Early Communication Development Research Articles

Phenotyping variability in early socio-communicative skills in young children with autism and its influence on later development.

Children with autism spectrum disorder (ASD) often face challenges in early social communication skills, prompting the need for a detailed exploration of specific behaviors and their impact on cognitive and adaptive functioning. This study aims to address this gap by examining the developmental trajectories of early social communication skills in preschoolers with ASD aged 18-60 months, comparing them to age-matched typically developing (TD) children. Utilizing the early social communication scales (ESCS), the research employs a longitudinal design to capture changes over time. We apply a principal component analysis (PCA) to ESCS variables to identify underlying components, and cluster analysis to identify subgroups based on preverbal communication profiles. The results reveal consistent differences in early social communication skills between ASD and TD children, with ASD children exhibiting reduced skills. PCA identifies two components, distinguishing objects-directed behaviors and social interaction-directed behaviors. Cluster analysis identifies three subgroups of autistic children, each displaying specific communication profiles associated with distinct cognitive and adaptive functioning trajectories. In conclusion, this study provides a nuanced understanding of early social communication development in ASD, emphasizing the importance of low-level behaviors. The identification of subgroups and their unique trajectories contributes to a more comprehensive understanding of ASD heterogeneity. These findings underscore the significance of early diagnosis, focusing on specific behaviors predicting cognitive and adaptive functioning outcomes. The study encourages further research to explore the sequential development of these skills, offering valuable insights for interventions and support strategies.

Early Communication Skills Training for Infants and Toddlers with Cochlear ImplantEarly Communication Skills Training for Infants and Toddlers with Cochlear Implant

Background and Aim: Early communication skills in children with hearing loss depend on the quantity and quality of information received from parents. The present study aimed to investigate the effectiveness of early communication skills training in developing the communication skills of infants and toddlers with cochlear implants. Methods: To this end, 54 infants and toddlers at the age range of 8–24 months with sever to profound hearing loss fitted by Cochlear Implant (CI) with their mothers participated in this study. The experimental and wait list control groups had auditory verbal therapy as the main intervention after the CI; however, the experimental group received a systematic early communication skills program. All subjects were assessed using the Communication and Symbolic Behaviour Scales Developmental Profile as the pre-and post-tests. Results: Multivariate analysis of covariance indicated the effect of systematic training on the early communication development of subjects in intervention group. Conclusion: Teaching the parents how to interact with infants and toddlers with CI could improve the communication skills of the infants and therefore it’s recommended to be included in the auditory rehabilitation programs.

Peran Orang Tua dalam Perkembangan Tindak Tutur Anak Usia Dini

This research discusses the role of parents in the development of early childhood speech acts. The aim of this research is to investigate the role played by parents in the development of early childhood speech acts. This study was carried out using a qualitative approach by collecting data using observation, interviews and document analysis. The research participants consisted of ten families with children aged 3-5 years taken from various social and economic backgrounds. The research results show that the role of parents has a significant impact on the development of children's speech acts, including vocabulary formation, speaking abilities, and social communication patterns. Factors such as parent-child interactions, communication patterns within the family, and the social environment also influence the development of children's speech acts. The implication of these findings is the need for greater attention to the role of parents in supporting early childhood language and communication development through educational programs and social support for families.

Analysis of Digital Media Usage in Promoting Communication Skills in Early Childhood

Digital media has become an omnipresent element in the lives of young children. This study aims to analyze the usage of digital media in promoting communication skills in early childhood. The proliferation of smartphones, tablets, and other digital devices has revolutionized how children interact with information and communicate with others. However, concerns have been raised regarding the potential impact of excessive screen time on children's development, particularly in areas such as language acquisition and social skills. This research employs a mixed-method approach, combining quantitative surveys and qualitative interviews with parents and educators of children aged 2 to 6 years. Quantitative data will be gathered to examine the frequency and duration of digital media usage among young children, while qualitative insights will delve into the perceived benefits and drawbacks of digital media on communication skills development. Additionally, observations of children's interactions with digital media tools will provide contextual understanding. The findings of this study are expected to contribute to a nuanced understanding of the role of digital media in early childhood communication development. By identifying effective usage patterns and potential pitfalls, educators and parents can make informed decisions regarding the integration of digital media into early childhood education and upbringing. Ultimately, this research aims to inform strategies that leverage digital media to enhance rather than hinder communication skills in young children, ensuring their holistic development in today's digital age.

Do Caregiver Perceptions of the Virtual More Than Words® Program Differ Based on Autistic Children's Attributes?

