Early Communication Development Research Articles

Communicative acts of a child with Rubinstein—Taybi syndrome during early communicative development

Rubinstein—Taybi syndrome (RTS) is a rare genetic developmental disorder that often shows associated language delay. However, literature on language development in RTS is very limited, particularly for the period of early communicative development, when standardized testing can be minimally informative. The purpose of the current study was to present a descriptive profile of the intentional communicative acts of a 4-year-old child with RTS, both to add to the literature on the syndrome, and as an example of non-standard profiling of early communication. The child was video-recorded in a natural context with familiar conversational partners. Analyses of the videotaped interactions included rate of communication, communicative functions and modes, and discourse patterns in terms of initiation and response. The child's mean rate of communication was 6 communicative acts per minute. In terms of communicative function, assertive (commenting) communicative acts were most common, followed by directive (requests) and expressive (affective) acts. Mode of communication was less advanced than communicative function; vocalizations were the most frequent mode, although linguistic skills were emerging (signs, single words). Implications for treatment are suggested for children with development delays on the threshold between prelinguistic and one-word phases of development.

The Early Language in Victoria Study (ELVS): A prospective, longitudinal study of communication skills and expressive vocabulary development at 8, 12 and 24 months

The aim of this paper is to provide an overview of the methods and preliminary findings from the Early Language In Victoria Study (ELVS) a prospective, longitudinal study of child language impairment. Specifically, we provide a summary of early communication and vocabulary development and examine the contributions a range of risk factors and predictors make to these outcomes. The sample was a community-ascertained cohort of 1911 infants, recruited at 8 months and followed at ages 12 and 24 months. The main outcomes of interest were parent reported infant and toddler communication (Communication and Symbolic Behavior Scales, CSBS) and expressive vocabulary (MacArthur-Bates Communicative Development Inventories, CDI). Predictors included gender, preterm birth, birth weight, multiple birth, birth order, socioeconomic status, maternal mental health, maternal vocabulary and education, maternal age at birth of child, non–English-speaking background, and a family history of speech and/or language difficulties. Results demonstrated rapid development in communication skills measured by the three CSBS domains (social, speech and symbolic) and in vocabulary development (CDI). There was rapid growth in gesture use between 8 and 12 months and symbolic use of objects between 12 to 24 months. At approximately 24 months, 19.7% had delayed expressive vocabulary. Male gender and family history were associated with poorer outcomes on the CSBS and the CDI at 8, 12 and 24 months, although the regression models explained only a small amount of the variance in outcome. In summary we measured rapid growth in communication skills and vocabulary between 12 and 24 months, but the hypothesized early risk factors and predictors explained little of the variation in these outcomes. We conclude that the risk factors/predictors examined in this study therefore seem unlikely to be helpful in screening for early language delay.

