Infant distractibility from social events mediates the relation between maternal responsiveness and infant language outcomes

Research demonstrates that contingent and appropriate maternal responsiveness to infant requests and bids for attention leads to better language outcomes. Research also indicates that infants who are less distracted by irrelevant competing stimulation and attend efficiently to audiovisual social events (e.g., faces and voices) show better language outcomes. However, few studies have assessed relations between maternal responsiveness, infant attention to faces and voices, and distractibility, and how together these factors lead to early language outcomes. A newly developed audiovisual protocol, the Multisensory Attention Assessment Protocol (MAAP; Bahrick et al., 2018), allows researchers to examine individual differences in attention to faces and voices and distractibility, and to assess relations with other variables. At 12 months, infants (n = 79) in an ongoing longitudinal study participated in the MAAP to assess intersensory matching of synchronous faces and voices and attention to an irrelevant competing visual distractor event. They also were observed in a brief play interaction to assess infant bids for attention and maternal responsiveness (accept, redirect, or ignore). At 18 months, receptive and expressive language were assessed using the Mullen Scales of Early Learning. Several noteworthy findings emerged: 1) mothers were generally responsive, accepting 74% and redirecting 14% of infant bids, 2) infants who had a greater number of their bids redirected by mothers, and who had better intersensory matching of synchronous faces and voices, showed less attention to the distractor, and 3) infants who showed less attention to the distractor had better receptive language. Findings demonstrate that maternal redirecting of infant attention by mothers who are generally responsive may promote better infant attentional control (lower distractibility) which in turn predicts better receptive language in toddlers.

Language Problems and ADHD Behaviors: Unique and Interactive Associations with School Readiness in a Socioeconomically Disadvantaged Preschool Sample

This study examined the unique and interactive effects of receptive language ability and ADHD behaviors on six school readiness outcomes, over and above the effects of socioeconomic status, in 49 preschoolers (M_age = 3.98, SD_age = .58; 53.06% female) recruited from Head Start-affiliated classrooms. Hierarchical regression analyses revealed unique positive associations between receptive language ability and cognitive and mathematics readiness, and unique negative associations between ADHD behaviors and social-emotional, physical, cognitive, and literacy readiness. Moderation analyses indicated that at higher, but not lower, levels of ADHD behaviors, lower receptive language ability was associated with lower social-emotional readiness. Results highlight that, when considered together, children's receptive language ability and ADHD behaviors vary in how they predict school readiness. Further, results provide preliminary evidence for ADHD behaviors as a risk factor in the association between receptive language deficits and social-emotional school readiness. Educational and clinical practice implications are discussed.

Theory of mind in children with cochlear implants: Comparison with age- and sex-matched children with normal hearing

OBJECTIVES/HYPOTHESIS

Theory of mind (ToM) is a crucial ability for maintaining normal social interaction and is directly related to language ability. This study was performed to compare ToM between children with congenital hearing loss who have received cochlear implantation (CI) and those with normal hearing (NH).

STUDY DESIGN

Case-control study design.

METHODS

One hundred children, aged 2-12 years, participated: 50 children who received CI before 36 months of age (CI group) and one-to-one age- and sex-matched children with normal hearing (NH group). All children underwent tests to examine receptive language ability and ToM. Receptive language was measured using the Receptive and Expressive Vocabulary Test, and ToM was measured using the Theory of Mind Task Battery (ToM-TB). The scores of the two tests were compared between the CI and NH groups.

RESULTS

The ToM-TB score in the CI group correlated positively with age and receptive language score. ToM-TB scores did not differ significantly between children in the CI group who achieved normal receptive language and the NH group. However, these children in the CI group scored lower than those in the NH group on some advanced ToM tasks that require the ability to understand second-order emotion, message-desire discrepancy, or second-order false belief.

CONCLUSIONS

This case-control study found that children with CI who achieve normal receptive language ability have ToM that is similar to that in children with NH. However, these children exhibited weakness in advanced ToM skills. Interventions to facilitate the development of advanced ToM are needed for children with CI.

Speech, language, and literacy outcomes for children with mild to moderate hearing loss: A systematic review

PURPOSE

To systematically review the current literature to describe the speech, language, and literacy skills of children with mild to moderate hearing loss (MMHL).

METHOD

Systematic searching of seven online databases identified 13 eligible studies examining speech, language, and literacy outcomes for children with MMHL. Studies were rated for quality. Findings were reported via narrative synthesis.

RESULTS

Many studies reported no significant differences between children with MMHL and hearing peers on speech, language, and literacy measures. Studies that did report significant differences reported that children with MMHL performed significantly more poorly than hearing peers in speech production, receptive morphology, following directions, recalling sentences, expressive morphology, and word and non-word reading.

CONCLUSIONS

Due to the heterogeneity in participant characteristics, moderating factors reported, and measures used, clear patterns in the outcomes were difficult to find. Further research into speech, language and literacy outcomes for children with MMHL from early childhood to adolescence (longitudinal studies) are required to describe possible trajectories for children with MMHL including how moderating factors (such as age of hearing aid fitting, duration of use, and access to early intervention) may be contributing to these trajectories.

Brief report: Parent-guided movements during play with children with autism spectrum disorder

BACKGROUND

Children with autism spectrum disorder (ASD) demonstrate social and communication impairments from an early age. While researchers have long investigated parenting behaviors in relation to children's social and communication development, fewer studies have examined the relevance of movement-based parenting behaviors to facilitating communication and social engagement with young children. The present study aimed to investigate: (1) parent-guided movements (PGMs) within dyads of parents and typically developing (TD) children and children with ASD; and (2) children's ASD diagnostic and receptive language scores as predictors of PGM frequency.

