Early Language Delay Research Articles

Data-driven prediction of early language delay at Youth Health Care Services in the Netherlands

Abstract Introduction Language development in early childhood significantly impacts future academic success, social interaction, and emotional well-being. This study aimed to develop and evaluate a prediction model using data on developmental milestones and parents’ socio-economic background known at age 2, and translate the results into an interactive digital dashboard and pilot it with Youth Health Care (YHC) professionals and parents. Methods A mixed-method study on retrospective cohort of children attending YHC at age 2, followed up until age 4. Data on language development, gender, parental education, and home language environment were obtained from YHC digital dossiers and linked to parental socio-economic status characteristics, and perinatal outcomes and healthcare costs using a secure remote access environment of Statistics Netherlands. Random forest and logistic regression models were computed with language development at age 4 as an outcome, initially using all available data at age 2 as predictors and then with a restricted model using variables readily available in YHC settings. Models performance was assessed using sensitivity, specificity, and AUC value. Results were visualized through an interactive dashboard and pilot-tested in simulated consultations. Results Among 9,148 children, 13.2% had language development delay at age 4. The full model had an AUC of 0.78, while the restricted model (gender, parental education, language environment, and language development), achieved an AUC of 0.77. YHC professionals and parents recognized the value of individualized, data-driven risk assessment for potential language delay to stimulate the discussion of preventive interventions. Conclusions A good quality prediction model for language development at age 4 can be derived from just a few background characteristics of the child and parents at age 2. The digital dashboard presents a practical approach of integrating prediction model results into daily YHC practice. Key messages • Language development at age of 4 can be predicted as early as age of 2 using just a few background characteristics of child and parents, which presents a window of opportunity for prevention. • The digital dashboard presents a practical approach of integrating prediction model results into preventive care practice.

Dynamics of Motor Skill Learning in American and Israeli Toddlers With Varied Language Proficiency.

The aim of the present study was twofold: to determine if deficits in motor skill proficiency and learning were present in 2-year-old children identified with early expressive language delay compared to peers without the delay, and to distinguish how motor skill proficiency and learning behaviors may manifest differently across culturally and linguistically diverse backgrounds. The study involved 54 children (24-36 months of age), 23 of whom were identified as having an expressive language delay. Furthermore, 16 participants were American and English-speaking and 38 were Israeli and Hebrew-speaking. After motor and language skill proficiency was assessed using a variety of measures, each child and participating parent were introduced to a nonsymmetrical-shaped insertion task so that motor learning skills could be observed. This block insertion task was observed for each child at three time points and included a transfer task (same task, new nonsymmetrical shape). Children with early expressive language delay were statistically significantly more likely to exhibit deficits in fine-motor proficiency than peers without language delay, regardless of country of origin or language spoken. Furthermore, participants with language delay demonstrated significantly higher error rates in transfer task completion compared with peers. Finally, participants in the U.S. sample indicated lower fine-motor skills and higher error rates than those in the Israeli sample. Differences in motor skill proficiency were universally associated with language delay status, indicating support for the notion that language acquisition deficits may extend beyond the linguistic system even in young children identified as late talkers.

Sign language delays in deaf 3- to 5-year-olds with hearing parents.

Deaf children of hearing parents (DOH) are at risk for early language delays (ELD) due to environmental and etiological factors, compounding the previously reported higher incidence of ELD in deaf children of deaf parents (DOD) compared to the general population. Archival data from the online database of the Visual Communication and Sign Language Checklist yielded 147 ratings of DOH 3- to 5-year-old children whose parents reported American sign language (ASL) being used in the home at least equally to spoken language. Research goals included (1) examining the incidence of ELD in this cohort, (2) investigating differences in outcomes based on the scaling method used, (3) exploring patterns among the ratings of DOH children identified with ELD, (4) comparing the DOH outcomes to published DOD data, and (5) investigating differences between ratings and individual children. The DOH outcomes suggested an incidence of ELD twice that of the previous DOD sample, with a higher percentage of more severe delays. Even DOH children not identified with ELD demonstrated less well-developed ASL skills than their DOD peers. This emphasizes the need for ongoing monitoring of early ASL skills to allow for early identification of needs and adjustment of interventions to address ASL development.

