Expressive Language Abilities Research Articles

Patterns of spontaneous neural activity associated with social communication abilities among infants and toddlers showing signs of autism.

Early disruptions to social communication development, including delays in joint attention and language, are among the earliest markers of autism spectrum disorder (autism, henceforth). Although social communication differences are a core feature of autism, there is marked heterogeneity in social communication-related development among infants and toddlers exhibiting autism symptoms. Neural markers of individual differences in joint attention and language abilities may provide important insight into heterogeneity in autism symptom expression during infancy and toddlerhood. This study examined patterns of spontaneous electroencephalography (EEG) activity associated with joint attention and language skills in 70 community-referred 12- to 23-month-olds with autism symptoms and elevated scores on an autism diagnostic instrument. Data-driven cluster-based permutation analyses revealed significant positive associations between relative alpha power (6-9Hz) and concurrent response to joint attention skills, receptive language, and expressive language abilities. Exploratory analyses also revealed significant negative associations between relative alpha power and measures of core autism features (i.e., social communication difficulties and restricted/repetitive behaviors). These findings shed light on the neural mechanisms underlying typical and atypical social communication development in emerging autism and provide a foundation for future work examining neural predictors of social communication growth and markers of intervention response.

Parental linguistic support in a home environment is associated with language development of preschool-aged children.

In today's increasingly digitalised society, there is a growing need for information on how parents can support their children's language development at home. We investigated the associations between three types of parental linguistic support and children's language skills in different domains. Between April 2019 and March 2020, 164 children aged between 2.5 and 4.1 years and their parents were recruited via daycare centres in Helsinki. Information on how frequently parents read, told free stories and sang to their children was collected. The children's lexical and grammatical skills and general language ability were assessed using validated instruments. More frequent reading, storytelling and singing were all separately associated with higher-level expressive lexical and general expressive language ability. More frequent reading and storytelling were also associated with higher-level phonological skills. Only reading was associated with receptive skills. The regression analyses revealed that reading had the highest explanatory value for lexical and general language ability after controlling for the effect of background factors. Furthermore, storytelling had the highest explanatory value for grammatical skills. The results highlight the benefits of parental reading. However, broad use of all parental linguistic activities is recommended to support the development of children's different language domains.

Evaluation of the Effect of Parental Participation on Chinese Adolescent Behavioral Development Through the Mediating Effect of Peers: A Moderated Mediation Model.

With the rapid changes in the social environment, adolescents are facing increasing academic pressure and challenges to their physical and mental development in the socialization process. The purpose of this study was to investigate the influence mechanisms of parental participation on adolescent behavioral development (learning persistence, expressive language ability and knowledge absorption ability), revealing the mediation role of adolescent positive and negative peer interactions between parental participation and behavioral development, and whether differences in parents and children's educational expectations moderate this process. This study was measured using the Parental Participation Questionnaire, Peer Interaction Questionnaire, Behavioral Development Scale, and Educational Expectancy Gap from the China Education Panel Survey. A total of 7730 seventh-grade students and their parents were invited to participate, to establish a moderated mediation model, and the significance of the mediation effect was tested using the bias-corrected percentile Bootstrap method. (1) High frequent parental participation has a significant positive effect on adolescent behavioral development, including behavioral participation, emotional participation, and educational participation all exerting varying degrees of positive influence, as well as positively influencing adolescents' peer interactions. (2) Positive and negative peer interactions play the mediation role of 12.3% and 2.5% respectively in the process of parental participation affecting adolescent behavioral development. (3) Comparing "educational expectation gap - equal", the "educational expectation gap - high" negatively moderates the effect of parental participation on adolescent behavioral development and positive peer interaction (inhibitory effect), the "educational expectation gap - low" positively moderates the effect of parental participation on negative peer interaction (facilitation effect), which meant that the "educational expectation gap - equal" between parents and children is a more desirable state. These findings provide empirical support and effective operational suggestions to further promote positive adolescent behavioral development. Particularly for developing countries, it is recognized that positive parental participation and peer interaction, as well as equal educational expectation of parents and children, are protective factors for adolescent development.

