Early Language Delay Research Articles

An analysis of language and speech disorders in preschool children in Turkey: The case of Beypazarı

The children with early language and speech delay have the risk to face with learning disabilities as well as psychological and behavioral adjustment problems in the preschool period. The aim of this study to analyse the language and speech disoders in the children aged between 3 and 6 years who attend kindergarden. 503 children who attend the kindergarden were determined in Beypazarı. However, 101 children were out of study for various reasons (N:402). The implementation of the study consists of two stages. In the first stage, the language and speech development of the children was questioned. The Turkish Preschool Language Scale-5 (TPLS-5) test was administered to the risky children in the second stage. A moderate (0,30<|r=0,49|<0,70), positive (r>0) and a significant correlation (p<0,05) was found between their chronological age and their receptive language age. A high level (0,70<|r=0,88|), positive (r>0) and significant correlation (p<0,01) was found between the chronological and expressive language of the children. The language and speech disorder has an important potential negative effect on families and societies both in the short and the long term. For this reason, it is quite important to follow the language and speech development of children closely in the preschool period.

Longitudinal growth of receptive language in children with cerebral palsy between 18 months and 54 months of age.

We examined receptive language developmental trajectories between 18 months and 54 months for three clinical speech-language profile groups of children with cerebral palsy (those with speech motor involvement, without speech motor involvement, and with anarthria) and quantified differences from age-level expectations. We identified latent classes of comprehension development, related these classes to clinical profile groups, and examined how well early receptive language predicted outcomes. We used a prospective longitudinal design. Eighty-five children with cerebral palsy (43 females, 42 males) were followed longitudinally from 18 to 54 months of age. Children were seen two to eight times (322 data points). Children were classified into clinical profile groups. Language comprehension age-equivalent scores were the primary measures of interest. Children with anarthria had significant language delays, limited developmental change over time, and comprised their own latent class. Children with speech motor impairment had slight receptive language delays over time. Children with no speech motor impairment had age-appropriate receptive language over time. Early language comprehension scores were highly predictive of later latent profile group membership. Early language comprehension abilities are highly predictive of language comprehension growth trajectory and suggest that children with early language delay, particularly those who are non-speaking, should receive language intervention to support development. There are two growth trajectories for language comprehension among children with cerebral palsy. Children with speech motor impairment had a constant 6-month receptive language delay. Children without speech motor impairment had age-appropriate receptive language. Non-speaking children had significant receptive language delay. Early language comprehension change was highly predictive of later trajectory group.

Trajectories of cognitive development in toddlers with language delays

BackgroundToddlers with early language delays (LD) are at risk for developmental difficulties, including autism spectrum disorder (ASD). However, little is known about early cognitive skill acquisition in this population. AimsTo explore heterogeneity in cognitive development in toddlers with significant LD (n = 30) or typical development (n = 61), and how this relates to 36-month outcomes (ASD, non-ASD delays, or no delays). MethodsGrowth mixture modeling of nonverbal and verbal mental age (NVMA, VMA) scores from the Mullen Scales of Early Learning was conducted with data from 18, 24 and 36 months. ResultsA two-class NVMA solution was selected (Age Appropriate, 82%, Delayed, 18%); class membership was related to the no delay outcome, and although the proportion of toddlers with ASD in the Age-Expected class was 17% compared to 50% of toddlers with non-ASD delays, this difference was not statistically significant. The best-fitting model for VMA included three classes: Age Appropriate (66%), Delay Catch-Up (23%), Delayed (11%); class assignment differed by outcome. Children in the Delay Catch-Up class were more likely to have non-ASD delays compared to ASD, while the reverse was true in the Delayed class. ConclusionsCognitive development in toddlers with LD is heterogeneous, and delayed verbal trajectories relate to later ASD diagnosis.

On developing adaptive vocabulary learning game for children with an early language delay

On developing adaptive vocabulary learning game for children with an early language delay

Visuospatial and Verbal Short-Term Memory Correlates of Vocabulary Ability in Preschool Children.