Predictive Measures in Child Language Development: The Role of Familial History and Early Expressive Vocabulary.

Prediction of developmental language disorder in children under 3 years of age is challenging. Among early risk factors, research has focused on having a positive familial history (FH+) for language or literacy problems and on late language emergence, that is, late-talker (LT) status. The interaction between these two risk factors and their cumulative effect is still debated. Here, we (a) investigate the effect of FH+ on 24-month language development, (b) test for cumulative effects of FH+ status and early language delay on 36-month language outcomes, and (c) disentangle the direct and indirect effects of familial history (FH) on the language outcome. One hundred eighty-five Italian children were followed up longitudinally between 24 and 36 months of age (64 FH+ and 121 FH-) through parental questionnaires and direct child assessment. At the age of 24 months, the FH+ group showed worse expressive vocabulary and higher prevalence of LT. At the age of 36 months, main effects of LT and FH were identified on lexical and phonological performances, respectively. Interestingly, significant interaction effects were identified on expressive vocabulary and phonological processing. Path analysis highlights that FH had a direct effect on later measures of phonology, whereas its effect on 36-month lexical abilities was indirect, via measures of expressive vocabulary at 24 months. The study suggests specific predictive roles of FH and LT status on language development. Interestingly, FH+ seems to represent an additive risk for LT children. The use of cumulative risk measures is confirmed as a powerful approach to identify those children with the highest probability of developing persistent language difficulties. https://doi.org/10.23641/asha.26790580.

Shared and divergent mental health characteristics of ADNP-, CHD8- and DYRK1A-related neurodevelopmental conditions

BackgroundNeurodevelopmental conditions such as intellectual disability (ID) and autism spectrum disorder (ASD) can stem from a broad array of inherited and de novo genetic differences, with marked physiological and behavioral impacts. We currently know little about the psychiatric phenotypes of rare genetic variants associated with ASD, despite heightened risk of psychiatric concerns in ASD more broadly. Understanding behavioral features of these variants can identify shared versus specific phenotypes across gene groups, facilitate mechanistic models, and provide prognostic insights to inform clinical practice. In this paper, we evaluate behavioral features within three gene groups associated with ID and ASD – ADNP, CHD8, and DYRK1A – with two aims: (1) characterize phenotypes across behavioral domains of anxiety, depression, ADHD, and challenging behavior; and (2) understand whether age and early developmental milestones are associated with later mental health outcomes.MethodsPhenotypic data were obtained for youth with disruptive variants in ADNP, CHD8, or DYRK1A (N = 65, mean age = 8.7 years, 40% female) within a long-running, genetics-first study. Standardized caregiver-report measures of mental health features (anxiety, depression, attention-deficit/hyperactivity, oppositional behavior) and developmental history were extracted and analyzed for effects of gene group, age, and early developmental milestones on mental health features.ResultsPatterns of mental health features varied by group, with anxiety most prominent for CHD8, oppositional features overrepresented among ADNP, and attentional and depressive features most prominent for DYRK1A. For the full sample, age was positively associated with anxiety features, such that elevations in anxiety relative to same-age and same-sex peers may worsen with increasing age. Predictive utility of early developmental milestones was limited, with evidence of early language delays predicting greater difficulties across behavioral domains only for the CHD8 group.ConclusionsDespite shared associations with autism and intellectual disability, disruptive variants in ADNP, CHD8, and DYRK1A may yield variable psychiatric phenotypes among children and adolescents. With replication in larger samples over time, efforts such as these may contribute to improved clinical care for affected children and adolescents, allow for earlier identification of emerging mental health difficulties, and promote early intervention to alleviate concerns and improve quality of life.

Factors Associated with Confirmed and Unconfirmed Autism Spectrum Disorder Diagnosis in Children Volunteering for Research.

