How Young Children Learn Language and Speech

Autism Spectrum Disorder at Home and in School

The diagnosis of autism spectrum disorder (ASD) brings a lifetime of considerations for individuals and their families. The core symptoms of ASD vary in severity and influence behavior and function across all environments. Co-occurring medical, mental health, cognitive, language, learning, and behavioral differences add challenges to those associated with core symptoms. Navigating the preschool, school, and transition ages in the educational setting requires continual reassessment of the strengths, weaknesses, and needs of the student to provide appropriate placement and services.

Unsupervised Screen Exposure and Poor Language Development: A Scoping Review to Assess Current Evidence and Suggest Priorities for Research

Screen exposure has both negative and positive effects on the level of language skills a child acquires. The purpose of this review is to address current literature on the possible relationship between unsupervised screen exposure and language development in children and to provide recommendations to caregivers regarding screen exposure of children, taking into consideration the possible effects. A scoping review was conducted using the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online) database. A total of 590 articles were retrieved and considered for inclusion. Twenty-one articles were finally included and reviewed with an emphasis on language, communication, and executive skills as well as cognitive development. The negative effects of screen exposure for children outweigh the positive effects. The largest number of studies demonstrate that unsupervised screen exposure may negatively impact a child's language usage and cognitive and executive skills, disrupt playtime, and affect the quality of sleep. On the other hand, supervised screen use is associated with improved language skills. More evidence is needed on unsupervised exposure in children to new types of screens. As technology could play a significant role in schools in the future, additional research is required to create educational media for schoolchildren with specific guidelines.

Social Brain Perspectives on the Social and Evolutionary Neuroscience of Human Language

Human language and social cognition are two key disciplines that have traditionally been studied as separate domains. Nonetheless, an emerging view suggests an alternative perspective. Drawing on the theoretical underpinnings of the social brain hypothesis (thesis of the evolution of brain size and intelligence), the social complexity hypothesis (thesis of the evolution of communication), and empirical research from comparative animal behavior, human social behavior, language acquisition in children, social cognitive neuroscience, and the cognitive neuroscience of language, it is argued that social cognition and language are two significantly interconnected capacities of the human species. Here, evidence in support of this view reviews (1) recent developmental studies on language learning in infants and young children, pointing to the important crucial benefits associated with social stimulation for youngsters, including the quality and quantity of incoming linguistic information, dyadic infant/child-to-parent non-verbal and verbal interactions, and other important social cues integral for facilitating language learning and social bonding; (2) studies of the adult human brain, suggesting a high degree of specialization for sociolinguistic information processing, memory retrieval, and comprehension, suggesting that the function of these neural areas may connect social cognition with language and social bonding; (3) developmental deficits in language and social cognition, including autism spectrum disorder (ASD), illustrating a unique developmental profile, further linking language, social cognition, and social bonding; and (4) neural biomarkers that may help to identify early developmental disorders of language and social cognition. In effect, the social brain and social complexity hypotheses may jointly help to describe how neurotypical children and adults acquire language, why autistic children and adults exhibit simultaneous deficits in language and social cognition, and why nonhuman primates and other organisms with significant computational capacities cannot learn language. But perhaps most critically, the following article argues that this and related research will allow scientists to generate a holistic profile and deeper understanding of the healthy adult social brain while developing more innovative and effective diagnoses, prognoses, and treatments for maladies and deficits also associated with the social brain.

Social inequalities in early childhood language development during the COVID-19 pandemic: a descriptive study with data from three consecutive school entry surveys in Germany

BACKGROUND

Social health inequalities are still of great public health importance in modern societies. The COVID-19 pandemic may have affected social inequalities in people's health due to containment measures. As these measures particularly affected children, they might have been particularly vulnerable to increased social inequalities. The aim of the study was to describe health inequalities during the pandemic based on language delay (LD) in children in order to inform public health interventions for a population at risk of long-term health and education inequalities.