A comparison of manufacturer-specific prescriptive procedures for infants

Early hearing detection and communication development (EHDCD) programs enable us to identify hearing loss in early infancy, making intervention by 6 months of age a reasonable goal. For infants and children fitted with hearing instruments, it is critical that the devices be adjusted appropriately so that the pre-lingual listener has full and consistent access to sound, without discomfort for loud sounds. Several published pediatric amplification guidelines are available to assist clinicians with the hearing aid fitting process for infants and children.1-5 While the guidelines were developed in different jurisdictions, similar recommendations are made for all stages of the hearing instrument fitting process. For example, the use of a systematic, evidence-based approach to hearing aid fitting that accounts for an infant’s external ear acoustics at the assessment, selection, and verification stages and that includes the measurement of hearing aid output limiting is a requirement of every current pediatric amplification protocol. While it is encouraging to see consensus in pediatric hearing aid fitting guidelines, there continue to be substantial differences among clinical practice behaviors. Surveys have indicated that the majority of pediatric audiologists use sound field-aided threshold measures to verify the electroacoustic performance of hearing instruments for young infants.6 Probe-microphone measures were used by roughly 20% of the audiologists fitting hearing aids to infants.6 It has been well-documented that behavioral measures (i.e., aided threshold measures) do not provide accurate estimates of the aided audibility of soft, average, and loud speech or the real-ear saturation response of the hearing aid and that infants 6 months of age and younger are not developmentally capable of performing this task.7,8 Failure to appropriately verify the electroacoustic performance of the hearing aid in terms of predicted speech audibility and maximum hearing instrument output can result in obstructing the language benefits an infant would have otherwise received from being identified at an early age and optimally fitted. It is also important to consider the prescriptive targets used to determine the recommended levels for amplified speech and target limits for hearing instrument output as a function of frequency. Prescriptive algorithms provide the foundation on which the hearing instrument performance characteristics are selected for the infant or child to be fitted. Recent survey data indicate that most audiologists fitting hearing aids to infants and young children use a published hearing aid prescriptive procedure.6,9 At present, prescriptive procedures can be divided into two classifications: (1) evidence-based generic prescriptive algorithms and (2) manufacturer-specific proprietary algorithms. Evidence-based generic prescriptive algorithms for children include the DSL m[i/o]10 and the NAL-NL1,11 both of which are intended for use with any hearing aid. Proprietary prescriptive methods incorporate prescriptive algorithms developed by manufacturers for use with their specific hearing instruments. The lack of published information regarding the development of pediatric manufacturer-specific proprietary algorithms makes it difficult for the audiologist to make an informed choice about which procedure will be best for their young patient.12 Some manufacturers have decided to forego the development of a proprietary pediatric algorithm and use either the NAL or DSL prescriptive algorithms for fitting children and have implemented these formulas in their fitting software. These generic prescriptive algorithms may have been adapted by the manufacturer to account for the unique characteristics (e.g., compression kneepoint) of their hearing aids. Several investigators have compared proprietary prescriptive algorithms for use with adults. Keidser and colleagues found a 10-dB variation in the amount of gain prescribed by NAL-NL1, DSL[i/o], and four proprietary algorithms for the same audiogram.12 A study by Hawkins and Cook compared simulated 2-cc versus actual 2-cc gain as well as simulated insertion versus actual insertion gain measures from the fitting software for 28 hearing aids of various styles from four major manufacturers.13 Results indicated a clear trend for the simulated values to overestimate what was actually provided by the hearing aids for both the 2-cc coupler and insertion gain comparisons.13 Differences of as much as 10 to 20 dB were noted for the various hearing aids and prescriptive algorithms in the study. “...an infant can end up with

Coordinated attention, declarative and imperative pointing in infants with and without Down syndrome: Sharing experiences with adults and peers

The link between coordinated attention, imperative and declarative pointing was assessed in a longitudinal study. Four groups of infants were studied in interaction with their mothers, a same-aged peer and the peer's mother. Two groups of infants had Down syndrome (DS), one ( n = 11) with a mean mental age (MA) of 0;8.6 and the other ( n = 11) with an MA of 1;4.5. These infants were matched on MA with two groups ( n = 10 each) of typically developing (TD) infants. The following hypotheses were confirmed: (a) that infants with DS produce less coordinated attention and declaratives than typically developing infants, but a comparable number of imperatives; (b) that coordinated attention predicts declarative but not imperative pointing; and (c) that coordinated attention, imperative and declarative pointing should be higher with adults than with peers. Discussion centers on the implications of these findings for theories of early communication development and mental state awareness.

Congenitally Deafblind Children and Cochlear Implants: Effects on Communication

There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on CI in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of five congenitally deafblind children who received cochlear implants between 2.2 and 4.2 years of age. Ratings of video observations were used to measure the children's early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits parents perceived regarding their children's cochlear implants. Two examples are included in this article to illustrate the parents' perspectives about CI in their deafblind children. Benefits of CI in this cohort of children included improved attention and emotional response as well as greater use of objects in interaction with adults. The best overall outcome of CI is not spoken language but better communication.

The Early Language in Victoria Study: predicting vocabulary at age one and two years from gesture and object use

The Macarthur-Bates Communicative Development Inventories (CDI) have been used widely to document early communicative development. The paper reports on a large community sample of 1,447 children recruited from low, middle and high socioeconomic (SES) areas across metropolitan Melbourne, Australia. Regression analyses were conducted to determine the extent to which communicative behaviours reported at 0 ; 8 and 1 ; 0 predicted vocabulary development at 1 ; 0 and 2 ; 0. In support of previous findings with smaller, often less representative samples, gesture and object use at 1 ; 0 were better predictors of 2 ; 0 vocabulary than were gesture and object use at 0 ; 8. At 1 ; 0, children from the lower SES groups were reported to understand more words than children from the higher SES groups, but there were no SES differences for words produced at 1 ; 0 or 2 ; 0. The findings add to our understanding of the variability in the development of early communicative behaviours.

Maternal dental history, child's birth outcome and early cognitive development.