Diagnostic accuracy of autism spectrum disorder (ASD) is crucial to track and characterize ASD, as well as to guide appropriate interventions at the individual level. However, under-diagnosis, over-diagnosis, and misdiagnosis of ASD are still prevalent. We describe 232 children (MAge = 10.71 years; 19% female) with community-based diagnoses of ASD referred for research participation. Extensive assessment procedures were employed to confirm ASD diagnosis before study inclusion. The sample was subsequently divided into two groups with either confirmed ASD diagnoses (ASD+) or unconfirmed/inaccurate diagnoses (ASD-). Clinical characteristics differentiating the groups were further analyzed. 47% of children with community-based ASD diagnoses did not meet ASD criteria by expert consensus. ASD + and ASD- groups did not differ in age, gender, ethnicity, or racial make-up. The ASD + group was more likely to have a history of early language delays compared to the ASD- group; however, no group differences in current functional language use were reported by caregivers. The ASD + group scored significantly higher on ADI-R scores and on the ADOS-2 algorithm composite scores and calibrated severity scores (CSSs). The ASD- group attained higher estimated IQ scores and higher rates of psychiatric disorders, including anxiety disorder, disruptive behavior, and mood disorder diagnoses. Broadly, caregiver questionnaires (SRS-2, CCC-2) did not differentiate groups. Increased reported psychiatric disorders in the ASD- group suggests psychiatric complexity may contribute to community misdiagnosis and possible overdiagnosis of ASD. Clinician-mediated tools (ADI-R, ADOS-2) differentiated ASD + versus ASD- groups, whereas caregiver-reported questionnaires did not.

A randomised controlled trial of the effectiveness of parent-based models of language intervention for 2- to 3-year-old children with speech, language and communication needs (SLCN) in areas of social disadvantage.

Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self-perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. To compare the impact of standard parent-based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. A multicentre clustered blind randomised controlled trial was used to compare the effect of parent-based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20-week period. Participants received one of two interventions: (1) Standard Care - indirect group PBI - (PBI) (2) Enhanced Care: indirect group enhanced PBI - (EPBI). Both standardised and non-standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure - Speech & Language Therapy (PAM-SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well-being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. One hundred fifty-five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur-Bates Communicative Development Inventories Sentence Length, from pre-intervention to post-intervention and 6 months post-intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval -0.02 to 0.76), although wide variation was found. This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents. What is already known on the subject Speech, language and communication needs (SLCN) have a knock-on effect on emotional well-being, school readiness, literacy and school attainment, putting children at increased risk of long-term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self-perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work? This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes.

Language Development in Children with Cochlear Implant using Bimodal Approach: SLP Perspective

Background: The development of language skills in children with cochlear implants is a vital area of research, particularly in understanding the impact of the bimodal approach. This study focuses on children with early language delays under the age of five, exploring how cochlear implantation and the bimodal approach influence their language development. Objective: The primary objective of this study was to evaluate the effectiveness of the bimodal approach (cochlear implant combined with a hearing aid) on language development in children with cochlear implants. The study aimed to understand the perspectives of speech-language pathologists (SLPs) on the challenges and successes associated with this approach. Methods: This descriptive study involved 50 SLPs from hospitals and rehabilitation centers across Pakistan, each with at least a year of clinical experience. Data were collected through a questionnaire focusing on various aspects of cochlear implantation and the bimodal approach. The questionnaire included questions on the age of implantation, additional medical complexities, effectiveness of the bimodal approach, and the impact on speech skills, social interaction, and cognitive functions. The study employed a cross-sectional design, and the data were analyzed using SPSS version 25 for statistical significance. Results: The majority (81.2%) of children received their cochlear implantation between 1-3 years. About 70.6% of respondents reported using a second hearing aid post-implantation. The bimodal approach was found effective by 78.4% of therapists in aiding speech comprehension. Approximately 88.2% believed that hearing devices improved speech skills, and 82.4% noted the benefit of an additional hearing aid. However, concerns were raised about potential dependencies on these devices. In terms of social and academic performance, 84.4% of therapists saw improvements. Conclusion: The study concludes that the bimodal approach is effective in enhancing language development in children with cochlear implants. Early implantation, combined with the use of a hearing aid, shows promising results in language acquisition and social interaction. Despite the limitations due to a small sample size and data collection constraints during the COVID-19 pandemic, the study provides valuable insights into the positive impact of the bimodal approach in language development.