More Than Words® (MTW) is a caregiver-mediated intervention program led by a speech-language pathologist (SLP) who teaches caregivers strategies to support their autistic child's early social communication and play development. The program includes group sessions composed of multiple families with children of varying profiles. We explored whether caregiver experiences and perceived outcomes of the virtual MTW program differed depending on the child's age and social communication stage. As part of a program evaluation of virtual MTW delivered to over 2,000 families in Ontario, Canada, between 2020 and 2021, we randomly selected 31 families across four social communication stages and two age groups using stratified sampling (n = 4, in all but one subgroup). The Final Reflection and Evaluation form was analyzed both qualitatively and quantitatively, and a modified RE-AIM framework guided our analyses, including theme development. Child attributes did not appear to impact caregivers' experiences, but perceived child skill improvements varied by children's social communication stage. The majority of caregivers reported changes in how they interact with their child. Four themes emerged: (a) perceived child skill improvements differed by social communication stage, (b) caregivers gained new knowledge and strategies regardless of child attributes, (c) SLPs effectively managed families' individual needs, and (d) program components were appropriate for a variety of families. Findings suggest that the content taught in the MTW program was relevant for a variety of children, including those beyond the program's intended age of 5 years and under. Grouping families of children with varying profiles does not appear to negatively influence caregivers' experiences or perceived outcomes. https://doi.org/10.23641/asha.25237009.

Quantity and quality of book reading to infants and toddlers: their effect on early communication and language development

Among the various parent-child interactions taking place in a typical family context, interactive shared book reading (ISBR) has been shown to have a superior value in fostering language development. Although many studies have established the linguistic benefits of ISBR in preschoolers, results on children younger than 3 years are scarce. This cross-sectional parental report study explores the contribution of the quantity and quality of shared book reading to the communicative and language skills of a large sample of infants and toddlers growing up in Greek-speaking families. The parents of 740 children aged 6 to 36 months filled in the Interactive Shared Book Reading Strategies Questionnaire that assesses the number and frequency of interactive strategies adopted by caregivers during shared book reading. Parents were also administered the Communication Development Report, a standardized instrument for assessing Greek-speaking children's communication and language skills. Results are presented on (a) shared book reading quantity (frequency) and quality (interactive strategies), (b) the effect of these two factors on children's nonverbal communication (nonvocal and vocal), as well as their language development (comprehension, expressive vocabulary, morphology, and syntax), and (c) the effect of several contextual factors on this association. Results highlight the large effect of both the quantity and the quality of shared book reading in different dimensions of the children's communication and language. Birth order, siblings, and maternal education affected the quantity (but not the quality) of shared book reading. Overall, results confirm and extend previous findings regarding the benefits of shared book reading to children's vocabulary, morphology and syntax, pointing to the significant contribution of its quality rather than its quantity. They also add interesting findings regarding the significant contribution of shared book reading to children's nonverbal communicative skills. Results are discussed based on previous relevant findings for their theoretical implications. Their applied interest in the early prevention of language difficulties is also discussed.

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

Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language-delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8-h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3-month online home intervention monitoring. 146 families whose children aged 12-68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between-group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. The online parent training focusing on improving daily interaction with children through speech-language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. What is already known on the subject Parent-implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech-language therapists and may be the primary mode of service delivery or may supplement in-person services. What this paper adds to the existing knowledge This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin-speaking children and it is equally effective for children with ASD and non-ASD diagnosis. What are the potential or actual clinical implications of this work? Developmental behavioural paediatricians and speech-language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience.

Early Communicative Development in Williams Syndrome: A Longitudinal Case Study.

Individuals with Williams Syndrome (WS) have a specific and atypical neuropsychological profile, where language is above what is expected for their mental age, although it shows a late onset. There exists only one longitudinal study in infants younger than 20 months old with WS about early language precursors (joint attention, referential and instrumental behaviors, pointing gesture, verbal tags). The aim of this investigation is to evaluate these precursors in a baby with WS (8 to 18 months). Seven sessions of systematic observation were performed (six at baby's home, one at the Early Childhood Assistance center). The Battelle Developmental Inventory was used to evaluate the baby's development in two occasions (12 and 18 months). The results show an atypical development, and he is 5-6 months under what is expected for his chronological age. Attention towards objects prevails over preference for faces, but this one tends to increase. The pointing gesture does not emerge at the end of the observation period and therefore follows the first words that appear. The implications for the comprehension of the early linguistic profile in WS are discussed, as well as the implications for specific intervention strategies in the context of early childhood care.

