex effects on the functional architecture of the brain and later behavioral performance remains to be elucidated. In this study, we used resting-state fMRI and a novel heatmap analysis to examine sex differences in functional connectivity with cross-sectional and longitudinal mixed models in a large cohort of infants (n = 319 neonates, 1-, and 2-year-olds). An adult dataset (n = 92) was also included for comparison. We investigated the relationship between sex differences in functional circuitry and later measures of language (collected in 1- and 2-year-olds) as well as indices of anxiety, executive function, and intelligence (collected in 4-year-olds). Brain areas showing the most significant sex differences were age-specific across infancy, with two temporal regions demonstrating consistent differences. Measures of functional connectivity showing sex differences in infancy were significantly associated with subsequent behavioral scores of language, executive function, and intelligence. Our findings provide insights into the effects of sex on dynamic neurodevelopmental trajectories during infancy and lay an important foundation for understanding the mechanisms underlying sex differences in health and disease.

Postoperative MRI features of cerebellar mutism syndrome: a retrospective cohort study

OBJECTIVE

In this study, the authors aimed to investigate the relationship between postoperative MRI features and cerebellar mutism syndrome.

METHODS

A retrospective cohort of patients who underwent tumor resection from July 2013 to March 2021 for midline posterior fossa tumors was investigated. All patients were followed up at least once. Clinical data were extracted from medical records and follow-up databases. Two neuroradiologists independently reviewed preoperative and postoperative MRI. Univariable and multivariable analyses were performed to compare the postoperative cerebellar mutism syndrome (pCMS) and non-pCMS groups. Correlation analysis was performed using the Spearman correlation coefficient analysis.

RESULTS

Of 124 patients, 47 (37.9%) developed pCMS. The median follow-up duration was 45.73 (Q1: 33.4, Q3: 64.0) months. The median duration of mutism was 45 days. The median tumor size was 48.8 (Q1: 42.1, Q3: 56.8) mm. In the univariable analysis, abnormal T2-weighted signal of the left dentate nucleus (DN) (74.5% in the pCMS group vs 36.4% in the non-pCMS group, p < 0.001), right DN (83.0% vs 40.3%, p < 0.001), left superior cerebellar peduncle (SCP) (74.5% vs 27.3%, p < 0.001), right SCP (63.8% vs 23.4%, p < 0.001), left middle cerebellar peduncle (MCP) (51.1% vs 26.0%, p = 0.008), and right MCP (61.7% vs 26.0%, p < 0.001); male sex (83.0% vs 45.5%, p < 0.001); vermis 3 impairment (49.4% vs 19.1%, p = 0.002); solid tumor (91.5% vs 72.7%, p = 0.022); and hydrocephalus (72.3% vs 45.5%, p = 0.006) were more frequent in the pCMS group than in the non-pCMS group. Multivariable logistic analysis showed that male sex (adjusted OR 4.08, p = 0.010) and the cerebro-cerebellar circuit score of T2-weighted images (adjusted OR 2.15, p < 0.001) were independent risk factors for pCMS. The cerebro-cerebellar circuit score positively correlated with the duration of mutism. In Cox regression analysis, the cerebro-cerebellar integrated circuit injury score of T2 (adjusted HR 0.790, 95% CI 0.637-0.980; p = 0.032) and injury of vermis 3 (adjusted HR 3.005, 95% CI 1.197-7.547; p = 0.019) were independently associated with the duration of mutism.

CONCLUSIONS

Male sex and cerebro-cerebellar circuit damage are independent risk factors for pCMS. The cerebro-cerebellar circuit score indicates the duration of mutism.

Sex differences in neural processing of speech in neonates

The large majority of studies shows that girls develop their language skills faster than boys in the first few years of life. Are girls born with this advantage in language development? The present study used fNIRS in neonates to investigate sex differences in neural processing of speech within the first days of life. We found that speech stimuli elicited significantly more brain activity than non-speech stimuli in both groups of male and female neonates. However, whereas girls showed significant HbO changes to speech stimuli only within the left hemisphere, boys exhibited simultaneous neural activations in both hemispheres, with a larger and more significant fronto-temporal cluster in the right hemisphere. Furthermore, in boys, the variation in time-to-peak latencies was considerably greater than in girls. These findings suggest an earlier maturation of language-related brain areas in girls and highlight the importance of sex-specific investigations of neural language networks in infants.

Male Predisposition in Cerebellar Mutism Syndrome: a Cohort Study

The aim of this study was to explore the association between sex and cerebellar mutism syndrome and to examine other potential risk factors. This ambispective cohort study examined 218 pediatric patients (132 boys) with a posterior fossa tumor who underwent tumor resection from July 2013 to March 2021. The patients' demographics and tumor characteristics were examined and statistically analyzed to explore the associations among the variables. Multivariable and subgroup analyses were conducted to validate the independent risk factors for cerebellar mutism syndrome (CMS). The male and female patients did not differ significantly in terms of age, tumor size, tumor location, tumor consistency, VP shunt placement before resection, extent of resection, or surgeon, as well as with respect to the presence of hydrocephalus or paraventricular edema. The overall incidence of CMS was 32.6%. The incidence of CMS was significantly higher in male patients than that in female patients (41.7% vs. 18.6%; P = 0.001). In the multivariable analysis, male sex (adjusted odds ratio [OR], 3.27; P = 0.001), solid tumor consistency (adjusted OR, 5.61; P = 0.001), midline location (adjusted OR, 3.78; P = 0.004), and hydrocephalus (adjusted OR, 2.56; P = 0.047) were independent risk factors for the CMS. Chi-square analysis revealed that solid tumor consistency and midline location were associated with medulloblastoma (P < 0.001). Male patients had a higher risk of developing CMS after a posterior fossa tumor resection. Midline location, solid tumor consistency, and hydrocephalus were independent risk factors for CMS.