Sign language delays in deaf 3- to 5-year-olds with deaf parents.

Research has demonstrated that deaf children of deaf signing parents (DOD) are afforded developmental advantages. This can be misconstrued as indicating that no DOD children exhibit early language delays (ELDs) because of their early access to a visual language. Little research has studied this presumption. In this study, we examine 174 ratings of DOD 3- to 5-year-old children, for whom signing in the home was indicated, using archival data from the online database of the Visual Communication and Sign Language Checklist. Our goals were to (1) examine the incidence of ELDs in a cohort of DOD children; (2) compare alternative scaling strategies for identifying ELD children; (3) explore patterns among behavioral ratings with a view toward developing a greater understanding of the types of language behaviors that may lie at the root of language delays; and (4) suggest recommendations for parents and professionals working with language-delayed DOD children. The results indicated that a significant number of ratings suggested ELDs, with a subset significantly delayed. These children likely require further evaluation. Among the less delayed group, ASL skills, rather than communication or cognition, were seen as the major concern, suggesting that even DOD children may require support developing linguistically accurate ASL. Overall, these findings support the need for early and ongoing evaluation of visual language skills in young DOD children.

Social Communication in Young Children With Sex Chromosome Trisomy (XXY, XXX, XYY): A Study With Eye Tracking and Heart Rate Measures.

Children with sex chromosome trisomy (SCT) have an increased risk for suboptimal development. Difficulties with language are frequently reported, start from a very young age, and encompass various domains. This cross-sectional study examined social orientation with eye tracking and physiological arousal responses to gain more knowledge on how children perceive and respond to communicative bids and evaluated the associations between social orientation and language outcomes, concurrently and 1 year later. In total, 107 children with SCT (33 XXX, 50 XXY, and 24 XYY) and 102 controls (58 girls and 44 boys) aged between 1 and 7years were included. Assessments took place in the USA and Western Europe. A communicative bids eye tracking paradigm, physiological arousal measures, and receptive and expressive language outcomes were used. Compared to controls, children with SCT showed reduced attention to the face and eyes of the on-screen interaction partner and reduced physiological arousal sensitivity in response to direct versus averted gaze. In addition, social orientation to the mouth was related to concurrent receptive and expressive language abilities in 1-year-old children with SCT. Children with SCT may experience difficulties with social communication that extend past the well-recognized risk for early language delays. These difficulties may underlie social-behavioral problems that have been described in the SCT population and are an important target for early monitoring and support.

Behavioural Profile, Linguistic skills, Adaptive Behaviours and Intellectual Functioning of School aged Children with History of Early Language Delay

Introduction: Language is a fundamental skill and a foundation stone for multiple cognitive and socio-emotional aspects of development. Considering that well-developed language abilities enable children to negotiate the social-relational demands of school life and provide the foundational knowledge upon which academic skills are built, there is a higher chance of scholastic difficulties, social and, behavioural and emotional maladjustments resulting in poor mental health in those who have language delay.&#x0D; Methods: An ambispective study conducted at a tertiary centre after taking ethical approval from the institutional review board. Children with isolated early language delay were reassessed at school age for intelligence quotient, language development, adaptive behaviours and behavioural issues.&#x0D; Results: out of 57 children, persistence of poor language skills was seen in 65%, mean IQ score was 90 ( ± 17. 067) and mean VABS score was 94 ( ± 15). 61.4% children had significant behavioural issues. On interview, most worrisome issue reported by children was ‘being teased by friends’ due to poor language skills. Additionally, lower social competence level was noted in children who had poor language skills.&#x0D; Conclusions: persistence of language, cognitive and behavioural dysfunctions in children with seemingly benign ‘speech and language delay’ at an early age, emphasizes the importance of comprehensive reassessment of these children at school age for early recognition and management.

Speech-in-noise perception in autistic adolescents with and without early language delay.