A Genealogy of Gestures: On the Nature and Emergence of Forms of Gestural Communication within Shared Routines

Communicative development can be better understood by examining the diversity of gestures and how various forms of gestures are interlinked in their developmental origins – their genealogy. To draw attention to the differences and interrelations among forms of gestures, we group gestures into three families based on their developmental origins: (1) action-based gestures that develop from infants’ spontaneous actions that others respond to; (2) conventional gestures; and (3) iconic gestures. Although these diverse gestures are acquired through somewhat different developmental pathways, we argue that they develop in the context of shared experiences within social routines. What differs is the relative role of the caregiver and child in initiating the routine. In viewing communicative development in this way, we show the importance of basing our investigations on an adequate conception of meaning in order to recognize the similarity in the underlying processes involved in early communicative development.

Comparing the benefits of parent–infant flute and singing groups for communication and parenting: A feasibility study

There is growing evidence highlighting benefits of musical exposure and participation on several aspects of development and parenting. Aiming to establish a rigorous protocol allowing researchers to study different types of musical interactions and their benefits on the development of early communication, the present study explored parents’ experiences of musically engaging with their infants in different types of music groups. Twenty-five infants and their parents were randomly assigned to one of three groups: (1) singing, (2) flute playing, or (3) control group. Music sessions were held weekly for 14 weeks and were followed by the home use of the recorded routines specific of each group, for further 3 months. Semi-structured interviews were conducted with the experimental groups’ participants, and pre/post quantitative developmental measures were collected from all groups, to assess participants’ compliance. Qualitative analyses of the interviews revealed both shared themes, (communication enhancement, enjoyment, and regulation); and unique themes (creativity and freedom in the flute group; familiarity and responsiveness in the singing group). The feasibility study was successful in establishing a workable protocol to use in RCT longitudinal interventions aiming to examine how specific aspects of the musical experience might differentially support developmental outcomes, in parent–infant groups.

Early Communication Indicator: An analysis with three Portuguese toddlers

Professionals need efficient tools in early childhood communication development to identify infants and toddlers who are at risk of communication disorders or language delays. In Portugal, this project was carried out to respond to these needs due to a lack of these resources and a high prevalence of children at risk for communication problems at early ages. This paper describes the first steps to adapt the Early Communication Indicator (ECI) for the Portuguese population. The ECI is a play-based expressive communication measure for infants and toddlers aged 6 to 42 months. The ECI was originally developed in the U.S. and was designed for use by service providers to provide information about growth in communication, to help in intervention decision making, and to be administered in any language. This paper analyzes the ECI results of three Portuguese children in relation to their communication progression, based on a one-year longitudinal study. The ECI was administered when children were 17, 24, and 30 months of age. The ECI results showed that two of the children follow the typical progression of communication acquisition, with acquisition of earlier prelinguistic skills preceding growth in spoken language. The ECI results for the other child showed a very different and slower progression in the communication skills. The data obtained provided just an initial demonstration of the use of the ECI with Portuguese children. More research is needed into the development of the ECI in the Portuguese context, such as the development of a nationally representative, normative sample. Therefore, a discussion of what is needed in research and practice to advance this project is provided.

Parental Responses to Prelinguistic Vocalizations of Very Young Children with Typical Development: A Systematic Review and Meta-Analysis

Parental contingent responses (PCRs) to infant’s vocalization are related to early communication and language development. This study identified the parental response patterns to infant vocalizations in the interaction between infants and their parents, the pattern of infant vocalizations, and parental language-expectant responses in the PCRs through a systemic literature review and meta-analysis. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), seven studies were met Participants, Intervention, Comparison, Outcomes, and Study design (PICOS) criteria from 8 databases. The quality of studies evaluated risk of bias and effect sizes were calculated using Hedges' &lt;i&gt;g&lt;/i&gt;. As a result of systematic review, the selected studies had an overall low risk of bias, and the subjects of all studies were infants who are within 14 months and mothers. As a result of meta-analysis, PCRs to infant vocalizations were significantly higher than parental non-contingent responses. Language-expectant responses appeared significantly more than language non-expectant responses in PCRs. This study showed that parents are more likely to respond verbally to their infants’ vocalizations with their infants, suggesting the significant role is very important in early interaction. These finding may provide foundation material to guide early intervention and parent coaching for infants at risk for communication disorders.

An Intervention Study on Children's Healthy Joint Attention Skills Based on a Mixed Instructional Approach of DTT and PRT.