METHODS

Data of 5-7 year old children from three consecutive school entry surveys in the German federal state of Brandenburg were used, including data compulsorily collected before the pandemic (2018/2019: n = 19,299), at the beginning of the pandemic (2019/2020: n = 19,916) and during the pandemic (2020/2021: n = 19,698). Bivariate and multivariate binary regression analyses [OR, 95% CI] cross-sectionally examined the relationship between the prevalence of LD [yes/no] and social inequalities, operationalized by family socioeconomic position [SEP low/middle/high], migration background [native-German language/non-native German language] and length of kindergarten attendance [< 4 years/ ≥ 4 years]. Factors contributing to inequality in LD were examined by socioeconomic stratification.

RESULTS

Cross-sectionally, LD prevalence has decreased overall (2018/2019: 21.1%, 2019/2020: 19.2%, 2020/2021: 18.8%), and among children from both high SEP and native German-speaking families. As LD prevalence increased among children from families with low SEP and remained stable among non-native German speakers, social inequalities in LD prevalence increased slightly during the pandemic i) by low SEP (2018/2019: OR = 4.41, 3.93-4.94; 2020/2021: OR = 5.12, 4.54-5.77) and ii) by non-German native language (2018/2019: OR = 2.22, 1.86-2.66; 2020/2021: OR = 2.54, 2.19-2.95). During the pandemic, both migration background and kindergarten attendance determined LD prevalence in the high and middle SEP strata. However, the measured factors did not contribute to LD prevalence in children from families with low SEP.

CONCLUSION

Social inequalities in LD increased due to opposing trends in prevalence comparing low and high SEP families. To promote health equity across the life course, early childhood should be of interest for tailored public health actions (e.g. through targeted interventions for kindergarten groups). Further analytical studies should investigate determinants (e.g., parental investment).

Effect of online parent training in promoting language development of children with language delay in Hubei province, China

BACKGROUND

Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay.

AIMS

This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language-delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home.

METHODS & PROCEDURES

The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8-h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3-month online home intervention monitoring.

OUTCOMES & RESULTS

146 families whose children aged 12-68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between-group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities.

CONCLUSION & IMPLICATIONS

The online parent training focusing on improving daily interaction with children through speech-language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs.

WHAT THIS PAPER ADDS

What is already known on the subject Parent-implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech-language therapists and may be the primary mode of service delivery or may supplement in-person services. What this paper adds to the existing knowledge This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin-speaking children and it is equally effective for children with ASD and non-ASD diagnosis. What are the potential or actual clinical implications of this work? Developmental behavioural paediatricians and speech-language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience.

Assessing specific items of Indian VSMS: Perspective of medical and rehabilitation professionals

Background

Adaptive behavior plays a crucial role in daily functioning, involving a complex interplay between individuals and their environment. In India, the Vineland Social Maturity Scale (VSMS) has been the preferred assessment tool for measuring adaptive behaviors, despite its age of over 85 years. However, periodic evaluation is necessary to ensure its continued relevance.

Aim

This study aims to critically evaluate selected items of the Indian version of the VSMS.

Materials and Methods

A survey form was developed through a focus group discussion (FGD), comprising 20 items from the Indian adaptation of the VSMS. The form was converted into a Google Form and distributed to medical and rehabilitation specialists across India. The responses were collected, recorded, and analyzed in an Excel sheet.

Results

Of the 107 responses received, 14 were incomplete and excluded, leaving 93 complete for analysis. The analysis revealed that less than half of the surveyed items and domains received ratings of disagreement from over a quarter of the respondents concerning their frequency, relevance, and diagnostic value.

Conclusion

This study underscores the need for a dynamic approach to defining and assessing adaptive behavior, especially in the Indian context. It highlights the importance of revising existing scales, incorporating technology-related items, and considering societal and cultural norms shifts. While acknowledging its limitations, this research sets the stage for future investigations to gain a more nuanced understanding of adaptive behaviors amidst changing societal dynamics. Ultimately, these efforts aim to develop more comprehensive and relevant assessment tools for adaptive behavior in today's rapidly evolving world.