Prenatal exposure to high levels of mercury, radiation and inflammation have been associated with adverse reproductive outcomes such as increases in preterm delivery, low birthweight and delayed neurodevelopment. Few data are available to evaluate the potential effects of prenatal low-level exposure to these factors as may occur during dental care. We evaluated maternal dental history prior to and during pregnancy in relation to birth outcomes and early communicative development among offspring in a large cohort (n = 7375) of British children born in 1991-92. Dental history was assessed by questionnaire. The child's communicative development was assessed using the MacArthur Communicative Development Inventory at 15 months of age. Total mercury was measured in umbilical cord tissue for a subset of the children. Overall, dental care, including amalgam fillings, was not associated with birth outcomes or language development. Having X-rays taken during pregnancy was not associated with birthweight measured continuously (b = 14.7, P = 0.4), but was associated with slightly increased odds of having a term, low-birthweight baby (OR 1.9, [95% confidence interval 1.0, 3.4]). More detailed evaluation of the potential adverse effects of elective dental treatment during pregnancy, particularly dental X-rays, may be warranted.

Characterizing communicative development in children referred for Autism Spectrum Disorders using the MacArthur-Bates Communicative Development Inventory (CDI)

Characterizing early communicative development in children with Autism Spectrum Disorders (ASD) is valuable for understanding profiles of ability in this population. The current investigation was modeled on Charman, Drew, Baird & Baird (2003b). Analyses explored parent report of early vocabulary, non-verbal communication, functional object use and play skills on the MacArthur-Bates Communicative Development Inventory (CDI) in 93 children with ASD, 31 children with developmental delay (DD) and 29 typically developing children. Results were generally consistent with those of Charman and colleagues (2003b), suggesting that skills improve with increasing non-verbal mental age and chronological age but that most children with ASD are delayed in receptive and expressive vocabulary and non-verbal communication, functional object use and play skills. Vocabulary profiles in the ASD sample were similar to those in the comparison samples, as was the developmental pattern of gesture and vocabulary mastery. However, when compared to published norms, children with ASD may show less of a discrepancy between their receptive and expressive vocabulary.

Early Autism Identification

To the Editor .— Applying an autism-specific screening tool at 18 months has been recommended by experts.1 In a recent commentary, repeat autism screening at 24 months, after the initial 18-month administration, is also advised by experts to detect autism concerns.2 These recommendations are currently evidence based and appropriate to known early social communication development. The proposed screening approach, combined with critically needed understanding by primary …

The Music One‐to‐One project: developing approaches to music with parents and under‐two‐year‐olds

Detailed analyses of adult–infant interaction among some European and North American populations have revealed that it resides on characteristics such as synchronous timing, phrasing, pitch contours and variations of dynamic intensity that are essentially musical in nature. Moreover, this musicality of infancy is the medium which enables and supports the development of early communication. Observations of practice and interviews with 15 early childhood music practitioners in England suggested that a consensual version of practice has evolved around the collective rendering of playful songs and musical activities. However, this version of practice does not offer infant‐appropriate musical experiences which might foster communicative musicality. The aim of the Music One‐to‐One project was to apply recent theories of infant musicality to practice. It was designed in three phases. A first stage gathered information from parents and practitioners about their current practices in music at home and in early chil...

Intelligence, Parental Depression, and Behavior Adaptability in Deaf Children Being Considered for Cochlear Implantation

Cognitive ability and behavioral adaptability are distinct, yet related, constructs that can impact childhood development. Both are often reduced in deaf children of hearing parents who do not provide sufficient language and communication access. Additionally, parental depression is commonly observed due to parent-child communication difficulties that can lead to parents' feelings of inadequacy and frustration. We sought to assess whether adaptive behavior in deaf children was associated with nonverbal intelligence and parental depression. Parents of precochlear implant patients seen for neuropsychological assessment were administered the Parenting Stress Index and Vineland Behavior Adaptive Scales to obtain measures of parental distress and child's behavioral adaptability. Precochlear implant patients' cognitive functioning was assessed via the Mullen Scales of Early Learning or the Leiter International Performance Scale-Revised, depending on the child's age at the time of testing. Regardless of age or neurological status, the deaf child's adaptive behavior consistently showed a strong relationship with intelligence. Moderate correlation between parental depression and the child's adaptive behavior was observed only in the younger group. The relationship between parental depression and communication subscale was moderated by intelligence for deaf children without neurological complications. The findings provide important implications for promoting family-centered interventions with early communication and language development.