Recent studies indicate that school-age children's patterns of performance on measures of verbal and visuospatial short-term memory (STM) and working memory (WM) differ across types of neurodevelopmental disorders. Because these disorders are often characterized by early language delay, administering STM and WM tests to toddlers could improve prediction of neurodevelopmental outcomes. Toddler-appropriate verbal, but not visuospatial, STM and WM tasks are available. A toddler-appropriate visuospatial STM test is introduced. Tests of verbal STM, visuospatial STM, expressive vocabulary, and receptive vocabulary were administered to 92 English-speaking children aged 2-5 years. Mean test scores did not differ for boys and girls. Visuospatial and verbal STM scores were not significantly correlated when age was partialed out. Age, visuospatial STM scores, and verbal STM scores accounted for unique variance in expressive (51%, 3%, and 4%, respectively) and receptive vocabulary scores (53%, 5%, and 2%, respectively) in multiple regression analyses. Replication studies, a fuller test battery comprising visuospatial and verbal STM and WM tests, and a general intelligence test are required before exploring the usefulness of these STM tests for predicting longitudinal outcomes. The lack of an association between the STM tests suggests that the instruments have face validity and test independent STM skills.

Subcortical Brain and Behavior Phenotypes Differentiate Infants With Autism Versus Language Delay

BackgroundYounger siblings of children with autism spectrum disorder (ASD) are themselves at increased risk for ASD and other developmental concerns. It is unclear if infants who display developmental concerns, but are unaffected by ASD, share similar or dissimilar behavioral and brain phenotypes to infants with ASD. Most individuals with ASD exhibit heterogeneous difficulties with language, and their receptive-expressive language profiles are often atypical. Yet, little is known about the neurobiology that contributes to these language difficulties. MethodsIn this study, we used behavioral assessments and structural magnetic resonance imaging to investigate early brain structures and associations with later language skills. High-risk infants who were later diagnosed with ASD (n = 86) were compared with high-risk infants who showed signs of early language delay (n = 41) as well as with high- and low-risk infants who did not have ASD or language delay (n = 255 and 143, respectively). ResultsResults indicated that diminished language skills were evident at 12 months in infants with ASD and infants with early language delay. At 24 months of age, only the infants with ASD displayed atypical receptive-expressive language profiles. Associations between 12-month subcortical volumes and 24-month language skills were moderated by group status, indicating disordinal brain-behavior associations among infants with ASD and infants with language delay. ConclusionsThese results suggest that there are different brain mechanisms influencing language development in infants with ASD and infants with language delay, and that the two groups likely experience unique sets of genetic and environmental risk factors.

Prefrontal Hemodynamics in Toddlers at Rest: A Pilot Study of Developmental Variability

Functional near infrared spectroscopy (fNIRS) is a non-invasive functional neuroimaging modality. Although, it is amenable to use in infants and young children, there is a lack of fNIRS research within the toddler age range. In this study, we used fNIRS to measure cerebral hemodynamics in the prefrontal cortex (PFC) in 18–36 months old toddlers (n = 29) as part of a longitudinal study that enrolled typically-developing toddlers as well as those “at risk” for language and other delays based on presence of early language delays. In these toddlers, we explored two hemodynamic response indices during periods of rest during which time audiovisual children's programming was presented. First, we investigate Lateralization Index, based on differences in oxy-hemoglobin saturation from left and right prefrontal cortex. Then, we measure oxygenation variability (OV) index, based on variability in oxygen saturation at frequencies attributed to cerebral autoregulation. Preliminary findings show that lower cognitive (including language) abilities are associated with fNIRS measures of both lower OV index and more extreme Lateralization index values. These preliminary findings show the feasibility of using fNIRS in toddlers, including those at risk for developmental delay, and lay the groundwork for future studies.

FACILITATING ENGAGEMENT WITH SPEECH AND LANGUAGE SERVICES IN CHILDREN OF ADOLESCENT MOTHERS

BACKGROUND: The relationship between early language delay and lower socioeconomic status is well established. This trend is particularly troubling when considering the outcomes of children born to adolescent mothers, whose incomes tend to fall well below the poverty line and whose difficult social circumstances may undermine the provision of an enriching home literacy environment for their children. Among the children of adolescent mothers involved in a Teen-Tot clinic, almost half of the children were identified with an expressive speech and language delay by the age of 18 months. Despite the successes of early intervention, it is believed that less than 25% of adolescent mothers involved with the Teen-Tot clinic whose children were identified with a speech delay followed-up with the recommended hearing assessment and referral to preschool speech and language services. OBJECTIVES: The purpose of this study was to better understand factors that would facilitate engagement with speech and language services for children of adolescent mothers, and to explore alternative delivery models for this service. DESIGN/METHODS: Adolescent mothers receiving care at a Teen-Tot clinic were invited to: 1) complete a survey that asked about their home literacy environment, their perception of their child’s speech and language development, and perceived barriers to accessing community-based speech and language services; and 2) participate in a single speech and language education session followed by a focus group to elicit their feedback about alternative delivery models for speech and language services. Survey data were analyzed using descriptive statistics, and the focus group discussions were analysed using a descriptive qualitative approach. RESULTS: Survey data revealed significant barriers to engagement with community-based speech and language services. When asked about preferred delivery models for speech and language services, focus groups participants indicated that they were most interested in attending group speech and language sessions offered within the Teen-Tot clinic by a speech and language professional. CONCLUSION: There is a high prevalence of early speech and language delay among the children of adolescent mothers. Many of these mothers face difficulties engaging with traditional speech and language services due to systemic barriers and personal circumstances. Our study revealed that group speech and language sessions offered within the setting of a Teen-Tot clinic may be an effective strategy for engaging young mothers in addressing their children’s early speech and language delay and ultimately facilitating positive developmental and socio-economic outcomes.