METHOD

Video-recorded play interactions of 33 TD dyads (mean age: 20.4 months) and 31 dyads with ASD (mean age: 32.6 months) were matched on child's expressive language. Data were obtained from a longitudinal study on developmental language trajectories in ASD and coded for PGMs.

RESULTS

Overall, parents of children with ASD initiated PGMs more frequently than parents of TD children during play (U = 269.00, z = - 3.58, p < 0.001). PGM frequency was predicted by children's ADOS scores (X ² = 5.46, p = 0.02, OR = 1.26, 95% CI [1.04, 1.54]) and receptive language (X ² = 4.15, p = 0.04, OR = 5.43, 95% CI [1.10, 27.67]).

CONCLUSIONS

Findings suggest that parents of children with ASD and low receptive language may utilize more movement-based strategies to compensate for their children's impaired social engagement and verbal comprehension. This study offers insight on a particular movement-based modality characterizing ASD dyads that can be used as a measure in parent-mediated interventions.

Distressing psychotic-like experiences, cognitive functioning and early developmental markers in clinically referred young people aged 8-18 years

PURPOSE

Neurocognitive difficulties and early childhood speech/motor delays are well documented amongst older adolescents and young adults considered at risk for psychosis-spectrum diagnoses. We aimed to test associations between unusual or psychotic-like experiences (PLEs), co-occurring distress/emotional symptoms, current cognitive functioning and developmental delays/difficulties in young people (aged 8-18 years) referred to Child and Adolescent Mental Health Services in South London, UK.

METHODS

Study 1 examined receptive language, verbal learning and caregiver-reported speech and motor delays/difficulties in a sample of 101 clinically-referred children aged 8-14 years, comparing those reporting no PLEs (n = 19), PLEs without distress (n = 16), and PLEs with distress (n = 66). Study 2 tested associations of severity of distressing PLEs with vocabulary, perceptual reasoning, word reading and developmental delays/difficulties in a second sample of 122 adolescents aged 12-18 years with distressing PLEs.

RESULTS

In Study 1, children with distressing PLEs had lower receptive language and delayed recall and higher rates of developmental delays/difficulties than the no-PLE and non-distressing PLE groups (F values: 2.3-2.8; p values: < 0.005). Receptive language (β = 0.24, p = 0.03) and delayed recall (β = - 0.17, p = 0.02) predicted PLE distress severity. In Study 2, the cognitive-developmental variables did not significantly predict PLE distress severity (β values = 0.01-0.22, p values: > 0.05).

CONCLUSION

Findings may be consistent with a cognitive-developmental model relating distressing PLEs in youth with difficulties in cognitive functioning. This highlights the potential utility of adjunctive cognitive strategies which target mechanisms associated with PLE distress. These could be included in cognitive-behavioural interventions offered prior to the development of an at-risk mental state in mental health, educational or public health settings.

Turner syndrome: language profile of young girls at 12 and 24 months of age

Background

Turner syndrome (TS) is a genetic disorder associated with complete or partial absence of an X chromosome affecting approximately 1/2000 live female births. Available evidence suggests that, in the school-age years, girls with TS often require speech and language services; however, little is known about the language development of infants and toddlers.

Method

This study (N = 31) explored the language profiles of 12- and 24-month-old girls with TS, as well as the percentage of girls who might be “at risk” for language delays. We also followed a subset of 12-month-old girls with TS to 24 months of age to determine the stability of the 12-month findings.

Results

Although all mean scores were within the average range at both time points, results revealed a higher prevalence of 24-month-old girls with TS “at risk” for receptive language difficulties. In addition, expressive language skills significantly exceeded receptive language skills at both time points. We found 12-month-old girls to be “at risk” for social and symbolic difficulties based on clinical assessment; only symbolic difficulties were significant based on caregiver report. At 24 months, clinical assessment indicated greater use of speech sounds and words than normative expectations. Caregivers reported greater use of speech sounds, and also, greater use of gestures. Although some changes occurred over a 1-year time span (12 to 24 months), all mean test scores remained within the average range and the changes in the percentage of girls manifesting “at risk” status on either the PLS-4 or CSBS-DP were non-significant.

Conclusions

Although within normal limits, receptive language skills were found to be significantly lower than expressive language skills at both ages. Social and symbolic communication skills also were in the average range, with both showing significant improvement from 12 to 24 months based on clinical assessment. Caregiver report found that use of gestures and production of speech sounds not only improved from 12 to 24 months, but also exceeded normative expectations. Findings suggest the presence of relatively intact speech and language abilities during the first 2 years of life, with perhaps some emergent concerns for receptive language development. Ongoing developmental surveillance will be important.

Expressive and Receptive Language in Russian Primary-School-Aged Children with Autism Spectrum Disorder

BACKGROUND

Abnormal language development in both expressive and receptive domains occurs in most children with Autism Spectrum Disorder (ASD), although the language deficit is not a core symptom of ASD. However, previous studies disagree on the difference in the degree of impairment between expressive and receptive language in ASD. Existing research has concentrated on vocabulary and 'global expressive and receptive language', often using parental reports for language assessment. Moreover, most of these studies have focused on toddlers and preschoolers with ASD, whereas data from school-aged children with ASD are very limited. At the same time, the age of children might account for the inconsistencies across publications on expressive-receptive language difference in children with ASD.

AIMS

The goal of the study was to directly compare the expressive and receptive language abilities of Russian primary-school-aged children with ASD (7-11 years old) at the levels of vocabulary, morphosyntax, and discourse.

METHODS

82 children with ASD participated in language testing. We used tests from the Russian Child Language Assessment Battery in order to assess vocabulary, morphosyntax, and discourse in expressive and receptive domains.

RESULTS

Our results revealed different expressive and receptive patterns, depending on the linguistic level and tests complexity. Importantly, we showed that children's non-verbal IQ partly accounted for the difference between production and comprehension abilities.