Language Delay in Patients with CLN2 Disease: Could It Support Earlier Diagnosis?

Neuronal ceroid lipofuscinosis type 2 (CLN2 disease) is a rare pediatric disorder associated with rapid neurodegeneration, and premature death in adolescence. An effective enzyme replacement therapy (cerliponase alfa) has been approved that can reduce this predictable neurological decline. The nonspecific early symptoms of CLN2 disease frequently delay diagnosis and appropriate management. Seizures are generally recognized as the first presenting symptom of CLN2 disease, but emerging data show that language delay may precede this. An improved understanding of language deficits in the earliest stage of CLN2 disease may support the early identification of patients. In this article, CLN2 disease experts examine how language development is affected by CLN2 disease in their clinical practices. The authors' experiences highlighted the timings of first words and first use of sentences, and language stagnation as key features of language deficits in CLN2 disease, and how deficits in language may be an earlier sign of the disease than seizures. Potential challenges in identifying early language deficits include assessing patients with other complex needs, and recognizing that a child's language abilities are not within normal parameters given the variability of language development in young children. CLN2 disease should be considered in children presenting with language delay and/or seizures to facilitate earlier diagnosis and access to treatment that can significantly reduce morbidity.

Assessment of Language Development in Dual Language Learners: A Case Report

Propelled by immigration, language diversity is increasing in the United States, and more young children are exposed to two or more languages at home from birth. Known as dual language learners (DLLs), the benefits of this exposure include multilingual and multiliterate outcomes. However, DLLs introduce complexity for the pediatric provider's assessment of language development, identification of potential language delays, and timely referrals. If language delays are not promptly identified and followed with early intervention, they can persist and lead to poor outcomes across multiple domains.

'Children awaken by playing': a qualitative exploration of caregivers' norms, beliefs and practices related to young children's learning and early childhood development in rural Burkina Faso

INTRODUCTION

Evidence suggests that responsive caregiving and early learning activities positively impact developmental outcomes, with positive effects throughout the life course. Early childhood development interventions should align with local values, beliefs and resources but there has been little research of caregiver beliefs and perspectives on development and learning, especially in sub-Saharan Africa. This qualitative study explored norms, beliefs, practices and aspirations around child development of caregivers of young children in rural Burkina Faso.

METHODS

We conducted 32 in-depth interviews with mothers and fathers of young children and 24 focus group discussions with mothers, fathers and grandmothers, which included trying behaviours and reporting on experiences. The research informed the development of Scaling Up Nurturing Care, a Radio Intervention to Stimulate Early Childhood Development (SUNRISE), an early child development radio intervention.

RESULTS

Caregivers described a process of 'awakening', through which children become aware of themselves and the world around them.Perceptions of the timing of awakening varied, but the ability to learn was thought to increase as children became older and more awake. Consequently, talking and playing with babies and younger children were perceived to have little developmental impact. Caregivers said children's interactions with them, alongside God-given intelligence, was believed to impact later behaviour and development. Caregivers felt their role in helping their children achieve later in life was to pay for education, save money, provide advice and be good role models. Interaction and learning activities were not specifically mentioned. Caregivers who trialled interaction and learning activities reported positive experiences for themselves and their child, but interactions were often caregiver led and directive and play was often physical. Key barriers to carrying out the behaviours were poverty and a lack of time.

CONCLUSIONS

Exploring early childhood beliefs and practices can reveal important sociocultural beliefs which, if incorporated into programme planning and implementation, could help achieve more impactful, acceptable and equitable programmes.

TRIAL REGISTRATION NUMBER

NCT05335395.