Syntax and Morphology in Danish-Speaking Children with Autism Spectrum Disorder.

The current study examined delays in syntax and morphology, and vocabulary, in autism spectrum disorder (ASD). Children ages 4-6 years with ASD (n = 21) and typical development (n = 21), matched on nonverbal mental age, completed five language tasks. The ASD group had significant delays in both syntax and morphology, and vocabulary measures, with significant within-group heterogeneity; furthermore, syntactic and morphological measures were impaired even for subgroups matched on vocabulary. Children in the ASD group without early language delay showed syntactic and morphological impairment, with intact performance on vocabulary and sentence repetition. Findings indicate that syntactic and morphological impairments are a significant concern for high-functioning children with ASD, and may be overlooked if language evaluation focuses exclusively on vocabulary.

Pragmatic Functions in Late Talkers

This study analyzed spontaneous language samples of three-year-olds with a history of expressive language delay (late talkers) and age-matched controls using Dore’s Conversational Acts analysis (1978) and Mean Length of Utterance (MLU; Brown, 1973). Differences were observed between groups in utterances classified as organizational device and miscellaneous. No differences were noted between groups in other pragmatic functions and the number of pragmatic functions that were used. Late talkers showed lower MLUs as compared to age-matched peers. Pragmatic language, in addition to morphosyntax, should be monitored in children with a history of early expressive language delay.

Spelling Impairments in Italian Dyslexic Children with and without a History of Early Language Delay. Are There Any Differences?

Language delay is considered a frequent antecedent of literacy problems and both may be linked to phonological impairment. However, while several studies have examined the relationship between language delay and reading impairment, relatively few have focused on spelling. In this study, spelling performance of 28 children with developmental dyslexia (DD), 14 children with a history of language delay (LD), and 14 children without (NoLD) and 28 control participants were examined. Spelling was investigated by a writing to dictation task that included orthographically regular stimuli (word and non-words), as well as words with unpredictable transcription. Results indicated that all dyslexic participants underperformed compared to controls on both regular and unpredictable transcription stimuli, but LD performance was generally the worst. Moreover, spelling impairment assumed different characteristics in LD and NoLD children. LD children were more sensitive to acoustic-to-phonological variables, showing relevant failure especially on stimuli containing geminate consonants but also on polysyllabic stimuli and those containing non-continuant consonants. Error analysis confirmed these results, with LD children producing a higher rate of phonological errors respect to NoLD children and controls. Results were coherent with the hypothesis that among dyslexic children, those with previous language delay have more severe spelling deficit, suffering from defective orthographic lexical acquisition together with long-lasting phonological difficulties.

Early productive vocabulary predicts academic achievement 10 years later

ABSTRACTWe use a longitudinal design to examine associations for a diverse sample of 2,120 Danish 16- to 30-month-old children between early expressive vocabulary and later reading and math outcomes in the sixth grade. Educational outcomes, in particular decoding and reading comprehension, can be predicted from an early vocabulary measure as early as 16 months with effect sizes (in proportion of variance accounted for) comparable to 1 year's mean growth in reading scores. The findings confirm in a relatively large population-based study that late talkers are at risk for low educational attainment because the majority of children experiencing early language delay obtain scores below average in measures of reading in the sixth grade. Low scores have the greatest predictive power, indicating that children with early delays have elevated risk for later reading problems.

Cerebellar gray matter differentiates children with early language delay in autism.