Factors associated with pain intensity and analgesic use during inpatient rehabilitation for hip fracture.

Effective pain management is vital for hip fracture recovery, yet the factors influencing pain reporting and pain medication use during inpatient rehabilitation for hip fractures are not well understood. This observational study aimed to (a) determine how cognitive abilities, expressive and receptive language abilities, and age are related to average daily pain intensity and analgesic use and (b) how average daily pain intensity and analgesic use are related to length of stay and functional outcomes in rehabilitation. Data were retrospectively obtained from 163 patients recovering from unilateral trochanteric fractures of the femur. During the first week of rehabilitation, patients received a daily average of 1,147.8 ± 978 mg of acetaminophen and a morphine milligram equivalent of 15.3 ± 18.2. Multivariable regression revealed independent relationships between more intact general cognitive abilities (B = -0.40, 95% CI [-0.70, -0.11]), and older age (B = -0.41, 95% CI [-0.70, -0.11]) with lower average daily pain intensity. Higher average daily pain intensity (B = 0.97, 95% CI [0.75, 1.20]) was independently related to greater opioid use. The length of stay was shorter among patients administered higher daily doses of acetaminophen (B = 0.03, 95% CI [-0.05, -0.01]). Average daily pain intensity and analgesic use were not related to functional outcomes in multivariable models. These findings inform the considerations for assessing and treating pain during inpatient rehabilitation. Supplemental strategies for assessing pain in older patients and alternative pain mitigation strategies for patients with impaired cognitive abilities should be considered. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Speech Sounds Production, Narrative Skills, and Verbal Memory of Children with 22q11.2 Microdeletion.

22q11.2 deletion syndrome (22q11.2DS), the most frequent microdeletion syndrome in humans, is related to a high risk of developing neurodevelopmental disorders. About 95% of patients with 22q11.2DS have speech and language impairments. Global articulation, story generation, and verbal memory tests were applied to compare articulatory characteristics of speech sounds, spontaneous language abilities, and immediate verbal memory between four groups of Serbian-speaking children: patients with 22q11.2DS, children with clinical presentation of 22q11.2DS that do not have the microdeletion, children with non-syndromic congenital heart defects, and their peers with typical speech-sound development. The obtained results showed that children with this microdeletion have impaired articulation skills and expressive language abilities. However, we did not observe weaker receptive language skills and immediate verbal memory compared to healthy controls. Children with 22q11.2DS should be considered a risk category for the development of speech-sound pathology and expressive language abilities. Since speech intelligibility is an instrument of cognition and adequate peer socialization, and language impairment in school-aged children with 22q11DS might be an indicator of increased risk for later psychotic symptoms, patients with 22q11.2 microdeletion should be included in a program of early stimulation of speech-language development immediately after diagnosis is established.

Resting Frontal Gamma Power is Associated with Both Expressive Language and Non-verbal Cognitive Abilities in Young Autistic Children.

Previous research links resting frontal gamma power to key developmental outcomes in young neurotypical (NT) children and infants at risk for language impairment. However, it remains unclear whether gamma power is specifically associated with language or with more general cognitive abilities among young children diagnosedwith autism spectrum disorder (ASD). The current study evaluates differences in resting frontal gamma power between young autistic and NT children and tests whether gamma power is uniquely associated with individual differences in expressive language, receptive language and non-verbal cognitive abilities in autistic and NT children. Participants included 48 autistic children and 58 age- and sex-matched NT children (ages 22-60months). Baseline electroencephalography (EEG) recordings were acquired from each participant. Children also completed the Mullen Scales of Early Learning (MSEL). We found thatfrontal gamma power at rest did not differ between autistic and NT children. Among autistic children, reduced frontal gamma power was significantly associated with both higher expressive language skills and higher non-verbal cognitive skills, controlling for age and sex. The interaction between frontal gamma power and diagnostic status no longer explained unique variance in expressive language skills after controlling for variance associated with non-verbal cognitive skills across autistic and NT children. Together, these findings suggest that reduced gamma power is associated with both better expressive language and non-verbal cognitive skills among young autistic children. Moreover, associations between high frequency neural activity and cognition are not specific to verbal abilities but reflect neural mechanisms associated with general higher-order cognitive abilities in ASD.

