Expressive Language Development Research Articles

Prenatal isolated mild ventriculomegaly is associated with persistent ventricle enlargement at ages 1 and 2

BackgroundEnlargement of the lateral ventricles is thought to originate from abnormal prenatal brain development and is associated with neurodevelopmental disorders. Fetal isolated mild ventriculomegaly (MVM) is associated with the enlargement of lateral ventricle volumes in the neonatal period and developmental delays in early childhood. However, little is known about postnatal brain development in these children. MethodsTwenty-eight children with fetal isolated MVM and 56 matched controls were followed at ages 1 and 2years with structural imaging on a 3T Siemens scanner and assessment of cognitive development with the Mullen Scales of Early Learning. Lateral ventricle, total gray and white matter volumes, and Mullen cognitive composite scores and subscale scores were compared between groups. ResultsCompared to controls, children with prenatal isolated MVM had significantly larger lateral ventricle volumes at ages 1 and 2years. Lateral ventricle volume at 1 and 2years of age was significantly correlated with prenatal ventricle size. Enlargement of the lateral ventricles was associated with increased intracranial volumes and increased gray and white matter volumes. Children with MVM had Mullen composite scores similar to controls, although there was evidence of delay in fine motor and expressive language skills. ConclusionsChildren with prenatal MVM have persistent enlargement of the lateral ventricles through the age of 2years; this enlargement is associated with increased gray and white matter volumes and some evidence of delay in fine motor and expressive language development. Further study is needed to determine if enlarged lateral ventricles are associated with increased risk for neurodevelopmental disorders.

Language Development Survey Provides a Useful Screening Tool for Language Delay in Preterm Infants

Developmental language disorder has been reported in 3% to 10% of term infants and 30% of preterm infants (<34 weeks gestation). Screening for language delay in preterm infants can be costly and time-consuming. The objective of this study was to assess the expressive language development of preterm infants using the Language Development Survey (LDS). A total of 178 preterm infants born at 23 to 34 weeks between 2006 and 2008 were enrolled. The LDS was completed by parents between 22 and 26 months at or shortly before 2-year neurodevelopmental assessment using the Bayley III Scale. A total of 26% of former preterm patients had language delay, using LDS. Significant correlations were observed between LDS results and Bayley III scores. Male gender and public health insurance were the most important risk factors for language delay in this cohort. Expressive language delay was present in 26% of preterm infants. LDS is a suitable and inexpensive screening tool for assessing language delay in preterm infants.

372 kb microdeletion in 18q12.3 causing SETBP1 haploinsufficiency associated with mild mental retardation and expressive speech impairment

Several cases of interstitial deletion encompassing band 18q12.3 are described in patients with mild dysmorphic features, mental retardation and impairment of expressive language. The critical deleted region contains SETBP1 gene (SET binding protein 1). Missense heterozygous mutations in this gene cause Schinzel-Giedion syndrome (SGS, MIM#269150), characterized by profound mental retardation and multiple congenital malformations. Recently, a 18q12.3 microdeletion causing SETBP1 haploinsufficiency has been described in two patients that show expressive speech impairment, moderate developmental delay and peculiar facial features. The phenotype of individual with partial chromosome 18q deletions does not resemble SGS. The deletion defines a critical region in which SETBP1 is the major candidate gene for expressive speech defect. We describe an additional patient with the smallest 18q12.3 microdeletion never reported that causes the disruption of SETBP1. The patient shows mild mental retardation and expressive speech impairment with striking discrepancy between expressive and receptive language skills. He is able to communicate using gestures and mimic expression of face and body with surprising efficacy. The significant phenotypic overlap between this patient and the cases previously reported enforce the hypothesis that SETBP1 haploinsufficiency may have a role in expressive language development.