Feasibility and Effectiveness of Speech Intervention Implemented with a Virtual Reality System in Children with Developmental Language Disorders: A Pilot Randomized Control Trial

Language disorders are characterized by impairments in verbal expression/understanding, including difficulties with one or more language components. The Virtual Reality Rehabilitation System (VRRS) is a bioelectromedical device equipped with exercise sections aimed at improving cognitive and language deficits. It also increases patient motivation and engagement. The aim of our study was to test the feasibility and efficacy of VRRS intervention to improve speech therapy treatment for children with speech disorders. Thirty-two patients were enrolled in this study and randomly assigned to the experimental (EG) or control group (CG). The CG underwent conventional speech therapy, while EG underwent VRRS-implemented speech therapy. Both groups were evaluated before (T0) and after (T1) the intervention using the Language Assessment Test. The results showed improvements in both groups. However, the EG group showed greater improvement in various areas, including comprehension of total words, repetition, naming of body parts, naming of everyday objects, total naming, morphosyntactic accuracy, sentence construction, average length of utterance, and spontaneous word production. This study demonstrated that VRRS can be a valuable tool for implementing effective speech rehabilitation. Further studies are needed, as the use of VRRS is still in its early stages, requiring larger samples sizes and long-term follow-up.

Nursing Practice and Care Structure for Children and Their Families in Need of Pediatric Palliative and End-of-Life Care in Japan: A Nationwide Survey

Many nurses experience difficulties in pediatric palliative care practice. The study aimed to describe the current situation and structure of pediatric palliative and end-of-life care nursing practices for children and their families in Japan. The research subjects were nurses working in hospitals; facilities for persons with severe physical, motor, and intellectual disabilities; and home-visit nursing stations. The practice ratio was calculated using a 79-item survey form, and factor analysis was conducted. A total of 113 facilities (acceptance rate: 26.5%) and 777 nurses (response rate: 44.6%) responded. Five items had a "Practicing" ratio of ≥90%. In factor analysis, 7 domains were identified: "preparing to face the time of death with the child and family," "ensuring child-centered care," "managing symptoms with the child and family," "considering and coordinating for the child's peaceful time of death," "understanding and respecting the culture of the child and family," "assessing the child and family as a whole person," and "performing self-reflection on an ethical issue." Nurses' practice of pediatric palliative care differs by practice domain. It is necessary to reflect on the educational programs under development to improve the quality of life of children and their families.

Psychometric Assessment of Pilot Language and Communication Items on the 2018 and 2019 National Survey of Children's Health

OBJECTIVE

Until recently, normative data on language and communication development among children in the United States have not been available to inform critical efforts to promote language development and prevent impairments. This study represents the first psychometric assessment of nationally representative data derived from a National Survey of Children's Health (NSCH) pilot measure of language and communication development among children ages 1 to 5 years.

METHODS

We analyzed 14,573 parent responses to language and communication items on the 2018 and 2019 NSCH to evaluate whether the newly added 11 items represent a single latent trait for language and communication development and to determine normative age of success on each item. We applied weighted, one-parameter Item Response Theory to rate and cluster items by difficulty relative to developmental language ability. We examined differential item functioning (DIF) using weighted logistic regression by demographic factors.

RESULTS

Together, exploratory factor analysis resulting in a single factor > 1 and explaining 93% of the variance and positive correlations indicated unidimensionality of the measure. Item characteristic curves indicated groupings were overall concordant with proposed milestone ages and representative of an approximate 90% success cut-point by child age. Indicated normative age cut-points for 3 of the items differed slightly from proposed milestone ages. Uniform DIF was not observed and potential nonuniform DIF was observed across 5 items.

CONCLUSIONS

Results have the potential to enhance understanding of risk and protective factors, inform efforts to promote language and communication development, and guide programmatic efforts on early detection of language delays.