Effects of neurodevelopmental risk factors on brainstem maturation in premature infants

BACKGROUND

Interpeak latencies (IPL), as measured by the auditory brainstem-evoked responses (ABR) test, represent the conduction time, and therefore the maturation of the brainstem auditory pathway. We aimed to study the effect of various risk factors for the neurodevelopmental delay on the conduction time in the auditory pathway among normal hearing premature infants, at term postmenstrual age (PMA).

METHODS

Retrospective analysis of 239 premature infants (gestational age 32.5 ± 2.1 weeks, birth weight 1827 ± 483 g). Interpeak latencies, demographic data, and risk factors were recorded.

RESULTS

Sex, PMA at ABR test, being small for gestational age (SGA), intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL), and days of invasive ventilation were found to significantly affect the IPL's in the auditory pathway in a univariate analysis. Multivariable regression analysis revealed that male sex and less advanced PMA at the examination were independent factors associated with prolonged IPL's, while bronchopulmonary dysplasia, IVH or PVL and being SGA shortened the IPL's. Non-invasive mechanical ventilation, did not affect the caudal part of the auditory pathway, despite its high noise level.

CONCLUSIONS

Among various risk factors for the neurodevelopmental delay, male sex was associated with delayed, while IVH or PVL, BPD and SGA could be associated with accelerated auditory brainstem maturation.

IMPACT

Auditory brainstem-evoked response (ABR) test, among normal hearing infants, can serve as a clinical tool to assess brainstem auditory maturation. Different neurodevelopmental risk factors could have different effects on the maturity of the auditory pathway. Male sex is significantly associated with prolonged interpeak latencies (IPL) among preterm and term infants, while intraventricular hemorrhage or periventricular leukomalacia, bronchopulmonary dysplasia, and being small for gestation age may be associated with shortened IPL The corrected age at ABR testing is of significance, among preterm and term infants.

Gesture development in infancy: Effects of gender but not bilingualism

Gesture is an important communication tool that provides insight into infants' early language and cognitive development and predicts later language skills. While bilingual school-age children have been reported to gesture more than monolinguals, there is a lack of research examining gesture use in infants exposed to more than one language. In this preregistered study, we compared three groups of 14-month-old infants (N = 150) learning French and/or English: bilinguals (hearing a second language at least 25% of the time), exposed (hearing a second language 10%-24% of the time), and monolinguals (hearing one language 90% of the time or more). Parent-reported use of communicative gestures was gathered from the MacArthur-Bates Communicative Development Inventories (CDI). Results showed that the three language groups had similarly sized gesture repertoires, suggesting that language exposure did not affect gesture development at this age. However, a gender effect was found, where girls produced more types of gestures than boys. Overall, these results suggest that gender, but not language exposure, contributes to differences in gesture development in infancy.

Can gesture input support toddlers' fast mapping?

Forty-eight toddlers participated in a word-learning task to assess gesture input on mapping nonce words to unfamiliar objects. Receptive fast mapping and expressive naming for target object-word pairs were tested in three conditions - with a point, with a shape gesture, and in a no-gesture, word-only condition. No statistically significant effect of gesture for receptive fast-mapping was found but age was a factor. Two year olds outperformed one year olds for both measures. Only one girl in the one-year-old group correctly named any items. There was a significant interaction between gesture and gender for expressive naming. Two-year-old girls were six times more likely than two-year-old boys to correctly name items given point and shape gestures; whereas, boys named more items taught with the word only than with a point or shape gesture. The role of gesture input remains unclear, particularly for children under two years and for toddler boys.

Integrating Gestures and Words to Communicate in Full-Term and Low-Risk Preterm Late Talkers