Early language delay (ELD) is one of the earliest indicators of autism spectrum disorder (ASD), and predicts later cognitive and behavioral outcomes. We aimed to determine the neural correlates of ELD in autism, and examine the relationships between gray matter (GM), age of first word/phrase, and core ASD symptoms. We used voxel-based morphometry to examine whole-brain differences in GM in 8-13 year old children with autism (n = 13 ELD; n = 22 non-ELD) and 35 age-matched typically developing (TD) children. Multiple regression analyses examined the relationships between GM, age of first word/phrase, and autism diagnostic observation schedule (ADOS) scores. Composite age of first word/phrase negatively correlated with GM throughout the cerebellum. Both ASD groups (ELD and non-ELD) had reduced GM in right cerebellar Crus I/II when compared to TD children. Left cerebellar Crus I/II was the only region in the brain that differentiated ELD and non-ELD children, with ELD children showing reduced GM relative to both non-ELD and TD groups. Group×score interactions converged in left Crus I/II, such that the non-ELD group showed poorer ADOS scores with increasing GM, whereas the ELD group showed poorer ADOS scores as GM decreased. Reduced GM in right cerebellar Crus I/I was related ASD diagnosis, while children with ELD showed additional reduced GM in left Crus I/II. These findings highlight the importance of specific cerebellar networks in both ASD and early language development, and suggest that bilateral disruption in cerebellar regions that interconnect with fronto-parietal networks could impact language acquisition in ASD. Autism Res 2016, 9: 1191-1204. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Nonword Repetition in Spanish-Speaking Toddlers with and without Early Language Delays

Background/Aims: Nonword repetition (NWR) studies with English-speaking toddlers indicate favorable diagnostic accuracy for identifying early language delays and strong associations with early vocabulary. While scarce, studies of Spanish NWR have revealed strong diagnostic accuracy with preschool- and school-age children. This study aimed to (1) establish the association between Spanish NWR and early linguistic measures, (2) compare the Spanish NWR skills of typical Spanish-speaking toddlers and those of toddlers with early language delays (ELD), and (3) establish the diagnostic accuracy of a Spanish NWR task. Methods: Sixty-five Spanish-speaking toddlers were given a NWR task and a language assessment while parents completed a vocabulary checklist and reported their child's longest utterances. Results: NWR scores were moderately correlated with vocabulary and language. The ELD group had significantly lower NWR scores than peers, and 68% of the sample was classified correctly, with desirable sensitivity but inadequate specificity obtained. Conclusion: Findings from this study revealed developmental trends in Spanish-speaking toddlers' ability to repeat nonwords and that most toddlers were not able to repeat 4- and 5-syllable nonwords. Furthermore, Spanish-speaking children with ELD had more difficulties with NWR than typical peers. The diagnostic accuracy results indicated that the clinical use of a Spanish NWR task for toddlers can serve to detect early language-learning difficulties, especially if used as one of multiple diagnostic sources of information to establish ELD.

Body movement imitation and early language as predictors of later social communication and language outcomes: A longitudinal study

Background and aims Over recent decades much research has focused on detecting predictors of different language trajectories in children with early language delay but there has been very little exploration of social communication trajectories in these children. We report a longitudinal study that investigated the predictive value and clinical significance of elicited body movement imitation and language for later social communication and language outcome in Late Talkers. Methods Participants were 29 German-speaking children who were identified with delayed onset and progression of language at two years and followed up at four years. Novel assessments of posture and gesture imitation were administered at Time 1, together with standardised language measures. All body movement imitation items involved self-other mappings, assumed to rely on sociocognitive capacities. At Time 2, children were assessed on standard language tests, together with parental reports of social communication. Results Early language skills at Time 1 were significantly associated with later language outcome and body movement imitation skills at Time 1 with later social communication outcome. Logistic regression analyses revealed that body movement imitation as well as language at Time 1 added significantly to the prediction of language outcome at Time 2, whereas only body movement imitation made a significant contribution to the prediction of social communication outcome at Time 2. Conclusions and implications Theoretically, results highlight the need to account for the heterogeneity of different language and communication trajectories in children with early language delay and point to the importance of sociocognitive difficulties observed in some of these children. Clinically, this study demonstrated that body movement imitation measures have the potential to improve the identification of pre-schoolers who are at risk of later social communication and language problems.

Preterm delivery and risk for early language delays: a sibling-control cohort study.