Speech-in-noise perception seems aberrant in individuals with autism spectrum disorder (ASD). Potential aggravating factors are the level of linguistic skills and impairments in auditory temporal processing. Here, we investigated autistic adolescents with and without language delay as compared to non-autistic peers, and we assessed speech perception in steady-state noise, temporally modulated noise, and concurrent speech. We found that autistic adolescents with intact language capabilities and not those with language delay performed worse than NT peers on words-in-stationary-noise perception. For the perception of sentences in stationary noise, we did not observe significant group differences, although autistic adolescents with language delay tend to perform worse in comparison to their TD peers. We also found evidence for a robust deficit in speech-in-concurrent-speech processing in ASD independent of language ability, as well as an association between early language delay in ASD and inadequate temporal speech processing. We propose that reduced voice stream segregation and inadequate social attentional orienting in ASD result in disproportional informational masking of the speech signal. These findings indicate a speech-in-speech processing deficit in autistic adolescents with broad implications for the quality of social communication.

N°222 – Analysis of brain encoding of speech sounds in newborns with complex congenital heart disease: Towards the identification of early language delay biomarkers

N°222 – Analysis of brain encoding of speech sounds in newborns with complex congenital heart disease: Towards the identification of early language delay biomarkers

Risk factors for early language delay in children within a minority ethnic, bilingual, deprived environment (Born in Bradford’s Better Start): a UK community birth cohort study

BackgroundPreschool language skills and language delay predict academic and socioemotional outcomes. Children from deprived environments are at a higher risk of language delay, and both minority ethnic and bilingual children...

Sentence Diversity in Spanish-English Bilingual Toddlers.

There remain few available tools to assess language development in Spanish-English dual language learner (DLL) toddlers in the United States. Of interest is the development of early sentences as children move from producing single words to producing multiword utterances. This study is the first to extend sentence diversity to the context of Spanish-English DLLs by describing development from 24 to 30 months of age in children with and without language delays (LDs). Spontaneous language samples were collected from Spanish-dominant DLL children and their mothers as they were observed during a free-play interaction. Existing sentence diversity protocols were adapted for the DLL context to describe children's flexibility in combining subjects and verbs to form utterances in Spanish and English. Children maintained an accurate separation in their grammars for subject-verb combinations in Spanish versus English. There was an overwhelming preference for Spanish subject-verb combinations with null subjects. The emergence of sentence diversity distinguished children with and without early LD unlike the emergence of word combinations. Consistent with prior research, findings showed that DLLs did not confuse grammatical structures across languages. Instead, they showed a differential pattern of results in each language, such that the strongest grammatical skills were evinced first in the dominant language. Sentence diversity shows promise for assessment and progress monitoring in Spanish-English DLLs in the United States.

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

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

Narrative macrostructure and microstructure profiles of bilingual children with autism spectrum disorder: differentiation from bilingual children with developmental language disorder and typical development

AbstractChildren with autism spectrum disorder (ASD) show heterogeneous language profiles beyond early language delays. Understanding the second language profiles of bilingual children with ASD is important for clinical practice in diverse societies. Accordingly, we examined the narrative abilities of bilinguals with ASD, with developmental language disorder (DLD), and with typical development (TD) to determine which narrative components best differentiate bilinguals with ASD from the other groups. Participants were 29 bilingual children with ASD, DLD, and TD who were matched for age (mean = 6;8), nonverbal intelligence, and receptive vocabulary. Narratives were coded for macrostructure (story grammar (SG) scores, number of individual SG components) and microstructure (syntactic complexity, mean length of utterance, lexical diversity, and story length). The TD group had superior SG scores, included more SG components, and used longer utterances and more complex syntax than the ASD group, whereas no differences were found between the clinical groups. For SG components requiring perspective-taking abilities, the ASD group had worse performance than the TD and DLD groups. Our results suggest that bilingual children with ASD show weaknesses in both macrostructure and microstructure, which can overlap with children with DLD. The linguistic profiles of bilingual children with ASD and DLD are thus both overlapping and distinct.