Psychometric Characteristics of the Visual Communication and Sign Language Checklist

Since its publication in 2013, the Visual Communication and Sign Language (VCSL) Checklist has been widely utilized to assess the development of early American Sign Language skills of deaf children from birth to age 5. However, little research has been published using the results of VCSL assessments. Notably, no psychometric analyses have been conducted to verify the validity of the VCSL in a population whose characteristics are different from those of the small sample of native signing children from whom the published norms were created. The current paper, using data from the online version of the VCSL (VCSL:O), addresses this shortcoming. Ratings of the 114 VCSL items from 562 evaluations were analyzed using a partial-credit Rasch model. Results indicate that the underlying skill across the age range comprises an adequate single dimension. Within the items' age groupings, however, the dimensionality is not so clear. Item ordering, as well as item fit, is explored in detail. In addition, the paper reports the benefits of using the resulting Rasch scale scores, which, unlike the published scoring strategy that focuses on basal and ceiling performance, makes use of the ratings of partial credit, or emerging, skills. Strategies for revising the VCSL are recommended.

Association Between Toy Type and Parent Language Input Provided to Children With Autism Spectrum Disorder and Age-Matched Children With Typical Development

This comparative effectiveness research study evaluates the association between toy type and parent language input during play with children with autism spectrum disorder (ASD) and those with typical development.

Neuronal Circuits Supporting Development of Visual Naming Revealed by Intracranial Coherence Modulations

Background

Improvement in visual naming abilities throughout the childhood and adolescence supports development of higher-order linguistic skills. We investigated neuronal circuits underlying improvement in the speed of visual naming with age, and age-related dynamics of these circuits.

Methods

Response times were electronically measured during an overt visual naming task in epilepsy patients undergoing stereo-EEG monitoring. Coherence modulations among pairs of neuroanatomic parcels were computed and analyzed for relationship with response time and age.

Results

During the overt visual naming task, mean response time (latency) significantly decreased from 4 to 23 years of age. Coherence modulations during visual naming showed that increased connectivity between certain brain regions, particularly that between left fusiform gyrus/left parahippocampal gyrus and left frontal operculum, is associated with improvement in naming speed. Also, decreased connectivity in other brain regions, particularly between left angular and supramarginal gyri, is associated with decreased mean response time. Further, coherence modulations between left frontal operculum and both left fusiform and left posterior cingulate gyri significantly increase, while that between left angular and supramarginal gyri significantly decrease, with age.

Conclusion

Naming speed continues to improve from pre-school years into young adulthood. This age-related improvement in efficiency of naming environmental objects occurs likely because of strengthened direct connectivity between semantic and phonological nodes, and elimination of intermediate higher-order cognitive steps.

Behavioral Pediatrics: A Team-Based Interprofessional Approach

An interprofessional approach to pediatric behavioral care is increasingly important in the care of pediatric patients, who present to healthcare settings with a wide variety of concerns ranging from potty training to depression. Previously, much of the care of these patients have focused on a narrow approach to the problem, based on the expertise of the professional providing care. Faculty from three disciplines: Social Work, Psychology, and Medicine collaborated to design a course for students from these three disciplines to collaborate in attaining three goals: (1) reinforce the importance of multidisciplinary collaboration, (2) share clinical techniques and skills in a simulated interprofessional setting, and (3) practice collaboration within interprofessional teams. We detail the course goals and design and topics covered and discuss implementation of this course. Suggested module content and pedagogical design are discussed, and case examples are detailed with the goal of encouraging the adoption of similar courses.