CONCLUSIONS

The expressive-better-than-receptive pattern in language has been considered by some authors as the unique hallmark of ASD. However, several studies, including our own, show that this is not a universal characteristic of ASD. We also revealed that expressive and receptive language patterns differed depending on the linguistic level, children's non-verbal IQ, and assessment tools.

Language abilities in children born to mothers diagnosed with diabetes: A systematic review and meta-analysis

BACKGROUND

This meta-analysis reviewed and synthesized the available evidence on the association between intrauterine exposure to maternal diabetes and language abilities in children.

METHOD

MEDLINE/PubMed, EMBASE, PsycINFO, Proquest Dissertations and Theses Global, and Google Scholar databases were searched through December 2020. Studies were systematically searched, and effect sizes were calculated using random effects models.

RESULTS

Twelve studies were identified for inclusion in this review, however, only 10 were included in the meta-analysis. Sample size ranged from 9 to 115 participants in the diabetes group and 28 to 8192 in the control and aged around 3 years. The pooled results of the meta-analysis showed a trend of decreased language abilities in receptive (z = -3.49, df = 10, I² = 34, p = 0.001), expressive language development (z = -2.29, df = 11, I² = 94%, p = 0.022) and general communication (z = -4.12, df = 4, I² = 2, p = 0.001) However, results showed a limited effect of maternal diabetes on children's language abilities after excluding high-risk categories such as children born to mothers with other gestational comorbidities, obesity and low socio-economic status.

CONCLUSION

Our meta-analysis recognises that exposure to maternal diabetes during pregnancy intersects with other factors within the intrauterine environment to create the conditions for reduced language abilities in the child. Multiple factors may contribute to the observed differences between groups in the meta-analysis. A focus on interventions to maintain optimal blood glucose levels during pregnancy and to screen for early developmental delay after birth is recommended.

Infants' vocalizations at 6 months predict their productive vocabulary at one year

Long before their first words, children communicate by using speech-like vocalizations. These protophones might be indicative of infants' later language development. We here examined infants' (n = 56) early vocalizations at 6 months (vocal reactivity scale of the IBQ-R) as a predictor of their expressive and receptive language at 12 months (German version of the CDI). Regression analyses revealed vocalizations to significantly predict expressive, but not receptive language. Our findings in German-learning 6-month-olds extend previous predictive evidence of early vocalizations reported for older infants. Together these findings are informative in light of early assessments monitoring typical and atypical language development.

The Impact of Contextual, Maternal and Prenatal Factors on Receptive Language in a Chilean Longitudinal Birth Cohort

A secondary analysis was conducted on longitudinal data collected from ELPI, a representative Chilean survey to model Chilean infant's receptive language using contextual, maternal and prenatal factors. The sample for the current study comprised children aged between 36 and 48 months (n = 3921). The sample was re-assessed when children were aged 60-72 months (n = 3100). Linear regression analyses were conducted. At the first time point, all the predictors included were significant (living area, health system provision, maternal intelligence and education, adolescent pregnancy, maternal medical appointments during pregnancy, and presence of a significant other at childbirth), except for smoking during pregnancy. The model explained 13% of the variance. However, when timepoint one receptive language scores were included in the analyses for when children were aged 60-72 months, only two variables remained as significant predictors: previous receptive language scores and maternal education, explaining 21% of the variance. Findings and implications are discussed.

Psychosocial deprivation and receptive language ability: a two-sample study

Background

The quality of early caregiving experiences is a known contributor to the quality of the language experiences young children receive. What is unknown is whether, and if so, how psychosocial deprivation early in life is associated with long-lasting receptive language outcomes.

Methods

Two prospective longitudinal studies examining early psychosocial deprivation/neglect in different contexts (i.e., deprivation due to institutional care or deprivation experienced by children residing within US families) and receptive language as assessed via the Peabody Picture Vocabulary Test (PPVT) were used to assess the magnitude of these associations. First, 129 participants from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care in Romania, completed a receptive language assessment at age 18 years. Second, from the USA, 3342 participants from the Fragile Families and Child Wellbeing Study were assessed from infancy until middle childhood.

Results

Children exposed to early institutional care, on average, had lower receptive language scores than their never institutionalized counterparts in late adolescence. While randomization to an early foster care intervention had no long-lasting association with PPVT scores, the duration of childhood exposure to institutional care was negatively associated with receptive language. Psychosocial deprivation in US families was also negatively associated with receptive language longitudinally, and this association remained statistically significant even after accounting for measures of socioeconomic status.

Conclusion

Experiences of psychosocial deprivation may have long-lasting consequences for receptive language ability, extending to age 18 years. Psychosocial deprivation is an important prospective predictor of poorer receptive language.

Trial registration

Bucharest Early Intervention Project ClinicalTrials.gov Identifier: NCT00747396

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.

The Predictive Value of Language Scales: Bayley Scales of Infant and Toddler Development Third Edition in Correlation With Korean Sequenced Language Scale for Infant

Objective

To compare the relationship of the Bayley Scales of Infant and Toddler Development 3rd Edition (K-BSID-III) language score and the Sequenced Language Scale for Infant (SELSI) score and evaluate the sensitivity and specificity of K-BSID-III language score and optimal cutoff value with receiver operator characteristic (ROC) curve analysis in infants and toddlers with delayed language development.

Methods

A total of 104 children with suspected language developmental delay were included in this retrospective study. Subjects were tested using the K-BSID-III and SELSI and subdivided into several groups according to the severity of language scores. ROC curve analysis was performed to assess K-BSID-III for delayed language development.