Young children use gestures to practice communicative functions that foster their receptive and expressive linguistic skills. Studies investigating the use of gestures by late talkers are limited. This study aimed to investigate the use of gestures and gesture–word combinations and their associations with word comprehension and word and sentence production in late talkers. A further purpose was to examine whether a set of individual and environmental factors accounted for interindividual differences in late talkers’ gesture and gesture–word production. Sixty-one late talkers, including 35 full-term and 26 low-risk preterm children, participated in the study. Parents filled out the Italian short forms of the MacArthur–Bates Communicative Development Inventories (MB–CDI), “Gesture and Words” and “Words and Sentences” when their children were 30-months-old, and they were then invited to participate in a book-sharing session with their child. Children’s gestures and words produced during the book-sharing session were transcribed and coded into CHAT of CHILDES and analyzed with CLAN. Types of spontaneous gestures (pointing and representational gestures) and gesture–word combinations (complementary, equivalent, and supplementary) were coded. Measures of word tokens and MLU were also computed. Correlational analyses documented that children’s use of gesture–word combinations, particularly complementary and supplementary forms, in the book-sharing session was positively associated with linguistic skills both observed during the session (word tokens and MLU) and reported by parents (word comprehension, word production, and sentence production at the MB–CDI). Concerning individual factors, male gender was negatively associated with gesture and gesture–word use, as well as with MB–CDI action/gesture production. In contrast, having a low-risk preterm condition and being later-born were positively associated with the use of gestures and pointing gestures, and having a family history of language and/or learning disorders was positively associated with the use of representational gestures. Furthermore, a low-risk preterm status and a higher cognitive score were positively associated with gesture–word combinations, particularly complementary and supplementary types. With regard to environmental factors, older parental age was negatively associated with late talkers’ use of gestures and pointing gestures. Interindividual differences in late talkers’ gesture and gesture–word production were thus related to several intertwined individual and environmental factors. Among late talkers, use of gestures and gesture–word combinations represents a point of strength promoting receptive and expressive language acquisition.

Aging, Gesture Production, and Disfluency in Speech: A Comparison of Younger and Older Adults

Age-related changes are observed in the speech and gestures of neurotypical individuals. Older adults are more disfluent in speech and use fewer representational gestures (e.g., holding two hands close to each other to mean small), compared to younger adults. Using gestures, especially representational gestures, is common in difficult tasks to aid the conceptualization process and to facilitate lexical access. This study investigates how aging can affect gesture production and the co-occurrence between gesture and speech disfluency. We elicited speech and gesture samples from younger and older adults (N = 60) by using a painting description task that provided concrete and abstract contexts. Results indicated that albeit the two age groups revealed comparable overall speech disfluency and gesture rates, they differed in terms of how their disfluencies and gestures were distributed across specific categories. Moreover, the proportion of speech disfluencies that occur with a gesture was significantly higher for younger than older adults. However, the two age groups were comparable in terms of the proportion of gestures that were accompanied by a speech disfluency. These findings suggest that younger adults' language production system might be better at benefiting from other modalities, that is, gesture, to resolve temporary problems in speech planning. However, from a gesture perspective, it might be difficult to differentiate between gestures' self-oriented and communicative functions and understand their role in speech facilitation. Focusing on specific cases where speech disfluency and gestures co-occur and considering individual differences might bring insight into multimodal communication.

Identifying Patterns of Similarities and Differences between Gesture Production and Comprehension in Autism and Typical Development

Production and comprehension of gesture emerge early and are key to subsequent language development in typical development. Compared to typically developing (TD) children, children with autism spectrum disorders (ASD) exhibit difficulties and/or differences in gesture production. However, we do not yet know if gesture production either shows similar patterns to gesture comprehension across different ages and learners, or alternatively, lags behind gesture comprehension, thus mimicking a pattern akin to speech comprehension and production. In this study, we focus on the gestures produced and comprehended by a group of young TD children and children with ASD—comparable in language ability—with the goal to identify whether gesture production and comprehension follow similar patterns between ages and between learners. We elicited production of gesture in a semi-structured parent–child play and comprehension of gesture in a structured experimenter-child play across two studies. We tested whether young TD children (ages 2–4) follow a similar trajectory in their production and comprehension of gesture (Study 1) across ages, and if so, whether this alignment remains similar for verbal children with ASD (M_age = 5 years), comparable to TD children in language ability (Study 2). Our results provided evidence for similarities between gesture production and comprehension across ages and across learners, suggesting that comprehension and production of gesture form a largely integrated system of communication.

Effect of sex and dyad composition on speech and gesture development of singleton and twin children

Children's early vocabulary shows sex differences - with boys having smaller vocabularies than age-comparable girls - a pattern that becomes evident in both singletons and twins. Twins also use fewer words than their singleton peers. However, we know relatively less about sex differences in early gesturing in singletons or twins, and also how singletons and twins might differ in their early gesture use. We examine the patterns of speech and gesture production of singleton and twin children, ages 0;10-to-3;4, during structured parent-child play. Boys and girls - singleton or twin - were similar in speech and gesture production, but singletons used a greater amount and diversity of speech and gestures than twins. There was no effect of twin dyad type (boy-boy, girl-girl, boy-girl) on either speech or gesture production. These results confirm earlier research showing close integration between gesture and speech in singletons in early language development, and further extend these patterns to twin children.