Sensorimotor development and dysregulation of activity in young children with autism and with intellectual disabilities

Dysregulation of activity linked with development was analysed in 12 children with intellectual disabilities (ID) and in 12 children with autism (ASD) matched on their developmental age (18 months). The “Batterie d’Evaluation du Développement Cognitif et Social” [Adrien, J. L. (1996). Autisme du jeune enfant. Développement psychologique et régulation de l’activité [ Autism in the young child: Psychological development and behavioral regulation]. Paris: Expansion Scientifique Française] and the «Regulation Disorders Evaluation Grid» [Adrien, J. L., Rossignol-Deletang, N., Martineau, J., Couturier, G., & Barthélémy, C. (2001). Regulation on cognitive activity and early communication development in young autistic, mentally retarded, and young normal children. Developmental Psychobiology, 39(2), 124–136] were used. T-test comparisons, partial correlation controlling for chronological age and clusters analyses by cases were completed. Children with ASD showed more dysregulation than ID children and both groups showed different patterns of specific dysregulation disorders. Dysregulation of activity was linked to development but correlations were much more numerous and intense within ASD group compared to ID group.

Early communication development and intervention for children with autism

Autism is a neurodevelopmental disorder defined by impairments in social and communication development, accompanied by stereotyped patterns of behavior and interest. The focus of this paper is on the early development of communication in autism, and early intervention for impairments in communication associated with this disorder. An overview of components of communication is provided. Communication characteristics that are diagnostic of autism are summarized, with consideration of the overlap between social and communication impairment, particularly for children with autism functioning at the prelinguistic level. Early communication development and predictors of communication functioning in autism are examined, based on a review of prospective and retrospective studies. The focus of the discussion then turns to intervention. Consideration is given to the rationale for beginning intervention as early in life as possible for children with autism. Implications of motor, imitation, and play deficits for communication-based intervention are examined. Finally, issues related to the design and delivery of intervention for young children with autism are presented, along with a review of the major early intervention approaches for autism.

Variation in vocal-motor development in infant siblings of children with autism.

In this study we examined early motor, vocal, and communicative development in a group of younger siblings of children diagnosed with autism (Infant Siblings). Infant Siblings and no-risk comparison later-born infants were videotaped at home with a primary caregiver each month from 5 to 14 months, with follow-up at 18 months. As a group, Infant Siblings were delayed in the onset of early developmental milestones and spent significantly less time in a greater number of postures, suggestive of relative postural instability. In addition, they demonstrated attenuated patterns of change in rhythmic arm activity around the time of reduplicated babble onset; and they were highly likely to exhibit delayed language development at 18 months.

Early Language and Communication Development of Infants Later Diagnosed with Autism Spectrum Disorder

It is well recognized that delayed "first words" is among the most common presenting symptoms of autistic spectrum disorders (ASD). However, data on earlier language and communication development in children with ASD are limited to retrospective reports from parents and from home videos. In this study, we prospectively collected parent report data on early communication and language development in 97 infant siblings of children with ASD and 49 low-risk controls. Parents completed the MacArthur Communicative Development Inventory--Infant Form at 12 and 18 months. Analysis compared 3 groups defined on the basis of diagnostic assessment at 24 months: (1) siblings with ASD (n = 15), (2) siblings not meeting diagnostic criteria for ASD (n = 82), and (3) low-risk controls, none of whom had ASD (n = 49). Children with ASD showed delays in early language and communication compared with non-ASD siblings and controls. At 12 months, the ASD group was reported to understand significantly fewer phrases and to produce fewer gestures. At 18 months, they showed delays in their understanding of phrases, comprehension and production of single words, and use of gestures. Siblings not diagnosed with ASD also used fewer play-related gestures at 18 months than low-risk controls, even when children with identified language delays were excluded. Overall, this prospective study confirms that delays in communication and language development are apparent early in life in children with ASD, and emphasizes that developmental surveillance should include monitoring for delays in gesture, which may be among the earliest signs of ASD.

Maternal sensitivity, infant co-operation and early linguistic development: Some predictive relations

Maternal sensitivity and infant co-operation during free play was analysed at the infant's age of 10 months and their contributions to early communicative and linguistic development at 12 months as well as later language outcome at 30 months were examined. In addition, the possible predictions of early skills to later development were considered. The participants were 27 Finnish-speaking mother – infant dyads. According to the results maternal sensitivity was associated with early intentional communication—particularly the use of communicative gestures, and also with symbolic behaviour and later comprehensive skills. No associations between infant co-operation and communicative and linguistic skills were found. As for expressive language skills, early capacities correlated with later outcome. The findings of the present study suggest that the effects of both maternal sensitivity and child characteristics on language development are likely to be specific rather than global.