Results

Receptive and expressive language subscales of the K-BSID-III showed markedly significant correlation with the SELSI scores (p<0.001). ROC analysis showed an area under the curve of 0.877 (p<0.001) in SELSI receptive score and 0.935 (p<0.001) in SELSI expressive score. The optimal cutoff value where sensitivity of 85% and specificity of 81% were achieved with the K-BSID-III receptive score was 1.50 (between average and low average) in the SELSI receptive score. The optimal cutoff value where sensitivity of 96% and specificity of 82% were achieved with the K-BSID-III expressive score was also 1.50 in the SELSI expressive score.

Conclusion

In this study, the correlations between K-BSID-III and SELSI language scores were statistically significant. However, the interpretation should be considered carefully in low average group due to tendency of underestimation of delayed language development.

Quantitative genome-wide association analyses of receptive language in the Danish High Risk and Resilience Study

BACKGROUND

One of the most basic human traits is language. Linguistic ability, and disability, have been shown to have a strong genetic component in family and twin studies, but molecular genetic studies of language phenotypes are scarce, relative to studies of other cognitive traits and neurodevelopmental phenotypes. Moreover, most genetic studies examining such phenotypes do not incorporate parent-of-origin effects, which could account for some of the heritability of the investigated trait. We performed a genome-wide association study of receptive language, examining both child genetic effects and parent-of-origin effects.

RESULTS

Using a family-based cohort with 400 children with receptive language scores, we found a genome-wide significant paternal parent-of-origin effect with a SNP, rs11787922, on chromosome 9q21.31, whereby the T allele reduced the mean receptive language score by ~ 23, constituting a reduction of more than 1.5 times the population SD (P = 1.04 × 10-8). We further confirmed that this association was not driven by broader neurodevelopmental diagnoses in the child or a family history of psychiatric diagnoses by incorporating covariates for the above and repeating the analysis.

CONCLUSIONS

Our study reports a genome-wide significant association for receptive language skills; to our knowledge, this is the first documented genome-wide significant association for this phenotype. Furthermore, our study illustrates the importance of considering parent-of-origin effects in association studies, particularly in the case of cognitive or neurodevelopmental traits, in which parental genetic data are not always incorporated.

Adaptation and validation of receptive expressive emergent Language Test-3: Evidence from Hindi speaking children with cochlear implant

INTRODUCTION

Selection of an effective tool for assessment of language learning outcomes in post cochlear implantation is always an important but challenging task. Receptive expressive emergent language test-3rd Eds. (REELT-3) is one of the comprehensive language assessment tools used in India. In case of administration of REELT-3, which is standardized in English speaking typically developing western population, to another language speaking population with post-cochlear implant condition, the test outcome may get compromised owing to linguistics and population variability. The objective of the study is to test and validate REELT-3 in Hindi speaking children with cochlear implantation.

METHODS

Ninety six typically developing children (22.3 ± 6.9 months, 48 boys and 48 girls) and 96 children with cochlear implantation (25.8 ± 9.2 months, 57 boys and 39 girls) participated in this study. As per the eligibility criteria of REELT-3, infants and toddlers with cochlear implant of age below 36 months participated in this study. Criterion, content and construct validity were tested using correlation based statistical analysis.

RESULTS

High content validity was established by obtaining very low correlation coefficient r = 0.16 across two distinct population of typically developing children and children with cochlear implantation. Similarly, correlation coefficient of r = 0.84 revealed high criterion validity across REELT-3 in English and Hindi speaking conditions. Finally, correlation coefficient of r = 0.87was obtained between language raw score and chronological age to establish construct validity. Chronbach alpha coefficient (Chronbach α = 0.85) and interclass correlation coefficient 0.87was observed for REELT-3 which suggests good internal consistency and test-retest reliability, respectively. Receiver Operating Characteristics curve analysis of the REELT-3 suggested that area under curve 0.95 (95% CI = 0.89-0.99, p < 0.001) is excellent. The cut-off Language Ability Score (LAS) was determined as 74.5 with the sensitivity of 87.9% and specificity of 84.1% infer high sensitivity and specificity.

CONCLUSIONS

These results validate that REELT-3 can be used in assessment of language outcome in Hindi speaking children with post-cochlear implantation. Clinical assessment of receptive and expressive language will be beneficial in effective evaluation as well as in therapeutic planning.

Cortical mapping of receptive language processing in children using navigated transcranial magnetic stimulation

We used a stepwise process to develop a new paradigm for preoperative cortical mapping of receptive language in children, using temporary functional blocking with transcranial magnetic stimulation (TMS). The method combines short sentences with a lexical decision task in which children are asked to point at a picture that fits a short sentence delivered aurally. This was first tested with 24 healthy children aged 4-16 years. Next, 75 sentences and 25 slides were presented to five healthy children in a clinical setting without TMS. Responses were registered on a separate computer, and facial expressions and hand movements were filmed for later offline review. Technical adjustments were made to combine these elements with the existing TMS equipment. The audio-recorded sentences were presented before the visual stimuli. Sentence lists were constructed to avoid similar stimuli in a row. Two different baseline lists were used before the TMS registration; the second baseline resulted in faster responses and was chosen as the reference for possible response delays induced by TMS. Protocols for offline reviews were constructed. No response, incorrect response, self-correction, delayed response, and perseveration were considered clear stimulation effects, while poor attention, discomfort, and other events were regarded as unclear. Finally, three children (6:2, 14:0, 14:10 years) with epilepsy and expected to undergo neurosurgery were assessed using TMS (left hemisphere in one; both hemispheres in the other two). In the two assessed bilaterally, TMS effects indicated bilateral language processing. Delayed response was the most common error. This is a first attempt to develop a new TMS paradigm for receptive language mapping, and further evaluation is suggested.