Gender differences in early stages of language development. Some evidence and possible explanations

It is a common feeling that girls speak earlier than boys; however, whether or not there are gender differences in early language acquisition remains controversial. The present paper aims to review the research on gender effects in early language acquisition and development, to determine whether, and from which age, an advantage for girls does eventually emerge. The focus is on the production of actions and communicative gestures, and early lexical comprehension and production, by girls and boys. The data from various studies that were conducted with direct and indirect tools suggest that some gender differences in actions, gesture, and lexical development depend on the interactions of different factors. Studies differ in terms of age ranges, sample sizes, and tools used, and the girl advantage is often slight and/or not evident at all ages considered. Statistical significance for gender differences appears to depend on the greater individual variability among boys, with respect to girls, which results in a greater number of boys classified as children with poor verbal ability. Biological (e.g., different maturational rates), neuropsychological (e.g., different cognitive strategies in solving tasks), and cultural (e.g., differences in the way parents relate socially to boys and girls) factors appear to interact, to create feedback loops of mutual reinforcement.

Do Biological Sex and Early Developmental Milestones Predict the Age of First Concerns and Eventual Diagnosis in Autism Spectrum Disorder?

Despite advances in early detection, the average age of autism spectrum disorder (ASD) diagnosis exceeds 4 years and is often later in females. In typical development, biological sex predicts inter-individual variation across multiple developmental milestones, with females often exhibiting earlier progression. The goal of this study was to examine sex differences in caregiver-reported developmental milestones (first word, phrase, walking) and their contribution to timing of initial concerns expressed by caregivers and eventual age of diagnosis. 195 (105 males) children and adolescents aged 8 to 17 years with a clinical diagnosis of ASD were recruited to the study (mean IQ = 99.76). While developmental milestones did not predict timing of diagnosis or age parents first expressed concerns, females had earlier first words and phrases than males. There was a marginal difference in the age of diagnosis, with females receiving their diagnosis 1 year later than males. Despite sex differences in developmental milestones and diagnostic variables, IQ was the most significant predictor in the timing of initial concerns and eventual diagnosis, suggesting children with lower IQ, regardless of sex, are identified and diagnosed earlier. Overall, biological sex and developmental milestones did not account for a large proportion of variance for the eventual age of ASD diagnosis, suggesting other factors (such as IQ and the timing of initial concerns) are potentially more influential. LAY SUMMARY: In this study, a later age of diagnosis in females having ASD was confirmed; however, biological sex was not the stronger predictor of age of diagnosis. Parents reported that females learned language more quickly than males, and parents noted their first concerns when females were older than males. In this sample, the strongest predictor of age of diagnosis was the age of first concerns.

Neonatal brain metabolite concentrations: Associations with age, sex, and developmental outcomes

Age and sex differences in brain metabolite concentrations in early life are not well understood. We examined the associations of age and sex with brain metabolite levels in healthy neonates, and investigated the associations between neonatal brain metabolite concentrations and developmental outcomes. Forty-one infants (36–42 gestational weeks at birth; 39% female) of predominantly Hispanic/Latina mothers (mean 18 years of age) underwent MRI scanning approximately two weeks after birth. Multiplanar chemical shift imaging was used to obtain voxel-wise maps of N-acetylaspartate (NAA), creatine, and choline concentrations across the brain. The Bayley Scales of Infant and Toddler Development, a measure of cognitive, language, and motor skills, and mobile conjugate reinforcement paradigm, a measure of learning and memory, were administered at 4 months of age. Findings indicated that postmenstrual age correlated positively with NAA concentrations in multiple subcortical and white matter regions. Creatine and choline concentrations showed similar but less pronounced age related increases. Females compared with males had higher metabolite levels in white matter and subcortical gray matter. Neonatal NAA concentrations were positively associated with learning and negatively associated with memory at 4 months. Age-related increases in NAA, creatine, and choline suggest rapid development of neuronal viability, cellular energy metabolism, and cell membrane turnover, respectively, during early life. Females may undergo earlier and more rapid regional developmental increases in the density of viable neurons compared to males.

Gesture Use and Processing: A Review on Individual Differences in Cognitive Resources

Speakers use spontaneous hand gestures as they speak and think. These gestures serve many functions for speakers who produce them as well as for listeners who observe them. To date, studies in the gesture literature mostly focused on group-comparisons or the external sources of variation to examine when people use, process, and benefit from using and observing gestures. However, there are also internal sources of variation in gesture use and processing. People differ in how frequently they use gestures, how salient their gestures are, for what purposes they produce gestures, and how much they benefit from using and seeing gestures during comprehension and learning depending on their cognitive dispositions. This review addresses how individual differences in different cognitive skills relate to how people employ gestures in production and comprehension across different ages (from infancy through adulthood to healthy aging) from a functionalist perspective. We conclude that speakers and listeners can use gestures as a compensation tool during communication and thinking that interacts with individuals' cognitive dispositions.

Gesture Development, Caregiver Responsiveness, and Language and Diagnostic Outcomes in Infants at High and Low Risk for Autism

We investigated gesture production in infants at high and low risk for autism spectrum disorder (ASD) and caregiver responsiveness between 12 and 24 months of age and assessed the extent to which early gesture predicts later language and ASD outcomes. Participants included 55 high-risk infants, 21 of whom later met criteria for ASD, 34 low-risk infants, and their caregivers. Results indicated that (a) infants with ASD outcomes used fewer gestures and a lower proportion of developmentally advanced gesture-speech combinations; (b) caregivers of all the infants provided similar rates of contingent responses to their infants' gestures; and (c) gesture production at 12 months predicted subsequent receptive language and ASD outcomes within the high-risk group.

