Delayed Language Development Research Articles

Factors influencing parents’ behaviours to promote early childhood development of 1–3-year-old children with delayed language development in Thailand

Children with delayed language development are long-term problems. The purpose of this study was to investigate behaviours and factors influencing parents’ behaviours to promote the language development of 1-3 years old children with delayed language in the 2nd Health Service Region in Thailand. The questionnaire consisted of 5 parts, 1) personal characteristics, 2) knowledge aspects, 3) perception aspects, 4) support reception aspects and 5) behaviours to promote language development. Researchers collected the data from 537 participants. Data were analyzed with descriptive statistics and multiple regression analysis. Results of the study showed that the participants’ overall behaviour to promote language development was at the high level (94.41%). The most frequent practice in general behaviour was observing children’s gestures to communicate understanding (64.25%); in receptive language it was training children to follow simple instructions (97.21%); and in expressive language it was giving chances for children to make utterances (94.59%). The factors influencing parents’ behaviours to promote language development of 1-3-year-old children with delayed language development at the statistical significance level of 0.05 were the main caregiver, support from communities and social networks, perceived self-efficacy in language development promotion, ages of caregivers, genders of caregivers, support from families, support from the health service units, occupation as government or state enterprise officers, perceived barriers in language development promotion, and grandparents as caregivers. For recommendations, many factors can affect parents’ behaviours to promote the language development of 1-3-year-old children with delayed language development. Therefore, the health service units should study methods that should be appropriate to promote early childhood with delayed language development.

Developmental exposure to thyroid disruptors: misprogramming of the brain's stem cells in later life?

Developmental exposure to thyroid disruptors: misprogramming of the brain's stem cells in later life?

The butyrate-producing and spore-forming bacterial genus Coprococcus as a potential biomarker for neurological disorders.

The host-intestinal microbiome interaction has gained much scientific attention in the past two decades, boosted by advances in DNA sequencing and cultivation techniques. An accumulating amount of evidence shows that gut microbes play crucial roles in gut homeostasis, immune system education, and are associated with quality-of-life indicators. Beneficial health factors are associated with the digestion of dietary fibres in the colon and the subsequent production of short-chain fatty acids, including acetate, propionate, and butyrate. Coprococcus is a butyrate-producing genus in the phylum Firmicutes, and its abundance is inversely correlated with several neuropsychological and neurodegenerative disorders. Case-control studies provide strong evidence of decreased abundance of Coprococcus spp. in depressed individuals. The species Coprococcus eutactus has the unique capacity to use two separate pathways for butyrate synthesis and has been found to be depleted in children with delayed language development and adults with Parkinson's disease. The combined literature on Coprococcus and the gut microbiota-brain axis points towards enhanced butyrate production and reduced colonisation of pathogenic clades as factors explaining its association with health effects. The genus Coprococcus is a promising candidate for a mental health biomarker and an interesting lead for novel dietary-based preventive therapies for specific neurological disorders.

Comparison of Hearing Impairment among Healthy and High-risk Neonates at a Tertiary Care Hospital, Rajasthan, India: A Cross-sectional Study