Breaking Sound Barriers: Cultivating Expressive Language in Children with Hearing Impairment Through a Computer-Based Intervention Program

The aim of this study was to assess the effectiveness of a linguistic educational program in improving expressive language skills among individuals with mild hearing impairment in the UAE. To achieve this goal, the researchers designed a computer-based program that targeted expressive language abilities in children with language disorders. The study recruited 30 children who were randomly assigned to either an experimental group, who received the computer-based program, or a control group, who underwent traditional training methods at centers. After conducting an analysis of covariance (ANCOVA), the data showed that the experimental group exhibited noteworthy enhancements in expressive language skills compared to the control group. Moreover, the statistical analysis unveiled that the academic level (grade) had a significant influence on the results, with the third level demonstrating the most substantial progress. However, gender did not appear to have any impact on the findings. Ultimately, the results were thoroughly reviewed and deliberated, culminating in the formulation of a set of recommendations.

Speech and language in DDX3X-neurodevelopmental disorder: A call for early augmentative and alternative communication intervention.

Pathogenic variants in DDX3X are associated with neurodevelopmental disorders. Communication impairments are commonly reported, yet specific speech and language diagnoses have not been delineated, preventing prognostic counseling and targeted therapies. Here, we characterized speech and language in 38 female individuals, aged 1.69-24.34 years, with pathogenic and likely pathogenic DDX3X variants (missense, n = 13; nonsense, n = 12; frameshift, n = 7; splice site, n = 3; synonymous, n = 2; deletion, n = 1). Standardized speech, language, motor, social, and adaptive behavior assessments were administered. All participants had gross motor deficits in infancy (34/34), and fine motor deficits were common throughout childhood (94%; 32/34). Intellectual disability was reported in 86% (24/28) of participants over 4 years of age. Expressive, receptive, and social communication skills were, on average, severely impaired. However, receptive language was significantly stronger than expressive language ability. Over half of the assessed participants were minimally verbal (66%; 22/33; range = 2 years 2 months-24 years 4 months; mean = 8 years; SD = 6 years) and augmented speech with sign language, gestures, or digital devices. A quarter of the cohort had childhood apraxia of speech (25%; 9/36). Despite speech and language impairments, social motivation was a relevant strength. Many participants used augmentative and alternative communication (AAC), underscoring the need for early, tailored, and comprehensive AAC intervention.

School-based delivery of a dialogic book sharing intervention: a feasibility study of Books Together

IntroductionGrowing numbers of children enter mainstream education without the skills needed to prosper in the school environment. Without additional support, these children face poor long-term outcomes in terms of academic attainment, mental health difficulties and social problems. The aim of this study was to investigate the feasibility and acceptability of school-based delivery of the Books Together dialogic book sharing program to groups of parents, and to explore whether it impacts parent and child outcomes in order to facilitate school readiness.MethodsParents of children aged 3–5 years old (n = 16) were recruited from four North Wales primary schools. Video observations of parent/child interactions, a gaming format measure of expressive child language ability, parent-report measures of children’s behavior, and social-emotional ability and of their parental competence were collected pre- and post-intervention. Thematic analysis of interviews with parents and the school-based staff who delivered the program explored feasibility and acceptability of the program.ResultsSignificant post-intervention increases in observed positive parenting and child expressive language skills and significant reductions in observed negative parenting were found. Parents reported significantly higher rates of child prosocial behavior and social/emotional ability as well as improved parenting competency at follow-up. Thematic analysis showed that staff and parents were satisfied with the program and that it was feasible to deliver in a school environment.DiscussionThe Books Together program is a low-cost intervention that, when delivered by school-based staff, shows promise for increasing the use of parenting strategies that build children’s language and social/emotional skills associated with school readiness.