Studies suggest that preterm delivery is a risk factor for early language delays, but knowledge is scarce about the persistence of the delays and whether the association is of a linear kind. To resolve this, effects of confounding risk factors that are both shared within a family and pregnancy specific need to be distinguished from effects of preterm delivery. Our study examines the association between early gestational age and language outcomes, using a sibling-control design. The sample comprises 22,499 siblings from the Norwegian Mother and Child Birth Cohort Study, recruited between 1999 and 2008. Mothers rated child language comprehension and production at 18 and 36 months. Analyses compared siblings discordant on gestational age group (early preterm, delivery at week 22-33; late preterm, 34-36; early term, 37-38; full term, >38) and type of onset of delivery (spontaneous; provider-initiated), and compared these findings with conventional cohort analyses. The findings revealed inverse linear relations between the gestational age groups, and persistent but diminishing language delays. Effects of preterm delivery were substantial on both language production and comprehension at 18 months. By 36 months, the effects of preterm delivery were weaker, but still extensive, in particular for language production in provider-initiated births. When comparing sibling-control with cohort analyses, preterm group was less important among spontaneous births, but remained important in provider-initiated births. Familial and pregnancy risk factors partly explained this. Distinctive factors seem to underlie effects of preterm delivery across spontaneous and provider-initiated births.

Investigating the Influences of Language Delay and/or Familial Risk for Dyslexia on Brain Structure in 5-Year-Olds.

Early language delay has often been associated with atypical language/literacy development. Neuroimaging studies further indicate functional disruptions during language and print processing in school-age children with a retrospective report of early language delay. Behavioral data of 114 5-year-olds with a retrospective report of early language delay in infancy (N = 34) and those without (N = 80) and with a familial risk for dyslexia and those without are presented. Behaviorally, children with a retrospective report of early language delay exhibited reduced performance in language/reading-related measures. A voxel-based morphometry analysis in a subset (N = 46) demonstrated an association between reduced gray matter volume and early language delay in left-hemispheric middle temporal, occipital, and frontal regions. Alterations in middle temporal cortex in children with a retrospective report of early language delay were observed regardless of familial risk for dyslexia. Additionally, while children with isolated familial risk for dyslexia showed gray matter reductions in temporoparietal and occipitotemporal regions, these effects were most profound in children with both risk factors. An interaction effect of early language delay and familial risk was revealed in temporoparietal, occipital, and frontal cortex. Our findings support a cumulative effect of early behavioral and genetic risk factors on brain development and may ultimately inform diagnosis/treatment.

What Our Hands Say: Exploring Gesture Use in Subgroups of Children With Language Delay.

The aim of this study was to investigate whether children with receptive-expressive language delay (R/ELD) and expressive-only language delay (ELD) differ in their use of gesture; to examine relationships between their use of gesture, symbolic comprehension, and language; to consider implications for assessment and for the nature of problems underlying different profiles of early language delay. Twelve children with ELD (8 boys, 4 girls) and 10 children with R/ELD (8 boys, 2 girls), aged 2-3 years, were assessed on measures of gesture use and symbolic comprehension. Performance of the R/ELD group was significantly poorer than performance of the ELD group on measures of gesture and symbolic comprehension. Gesture use and symbolic comprehension were significantly associated with receptive language, but associations with expressive language were not significant. Findings of this study support previous research pointing to links between gesture and language development, and more specifically, between delays in gesture, symbolic understanding, and receptive rather than expressive language. Given potentially important implications for the nature of problems underlying ELD and R/ELD, and for assessment of children with language delay, this preliminary study invites further investigation comparing the use of different gesture types in samples of children matched on age and nonverbal IQ.

Early markers of language delay in children with and without family risk for dyslexia

This study examined the extent to which receptive and productive vocabulary between ages 12 and 18 months predicted language skills at age 24 months in children born with family risk for dyslexia (FR) and a control group born without that risk. The aim was to identify possible markers of early language delay. The authors monitored vocabulary growth in 32 FR children and 21 control children longitudinally by using the Norwegian adaption of the MacArthur–Bates Communicative Development Inventories. The results show different patterns in the two groups: the study found a stronger interdependence of early receptive and productive vocabulary and a stronger stability in vocabulary growth in the second year of life in FR children than in controls. The combination of poor receptive vocabulary at 12 months and poor productive vocabulary at 18 months appeared to be important markers of later language delay in the FR group.

Narrowing Care Gaps for Early Language Delay: A Quality Improvement Study.

Poverty is a risk factor for both language delay and failure to access appropriate therapies. The objective of this study was to increase the percentage of children 0 to 3 years old referred from an urban primary care center who attended an initial appointment with speech pathology or audiology within 60 days from 40% to 60%. The Model for Improvement was used to develop and test the intervention, which addressed potential logistical barriers faced by low-income families. Adherence was plotted on run charts in time series to assess overall improvement, and subgroups were analyzed to identify reduction in disparities. Median referral adherence improved from 40% to 60%. Families from lower income neighborhoods had lower preintervention adherence; these differences were eliminated postintervention. System-level changes improved access to evaluation and treatment for low-income children with language delay and narrowed the gap in access between families in lower versus higher income neighborhoods.