Introduction: Hearing impairment is caused by damage in the inner ear (can be even birth defect), ear infection, ruptured eardrum and so on. It can be prevented using early detection thus, helps in avoiding severe psychosocial, educational, and linguistic repercussions. Infants, who are not diagnosed of hearing impairment before six months of age, will have delays in speech and language development. Aim: To determine the prevalence of hearing impairment in highrisk neonates and to establish the fact that, these neonates have higher prevalence of hearing impairment as compared to normal population. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics at Jawaharlal Nehru Medical College and Hospital, Ajmer, Rajasthan, India. The duration of the study was six months, from December 2012 to May 2013. A total of 500 babies including 297 normal and 203 high-risk babies were enrolled into the study. All the neonates were screened using Behavioural Observation Audiometry (BOA) and Distortion Product Oto-acoustic Emission (DPOAE) preferably within three days of life. Those, who failed under this test, underwent for Brain stem Evoked Response Audiometry (BERA). Data was collected in the Microsoft Excel and analysis done by Statistical Package for Social Sciences (SPSS) version 23.0. Results: The mean age of the newborns on admission, was 3.86±4.25 days and the mean weight was 2560±510 g. Out of 500 newborns screened, 58 babies had abnormal results with the first screening test. When these 58 babies subjected to BERA, eight babies showed Hearing Loss (HL). Sepsis, Neonatal Intensive Care Unit (NICU) stay >5 days and use of aminoglycosides >7 days were the important risk factors associated with hearing impairment. Prevalence of hearing impairment in the present study was came out to be 16/1000. This finding was statistically significant with p-value<0.05. Conclusion: There was high prevalence of hearing impairment in high-risk newborns, majority of which were bilateral. The authors recommend multistage screening in all newborns at birth or within month’s time at all level of healthcare facility. Newborns with sepsis, NICU stay >5 days and use of aminoglycosides >7 days should have mandatory audiologic evaluation at discharge.

Exploring Language Development Support for Foster Children: A Scoping Review of Interventions for Foster Care Families.

Children in foster care are at an increased risk for language delays and disorders, and foster parents can play a significant role in preventing delays in early language development. This scoping review explored empirical studies that included foster parent training programs for families with foster children under the age of 5 years. Using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews), multiple databases were searched, and resulting article titles and abstracts were screened for inclusion in the review. Each study that met inclusion criteria was then coded for the training methods used to teach foster parents intervention strategies and the targeted outcomes of the intervention. A total of 24 studies were identified. Of the 24 studies reviewed, all included interventions focused on increasing parent-child relationships and decreasing child challenging behaviors, but few included opportunities for foster parents to practice using intervention strategies with their foster child. None of the studies focused specifically on strategies for promoting children's language development. When outcomes across the studies were reviewed, only two focused on children's language. The results of this review point to the need for more research on language interventions that can be implemented by foster parents. The discussion focuses on the important role speech-language pathologists can play in the prevention of early language delays or disorders in young foster children. https://doi.org/10.23641/asha.21714311.

Pathological tortuosity of the internal carotid arteries in childhood

Objective — to identify the incidence of PT ICA in pediatric patients and assess their clinical significance depending on the clinical and anatomical forms. Methods and subjects. On the basis of the Department of Vascular Surgery of the Department of Emergency and Restorative Vascular Surgery of the Institute of Emergency and Restorative Surgery named after V. K. Husaka of the National Academy of Sciences of Ukraine, together with the Donetsk regional children’s psychoneurological dispensary, we conducted a screening study of brachiocephalic arteries in 420 children in the period from 2005 to 2007. The age of the patients is from 2 to 16 years, the average age is (9 ± 4) years. The control group consisted of 100 people without complaints, neurological deficits, and psycho‑emotional retardation. A comprehensive examination included an examination by a pediatrician, a pediatric neurologist, a cardiologist, a vascular surgeon, a psychoneurologist, a duplex scan of the brachiocephalic vessels, a study of cardiac hemodynamics (electrocardiography, echocardiography), and magnetic resonance imaging of the brain as indicated. The criteria for the hemodynamic significance of LV were considered to be: the presence of a septal inflection of the ICA, an angle < 60°, microaneurysms, loop formation, blood flow acceleration in the zone of LV > 140 cm/s, the value of the resistivity index in the presence of a microaneurysm < 0.5, in the absence of a microaneurysm > 0.7. The type of PZ ICA was determined according to the classification of J. Weibel and W. Fields (1965) with additions by J. Vollmar (1976). Results. Hemodynamically significant ISA was detected in 108 (25.7 %) children of the main group (in 32 (30 %) boys and 76 (70 %) girls), the presence of transient ischemic attacks was in 8 (7.4 %), ischemic stroke was in 5 (4.6 %) school‑age patients due to disease progression. The most clinically unfavorable clinico‑anatomical forms are S‑like PZ ICA (42 (39 %)) and loop formation (11 (10 %)). The most frequent neurological disorders in preschool children caused by the pathological tortuosity of the internal carotid arteries are delayed language development (29 (27 %), impaired adaptation in a team, delayed self‑care skills (delayed in neuropsychological development) (33 (31 %)), impaired emotional sphere and behavior (irritability, mild excitability) (84 (78 %)), sleep disturbances (16 (15 %)). The most serious neurological disorders in children with pathological tortuosity of the internal carotid arteries occur during the school period, which is the result of the progression of early cerebrovascular insufficiency. At this age, the following manifestations of early cerebrovascular insufficiency are typical: headache (100 (93 %)), decreased vision (35 (32 %)), decreased performance at school (88 (82 %)), irritability, anxiety, reduced work capacity, attention disorders (96 (89 %)), cerebral circulation disorders (5 (4.6 %)).Predominant neurological disorders in preschool‑aged children with PT ICA: delayed language development (29 (27 %)), delayed self‑care skills (delayed neuropsychological development) — 33 (31 %); disorders of the emotional sphere and behavior — 84 (78 %), sleep disorders (16; 15 %). Conclusions. Timely detection and early diagnosis of ICA in children by a screening examination prevent the progression of cerebrovascular insufficiency.