An Investigation of The Development of Imitation Skill in Children with Autism and Its Relations with Receptive- Expressive Language Development and The Development of Symbolic Play

An Investigation of The Development of Imitation Skill in Children with Autism and Its Relations with Receptive- Expressive Language Development and The Development of Symbolic Play

Effect of Pediatric Bilateral Cochlear Implantation on Language Development

To examine spoken language outcomes in children undergoing bilateral cochlear implantation compared with matched peers undergoing unilateral implantation. Case-control, frequency-matched, retrospective cross-sectional multicenter study. Two Belgian and 3 Dutch cochlear implantation centers. Twenty-five children with 1 cochlear implant matched with 25 children with 2 cochlear implants selected from a retrospective sample of 288 children who underwent cochlear implantation before 5 years of age. Cochlear implantation. Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales and Schlichting Expressive Language Test). On the receptive language tests (mean difference [95% CI], 9.4 [0.3-18.6]) and expressive language tests (15.7 [5.9-25.4] and 9.7 [1.5-17.9]), children undergoing bilateral implantation performed significantly better than those undergoing unilateral implantation. Because the 2 groups were matched with great care on 10 auditory, child, and environmental factors, the difference in performance can be mainly attributed to the bilateral implantation. A shorter interval between both implantations was related to higher standard scores. Children undergoing 2 simultaneous cochlear implantations performed better on the expressive Word Development Test than did children undergoing 2 sequential cochlear implantations. The use of bilateral cochlear implants is associated with better spoken language learning. The interval between the first and second implantation correlates negatively with language scores. On expressive language development, we find an advantage for simultaneous compared with sequential implantation.

Sertraline may improve language developmental trajectory in young children with fragile x syndrome: a retrospective chart review.

Young children with fragile X syndrome (FXS) often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL) for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC) scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD) was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99) and from 12 to 50 months (mean 29.94, SD 8.64) for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (P < 0.0001 and P = 0.0071, resp.). This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

Study of Effect of Ebru Training on the Developmental Areas of Children Aged Under Five

The study aims at determining the development areas and the effect of ebru art training on the development areas of children aged under five attending kindergartens of elementary schools. The study domain consisted of children aged under five with normal development, who attended kindergartens of elementary schools of Ministry of National Education in the central distinct of Ankara. Two kindergarten classes of elementary schools that were determined as not having any art training were included into the study from among the schools of Ministry of National Education in the central district of Ankara. Test and control groups were determined by random sampling from the kindergarten classes. Experimental pattern with pre-test and post-test control was used in the study. Information on children and families participating in the study was collected from the school records and with the used “Family Information Form” developed by the author. “Brigance Early Preschool Screen II”, which was adapted to Turkish by Aral et al. (2008), was used to determine the development level of children. Art of ebru training program was prepared specifically for the development characteristics of children aged under five in the study. Prior to application of the training program, Brigance Early Preschool Screen II was applied as pre-test on the test and control groups. Art of ebru training was given to children in the test group for a period of approximately one hour per day for ten weeks with education provided within the framework of the preschool education program of the Ministry of National Education during the remaining education time. Children in the control group continued the preschool education program of the Ministry of National Education. Brigance Early Preschool Screen II was applied as the post-test on the test and control groups after the education program. At the end of this research, it has been determined that group x common effect of scores which are gotten from Brigance Early Development Inventory II Receptive and Expressive Language Development Sub-dimension is significant (p<.05). However, group x common effect gotten from total score and scores obtained from other sub-dimensions of Brigance Early Development Inventory II is not significant (p>.05).

Auditory-Motor Mapping Training as an Intervention to Facilitate Speech Output in Non-Verbal Children with Autism: A Proof of Concept Study

Although up to 25% of children with autism are non-verbal, there are very few interventions that can reliably produce significant improvements in speech output. Recently, a novel intervention called Auditory-Motor Mapping Training (AMMT) has been developed, which aims to promote speech production directly by training the association between sounds and articulatory actions using intonation and bimanual motor activities. AMMT capitalizes on the inherent musical strengths of children with autism, and offers activities that they intrinsically enjoy. It also engages and potentially stimulates a network of brain regions that may be dysfunctional in autism. Here, we report an initial efficacy study to provide ‘proof of concept’ for AMMT. Six non-verbal children with autism participated. Prior to treatment, the children had no intelligible words. They each received 40 individual sessions of AMMT 5 times per week, over an 8-week period. Probe assessments were conducted periodically during baseline, therapy, and follow-up sessions. After therapy, all children showed significant improvements in their ability to articulate words and phrases, with generalization to items that were not practiced during therapy sessions. Because these children had no or minimal vocal output prior to treatment, the acquisition of speech sounds and word approximations through AMMT represents a critical step in expressive language development in children with autism.