Association between Mother's Educational Status And Home Literacy Environment With The Language Abilities Of Seven Year-Old Children: Path Analysis Evidence

<p><strong>Background</strong><strong>: </strong>Factors that can influence the success of the educational process are family environmental factors, school environment, and community environment. The role of parents is to provide materials and help their children when they experience difficulties in the learning process. Language skills emerge in early childhood and are critical in promoting later literacy competencies, such as reading and writing. The period from birth to age 3 is critical for language development, as nearly all typically developing children acquire important language skills by age 3. During this period, children's home environment is especially important, as parents are the main providers of language input and support, allowing most children to acquire a basic foundation of language.</p><p><strong>Methods: </strong>This study used a cross sectional study design, which was conducted in Surakarta City. A sample of 100 people was selected using a random sampling technique. Data collection was performed using a questionnaire and analyzed by path analysis.</p><p><strong>Results:</strong> The direct relationship between expressive language abilities of children who have mothers with higher education is 2.2 units higher than children with mothers with low education (b=2.2; 95% CI= 0.9 to 3.5; p= 0.001). A high home literacy environment had a log odd of experiencing good expressive language skills of 2.04 units higher than children with a low home literacy environment (b=2.04; 95% CI= 0.7 to 3.3; p= 0.002). The indirect relationship between maternal higher education and expressive language abilities through the child's home literacy environment is statistically significant. Children who have mothers with higher education have log odd for high language expressive abilities of 2.8 units higher than children with mothers with low education (b=2.8; 95% CI= 1.7 to 3.9; p= <;0.001). </p><p><strong>Conclusion:</strong> A child's good expressive language abilities are influenced indirectly by the mother's high education through a high home literacy environment.</p>

Evidence of Language Development Using Brief Animated Stimuli: A Systematic Review.

There is limited evidence regarding the effect of animation compared to static pictures on children's language development. The aim was to systematically review the available literature for evidence concerning the effect of brief animation on spoken language responses (receptive-listening or expressive-speaking) in typically developing (TD) children aged 3 to 9 years. Five databases were searched, resulting in seven included studies. The characteristics of animated stimuli, the manner of presentation, and the language-related tasks were recorded, and questions were posed about the effect of brief animation on children's receptive and expressive language abilities. The evidence suggests that animation may have a positive effect on expressive language abilities of children compared to static pictures. As far as the effect of animation on receptive language performance is concerned, the evidence is less concrete. Future directions regarding the potential of animation on language development are discussed.

The use of Arabic Language Sample Analysis as a screening tool in kindergarten Egyptian bilingual children

BackgroundLanguage sample analysis is a naturalistic method used for measuring child’s expressive language abilities. It is used in case of difficulty in direct interaction in remote places or pandemics.Aim of the workThe aim of this study is to evaluate the use of a language sample analysis as an easy applicable screening tool for narrative ability in kindergarten Egyptian bilingual children in order to reach a better understanding of their language profile. Subjects and methods: 150 bilingual Egyptian preschool male and female children exposed to Arabic and English languages were included and divided into two groups according to their age. All were subjected to the BEA-LSA narration assessment including macrostructure, microstructure items, and conversation assessment including verbal and nonverbal items.ResultsThe results revealed that bilingual children showed better performance in English than Arabic in most of the narration and conversation tasks. However, there was equal development between both age groups in English language regarding temporality, connectives, and reference clarity. The older age group showed higher code switching than younger age group and code switching occurred more from Arabic to English language. Both age groups bilingual children showed better frequency of words and mean length of utterance in narration. While in conversation, both age groups showed better type token ratio. Language sample analysis showed good test–retest reliability.ConclusionLanguage sample analysis could identify the characteristic profile of bilingual kindergarten Egyptian children and was a reliable method to analyze both narration and conversation skills of bilingual children.

Factors associated with receptive and expressive language in autistic children and siblings: A systematic review.