A high fat diet in glutamate 3-/Y mice causes changes in behavior that resemble human intellectual disability

Cognitive impairment in individuals with intellectual disability (ID) is characterized by developmental delay and deficits in language and memory. Ionotropic AMPA mediate the majority of excitatory synaptic transmission in the central nervous system and are essential for the induction and maintenances of long-term potentiation (LTP) and long-term depression (LTD), two cellular models of learning and memory underlie many the symptoms of ID. Clinical research has found obese male patients with GluA3 interrupted underlie the symptom of ID. We tested GluA3-/Y mice under high fat diet (HFD) stress on a series of behavioral paradigms associated with symptoms of ID: wild type mice showed significant levels of sociability, while GluA3-/Y mice did not. Wild type mice showed significant preference for social novelty, while GluA3-/Y mice did not. Normal scores on relevant control measures confirmed general health and physical abilities in both GluA3-/Y and wild type mice (WT), ruling out artifactual explanations for social deficits. GluA3-/Y mice also showed working spatial memory behavior impairment in Y-maze test and abnormal anxiety in open-field test, compared to wild-type littermate controls. GluA3-/Y mice had a significantly reduced spontaneous activities tested by elevated plus maze, display both low social approach and resistance to change in routine on the T-maze, consistent with an ID-like phenotype. These findings demonstrate that selective gene deletion of GluA3 receptor in male mice under oxidative stress induced phenotypic abnormalities related to ID-like symptoms.

Family-centered rehabilitation in high risk infant; A case report

Preterm infants are categorized as a high-risk group in neonatology. Theyare physiologically less mature and have limited compensatory responsesto the extrauterine environment compared with term infants. Preterminfants need long-term evaluation, monitoring, and follow-up to optimizeneonatal care and development through an extensive rehabilitationperiod. However, the COVID-19 pandemic restricted patient care andfollow-up in the outpatient hospital setting. This case report discusses ahigh-risk infant treated with family-centered rehabilitation (FCR). Thepatient's rehabilitation issues included delays in gross motor, fine motor,and language development and preventing complications that may arisein a high-risk premature infant. Considering recent occurrences, ourapproach to rehabilitation programs for high-risk infants needs to bereevaluated and revised, focusing on home programs through familycentered treatment. These techniques may aid in delivering rehabilitationtreatments to children with developmental delays during COVID-19.

Maternal cytomegalovirus infection and delayed language development in children at 3 years of age-a nested case-control study in a large population-based pregnancy cohort.