The emergence of nonverbal joint attention and requesting skills in young children with autism

Joint attention (JA) skills are deficient in children with autism; however, children with autism seem to vary in the degree to which they display joint attention. Joint attention skills refer to verbal and nonverbal skills used to share experiences with others. They include gestures such as pointing, coordinated looks between objects and people, and showing. Some nonverbal gestures are used to request rather than merely to share. These requesting gestures include reaching, pointing to request, and giving to gain assistance. Although these skills also relate to expressive language development, we know little about when they emerge and how they change as language develops in children with autism. Several studies report the emergence of nonverbal requests in children with autism to be similar to that of typically developing children, but other studies report impairments in such skills. This study investigates the emergence of nonverbal JA and requesting skills in typically developing children and in children with autism with expressive language ages between 12 and 60 months, using both a both cross-sectional and a longitudinal design. Results suggest that the sequence of JA skill emergence in autism differs from a normative model, while the sequence of requesting skills emerges in accord with typical development. Furthermore, several joint attention skills appeared to emerge later than in typical children. With regards to intervention it appears that a curriculum based on a normative developmental model for the emergence of requesting skills is mostly appropriate for use with children with autism. However, since children with autism acquired nonverbal joint attention skills in a sequence that differed from a normative model, it might be that a non-normative autism-specific joint attention curriculum would be more likely to benefit children with autism. Learning outcomes: The reader will (1) identify 3 specific initiating gestures used to communicate for the purpose of joint attention, (2) identify 2 specific nonverbal responsive joint attention skills, (3) be able to state that children with autism appear to develop specific nonverbal requesting gestures in a similar sequence to typically developing children, (4) be able to state that children with autism appear to develop specific nonverbal joint attention gestures in a different sequence than that of typically developing children, and (5) be able to identify 2 specific nonverbal joint attention skills that appear significantly impaired in children with autism relative to typically developing children.

Impact of Early Intervention on Expressive and Receptive Language Development Among Young Children with Permanent Hearing Loss

Along with early detection, early intervention (EI) is critical for children identified with hearing loss. Evidence indicates that many children with sensorineural hearing loss experience improved language abilities if EI services were initiated at an "early" age. The present study's objectives were to determine the impact of a state EI program on language over time of children with permanent hearing loss and evaluate the association of EI enrollment by age 6 months with early language skill development. Young children in a state EI program were included in this longitudinal study. Results indicate that children enrolled prior to age 6 months were more likely to have age-appropriate language skills at baseline than children enrolled at or after 6 months, and maintained age-appropriate skills over time. Children enrolled at or after 6 months had lower baseline skills but made significant language progress, irrespective of hearing loss severity.

Desenvolvimento cognitivo e da linguagem expressiva: diversidade e complexidade das produções infantis

Objective and systematized analysis of cognitive and expressive language development. To characterize expressive language and cognitive development considering the diversity and complexity of children's productions. This study involved 20 subjects (10 male and 10 female), who were adequate for gestational age and birth weight and had no pre, peri or post natal intercurrences. Participants were submitted to 30-minute sessions, once a month, for the observation of expressive language and cognitive development. The observations were made during the period that went from eight to 18 months of age, using the material and application procedures suggested by the PELCDO-r. The amount of different schemes, gestures and verbalizations that children were capable of producing (diversity and complexity) are presented and analyzed considering each one of the 30-minute sessions as well as the overall total during the period of observation (from eight to 18 months). The PELCDO-r allowed the characterization of expressive language and cognitive development by means of the objective observation of this process concerning the diversity and complexity of subjects' productions, considering the period between the fourth phase of sensorimotor stage and the beginning of preoperational stage.

Estado nutricional e desenvolvimento da linguagem em crianças de uma creche pública