Social Communication and Structural Language of Girls With High-Functioning Autism Spectrum Disorder

Purpose The purpose of this study was to characterize social communication and structural language of school-age girls with high-functioning autism spectrum disorder (HF-ASD) compared to a matched group of girls who are typically developing (TD). Method Participants were 37 girls between 7;5 and 15;2 (years;months)-18 HF-ASD and 19 TD. Children completed the Test of Pragmatic Language-Second Edition (TOPL-2) and Clinical Evaluation of Language Fundamentals-Fifth Edition. Parents completed the Children's Communication Checklist-2 United States Edition (CCC-2) and Receptive and Expressive Communication subdomains of the Vineland Adaptive Behavior Scales-Second Edition. Results In the area of social communication, girls with HF-ASD earned significantly lower scores and were more often classified as having an impairment on the TOPL-2 and the CCC-2. However, 28% and 33% earned average scores on the TOPL-2 and the CCC-2, respectively. In the area of structural language, no significant differences were found between groups on Clinical Evaluation of Language Fundamentals-Fifth Edition indexes. In contrast, girls with HF-ASD earned significantly lower scores and were more often classified as having an impairment on the Vineland Adaptive Behavior Scales-Second Edition. Sixty-one percent and 83% scored below average on the Receptive and Expressive Communication subdomains, respectively. Conclusions It has been argued that girls with HF-ASD, when compared to boys with HF-ASD, may have advantages for social communication and structural language that mask their impairments. However, when compared to girls who are TD, girls with HF-ASD demonstrated impaired social communication and structural language. Clinicians should include and carefully examine multiple sources of information when assessing girls with HF-ASD.

Relations between Everyday Executive Functioning and Language in Youth with Down Syndrome and Youth with Autism Spectrum Disorder

Language and executive functioning are major impairments in many neurodevelopmental disorders, but little is known about the relations between these constructs, particularly using parent-report. Thus, the current research sought to examine relations between executive function and language in two groups - Down syndrome (DS; n=41; Mage = 11.2) and autism spectrum disorder (ASD; n=91; Mage = 7.7). Results were as follows: in DS, executive function predicted pragmatic, but not structural language after covarying for age, sex, and social functioning; in ASD, executive function predicted both. Findings highlight the interrelatedness of language and executive functioning and may have implications for intervention development.

Do you understand what I want to tell you? Early sensitivity in bilinguals' iconic gesture perception and production

Previous research has shown differences in monolingual and bilingual communication. We explored whether monolingual and bilingual pre-schoolers (N = 80) differ in their ability to understand others' iconic gestures (gesture perception) and produce intelligible iconic gestures themselves (gesture production) and how these two abilities are related to differences in parental iconic gesture frequency. In a gesture perception task, the experimenter replaced the last word of every sentence with an iconic gesture. The child was then asked to choose one of four pictures that matched the gesture as well as the sentence. In a gesture production task, children were asked to indicate 'with their hands' to a deaf puppet which objects to select. Finally, parental gesture frequency was measured while parents answered three different questions. In the iconic gesture perception task, monolingual and bilingual children did not differ. In contrast, bilinguals produced more intelligible gestures than their monolingual peers. Finally, bilingual children's parents gestured more while they spoke than monolingual children's parents. We suggest that bilinguals' heightened sensitivity to their interaction partner supports their ability to produce intelligible gestures and results in a bilingual advantage in iconic gesture production.

Neurophysiological evidence for rapid processing of verbal and gestural information in understanding communicative actions

During everyday social interaction, gestures are a fundamental part of human communication. The communicative pragmatic role of hand gestures and their interaction with spoken language has been documented at the earliest stage of language development, in which two types of indexical gestures are most prominent: the pointing gesture for directing attention to objects and the give-me gesture for making requests. Here we study, in adult human participants, the neurophysiological signatures of gestural-linguistic acts of communicating the pragmatic intentions of naming and requesting by simultaneously presenting written words and gestures. Already at ~150 ms, brain responses diverged between naming and request actions expressed by word-gesture combination, whereas the same gestures presented in isolation elicited their earliest neurophysiological dissociations significantly later (at ~210 ms). There was an early enhancement of request-evoked brain activity as compared with naming, which was due to sources in the frontocentral cortex, consistent with access to action knowledge in request understanding. In addition, an enhanced N400-like response indicated late semantic integration of gesture-language interaction. The present study demonstrates that word-gesture combinations used to express communicative pragmatic intentions speed up the brain correlates of comprehension processes – compared with gesture-only understanding – thereby calling into question current serial linguistic models viewing pragmatic function decoding at the end of a language comprehension cascade. Instead, information about the social-interactive role of communicative acts is processed instantaneously.

Does gender affect Bayley-III scores and test-taking behavior?