Towards a model of language neurobiology in early development

Understanding language neurobiology in early childhood is essential for characterizing the developmental structural and functional changes that lead to the mature adult language network. In the last two decades, the field of language neurodevelopment has received increasing attention, particularly given the rapid advances in the implementation of neuroimaging techniques and analytic approaches that allow detailed investigations into the developing brain across a variety of cognitive domains. These methodological and analytical advances hold the promise of developing early markers of language outcomes that allow diagnosis and clinical interventions at the earliest stages of development. Here, we argue that findings in language neurobiology need to be integrated within an approach that captures the dynamic nature and inherent variability that characterizes the developing brain and the interplay between behavior and (structural and functional) neural patterns. Accordingly, we describe a framework for understanding language neurobiology in early development, which minimally requires an explicit characterization of the following core domains: i) computations underlying language learning mechanisms, ii) developmental patterns of change across neural and behavioral measures, iii) environmental variables that reinforce language learning (e.g., the social context), and iv) brain maturational constraints for optimal neural plasticity, which determine the infant's sensitivity to learning from the environment. We discuss each of these domains in the context of recent behavioral and neuroimaging findings and consider the need for quantitatively modeling two main sources of variation: individual differences or trait-like patterns of variation and within-subject differences or state-like patterns of variation. The goal is to enable models that allow prediction of language outcomes from neural measures that take into account these two types of variation. Finally, we examine how future methodological approaches would benefit from the inclusion of more ecologically valid paradigms that complement and allow generalization of traditional controlled laboratory methods.

Right-hemispheric language reorganization in patients with brain arteriovenous malformations: A functional magnetic resonance imaging study

Brain arteriovenous malformation (AVM), a presumed congenital lesion, may involve traditional language areas but usually does not lead to language dysfunction unless it ruptures. The objective of this research was to study right-hemispheric language reorganization patterns in patients with brain AVMs using functional magnetic resonance imaging (fMRI). We prospectively enrolled 30 AVM patients with lesions involving language areas and 32 age- and sex-matched healthy controls. Each subject underwent fMRI during three language tasks: visual synonym judgment, oral word reading, and auditory sentence comprehension. The activation differences between the AVM and control groups were investigated by voxelwise analysis. Lateralization indices (LIs) for the frontal lobe, temporal lobe, and cerebellum were compared between the two groups, respectively. Results suggested that the language functions of AVM patients and controls were all normal. Voxelwise analysis showed no significantly different activations between the two groups in visual synonym judgment and oral word reading tasks. In auditory sentence comprehension task, AVM patients had significantly more activations in the right precentral gyrus (BA 6) and right cerebellar lobule VI (AAL 9042). According to the LI results, the frontal lobe in oral word reading task and the temporal lobe in auditory sentence comprehension task were significantly more right-lateralized in the AVM group. These findings suggest that for patients with AVMs involving language cortex, different language reorganization patterns may develop for different language functions. The recruitment of brain areas in the right cerebral and cerebellar hemispheres may play a compensatory role in the reorganized language network of AVM patients.

[Impact of the COVID-19 pandemic on speech therapy for children with Speech and Language Disorders]

OBJECTIVE

 In December 2019, the COVID-19 pandemic began to spread around the world and caused massive restrictions in our daily life. Many educational facilities and practices delivering speech therapy were temporally closed (so-called lockdown). Children with a speech and language disorder were forced to pause their therapy. The aim of this study was to describe if and how speech therapy was delivered during lockdown and what psychological burden was associated to affected parents.

MATERIAL AND METHODS

 Parents of children with a speech and language disorder were asked about their child´s therapy during lockdown and about their fears and worries associated with it.

RESULTS

 For 17 patients speech therapy was paused during lockdown while 20 patients could continue their therapy. Children speaking a language other than German had a higher risk for having their therapy paused during lockdown (Odds ratio = 5.11, with 95 % confidence interval = 1.09-32.54). Parents whose children did not receive speech therapy during lockdown were more worried about their child's development.

CONCLUSIONS

 There is no common concept on how speech therapy can be delivered safely during lockdown. Possible barriers to healthcare might be more pronounced during the pandemic and parents experience a high psychosocial burden.

Bayonet-shaped language development in autism with regression: a retrospective study

Background

Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language level and socio-communicative ability is uncertain. This study aimed to establish the predictive value of ELR on the progression of language development and socio-communicative outcomes to guide clinicians in addressing parents’ concerns at the time of diagnosis.