Maternal cytomegalovirus (CMV) infection in pregnancy may result in vertical transmission of CMV to the child. Long-term effects of congenital CMV infection include visual, cognitive as well as neurological impairment. The aim of this study was to estimate the odds ratios for CMV seropositivity and seroconversion in mothers, with and without delayed language development in 3 year old children, nested within a large cohort. The Norwegian Mother, Father and Child Cohort Study (MoBa) is a prospective population-based pregnancy cohort that includes 95 200 mothers and 114 500 children. Blood samples were obtained from mothers during pregnancy weeks 17 or 18 in pregnancy and after birth. We included 300 women from MoBa with children suffering from delayed language development at three years of age, based on validated questionnaires. Within the cohort, 1350 randomly selected women were included as controls to perform a nested case-control study. The cases and controls were tested for CMV IgG antibodies by an enzyme-linked immunosorbent assay. Among mothers of cases, 63.2% were CMV-IgG positive in the sample at birth, as compared to 55.9% among controls; OR 1.36, (95% CI; 1.05 to 1.76). Also, among case mothers, 8/118 (6.8%) initially seronegative cases, seroconverted. Among initially seronegative controls, seroconversion occurred in 23/618 (3.7%) mothers. The OR for seroconversion in cases as compared to control mothers was 1.88 (CI; 0.82 to 4.31), thus not statistically significant different. This study shows a higher risk of delayed language development at three years of age in children born by mothers seropositive for CMV, compared to children born from seronegative mothers.

Breastfeeding Duration More than 18 Months Possibly Lowers the Risk of Language Development Delay in Children Aged 18–35 Months

Studies have demonstrated the benefits of breastfeeding (BF) on children’s cognitive function and language development. However, most cognitive and language tools used in these studies have limited ability to identify children’s language development delays. The Language Development Survey (LDS) is expected to provide detailed information on children’s language development. This study aimed to examine the association between BF duration and children’s LDS. A questionnaire was administered to 286 BF mothers to obtain information on their BF duration, and LDS was employed to assess children’s language development. Language delays were detected in 91 (31.8%) children (LDS-vocabulary) and 35.7% children (LDS-phrase). This study also found that children who were breastfed for ≤6 months and 7–18 months had an adjusted OR (AOR) of 0.86 of LDS-vocabulary, and 0.8 of LDS-phrase, whereas children who were breastfed for >18 months had AOR’s LDS-vocabulary of 0.57 and LDS-phrase of 0.46. This study found no significant association between BF duration and LDS score. Nevertheless, BF duration of >18 months possibly lowers the risk of children’s language development delay. More studies are required to investigate this observation’s relationship with children’s language development.

Challenges and Neuropsychological Functioning in Children and Adolescents with Borderline Intellectual Functioning.

This retrospective chart review study sought to explore neuropsychological profiles, neuropsychiatric and psychiatric comorbidity, changes in diagnoses, support at daycare and school, medication use, psychiatric referrals, and progression into further education in a cohort of participants with borderline intellectual functioning (BIF). Additionally, developmental factors connected to BIF were studied. Delays in language and gross motor development were the initial reasons for the parents to seek health care. Comorbid neuropsychiatric and psychiatric diagnoses were frequent, a total of 41% of participants were referred to psychiatric services, and 45% used medication. Educational support was needed by 92% of the study participants. The majority of those graduating elementary school continued their studies at ordinary or special vocational schools. The risk of dropping out during secondary studies appeared to increase. The results in most of the neuropsychological subdomains declined over time, and 23% of the participants were later diagnosed with an intellectual disability (ID). The early developmental signs pointing towards BIF and the need for prompt support were a delay in language and motor development, difficulties in executive function, a delay in learning the activities of daily living among children under school age, and difficulties in reading and arithmetic skills and abstract reasoning at school age. It is important to follow up and support individuals with BIF as their risk for being left behind in the society is increased. Also, it would be important to repeat the neuropsychological testing of cognitive and adaptive functions before graduating elementary school as to capture those who meet the ID criteria.

Diagnostic value of molecular approach in screening for fragile X premutation cases.