The mediating role of joint attention in the relationship between motor skills and receptive and expressive language in siblings at risk for autism spectrum disorder

Language problems are highly prevalent in younger siblings of children with autism spectrum disorder (HR-sibs), yet little is known about early predictors. There is growing evidence that motor and language development are linked and this connection might be mediated by joint attention. Developmental changes in motor abilities change how children interact with objects and people (e.g., by showing), which may influence language development. This association has however not yet been studied in HR-sibs. The interrelationship between motor, joint attention and language skills was explored in younger siblings of typically developing children (LR-sibs, N = 31) and HR-sibs (N = 32). In both groups, motor skills (composite of fine and gross motor skills) at 10 months influenced receptive and expressive language at 36 months directly and indirectly through joint attention at 14 months. Group status moderated this direct and indirect effect with mainly significant effects in HR-sibs. This indicates that lower motor skills can have cascading effects on joint attention and language in HR-sibs. Consequently, assessment of early motor skills in HR-sibs might hold promise for early identification of motor difficulties but can also be indicative of language difficulties later in life, especially when difficulties with joint attention are also present.

Changes in functional organization and functional connectivity during story listening in children with benign childhood epilepsy with centro-temporal spikes

Children with Benign Epilepsy with Centrotemporal Spikes (BECTS), despite high likelihood for seizure remission, are reported to have subtle difficulties in language and other cognitive skills. We used functional MRI and a story listening task to examine the effect of BECTS on patterns of activation and connectivity. Language and cognitive skills were assessed using standardized measures. Twenty-four children with recently diagnosed BECTS and 40 typically-developing children participated. In a functionally-defined region of interest in right inferior frontal gyrus, BECTS patients showed a lower level of activation. Across both groups combined, increased activation in superior/middle temporal regions of interest was associated with better language scores. Connectivity in the story processing network was similar between groups, but connectivity within left inferior frontal gyrus was decreased in children with BECTS. These results suggest that language networks are largely maintained in new-onset BECTS, but some subtle changes in activation and connectivity can be observed.

Toddlers with Autism Spectrum Disorder Can Use Language to Update Their Expectations About the World

This study examined if two-year-olds with ASD can update mental representations on the basis of verbal input. In an eye-tracking study, toddlers with ASD and typically-developing nonverbal age-matched controls were exposed to visual or verbal information about a change in a recently encoded scene, followed by an outcome that was either congruent or incongruent with that information. Findings revealed that both groups looked longer at incongruent outcomes, regardless of information modality, and despite the fact that toddlers with ASD had significantly lower measured verbal abilities than TD toddlers. This demonstrates that, although there is heterogeneity on the individual level, young toddlers with ASD can succeed in updating their mental representations on the basis of verbal input in a low-demand task.

Data-driven item selection for the Shirts and Shoes Test

PURPOSE

The first stage of test development is the generation of a pool of potential items to be used in the assessment. Ideally, these items are then tested in the field on members of the population for which the assessment is intended. This initial analysis assures that tests build in validity at the level of the individual items.

METHOD

Seventy-four potential test items developed for the Shirts and Shoes Test (Plante & Vance, 2012) were tested on 513 children between the ages of 3 and 6 years. An Item Response Theory (IRT) approach was used to identify potential items in the item pool which are unsuitable due to one or more types of deviation from the IRT model. Furthermore, an IRT approach provides data that permits the ordering of items by difficulty.

RESULTS

A total of 19 items were discarded due to noteworthy deviations in one or more of the measures related to item response characteristics. The remaining 55 items reflected a range of skill difficulty and were deemed suitable for an age range of 3- to 6-years.

CONCLUSIONS

Item Response Theory can be used productively to identify items that fail to add to the reliability and validity of a test during the earliest stages of test development. The number of items culled for this test demonstrates that the content of the items alone does not assure that the items perform in ways that promote accurate skill measurement.

The Development of an Interventional Package on "Receptive Vocabulary" For Cochlear Implanted Children

OBJECTIVES

Considering the shortage of language intervention protocols which specifically concentrate on cochlear implanted children and considering the importance of timely language intervention in this group of children, the aim of the present study was to develop an interventional package on "receptive vocabulary" for cochlear implanted children.

MATERIALS & METHODS

By reviewing the literature related to language acquisition theories in normal and language disordered children, as well as literature on production of intervention protocols, especially those for language impaired children, and also considering the normal process of language and speech development in normal children, the first draft of the intervention protocol was prepared. Then, the face and content validity of the intervention protocol was assessed by a Delphi team through three rounds and finally approved.

RESULTS

A language intervention protocol was developed to enhance receptive vocabulary in 12-48 months-old cochlear implanted children, based on cognitive, behavioral and developmental theories. This protocol includes 5 interventional stages: 1-Drilling and Imitation; 2-Modeling; 3-Motor training; 4-Deliberate error correction; 5- Reinstatement and Generalization. Each stage consists of the description of the aims of that stage, a list of techniques, the tools required, the detailed step by step explanation of the intervention, how re-enforcement must take place, and finally the indicators of success which permit to move forward to the next stage.

CONCLUSION

The interventional package produced is believed to facilitate language acquisition in cochlear implanted children, according to expert qualitative assessment and approval. Experimental research is required for verification of this assumption.

Designing Receptive Language Programs: Pushing the Boundaries of Research and Practice

Initial difficulty with receptive language is a stumbling block for some children with autism. Numerous strategies have been attempted over the years, and general guidelines for teaching receptive language have been published. But what to do when all else fails? This article reviews 21 strategies that have been effective for some children with autism. Although many of the strategies require further research, behavioral practitioners should consider implementation after careful review. The purpose of this article is to help behavior analysts in practice to categorize different teaching procedures for systematic review, recognize the conceptually systematic rationale behind each strategy, identify different client profiles that may make 1 strategy more effective than another, and create modifications to receptive language programming that remain grounded in research.

Passive functional mapping of receptive language areas using electrocorticographic signals

OBJECTIVE

To validate the use of passive functional mapping using electrocorticographic (ECoG) broadband gamma signals for identifying receptive language cortex.