Language abilities of autistic children and children at elevated likelihood for autism (EL-siblings) are highly heterogeneous, and many of them develop language deficits. It is as of yet unclear why language abilities of autistic children and EL-siblings vary, although an interaction of multiple influential factors is likely at play. In this review, we describe research articles that identify one or multiple of such factors associated with the receptive or expressive language abilities of autistic children and EL-siblings since the introduction of the DSM-5. Our aim was to identify and summarize factors that are linked to language development in autistic children and siblings in the recent literature to ultimately gain insight into the heterogeneity of language abilities in these children. The search strategy of this review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were consulted: Embase, MEDLINE, Web of Science Core Collection, and Scopus. Inclusion criteria for studies were the presence of a sample of autistic children no older than 7 years old who were diagnosed with autism spectrum disorder per the criteria of the DSM-5. Intervention studies and studies without an explicitly reported language measure were excluded. Risk of bias assessment was completed using the Newcastle-Ottawa Scales. Ultimately, 55 articles were included in this review. Fifty-six factors were identified to be related to receptive or expressive language abilities of autistic children and EL-siblings. They were grouped into three main categories: biological factors; psychosocial and environmental factors; and age-related and developmental factors, each with different subcategories. Although many of the identified variables were only examined in one article, some well-researched associated factors were reported across multiple studies and were present in both autistic children and EL-siblings, in particular joint attention, nonverbal cognitive abilities and frontal EEG power. Better insight in these factors associated with language abilities in autistic children and siblings at elevated likelihood can inform future intervention strategies to reduce language deficits and its corresponding negative consequences in these children. Our results confirm that multiple different factors likely underlie language deficits in autism. Important aspects that should be considered are, among others, social factors such as joint attention, child characteristics such as nonverbal cognition, and neurocognitive factors.

Efficacy of Script Training on Broca’s Aphasia Patients

Background: Broca’s Aphasia is a language disorder characterized by difficulties in speech production and fluency, significantly affecting communication. Script training, a language rehabilitation technique, has shown promise in treating this condition. However, its efficacy in a controlled clinical setting had yet to be fully explored. Objective: The objective of this study was to assess the effectiveness of script training in improving the expressive language abilities of individuals with Broca’s Aphasia. Methods: This case report study was conducted over a period of six months at the University of Lahore Teaching Hospital. Using purposive sampling, patients diagnosed with Broca’s Aphasia were selected. Participants underwent script training sessions, which involved repetitive practice of personalized scripts. The Mississippi Aphasia Screening Test (MAST) was employed for initial assessments and tracking progress. Ethical considerations were strictly adhered to, with informed consent obtained from all participants. The study included both quantitative and qualitative methods for data analysis. Results: The study demonstrated significant improvements in participants' expressive language abilities. Pre-therapy MAST scores averaged at 10/50, which increased to an average of 23/50 post-therapy. Notable areas of improvement included Naming (from 3/10 to 6/10), Automatic Speech (from 1/10 to 6/10), and Verbal Fluency (from 1/10 to 6/10). However, Repetition and Writing/Spelling showed minimal changes. Conclusion: Script training showed a significant positive impact on the expressive language skills of individuals with Broca’s Aphasia. This suggests that script training can be a beneficial therapeutic intervention in the language rehabilitation of Broca’s Aphasia patients, particularly in enhancing Naming, Automatic Speech, and Verbal Fluency. Future studies should investigate long-term effects and the integration of script training with other therapeutic approaches.

Cross-Sectional Analysis of Caregiver-Reported Expressive Language Profiles and Associated Covariates in Individuals with Down Syndrome.