Methods

We used socio-communicative, language, and cognitive data of 2,047 autism spectrum participants from the Simons Simplex Collection, aged 4–18 years (mean = 9 years; SD = 3.6). Cox proportional hazard and logistic regression models were used to evaluate the effect of ELR on language milestones and the probability of using complex and flexible language, as defined by the choice of ADOS module at enrollment. Linear models were then used to evaluate the relationship of ELR and non-verbal IQ with socio-communicative and language levels.

Results

ELR is associated with earlier language milestones but delayed attainment of fluent, complex, and flexible language. However, this language outcome can be expected for almost all autistic children without intellectual disability at 18 years of age. It is mostly influenced by non-verbal IQ, not ELR. The language and socio-communicative level of participants with flexible language, as measured by the Vineland and ADOS socio-communicative subscales, was not affected by ELR.

Limitations

This study is based on a relatively coarse measure of ultimate language level and relies on retrospective reporting of early language milestones and ELR. It does not prospectively document the age at which language catches up, the relationship between ELR and other behavioral areas of regression, nor the effects of intervention.

Conclusions

For autistic individuals with ELR and a normal level of non-verbal intelligence, language development follows a “bayonet shape” trajectory: early first words followed by regression, a plateau with limited progress, and then language catch up.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13229-021-00444-8.

Predictive modeling of neurobehavioral state and trait variation across development

A key goal of human neurodevelopmental research is to map neural and behavioral trajectories across both health and disease. A growing number of developmental consortia have begun to address this gap by providing open access to cross-sectional and longitudinal 'big data' repositories. However, it remains challenging to develop models that enable prediction of both within-subject and between-subject neurodevelopmental variation. Here, we present a conceptual and analytical perspective of two essential ingredients for mapping neurodevelopmental trajectories: state and trait components of variance. We focus on mapping variation across a range of neural and behavioral measurements and consider concurrent alterations of state and trait variation across development. We present a quantitative framework for combining both state- and trait-specific sources of neurobehavioral variation across development. Specifically, we argue that non-linear mixed growth models that leverage state and trait components of variance and consider environmental factors are necessary to comprehensively map brain-behavior relationships. We discuss this framework in the context of mapping language neurodevelopmental changes in early childhood, with an emphasis on measures of functional connectivity and their reliability for establishing robust neurobehavioral relationships. The ultimate goal is to statistically unravel developmental trajectories of neurobehavioral relationships that involve a combination of individual differences and age-related changes.

Neonatal white matter tract microstructure and 2-year language outcomes after preterm birth

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Preterm infant white matter tracts uniquely predict later toddler language.

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Neonatal medical history moderates posterior corpus callosum–language relations.

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Different associations by tract may relate to brain maturation and medical history.

Aim

To determine whether variability in diffusion MRI (dMRI) white matter tract metrics, obtained in a cohort of preterm infants prior to neonatal hospital discharge, would be associated with language outcomes at age 2 years, after consideration of age at scan and number of major neonatal complications.

Method

30 children, gestational age 28.9 (2.4) weeks, underwent dMRI at mean post menstrual age 36.4 (1.4) weeks and language assessment with the Bayley Scales of Infant Development–III at mean age 22.2 (1.7) months chronological age. Mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated for 5 white matter tracts. Hierarchical linear regression assessed associations between tract FA, moderating variables, and language outcomes.

Results

FA of the left inferior longitudinal fasciculus accounted for 17% (p = 0.03) of the variance in composite language and FA of the posterior corpus callosum accounted for 19% (p = 0.02) of the variance in composite language, beyond that accounted for by post-menstrual age at scan and neonatal medical complications. The number of neonatal medical complications moderated the relationship between language and posterior corpus callosum FA but did not moderate the association in the other tract.

Conclusion

Language at age 2 is associated with white matter metrics in early infancy in preterm children. The different pattern of associations by fiber group may relate to the stage of brain maturation and/or the nature and timing of medical complications related to preterm birth. Future studies should replicate these findings with a larger sample size to assure reliability of the findings.