The Neo-Vygotskian Approach to Early Communication

This article contains a theoretical analysis of the neo-vygotskian approach to early communication, represented by the cultural-historical activity-concept of child communication (Lisina, Leontiev, Vygotsky). The article focuses on the ontogenesis of communication and early socio-emotional development from a cultural-historical point of view, highlighting the following aspects: 1) the basic principles and main concepts of early communication and early development for a Russian neo-vygotskian (RNV), cultural-historical, psychological perspective; 2) relations between and approaches to activity and communication within cultural-historical psychology, based on A. N. Leontiev’s theory of activity, the vygotskian cultural-historical concept of early cultural genesis, and Maia Lisina’s theory on the ontogeny of communication.

A single case study of the communication development of a high-risk neonate, from birth to discharge from a Neonatal Intensive Care Unit (NICU)

Since preterm and low birth weight infants display a high-risk for communication disorders or delays, the Neonatal Intensive Care Unit (NICU) provides the earliest opportunity where family-centered early communication intervention (ECI) services can be initiated. Extensive knowledge about high-risk neonates exists, but there appears to be limited knowledge about the emergence of early communication skills in these neonates. The aim of the study was to provide a systematic description of the successive communication developmental steps of a high-risk neonate on a weekly basis, from birth to discharge from a NICU, in order to guide further research on a larger scale. An A-type single case study design was used to collect prospective data over 14 sessions during the participant's 51-day stay in the NICU. Using a comprehensive data-collection protocol, rich data sets were gleaned over time. The results are described as a chronology of events contributing to the participant's risk status and influencing his early communication development. The successive emergence of the different components of language skills in the participant provided new insights into the communication development of a preterm neonate and should be further investigated. An ECI programme and guidelines for implementation in the NICU are discussed as a treatment option.

Communicative skills in relation to gender, birth order, childcare and socioeconomic status in 18‐month‐old children

Variation in communicative skills, defined as gestures, vocabulary comprehension and vocabulary production, was examined as a function of gender, birth order, childcare and socioeconomic status (SES) in 1,019 18-month-old children. The children were recruited at their regular check-up at a number of randomly selected Child Health Care centers in a Swedish county. The participation rate was 88%. The children were assessed by their mothers using a short version of the Swedish Early Communicative Development Inventories. The results demonstrate significant effects of gender and birth order on vocabulary comprehension and vocabulary production. Girls scored higher than boys and first-born children scored higher than later-born children. Type of childcare (family care, care at home and day-care centers) interacted with gender and birth order on vocabulary production and indicated that family care is not as advantageous as care at home or at day-care centers. SES had no effect on children's communicative skills at this age.

Maternal responsiveness and infant intentional communication: implications for the early communicative and linguistic development

Maternal responsiveness has been found to have an important role in early language acquisition. From early on, children can also be regarded as active participants in interaction who demonstrate increasing competence in conveying messages to their interactive partners. Hence, in order to demonstrate consistent effects of maternal responses, it is important to take into account individual differences among children. In the present study, the relation between the frequencies of maternal responses and infant intentional communicative acts as well as their predictive validity to subsequent early communicative and linguistic skills was examined. The participants were 27 Finnish-speaking mothers and their healthy firstborn infants. Maternal and infant interactive behaviour was analysed from 20-min samples of free play collected during home visits at the infants' age of 10 months. At 12 months the children were assessed for their communicative and linguistic skills by using the Finnish version of the MacArthur Communicative Development Inventories and the Communication and Symbolic Behaviour Scales. The frequencies of maternal responses and infant intentional communicative acts were not intercorrelated. As for subsequent communicative and linguistic skills, the results of regression analyses indicated that both maternal responsiveness and infant intentional communication predict early comprehensive skills, whereas expressive skills--the use of both verbal and gestural communicative means--are predicted only by infant intentional communication. The results of the present study suggest that maternal responsiveness during the prelinguistic stage is not necessarily dependent on children's communicative competence. As predictors of early communicative and linguistic skills, both maternal responsiveness and infant intentional communication make a distinctive contribution.