The developmental test Bayley-III is widely used in clinical and research settings, but there are no published gender-specific norms. The purpose of the present study was to investigate gender differences in Bayley-III scores in a sample of 55 typically developing children assessed repeatedly at ages 4, 7, 10, 13, 24 and 36 months, and to investigate gender differences in the test-taking behavior of the children as measured with the BRS at 36 months. The results of the study demonstrated gender differences at 24 and 36 months for the Cognitive Scale, at 10, 13, 24 and 36 months for the Language Scale and at 36 months for the Motor Scale. On a subtest level, gender differences were found for the Receptive Communication subtest at 13, 24 and 36 months and for the Fine Motor subtest at 7 and 36 months. In all cases where significant gender differences were found, girls achieved higher mean scores than boys. No gender differences were found in the children's test-taking behavior at 36 months on any of the BRS scales, but independently of gender, higher Bayley-III Cognitive and Motor Scale scores were associated with more compliant test-taking behavior.

Sex differences in early communication development: behavioral and neurobiological indicators of more vulnerable communication system development in boys

Perhaps due to different roles they have had in social groups during evolution, men and women differ in their verbal abilities. These differences are also (if not even more) present in children, both in the course of typical and pathological development. Beside the fact that girls have a well-documented advantage in early language development, almost all developmental disorders primarily affecting communication, speech, and language skills are more frequent in boys. The sex-related difference in the prevalence of these disorders is especially pronounced in autism spectrum disorder (1 girl for each 4-5 boys is affected). The aim of this review is to present the sex differences in typical communication and language development and in the prevalence of communication-related neurodevelopmental disorders. Also, a special focus is put on data from the field of neuroscience that might provide insight into the neurobiological mechanisms that can add to the understanding of this phenomenon. We argue that the functional organization of the female brain gives women an inherent advantage in the acquisition of communication and language system over men.

Sex differences in early communication development: behavioral and neurobiological indicators of more vulnerable communication system development in boys

Perhaps due to different roles they have had in social groups during evolution, men and women differ in their verbal abilities. These differences are also (if not even more) present in children, both in the course of typical and pathological development. Beside the fact that girls have a well-documented advantage in early language development, almost all developmental disorders primarily affecting communication, speech, and language skills are more frequent in boys. The sex-related difference in the prevalence of these disorders is especially pronounced in autism spectrum disorder (1 girl for each 4-5 boys is affected). The aim of this review is to present the sex differences in typical communication and language development and in the prevalence of communication-related neurodevelopmental disorders. Also, a special focus is put on data from the field of neuroscience that might provide insight into the neurobiological mechanisms that can add to the understanding of this phenomenon. We argue that the functional organization of the female brain gives women an inherent advantage in the acquisition of communication and language system over men.

Parental use of spatial language and gestures in early childhood

Parents' use of spatial language and gestures is closely linked to children's spatial language development. Little is known about the quantity and quality of early spatial input and how infants' individual characteristics may be related to the spatial input they receive. Here, we examine (1) the amount and type of spatial input 16- to 21-month-old Turkish-learning children (n = 34) received in the context of a spatial activity (puzzle play) and (2) whether parental spatial input in the form of speech and gesture varies based on children's age, sex, and early spatial vocabulary comprehension assessed in an earlier session. Results of the regression analyses showed that parents' use of spatial words was predicted by children's age over and beyond earlier spatial word comprehension and sex. In particular, parents used more spatial speech as their children got older even in this restricted age range. Children's early spatial word comprehension also correlated with parents' spatial word production. Yet, parents' overall gesture use and gestures with spatial words were not predicted by children's age, sex, or early spatial word comprehension. These findings suggest that in the spatial domain, early verbal input, but not gestural input, can change depending on children's age and children's spatial vocabulary comprehension may also be related to parental use of later spatial language. Statement of contribution What is already known on this subject? Parents enhance their children's spatial skills using spatial language and gestures. Parental spatial talk is related to children's later spatial skills. What does this study add? We assess both spatial talk and gesture in early childhood. We examine the children's characteristics (age, sex) in relation to spatial talk and gesture. We present how children's earlier vocabulary competence relates to parental input.

Impact of Demographic and Obstetric Factors on Infant Brain Volumes: A Population Neuroscience Study

Individual differences in neuroanatomy are associated with intellectual ability and psychiatric risk. Factors responsible for this variability remain poorly understood. We tested whether 17 major demographic and obstetric variables were associated with individual differences in brain volumes in 756 neonates assessed with MRI. Gestational age at MRI, sex, gestational age at birth, and birthweight were the most significant predictors, explaining 31% to 59% of variance. Unexpectedly, earlier born babies had larger brains than later born babies after adjusting for other predictors. Our results suggest earlier born children experience accelerated brain growth, either as a consequence of the richer sensory environment they experience outside the womb or in response to other factors associated with delivery. In the full sample, maternal and paternal education, maternal ethnicity, maternal smoking, and maternal psychiatric history showed marginal associations with brain volumes, whereas maternal age, paternal age, paternal ethnicity, paternal psychiatric history, and income did not. Effects of parental education and maternal ethnicity are partially mediated by differences in birthweight. Remaining effects may reflect differences in genetic variation or cultural capital. In particular late initiation of prenatal care could negatively impact brain development. Findings could inform public health policy aimed at optimizing child development.

Do Parents Model Gestures Differently When Children's Gestures Differ?