Fragile X syndrome (FXS) is the most common form of inherited intellectual disability, caused by CGG-repeats expansion (> 200 repeats). Premutation alleles (PM) (55-200 CGG repeats) are associated with tremor ataxia syndrome (FXTAS), fragile X-associated primary ovarian insufficiency (FXPOI), and autistic problems. To screen the frequency of premutation carriers using molecular diagnostic assays, in a cohort of Egyptian males with suspected clinical features of (FXS) checking for the presence of premutation alleles. The current study comprised 192 Egyptian male children, 92 participants presented with intellectual disability, delayed language development, autistic-like features, behavioral difficulties, anxiety, seizures, and depression compared to 100 healthy males. All cases were subjected to clinical and neuroimaging assessments, when indicated as well as molecular analysis using methylation-specific PCR (MS-PCR) and quantitative real-time PCR (qRT-PCR). Thirty-four premutation carriers out of 92 Egyptian males (37%) of CGG repeats (55 to 200) were illustrated with elevated FMR1 mRNA expression level (p-value < 0.001). Additionally, 2 intermediate (IM) cases (0.03%) (45-55 CGG repeats) showed poor increase in expression level (p-value = 0.02838) plus 6 full mutation (FM) patients (0.07%) with (> 200 CGG repeats) (p-value < 0.001) resulted in FMR1 gene silence. Molecular diagnostic assay including (MS-PCR) and (qRT-PCR) proved to be a sensitive and rapid screening tool for the detection of premutation cases. Furthermore, the presence of positive correlation between FMR1 mRNA expression levels with CGG repeats in premutation cases could serve as a potential diagnostic marker. Application of these diagnostic tools on larger number clinically suspected cases is recommended.

How Early Can We Predict the Need for VPI Surgery?

This retrospective study reviewed documentation of children with moderate-to-severe VPI at age 3 years who did not undergo VPI surgery until age 5 years. Based on the national cleft register, 959 patients with syndromic and nonsyndromic CP were treated by the craniofacial team at Helsinki University Hospital, Finland between 2000 and 2014. Eighty-six patients fulfilled the study inclusion criteria. The speech pathologist evaluated velopharyngeal function at age 3, 5, and 8 years. Of the 86 children presenting with moderate-to-severe VPI at age 3 years, 94% still had moderate-to-severe VPI at age 5 years, even though speech therapy was offered to 77%. Of those whose velopharyngeal function improved by age 5 years, function regressed to incompetent over time. Overall, 93% underwent VPI surgery and 82% underwent VPI surgery between ages 5 and 8 years. Only 23% at age 8 years still had moderate-to-severe VPI. Speech therapy alone did not improve VPI speech characteristics. Moderate-to-severe VPI did not improve from 3 to 5 years or improved but subsequently relapsed. This suggests that the decision for VPI surgery can be made for children aged 3 years with moderate-to-severe VPI.

Knowledge of mothers regarding developmental milestones of infants: A Descriptive Cross-sectional study

Developmental milestones in children or infants are a certain set of skills or age-specific tasks. Missed or delayed milestones in infancy can be symptoms of serious medical conditions. If parents understand their children’s development, they can tailor their expectations and provide stimulation. This study was conducted to assess the level of knowledge regarding the development milestones of infants among mothers. A descriptive study was conducted on 100 mothers of neonates visiting pediatric OPD and gynecological unit (Postnatal Ward).A convenience sampling technique was used to collect data. More than half of mother’s i.e. 60% had an average level of knowledge, 22% of mothers had a poor level of knowledge and 18% of mothers had a good level of knowledge. Mothers had the highest (75.25%) mean knowledge percentage in general information followed by 53.33%, in developmental delay and least (37.50%) mean knowledge percentage in language development. The overall mean knowledge score is 10.240±2.40 and there is no association (p&gt;0.05) between the knowledge level of mothers with selected demographic variables. It is concluded that the majority of the mothers of neonates had average knowledge regarding developmental milestones.

Expansion of the mutation spectrum and phenotype of USP7-related neurodevelopmental disorder.