Joint attention is an important element that influences children's early development of communication and sociality, and joint attention is more often than not the earliest incipient of their prosocial behavior. Joint attention skills are one of the core deficits of children with autism, and identifying and remediating the core problems of autism is a popular area of interest, with joint attention being the focus of attention. The aim of this study was to investigate whether the combined orientation model of Discrete Trial Teaching (DTT) and Pivotal Response Training (PRT) could improve the joint attention skills of children with autism. This study used a cross-behavioral multitest design in a single-subject study with two preschool children with autism as subjects, with the independent variable being joint attention teaching and the dependent variable being the three joint attention skills (eye gaze, following directions, and active display). After the instructional intervention, children with autism showed a significant increase in the correctness of “eye alternation,” “following directions,” and “moving displays.”

\u2018Making the most of together time\u2019: development of a Health Visitor\u2013led intervention to support children\u2019s early language and communication development at the 2\u20132\xbd-year-old review

BackgroundEarly interventions to support young children’s language development through responsive parent–child interaction have proven efficacy but are not currently delivered universally. A potential universal delivery platform is the Health Visitor (HV)–led 2–2½-year-old review in England’s Healthy Child Programme. It is unclear if it is feasible to offer such interventions through this platform. We report an intervention development process, including extensive stakeholder consultation and co-design which aimed to develop an acceptable, feasible and equitable early language intervention for delivery in this context.MethodsThe study involved five phases including 13 stakeholder co-design workshops with 7 parents and 39 practitioners (HVs, early years practitioners and speech and language therapists): (1) Identification of existing intervention evidence, (2) qualitative review of intervention studies extracting candidate target behaviours for intervention and intervention techniques, (3) co-design workshops with parents and practitioners examining acceptability, barriers and enablers to those behaviours and techniques (particular attention was paid to diverse family circumstances and the range of barriers which might exist), (4) findings were analysed using COM-B and theoretical domains frameworks and a prototype intervention model designed, and (5) co-design workshops iteratively refined the proposed model.ResultsPractitioners were committed to offering language intervention at the 2–2½-year-old review but were not sure precisely how to do so. Parents/caregivers wanted to be proactive and to have agency in supporting their own children and to do this as soon as possible. For equitable intervention, it must be proportionate, with higher ‘intensity’ for higher levels of disadvantage, and tailored, offering differing approaches considering the specific barriers and enablers, assets and challenges in each family. The importance and potential fragility of alliances between parent/caregiver and practitioner were identified as key, and so, strategies to engender successful collaborative partnership are also embedded in intervention design.ConclusionIt is possible to develop a universal intervention which parents and practitioners judge would be acceptable, feasible and equitable for use at the 2–2½-year review to promote children’s language development. The result is one of the most explicitly developed universal interventions to promote children’s language development. Further development and piloting is required to develop materials to support successful widespread implementation.

Early communication development in infants and toddlers with Fragile X syndrome.

Individuals with fragile X syndrome (FXS) characteristically struggle with language and communication throughout the life course, but there is limited research on the development of communication before 24 months. The purpose of this study is to describe the early communication of infants and toddlers with FXS using the Communication and Symbolic Behavior Scales-Caregiver Questionnaire (CSBS-CQ), a standardized communication screening measure, as compared to the reported normative data of the CSBS-CQ and identify the percentage of infants and toddlers who scored within the range of concern. Documenting how children with FXS perform on screening measures can provide a quick snapshot of skills to help clinicians determine the need for services. Participants were 22 infants and toddlers with FXS between 6 and 29 months. Performance on the CSBS-CQ was compared to the measure's normative data. The CSBS-CQ was completed by mothers, and children were administered the Mullen Scales of Early Learning. Because co-occurring autism is common in FXS, the presence of autism was determined using a clinical best estimate procedure. Overall and within the domains and subdomains of the CSBS-CQ, infants and toddlers with FXS had significantly lower scores than the normative data. Further, 68.2% of our sample was in the range of concern for their overall communication score. The presence of autism led to consistently lower scores, and more infants and toddlers with FXS + autism scored within the range of concern. Our findings suggest that delays in early communication are evident in comparison to typically developing norms before 24 months. These findings also emphasize that infants and toddlers with FXS would likely benefit from early language intervention given that 68.2% of our sample was in the range of concern for their overall communication score. Early identification and developmental monitoring of children with FXS will help to determine concerns in communication and other domains of development. While early communication broadly may not be an early indicator of autism in FXS, some specific skills, such as eye gaze, may serve as such an indicator. Screening measures, like the CSBS-CQ, may help monitor both early communication impairments and autism symptoms. Infants and toddlers with FXS, regardless of autism status, will benefit from early language interventions.

Early social communication development in infants with autism spectrum disorder.