Children with autism spectrum disorder (ASD) or with Down syndrome (DS) show diagnosis-specific differences from typically developing (TD) children in gesture production. We asked whether these differences reflect the differences in parental gesture input. Our systematic observations of 23 children with ASD and 23 with DS (Mages = 2;6)-compared to 23 TD children (Mage = 1;6) similar in expressive vocabulary-showed that across groups children and parents produced similar types of gestures and gesture-speech combinations. However, only children-but not their parents-showed diagnosis-specific variability in how often they produced each type of gesture and gesture-speech combination. These findings suggest that, even though parents model gestures similarly, the amount with which children produce each type largely reflects diagnosis-specific abilities.

The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort

PURPOSE

For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years.

METHOD

This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and environmental measures and first-degree relative history of stuttering. Comorbidities examined at 7 years included temperament, language, nonverbal cognition, and health-related quality of life.

RESULTS

The recovery rate by the age of 7 years was 65%. Girls with stronger communication skills at the age of 2 years had higher odds of recovery (adjusted OR = 7.1, 95% CI [1.3, 37.9], p = .02), but similar effects were not evident for boys (adjusted OR = 0.5, 95% CI [0.3, 1.1], p = .10). At the age of 7 years, children who had recovered from stuttering were more likely to have stronger language skills than children whose stuttering persisted (p = .05). No evident differences were identified on other outcomes including nonverbal cognition, temperament, and parent-reported quality of life.

CONCLUSION

Overall, findings suggested that there may be associations between language ability and recovery from stuttering. Subsequent research is needed to explore the directionality of this relationship.

Turning 1 Year of Age in a Low Socioeconomic Environment: A Portrait of Disadvantage

In the United States today, 16 million children are growing up poor. Few studies report multiple environmental factors associated with poverty during the first year of life and effects on infant development.

OBJECTIVES

To evaluate maternal, home, and neighborhood environment of low and higher socioeconomic status (SES) infants from birth to 1 year and to evaluate the impact of SES and environment on infant developmental outcome at 1 year.

METHODS

Low (n = 30) and higher SES (n = 30) African-American mothers and their healthy term gestation female infants were prospectively compared for environmental characteristics and infant developmental outcome. Wechsler Adult Intelligence Scale-IV (WAIS-IV); Beck Depression Inventory; Perceived Stress Scale; Parenting Stress Index-Fourth Edition (PSI-4); Social Support Scale; Home Observation Measurement of the Environment (HOME); Household Food Insecurity (HFI); Concentrated Neighborhood Disadvantage (CND). Bayley Scales of Infant Development Third Edition (BSID-III); Preschool Language Scale (PLS-5).

RESULTS

Environmental risk was greater for low compared with higher SES: lower WAIS-IV (p < .001); higher PSI-4 total (p = .003); lower HOME total and 3 subscales (p < .002); higher HFI (p = .012); and higher CND (p = .027). Low SES infant outcomes differed from higher SES: lower BSID-III Cognitive Composite (p = .005), PLS-5 Total Language (p ≤ .017), and Auditory Comprehension (p ≤ .008). In regressions, after controlling for SES, effects of environmental factors were not found.

CONCLUSION

By age 1, low SES infants had been exposed to greater environmental disadvantage and already exhibited poorer developmental functioning than higher SES infants. These findings suggest that support for families and children from impoverished circumstances cannot begin too early.

Who Did What to Whom? Children Track Story Referents First in Gesture

Children achieve increasingly complex language milestones initially in gesture or in gesture+speech combinations before they do so in speech, from first words to first sentences. In this study, we ask whether gesture continues to be part of the language-learning process as children begin to develop more complex language skills, namely narratives. A key aspect of narrative development is tracking story referents, specifying who did what to whom. Adults track referents primarily in speech by introducing a story character with a noun phrase and then following the same referent with a pronoun-a strategy that presents challenges for young children. We ask whether young children can track story referents initially in communications that combine gesture and speech by using character viewpoint in gesture to introduce new story characters, before they are able to do so exclusively in speech using nouns followed by pronouns. Our analysis of 4- to 6-year-old children showed that children introduced new characters in gesture+speech combinations with character viewpoint gestures at an earlier age than conveying the same referents exclusively in speech with the use of nominal phrases followed by pronouns. Results show that children rely on viewpoint in gesture to convey who did what to whom as they take their first steps into narratives.

Hospice Use for Infants With Life-Threatening Health Conditions, 2007 to 2010

BACKGROUND

Infant deaths account for a majority of all pediatric deaths. However, little is known about the factors that influence parents to use hospice care for their infant with a life-threatening health condition.

METHODS

Data were used from 2007 to 2010 California Medicaid claims files (N = 207). Analyses included logistic and negative binomial multivariate regression models.

RESULTS

More than 15% of infants enrolled in hospice care for an average of 5 days. Infant girls and infants with congenital anomalies were more likely to enroll in hospice care and to have longer stays. However, cardiovascular and respiratory conditions were negatively related to hospice enrollment and hospice length of stay.