Hao-fountain syndrome (HAFOUS) is a neurodevelopmental syndrome characterized by global developmental and severe language delays, behavioral abnormalities (including autism), and mild dysmorphic impairment of intellectual development. It is a dominant genetic disease caused by USP7 gene (*602519) mutations on chromosome 16p13.2. So far, only 15 cases with 14 deleterious variants in the USP7 gene have been reported. This study describes three unrelated patients with USP7 variants. Besides, we identified novel de novo heterozygous USP7 variants using trio-whole exome sequencing and verified by Sanger sequencing. Furthermore, clinical characteristics were evaluated by reviewing the medical records. The three identified variants, i.e., one frameshift variant (c.247_250del, p.Glu83Argfs × 18) and two missense variants (c.992A > G, p.Tyr331Cys; c.835T > G, p.Leu279Val) are unreported. The predominant clinical manifestations of the three patients included: DD/ID; language impairment; abnormal behavior; abnormal brain magnetic resonance (dilation of lateral ventricles, dilation of Virchow-Robin spaces, dilated the third ventricle, abnormal cerebral white matter morphology in bilateral occipital lobes, hypodysplasia of the corpus callosum, arachnoid cyst, delayed myelination, and widened subarachnoid space); some also had facial abnormalities. In summary, DD/ID is the most prevalent clinical phenotype of HAFOUS, although some patients also exhibit language and behavioral abnormalities. For the first time in China, we identified three variants of the USP7 gene using whole-genome sequence data. This work expands the USP7 gene mutation spectrum and provides additional clinical data on the clinical phenotype of HAFOUS.

Production of pronoun gender by children acquiring Russian as a minority language: comparison with the effects of developmental language disorder

This paper studies the acquisition of Russian pronominal gender by Dutch-Russian simultaneous bilinguals (4;3-7;11) growing up in the Netherlands. The performance of the bilingual group is compared to that of age-matched monolinguals with and without developmental language disorder (DLD). We hypothesize that reduced exposure toRussian in the minority-language context may lead to delays in language development, comparable to problems attested in DLD (in this case due to reduced intake). The results of a narrative elicitation task demonstrate that both monolingual groups performed at ceiling from age 4 onwards. Monolingual children with DLD were as accurate at using pronominal gender as their unimpaired peers fromthe earliest ages studied, which supports the processing accounts of DLD taking morphological richness of the target language into account. In contrast, 4-year-old bilinguals performed around chance level. The performance of the bilingual group improved with age and reached the monolingual level only by age 7. The results suggest that reduced input has more impact on theacquisition of gender in a morphologically rich language, whereas the possible effects of DLD are no longer visible after age 3.

Improving Children's Expressive Language and Auditory Comprehension Through Responsive Caregiving: Evidence from a Randomized Controlled Trial of a Strength-Based Video-Coaching Intervention.

Young children from low-SES backgrounds are at higher risk for delayed language development, likely due to differences in their home language environment and decreased opportunities for back and forth communicative exchange. Intervention strategies that encourage reciprocal caregiver-child interactions may effectively promote young children's language development and enhance optimal language outcomes. The Filming Interactions to Nurture Development (FIND) program is a brief strength-based video-coaching intervention designed to promote increased back and forth ("serve and return") interactions between caregivers and their children. The current study used data from a randomized controlled trial (RCT) to examine the effectiveness of the FIND program in improving auditory comprehension and expressive communication skills among children from low-SES backgrounds. The current study used a pretest-posttest design to evaluate intervention effects from an RCT with 91 low-SES families. Families with children aged 4 to 36months old (41.8% female) were randomly assigned to an active control or FIND intervention group. Children's auditory comprehension and expressive communication were assessed using the Preschool Language Scales, Fifth Edition (PLS-5) during both pre- and post-intervention sessions. Children in the FIND intervention group showed significantly increased expressive communication skills and a non-significant increase in auditory comprehension skills across the intervention period. In contrast, children in the active control group showed non-significant changes in expressive communication and a statistically significant decline in auditory comprehension abilities between pre- and post-intervention assessments. All analyses controlled for sex, age, and home language. This study provides preliminary evidence that the FIND intervention promotes the development of expressive and receptive language skills among young children in high-stress, low-SES environments.