Social-communication differences are a robust and defining feature of autism spectrum disorder (ASD) but identifying early points of divergence in infancy has been a challenge. The current study examines social communication in 9- to 12-month-old infants who develop ASD (N=30; 23% female; 70% white) compared to typically developing (TD) infants (N=94, 38% female; 88% white). Results demonstrate that infants later diagnosed with ASD were already exhibiting fewer social-communication skills using eye gaze, facial expression, gestures, and sounds at 9months (effect size: 0.42-0.89). Moreover, three unique patterns of change across distinct social-communication skills were observed within the ASD group. This study documents that observable social-communication differences for infants with ASD are unfolding by 9months, pointing to a critical window for targeted intervention.

The origin of language and relative roles of voice and gesture in early communication development

Both vocalization and gesture are universal modes of communication and fundamental features of language development. The gestural origins theory proposes that language evolved out of early gestural use. However, evidence reported here suggests vocalization is much more prominent in early human communication than gesture is. To our knowledge no prior research has investigated the rates of emergence of both gesture and vocalization across the first year in human infants. We evaluated the rates of gestures and speech-like vocalizations (protophones) in 10 infants at 4, 7, and 11 months of age using parent-infant laboratory recordings. We found that infant protophones outnumbered gestures substantially at all three ages, ranging from >35 times more protophones than gestures at 3 months, to >2.5 times more protophones than gestures at 11 months. The results suggest vocalization, not gesture, is the predominant mode of communication in human infants in the first year.

No evidence of an association between parental mind-mindedness at 9 months and language development at either 9 or 25 months in Swedish infants

Mind-mindedness (MM), the parent’s propensity to treat their young child as an individual with a mind of their own, has repeatedly been found to be positively associated with subsequent child development outcomes. In the current Swedish study, the first aim was to investigate the main features of MM in this cultural context and the second aim was to investigate its association with early child language development. Sixty-three parent-child dyads participated. MM was assessed by videotaped laboratory-based parent-child dyad free-play sessions. Language development was assessed using the parent questionnaire Swedish Early Communicative Development Inventory (SECDI), a Swedish adaptation of the internationally used MacArthur-Bates Communicative Development Inventories (MB-CDI). The ratio between Appropriate MM and Non-attuned MM was 4:1 and there was no statistically significant correlation between these two variables. There were no statistically significant correlations between Total MM or Appropriate MM and language ability ratings at either 9 or 25 months. This may be due to methodological issues concerning elicitation of MM in a Swedish context. We emphasize the importance of further theoretical and empirical studies of cross-cultural validation of MM.

An exploration of the relationship between schema and language: four young child case studies

ABSTRACT This study draws on four case studies of young children in order to explore the relationship between children’s action schema [Athey, C. (1990). Extending though in young children: A parent-teacher partnership. London: Paul Chapman] and their developing speech, language and communication. What emerged was a connection through children’s thinking and thoughts, with a recognition that practitioners might further support early speech, language and communication development through careful consideration of children’s ‘conceptual concerns’ [Atherton, F., & Nutbrown, C. (2013). Understanding Schemas and young children from birth to three. London: Sage].

Communication skills predict social-emotional competencies

IntroductionStudies have shown that many children with early language difficulties also have delays in social-emotional competencies as well as social-emotional and behavioral problems. It is unclear if these conditions are causally related, if they share a common underlying etiology, or if there are bidirectional effects. Studies investigating these associations have mostly involved children who are already using words to communicate, but it is important to know whether delays in preverbal communication and language development have any effects on these associations. The aim of the present study was to examine associations between preverbal communication and early verbal skills in infancy and subsequent social-emotional competencies and ensuing social-emotional and behavioral problems in early toddlerhood. The role of background factors known to influence early language development was also examined. MethodsThe sample consisted of 395 children (51.6% boys) from the Finnish Steps Study cohort. Language was assessed at age 13 months (+ 1 month) with the MacArthur Communicative Development Inventory for Infants (CDI-I), and the social-emotional domain was assessed at age < 17 months with the Brief Infant–Toddler Social and Emotional Assessment (BITSEA). ResultsInfants with lower preverbal gestural communication and receptive language skills had a higher risk of delays in social-emotional competencies in toddlerhood than children with better communication skills, but not of elevated social-emotional and behavioral problems. ConclusionsThe results indicate that lower early communication skills can predict delays in the development of social-emotional competencies, which has been found to be a risk factor for later development of social-emotional and behavioral problems. It is important to monitor early communication skills to provide guidance to parents in supporting early pragmatic communication and language development in infancy, if needed.