CONCLUSIONS

This study provides insights for nurses and other clinicians who care for infants and their families at end of life and suggests that nurses can assist families in identifying infant hospice providers who may help families understand their options for end-of-life care.

Early deictic but not other gestures predict later vocabulary in both typical development and autism

Research with typically developing children suggests a strong positive relation between early gesture use and subsequent vocabulary development. In this study, we ask whether gesture production plays a similar role for children with autism spectrum disorder. We observed 23 18-month-old typically developing children and 23 30-month-old children with autism spectrum disorder interact with their caregivers (Communication Play Protocol) and coded types of gestures children produced (deictic, give, conventional, and iconic) in two communicative contexts (commenting and requesting). One year later, we assessed children's expressive vocabulary, using Expressive Vocabulary Test. Children with autism spectrum disorder showed significant deficits in gesture production, particularly in deictic gestures (i.e. gestures that indicate objects by pointing at them or by holding them up). Importantly, deictic gestures-but not other gestures-predicted children's vocabulary 1 year later regardless of communicative context, a pattern also found in typical development. We conclude that the production of deictic gestures serves as a stepping-stone for vocabulary development.

Fundamental Frequency of Crying in Two-month-old Boys and Girls: Do Sex Hormones During Mini-puberty Mediate Differences?

OBJECTIVE

To evaluate whether the puberty-like sex hormone surge during the first months of life (mini-puberty) affects fundamental frequency (fo) in infant crying as one would derive from hormone influences on voice in adults.

STUDY DESIGN

Populational prospective study.

PARTICIPANTS

Twenty healthy normal-hearing infants (nine boys) were recruited for participation.

METHODS

Spontaneously uttered cries were collected from each infant at 8 weeks of age. The cries were acoustically analyzed for mean fo and fo range. The fo properties were correlated to the average serum levels of bioavailable estradiol (E2) (mean E2/sex hormone-binding globulin [SHBG]) and testosterone (T) (mean T/SHBG) across the second month of life.

RESULTS

Whereas no significant hormone effect was found for mean fo, a significant negative correlation (r = -0.55) was found between fo range and mean E2/SHBG. No indication for a T influence on fo features was found at this age. Although girls showed a slightly higher mean E2 concentration than boys did, the observed differences in cry fo range were judged to be reflective of an infant's serum concentration of E2 rather than a sex-based difference.

CONCLUSION

In the absence of laryngeal size differences between female and male infants, the result was interpreted as indicative of an E2 influence on viscoelastic properties of the vocal folds. In our opinion, the investigation of young infants' vocalizations during the early postnatal surge of sex steroids (mini-puberty) may advance our understanding of the mechanisms mediating average sex differences in vocal development and early communication.

Sex Differences in Language Across Early Childhood: Family Socioeconomic Status does not Impact Boys and Girls Equally

Child sex and family socioeconomic status (SES) have been repeatedly identified as a source of inter-individual variation in language development; yet their interactions have rarely been explored. While sex differences are the focus of a renewed interest concerning emerging language skills, data remain scarce and are not consistent across preschool years. The questions of whether family SES impacts boys and girls equally, as well as of the consistency of these differences throughout early childhood, remain open. We evaluated consistency of sex differences across SES and age by focusing on how children (N = 262), from 2;6 to 6;4 years old, from two contrasting social backgrounds, acquire a frequent phonological alternation in French - the liaison. By using a picture naming task eliciting the production of obligatory liaisons, we found evidence of sex differences over the preschool years in low-SES children, but not between high-SES boys and girls whose performances were very similar. Low-SES boys' performances were the poorest whereas low-SES girls' performances were intermediate, that is, lower than those of high-SES children of both sexes but higher than those of low-SES boys. Although all children's mastery of obligatory liaisons progressed with age, our findings showed a significant impeding effect of low-SES, especially for boys.

Extensão média do enunciado-palavras em crianças de 4 e 5 anos com desenvolvimento típico da linguagem

Resumo:OBJETIVO:analisar a Extensão Média do Enunciado-palavras (EME-p) em crianças entre os 4;00 e os 5;05.MÉTODOS:foram observadas 92 crianças portuguesas com desenvolvimento típico: 49 meninas e 43 meninos, divididas em grupos etários com 6 meses de intervalo. Foi recolhida para cada criança uma amostra de 100 enunciados produzidos em discurso espontâneo. Os enunciados foram transcritos e analisados.RESULTADOS:a EME-p variou de 4,5 a 5 palavras, aumentando com a idade. Esta progressão foi verificada anteriormente em crianças falantes de Inglês dos EUA e de Português do Brasil, embora no Português Europeu o número de palavras seja, no geral, um pouco superior. O desempenho de meninos e meninas foi idêntico. A escolaridade dos pais mostrou ter alguma influência, mas não em todos os grupos etários. Os resultados mostraram uma correlação positiva e significante com um teste formal de linguagem, tanto na compreensão, como na expressão.CONCLUSÃO:a EME-p é uma boa medida de desenvolvimento da linguagem até aos 5 anos. Os valores encontrados podem servir como referência normativa relativamente às crianças portuguesas, mas também em estudos comparativos sobre o desenvolvimento da linguagem espontânea.