METHODS

We mapped language function in 23 patients using ECoG and using electrical cortical stimulation (ECS) in a subset of 15 subjects.

RESULTS

The qualitative comparison between cortical sites identified by ECoG and ECS show a high concordance. A quantitative comparison indicates a high level of sensitivity (95%) and a lower level of specificity (59%). Detailed analysis reveals that 82% of all cortical sites identified by ECoG were within one contact of a site identified by ECS.

CONCLUSIONS

These results show that passive functional mapping reliably localizes receptive language areas, and that there is a substantial concordance between the ECoG- and ECS-based methods. They also point to a more refined understanding of the differences between ECoG- and ECS-based mappings. This refined understanding helps to clarify the instances in which the two methods disagree and can explain why neurosurgical practice has established the concept of a "safety margin."

SIGNIFICANCE

Passive functional mapping using ECoG signals provides a fast, robust, and reliable method for identifying receptive language areas without many of the risks and limitations associated with ECS.

Sample First versus Comparison First Stimulus Presentations: Preliminary Findings for Two Individuals with Autism

The current study was a replication of Petursdottir and Aguilar (Journal of Applied Behavior Analysis, 46, 58-68, 2016). Two different stimulus presentations were evaluated during auditory-visual discrimination training. A sample-first procedure, in which the sample stimulus was presented before the comparison stimuli, was compared to a comparison-first procedure, in which the sample presentation was presented after the comparison stimuli. The results indicated that both participants learned more quickly in the comparison-first condition, a finding that differed from Petursdottir and Aguilar (Journal of Applied Behavior Analysis, 46, 58-68, 2016).

Receptive language is associated with visual perception in typically developing children and sensorimotor skills in autism spectrum conditions

A number of studies have evidenced marked difficulties in language in autism spectrum conditions (ASC). Studies have also shown that language and word knowledge are associated with the same area of brain that is also responsible for visual perception in typically developing (TD) individuals. However, in ASC, research suggests word meaning is mapped differently, on to situational sensorimotor components within the brain. Furthermore, motor coordination is associated with communication skills. The current study explores whether motor coordination and visual perception are impaired in children with ASC, and whether difficulties in coordination and visual perception correlate with receptive language levels. 36 children took part: 18 with ASC and 18 TD children, matched on age and non-verbal reasoning. Both groups completed the Movement ABC, Beery-Buktenica Developmental Test of Visual-Motor Integration, British Picture Vocabulary Scale and Matrices (WASI). Results showed that ASC children scored significantly lower on receptive language, coordination and visual motor integration than the TD group. In the TD group receptive language significantly correlated with visual perception; in the ASC group receptive language significantly correlated with balance. These results imply that sensorimotor skills are associated with the understanding of language in ASC and thus the relationship between sensorimotor experiences and language warrants further investigation.

An Evaluation of Differential Observing Responses During Receptive Label Training

The current study compared the use of a differential observing response (DOR) during receptive label training to a condition without the DOR. We extended the research on DORs used during receptive label training by using them with progressive prompt delay procedures and assessing responding following mastery without the DOR. Results indicated that both participants performed better in the DOR condition during the first comparison, but results were less clear in the second comparison.

Emotional and behaviour difficulties in teenagers with permanent childhood hearing loss

OBJECTIVES

It is known that during the middle childhood years those with permanent childhood hearing loss (PCHL) are at increased risk of showing emotional and behaviour difficulties (EBD). It has yet to be established whether this risk continues into the late teenage years. There is a paucity of longitudinal studies on the association between PCHL and EBD.

METHODS

The Strengths and Difficulties Questionnaire (SDQ) was used to measure EBD based on parent, teacher and self-ratings in 76 teenagers with PCHL and 38 in a hearing comparison group (HCG) from a population sample of children that was followed up from birth to adolescence.

RESULTS

On parent-rated SDQ, the PCHL group had significantly higher Total Difficulties score than the HCG (Standardised mean difference (SMD) = +0.39, 95%CI 0.00 to 0.79). Amongst the PCHL group the presence of disabilities other than hearing loss had a substantial impact on the level of parent-rated EBD (SMD = +1.68, 1.04 to 2.33). There was a relationship between receptive language ability and EBD in both the HCG (r = -0.33, 95%CI -0.59 to -0.01) and the PCHI group (r = -0.33, 95%CI -0.53 to -0.02). The effect of PCHL on EBD became non-significant when receptive language was included as a covariate (F = 0.12, df = 1,95, p = 0.729). Early confirmation of hearing loss (i.e. before 9 months of age) did not have a significant effect on EBD scores (SMD = +0.31, 95%CI -0.15 to 0.77).

CONCLUSIONS

PCHL continues to be associated with elevated EBD scores as measured by parent rated SDQ into the late teenage years but the degree of this elevation is less than in childhood and is not apparent on teacher or self-ratings. Poor receptive language ability appeared to account for these elevated EBD scores in the group with PCHL. Particular attention needs to be paid to the mental health of children and adolescents with PCHL that is accompanied by other disabilities and to those with poor receptive language ability. However, the majority of teenagers with PCHL do not show clinically significant elevated levels of EBD.

The association between the early motor repertoire and language development in term children born after normal pregnancy

BACKGROUND

The assessment of the early motor repertoire is a widely used method for assessing the infant's neurological status.

AIM

To determine the association between the early motor repertoire and language development.

STUDY DESIGN

Prospective cohort study.

SUBJECTS

22 term children born after normal pregnancy; video recorded for the assessment of the early motor repertoire including their motor optimality score (MOS), according to Prechtl, at 3 and 5months post term.

OUTCOME MEASURES

At 4years 7months and 10years 5months, we tested the children's language performance by administering three tests for expressive language and two for receptive language.