OBJETIVO: Investigar a associação entre estado nutricional e desenvolvimento da linguagem infantil. MÉTODOS: Participaram do estudo 34 crianças de quatro a seis anos e 11 meses de idade de creches de Belo Horizonte, Minas Gerais. As crianças foram avaliadas quanto ao desenvolvimento da linguagem receptiva e expressiva utilizando-se as tarefas do instrumento de Avaliação de Desenvolvimento de Linguagem (ADL). Para a avaliação nutricional foram utilizados os índices estatura/idade e peso/idade, de acordo com os padrões e curva de crescimento da OMS. RESULTADOS: Em relação à linguagem, 13 (38%) apresentaram alterações; e quanto ao estado nutricional, 26 crianças (76%) eram eutróficas, seis (18%) estavam em risco nutricional, uma (3%) estava desnutrida e uma (3%) tinha sobrepeso. Ao comparar as médias dos percentis estatura/idade e peso/idade entre as crianças com e sem distúrbio do desenvolvimento da linguagem, não se encontrou diferença. CONCLUSÃO: Não foi observada associação entre estado nutricional e desenvolvimento da linguagem nas crianças. Contudo, os percentis estatura/idade e peso/idade foram, tendenciosamente, menores no grupo de crianças com distúrbio de linguagem.

High Prevalence/Low Severity Language Delay in Preschool Children Born Very Preterm

To examine the language development at corrected age 4 years of a regionally representative cohort of children born very preterm (VPT). Of particular interest was the identification of biological and socioenvironmental risk and protective factors that influence VPT children's early language development. Data were collected as part of a prospective longitudinal study of 110 VPT (VPT: ≤ 33 weeks gestation) and 113 full-term children (full term: 37-41 weeks gestation) born in Canterbury, New Zealand from 1998 to 2000. At corrected age 4 years, all children were assessed with the preschool version of the Clinical Evaluation of Language Fundamentals. Extensive information was also collected about children's family social background, perinatal health, childrearing environment, education/intervention exposures, and neurodevelopmental progress from birth to age 4. At the age of 4 years, VPT children were characterized by poorer receptive and expressive language development than full-term children. These differences persisted after exclusion of children with neurosensory impairment as well as statistical adjustment for the effects of social risk. Within the VPT group, the key predictors of children's overall language development were family social risk at birth (p =.05), severity of white matter abnormalities on neonatal magnetic resonance imaging (p =.49), observed parent-child synchrony (p =.001), and concurrent child cognitive ability (p =.001). Together, these factors accounted for 45% of the variance in children's total Clinical Evaluation of Language Fundamentals-Preschool scores. By preschool age, children born VPT show early emerging mild to moderate language delays that are likely to affect their school success and longer-term developmental progress. Findings highlight the importance of potentially modifiable factors such as early brain injury and parenting quality in predicting the language outcomes of children born VPT.

RTI Progress Monitoring Tools

RTI Progress Monitoring Tools

Language development in children after receiving bilateral cochlear implants between 5 and 18 months

Objective The objective of this study was to examine receptive and expressive language development in children who received simultaneous bilateral cochlear implants (CIs) between 5 and 18 months of age and to compare the results with language development in chronologically age-matched children with normal hearing. Methods The study used a prospective, longitudinal matched-group design. Data were collected in a clinical setting at postoperative cochlear implant check-ups after 3, 6, 9, 12, 18, 24, 36, and 48 months of implant use. The sample included 42 children: 21 cochlear implant users and 21 with normal hearing, matched pairwise according to gender and chronological age. Communication assessments included the LittlEARS questionnaire, the Mullen Scale of Early Learning, and the Minnesota Child Development Inventory. Results The cochlear implant users’ hearing function according to LittlEARS was comparable to that of normal-hearing children within 9 months post-implantation. The mean scores after 9 and 12 months were 31 and 33, respectively in the prelingually deaf versus 31 and 34 in the normal-hearing children. The children's receptive and expressive language scores showed that after 12–48 months with cochlear implants, 81% had receptive language skills within the normative range and 57% had expressive language skills within the normative range. The number of children who scored within the normal range increased with increasing CI experience. Conclusions The present study showed that prelingually deaf children's ability to develop complex expressive and receptive spoken language after early bilateral implantation appears promising. The majority of the children developed language skills at a faster pace than their hearing ages would suggest and over time achieved expressive and receptive language skills within the normative range.