Correlation of Language Assessment Batteries of Toddlers With Developmental Language Delay

To analyze the correlation between standardized language assessment batteries of toddlers and developmental language delays. A total of 319 children with suspected language developmental delays were enrolled in this study retrospectively. They underwent the Receptive and Expressive Vocabulary Test (REVT) for vocabulary development assessment and at least one of two language assessment batteries: The Sequenced Language Scale for Infants (SELSI) or the Preschool Receptive-Expressive Language Scale (PRES) for language development assessment. The correlation of the results for receptive and expressive language between the scales were analyzed. The participants were divided into two groups: SELSI and REVT (n=45) and PRES and REVT (n=273). When the children's results were classified into groups (average, mild delay, and delay), receptive and expressive scores were significantly correlated with each other in both SELSI-REVT and PRES-REVT groups. In addition, the correlation of mean developmental age between tests are analyzed. In the SELSI-REVT group, there was weak correlation of mean developmental age between tests for receptive and expressive language. In the PRES-REVT group, there was a strong positive correlation of mean developmental age for receptive and expressive language in children aged >36 months. Attention deficits during the test was found to be the statistically significant factor affecting the differences between the tests. The odds ratios for receptive and expressive language were 2.60 (95% confidence interval,1.15-5.84) and 1.94 (95% confidence interval, 1.15-3.27), respectively. This study examined the correlations and influencing factors between language development evaluation tools for toddlers. An integrated interpretation of comprehensive language and vocabulary evaluation tools may be possible in children older than 3 years of language developmental age.

STORYTELLING PADA ANAK DENGAN KETERLAMBATAN PERKEMBANGAN BERBAHASA EKSPRESIF

Language development in early childhood is a foundations in both mastering academic skills and social skills. Delays in early intervention will increase the risk of children experiencing problems as adults. TDB is a kindergarten student with the age of 5 years 9 months who was identified with expressive language developmental delay. The results of the assessment showed that the development of expressive language of TDB was not in accordance with its chronological age. Intelligence test results show the level of intelligence is in the category above average. The storytelling method with puppet sticks was provided to TDB for seven sessions. In each session, the researcher did storytelling using puppet stick media and then asked TDB to repeat the story that had been told by the researcher. There are seven different stories used in each session. The results of observations on the mean length of utterance show that there is an increase in the mean length of utterance from 2.3 to 3.6. This shows that the storytelling method with puppet sticks is quite effective in increasing the development of expressive language.

Prenatal titanium exposure and child neurodevelopment at 1 year of age: A longitudinal prospective birth cohort study

Previous animal studies provided the evidence that prenatal titanium exposure can cause neurotoxicity in their offspring, while human data is vacant. Our aim was to identify the associations of prenatal titanium exposure with the child neurodevelopment. Participants in present study were recruited during early pregnancy between 2014 and 2017. Urinary concentrations of titanium at first trimester were determined. We assessed child neurodevelopment using the Chinese version of Gesell Developmental Schedules at first year follow-up. The multivariable linear regressions and the robust modified Poisson regressions were used to estimate the associations of specific gravity corrected urinary titanium concentrations with the child neurodevelopment. In adjusted models, children's developmental quotient scores in the language domain were 2.03 points (95% CI: −3.66, −0.40) lower in the highest tertile of prenatal urinary titanium than in the lowest tertile. Also, children with prenatal urinary titanium in the highest tertile had 1.42 times (95% CI: 1.17, 1.72) increased risk of language development delay compared to those in the lowest tertile. No statistically significant associations were observed between titanium exposure and child development delay in motor, adaptive and social areas. The findings indicated that prenatal higher titanium exposure was associated with impaired language development, suggesting that titanium might act as developmental neurotoxicants.