RESULTS

Smooth and fluent movements at 3months of age was associated with better expressive language outcome at both 4years 7months and 10years 5months (betas 0.363 and 0.628). A higher MOS at 5months was associated with better expressive language at both ages (betas 0.486 and 0.628). The item postural patterns at 5months was the only aspect associated with poorer expressive language outcome (beta -0.677).

CONCLUSION

Predominantly, qualitative aspects of the early motor repertoire at the age of 3 and 5months are associated with language development.

Receptive and expressive English language assessments used for young children: a scoping review protocol

BACKGROUND

The majority of a child's language development occurs in the first 5 years of life when brain development is most rapid. There are significant long-term benefits to supporting all children's language and literacy development such as maximizing their developmental potential (i.e., cognitive, linguistic, social-emotional), when children are experiencing a critical period of development (i.e., early childhood to 9 years of age). A variety of people play a significant role in supporting children's language development, including parents, guardians, family members, educators, and/or speech-language pathologists. Speech-language pathologists and educators are the professionals who predominantly support children's language development in order for them to become effective communicators and lay the foundation for later developing literacy skills (i.e., reading and writing skills). Therefore, these professionals need formal and informal assessments that provide them information on a child's understanding and/or use of the increasingly complex aspects of language in order to identify and support the receptive and expressive language learning needs of diverse children during their early learning experiences (i.e., aged 1.5 to 9 years). However, evidence on what methods and tools are being used is lacking.

METHODS

The authors will carry out a scoping review of the literature to identify studies and map the receptive and expressive English language assessment methods and tools that have been published and used since 1980. Arksey and O'Malley's (2005) six-stage approach to conducting a scoping review was drawn upon to design the protocol for this investigation: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results; and (6) consultation.

DISCUSSION

This information will help these professionals identify and select appropriate assessment methods or tools that can be used to support development and/or identify areas of delay or difficulty and plan, implement, and monitor the progress of interventions supporting the development of receptive and expressive language skills in individuals with diverse language needs (e.g., typically developing children, children with language delays and disorders, children learning English as a second or additional language, Indigenous children who may be speaking dialects of English). Researchers plan to evaluate the effectiveness of the assessment methods or tools identified in the scoping review as an extension of this study.

Do the early development of gestures and receptive and expressive language predict language skills at 5;0 in prematurely born very-low-birth-weight children?

It is unclear what the predictive value of very early development of gestures and language is on later language ability in prematurely born very-low-birth-weight (VLBW; birth weight ≤1500g) children. The aim of the present study was to analyse the predictive value of early gestures and a receptive lexicon measured between the ages of 0;9 and 1;3, as well as the predictive value of receptive and expressive language ability at 2;0 for language skills at 5;0 in VLBW children. The subjects were 29 VLBW children and 28 full-term children whose language development has been followed intensively between the ages of 0;9 and 2;0 using the Finnish version of the MacArthur Developmental Inventory and the Reynell Developmental Language Scales (RDLS III). At 5;0, five selected verbal subtests of the Nepsy II test and the Boston Naming Test (BNT) were used to assess children's language skills. For the first time in VLBW children, the development of gestures measured between the ages of 0;9 and 1;3 was shown to correlate significantly and positively with language skills at 5;0. In addition, both receptive and expressive language ability measured at 2;0 correlated significantly and positively with later language skills in both groups. Moreover, according to the hierarchical regression analysis, the receptive language score of the RDLS III at 2;0 was a clear and significant predictor for language skills at 5;0 in both groups. The findings particularly underline the role of early receptive language as a significant predictor for later language ability in VLBW children. The results provide evidence for a continuity between early language development and later language skills.

LEARNING OUTCOMES

After reading this article, readers will understand the associations between the very early (≤2 years of age) development of gestures and language (i.e. early receptive lexicon, expressive lexicon at 2;0, receptive and expressive language ability at 2;0) and the language skills at 5;0 in prematurely born very-low-birth-weight (VLBW) children. In addition, readers will understand the heterogeneity of the group of VLBW children. The information presented in this article is informative for those who work in a clinical context and who want to be able to identify those VLBW children who need support for their language development at an early age.

Socioeconomic (SES) differences in language are evident in female infants at 7months of age

BACKGROUND

Language skills, strongly linked to academic success, are known to differ by socioeconomic status (SES), with lower SES individuals performing less well than higher SES.

AIMS

To examine the effect of SES on infant language at 7months of age and the relationship between maternal vocabulary skills and infant language function. To determine if the relationships between SES and infant language are mediated by maternal vocabulary skills.

STUDY DESIGN

Longitudinal follow-up of healthy term female African American infants born to mothers in two SES groups: Low SES (income-to-needs≤1, no education beyond high school) and Higher SES (Income-to-Needs >1, at least a high school diploma).

SUBJECTS

54 infants tested at 7months of age; 54 mothers tested at infant age 7months.

OUTCOME MEASURES

Preschool Language Scale-5 (PLS-5), Vocabulary and Matrix Reasoning subtests of the Wechsler Adult Intelligence Scale-IV.

RESULTS

Low SES infants (n=29) performed less well than Higher SES (n=25) on PLS-5 Total Language, Auditory Comprehension, and Expressive Communication (p≤0.012). Maternal Vocabulary subtest scores were lower in Low SES than Higher SES (p=0.002), but not related to infant PLS Language scores (p≥0.17). Maternal vocabulary did not mediate the relationship between SES and infant language skills at age 7months.

CONCLUSIONS

In this single sex and race cohort of healthy, term, female infants, lower SES exerted negative effects on infant language by 7months of age. While maternal vocabulary scores showed no relation with infant language skills at 7months, continued study of the relations between SES, infant outcomes and maternal characteristics is needed to determine how low SES conditions impact early language. These findings underscore the importance of early interventions, as well as policies designed to improve socioeconomic conditions for infants and families.