The perspective of Speech and Language Pathologist about Outcomes of an Early Language Delay in Children Less than 5 Years Old

Background: Language is the systematic and standard use of sounds (or signs or written symbols) for communication or expression purpose. In humans language is controlled primarily by the left cerebral hemisphere, and the right hemisphere is specialized for processing visual-spatial information. This actually depends on the handedness of humans. It is evaluated that around 95% of right-handers and 70% of left-handers appear left-hemisphere dominant for language. Early language delay is a condition that called a common developmental disorder. Persistent delay may lead to adverse impacts on the emotional, behavioral and social abilities of children.&#x0D; Objective: The objective of the present study was to find out the perspective of speech and language pathologists/therapists about the outcomes of an early language delay in children less than 5 years old.&#x0D; Materials &amp; Methods: This descriptive study was carried out at NUR International University, from 1st March 2021 to 30 September 2021 to determine the outcomes of an early language delay in less than 5 years old. For this purpose data was collected from almost 50 speech therapist working with the language delaychildrensthrough self-designed questionnaire. Questionnaire which was used as data collecting instrument that was designed by expert opinion and literature review.&#x0D; Results: Results show that the most facing outcomes are difficulty in understanding verbal communication 30(60%), turn-taking during conversation as well as playing 32(64%), focus and concentration difficulties 28(56%), difficulty in linguists use 30(60%), difficulty in imitation 25(50%), performing cognitive tasks30(60%), academic issues 30(60%), arranging syntactic and semantics 25(50%), non-compliance 29(58%), emotional tantrums 35(70%) and physical aggression on siblings and animals 31(62%).&#x0D; Conclusion: The children are facing difficulties in their academic life and extremely confront the behavioral, social and, emotional problems in their daily life.

The Ability of Saudi Parents' To Detect Early Language Delay in Their Children: A Study in Primary Health Care Centers, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

PurposeOur study aims to assess parents’ ability to detect early language delay in their children in association with related demographic and environmental factors to help in predicting its risk.MethodsA cross-sectional study was conducted at three main primary health care centers at National Guard Health Affairs, Riyadh, Saudi Arabia. Participating parents were asked if they think their children have language delay and if they were able to detect it early. Then, validated age-appropriate screening tools were administered to assess the child’s language development. The parents' answers regarding their child’s language development were then compared to the screening tool assessment results.ParticipantsA total of 250 parents attending a well-baby clinic for their children’s routine vaccinations participated in the study after informed consent was obtained.ResultsLanguage delay was more prominent in the one-year-old age group (26.7%). In addition, children who were not breastfed were significantly more likely to have language delays (P-value 0.014). The parents’ ability to detect language delay varied among the different age groups. Fifty-seven point one percent (57.1%) of children aged two years old and 61.5% of children aged five years old who were found to have language delay were not noticed by their parents (P-value 0.03, 0.02).ConclusionParents showed a lack of ability to detect language delay early. Increasing their awareness of the typical language development milestones and the importance of early intervention is very important to minimize the consequences of late intervention.

Psychometric Properties of the English-Spanish Vocabulary Inventory in Toddlers With and Without Early Language Delay.

Purpose:Despite the increasing population of dual language learners (DLLs) in the United States, vocabulary measures for young DLLs have largely relied on instruments developed for monolinguals. The multistudy project reports on the psychometric properties of the English–Spanish Vocabulary Inventory (ESVI), which was designed to capture unique cross-language measures of lexical knowledge that are critical for assessing DLLs' vocabulary, including translation equivalents (whether the child knows the words for the same concept in each language), total vocabulary (the number of words known across both languages), and conceptual vocabulary (the number of words known that represent unique concepts in either language).Method:Three studies included 87 Spanish–English DLLs (M age = 26.58 months, SD = 2.86 months) with and without language delay from two geographic regions. Multiple measures (e.g., caregiver report, observation, behavioral tasks, and standardized assessments) determined content validity, construct validity, social validity, and criterion validity of the ESVI.Results:Monolingual instruments used in bilingual contexts significantly undercounted lexical knowledge as measured on the ESVI. Scores on the ESVI were related to performance on other measures of communication, indicating acceptable content, construct, and criterion validity. Social validity ratings were similarly positive. ESVI scores were also associated with suspected language delay.Conclusions:These studies provide initial evidence of the adequacy of the ESVI for use in research and clinical contexts with young children learning English and Spanish (with or without a language delay). Developing tools such as the ESVI promotes culturally and linguistically responsive practices that support accurate assessment of DLLs' lexical development.Supplemental Material: https://doi.org/10.23641/asha.17704391