On the Value of Repeated Measures of Intention, Vocabulary, and Grammar for Children With Autism

Purpose: Repeated measures of communica- tive intention, vocabulary, and grammar were collected from a child with autism during the course of commu- nity-based treatment. Method: Data were collected for 14 months using language samples and the MacArthur Communicative Development Inventory (Fenson et al., 1993). Results: During every session, the child's abilities in communicative intention, vocabulary, and grammar were lower than expected for his age. Nevertheless, the child increased his abilities in all 3 areas across time. His growth in the social engagement domain for communica- tive intents rather than in the behavior regulation domain was positively related to his development of expressive language. Conclusion: These findings are consistent with other studies that have examined similarly aged children with autism who also showed high and steady advances in their development of language during the course of com- munity-based treatment. For clinical purposes, repeated measures of these 3 skill areas helped confirm the high functioning language status and positive growth trajectory of the child relative to other children with autism.

Cochlear Implantation in the Very Young Child: Issues Unique to the Under-1 Population

Since the advent of cochlear implantation, candidacy criteria have slowly broadened to include increasingly younger patients. Spurred by evidence demonstrating both perioperative safety and significantly increased speech and language benefit with early auditory intervention, children younger than 12 months of age are now being successfully implanted at many centers. This review highlights the unique challenges involved in cochlear implantation in the very young child, specifically diagnosis and certainty of testing, anesthetic risk, surgical technique, intraoperative testing and postoperative programming, long-term safety, development of receptive and expressive language, and outcomes of speech perception. Overall, the current body of literature indicates that cochlear implantation prior to 1 year of age is both safe and efficacious.

Congenital polymicrogyria including the perisylvian region in early childhood

Six pediatric cases including four infants with congenital polymicrogyria including the perisylvian region are presented herein. Their clinical features were analyzed and compared with patients suffering from congenital bilateral perisylvian syndrome (CBPS). Two specific abnormalities were diagnosed as accompanying disorders in two cases, namely Kabuki syndrome and Peters' anomaly. In the other four cases, the pathogenetic etiology was not elucidated. Subtle symptoms, such as choking and drooling became detectable in one case each, and expressive language development was delayed in two patients. A developmental delay became apparent in five cases during the follow-up period, and epilepsy was observed in one patient with onset at 12 years of age. Our results indicate that the presence of perisylvian polymicrogyria may not always result in the development of oropharyngoglossal dysfunction or dysarthria, although most patients tend to gradually show the onset of developmental disorders. To support cognitive and psychosocial development, an early integrated approach, including not only conventional speech and language therapy, but also various communication methods is essential for patients with congenital polymicrogyria including the perisylvian region.

Fathers' Early Contributions to Children's Language Development in Families from Low-income Rural Communities.

This study utilized a large sample of two-parent families from low-income rural communities to examine the contributions of father education and vocabulary, during picture book interactions with their infants at 6 months of age, to children's subsequent communication development at 15 months and expressive language development at 36 months. After controlling for family demographics, child characteristics, as well as mother education and vocabulary, father education and father vocabulary during the picture-book task were related to more advanced language development at both 15 and 36 months of age. Only mother education, but not vocabulary during book-reading was related to children's later language. These findings support the growing evidence on the importance of fathers in understanding children's early communication and language development.

Evaluation for language and speech development in Kabuki make-up syndrome: A case report

Kabuki make-up syndrome (KMS) is defined as a rare syndrome with mental retardation, growth deficiency and multiple anomalies of unknown cause. Cases have a characteristic facial appearance of broad and low auricles, wide forehead, broad and flattened nose root. In this article, 4-year, 10-month-old boy with speech delay reported due to characteristics of the facial appearance is considered as KMS, a rare syndrome. Otological, audiological and developmental evaluation of the patient consisted of six parameters. (1) ENT examination: normal. (2) Audiological findings were at normal hearing levels. (3) General development (according to the Denver II test), was normal. (4) Language and speech development: receptive language development was 2 years more than the chronological age. However in expressive language development, there was 5-month delay which was likely to complete by training in a short time. (5) The development of speech sounds and articulation: the delay is observed in CVC words. Speech sounds of /l/, /t/, /r/ and /g/ were evaluated as “distorted expression”. He used /v/ instead of /l/; /y/ instead of /r/; /d/ instead of /g/. (6) Observations: diffident, deficit in self-confidence, and difficulty in communicating have been observed.Unlike the cases in literature, mental retardation, growth deficiency and learning difficulties were not found in our case with KMS. Normal findings were obtained in five parameters. Only the /l/, /r/ and /g/ speech sounds were expressed as distorted. For our case, we planned to follow him in the future to see whether developmental and central auditory processing disorders will occur or not.