Training understanding of reversible sentences: a study comparing language-impaired children with age-matched and grammar-matched controls

Introduction. Many children with specific language impairment (SLI) have problems with language comprehension, and little is known about how to remediate these. We focused here on errors in interpreting sentences such as "the ball is above the cup", where the spatial configuration depends on word order. We asked whether comprehension of such short reversible sentences could be improved by computerized training, and whether learning by children with SLI resembled that of younger, typically-developing children. Methods. We trained 28 children with SLI aged 6-11 years, 28 typically-developing children aged from 4 to 7 years who were matched to the SLI group for raw scores on a test of receptive grammar, and 20 typically-developing children who were matched to the SLI group on chronological age. A further 20 children with SLI were given pre- and post-test assessments, but did not undergo training. Those in the trained groups were given training on four days using a computer game adopting an errorless learning procedure, during which they had to select pictures to correspond to spoken sentences such as "the cup is above the drum" or "the bird is below the hat". Half the trained children heard sentences using above/below and the other half heard sentences using before/after (with a spatial interpretation). A total of 96 sentences was presented over four sessions. Half the sentences were unique, whereas the remainder consisted of 12 repetitions of each of four sentences that became increasingly familiar as training proceeded. Results. Age-matched control children performed near ceiling (≥ 90% correct) in the first session and were excluded from the analysis. Around half the trained SLI children also performed this well. Training effects were examined in 15 SLI and 16 grammar-matched children who scored less than 90% correct on the initial training session. Overall, children's scores improved with training. Memory span was a significant predictor of improvement, even after taking into account performance on training session 1. Unlike the grammar-matched controls, children with SLI showed greater accuracy with repeated sentences compared with unique sentences. Training did not improve children's performance on a standardized test of receptive grammar. Discussion. Overall, these results indicate that a subset of children with SLI perform well below ceiling on reversible sentences with three key words and simple syntactic structure. For these children, weak verbal short-term memory appears to impair comprehension of spoken sentences. In contrast to the general finding that rule-learning benefits from variable input, these children seem to do best if given repeated exposure to the same nouns used with a given sentence frame. Generalisation to other sentences using the same syntactic frame may be more effective if preceded by such item-specific learning.

The role of the insula in speech and language processing

Lesion and neuroimaging studies indicate that the insula mediates motor aspects of speech production, specifically, articulatory control. Although it has direct connections to Broca's area, the canonical speech production region, the insula is also broadly connected with other speech and language centres, and may play a role in coordinating higher-order cognitive aspects of speech and language production. The extent of the insula's involvement in speech and language processing was assessed using the Activation Likelihood Estimation (ALE) method. Meta-analyses of 42 fMRI studies with healthy adults were performed, comparing insula activation during performance of language (expressive and receptive) and speech (production and perception) tasks. Both tasks activated bilateral anterior insulae. However, speech perception tasks preferentially activated the left dorsal mid-insula, whereas expressive language tasks activated left ventral mid-insula. Results suggest distinct regions of the mid-insula play different roles in speech and language processing.

Eye tracking as a measure of receptive vocabulary in children with autism spectrum disorders

This study examined the utility of eye tracking research technology to measure speech comprehension in 14 young boys with autism spectrum disorders (ASD) and 15 developmentally matched boys with typical development. Using eye tracking research technology, children were tested on individualized sets of known and unknown words, identified based on their performance on the Peabody Picture Vocabulary Test. Children in both groups spent a significantly longer amount of time looking at the target picture when previous testing indicated the word was known (known condition). Children with ASD spent similar amounts of time looking at the target and non-target pictures when previous testing indicated the word was unknown (unknown condition). However, children with typical development looked longer at the target pictures in the unknown condition as well, potentially suggesting emergent vocabulary knowledge.

Problem solving ability in children with intellectual disability as measured by the Raven's colored progressive matrices

This study investigated the developmental trajectory of problem solving ability in children with intellectual disability (ID) of different etiologies (Down Syndrome, Idiopathic ID or low functioning Autism) as measured on the Raven's Colored Progressive Matrices test (RCPM). Children with typical development (TD) and children with ID were matched on total correct performance (i.e., non-verbal mental age) on the RCPM. RCPM total correct performance and the sophistication of error types were found to be associated with receptive vocabulary in all participants, suggesting that verbal ability plays a role in more sophisticated problem solving tasks. Children with ID made similar errors on the RCPM as younger children with TD as well as more positional error types. This result suggests that children with ID who are deficient in their cognitive processing resort to developmentally immature problem solving strategies when unable to determine the correct answer. Overall, the findings support the use of RCPM as a valid means of matching intellectual capacity of children with TD and ID.

Preschool speech intelligibility and vocabulary skills predict long-term speech and language outcomes following cochlear implantation in early childhood

Speech and language measures during grade school predict adolescent speech-language outcomes in children who receive cochlear implants (CIs), but no research has examined whether speech and language functioning at even younger ages is predictive of long-term outcomes in this population. The purpose of this study was to examine whether early preschool measures of speech and language performance predict speech-language functioning in long-term users of CIs. Early measures of speech intelligibility and receptive vocabulary (obtained during preschool ages of 3-6 years) in a sample of 35 prelingually deaf, early-implanted children predicted speech perception, language, and verbal working memory skills up to 18 years later. Age of onset of deafness and age at implantation added additional variance to preschool speech intelligibility in predicting some long-term outcome scores, but the relationship between preschool speech-language skills and later speech-language outcomes was not significantly attenuated by the addition of these hearing history variables. These findings suggest that speech and language development during the preschool years is predictive of long-term speech and language functioning in early-implanted, prelingually deaf children. As a result, measures of speech-language functioning at preschool ages can be used to identify and adjust interventions for very young CI users who may be at long-term risk for suboptimal speech and language outcomes.