To describe the distribution of expressive language abilities of individuals with Down syndrome (DS) in a clinical sample and characterize demographic, environmental, and medical factors associated with varying expressive language profiles. Cross-sectional analysis was completed on a sample of 345 individuals with DS between the ages of 4 and 22 years who were enrolled into a longitudinal clinical database between March 2018 and August 2021. Expressive language-related items on a standardized caregiver-reported questionnaire assessing domains of functioning in neurodevelopmental disorders were used to conduct latent variable modeling and determine caregiver-reported expressive language (CREL) classes across the sample. Linear regression was used to explore associations between CREL classes and predictor variables. Latent variable modeling revealed 3 distinct classes of CREL abilities representing higher, middle, and lower CREL. Individuals in the lower CREL class were more likely to be female, to use sign language or visual communication systems, have reduced pronunciation, attend private or residential school, and to be in a substantially separate classroom. Membership was not predicted by complex medical histories or co-occurring neurodevelopmental diagnoses. Caregiver-reported expressive language abilities in a cohort of individuals with DS were variable, with most of the individuals belonging to higher or middle CREL classes, relative to one another. Additional studies are indicated to understand factors that predict higher expressive language ability and explore how to direct services to individuals who are at risk of more profound language delays.

Pengaruh Dukungan Sosial Keluarga terhadap Kemampuan Bahasa Ekspresif Anak Autisme di Pusat Layanan Autis Yogyakarta

ABSTRACT
 Research Background: Family is the closest social environment that is owned by every human being. Social support is the perception and reality that an individual can get help from other people in his social network. Expressive language is the language children use to express their desires and to ask and answer questions. Children with autism disorder are children who have problems in aspects of language, one of them is expressive language. Goals: This research aims to determine whether family social support can affect the expressive language skills of children with autism at the Yogyakarta Autism Service Center. Methods: This research is a quantitative research with cross sectional research design. The sampling technique used a purposive sampling technique with a total sample of 30 autistic children at the Yogyakarta Autism Service Center. The data in this study were analyzed univariately and bivariately. The statistical test used is the Spearment Rank test. Research Result: The test results of bivariate analysis of family social support with expressive language skills of children with autism showed that ρ=0.000 with a correlation coefficient of r=0.628 it’s means that there is an influence between family social support and expressive language abilities of children with autism at the Yogyakarta Autism Service Center. The relationship between the two variables is included in the strong category with a positive direction. Conclusion: Family social support influences the expressive language skills of children with autism at the Yogyakarta Autism Service Center.
 Keywords: Family Social Support, Expressive Language Skills, Autism.

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.

Piloting building early sentences therapy for pre-school children with low language abilities: An examination of efficacy and the role of sign as an active ingredient.

Early intervention is recommended for pre-school children with low language. However, few robustly evaluated language interventions for young children exist. Furthermore, in many interventions the theoretical underpinnings are underspecified and the 'active ingredients' of the interventions not tested. This paper presents a quasi-experimental study to test the efficacy and examine the active ingredients of Building Early Sentences Therapy (BEST): an intervention based on usage-based theory designed to support young children to understand and produce two-, three- and four-clause element sentences. BEST manipulates the input children hear to support them to harness the cognitive mechanisms hypothesized in usage-based theories to promote the development of abstract linguistic representations. One such input manipulation is the use of signing alongside verbal input signalling both content and morphology of target sentences. To examine whether (1) BEST is more efficacious than treatment as usual (TAU); and (2) signing of content and morphology is an active ingredient of the intervention. A quasi-experimental study recruited children aged 3;5-4;5 years from 13 schools. Schools were assigned to receive either BEST with sign, BEST without sign or TAU. The TAU group received their usual classroom provision. Across arms schools were matched with respect to classroom oral language environment and indices of deprivation. Participants were 48 children (28 boys) with expressive and/or receptive language abilities ≤ 16th centile measured using the New Reynell Developmental Language Scales (NRDLS). Outcomes gathered by researchers blind to treatment arm were NRDLS production and comprehension standard scores and measures of production of targeted sentence structures. Primary outcomes indicate that BEST with sign was significantly more efficacious than TAU with respect to NRDLS production standard score, but not comprehension. The advantage for production was maintained at follow-up. BEST without sign was significantly more efficacious than TAU on measures of targeted vocabulary, sentence structure and morphology. The results from this quasi-experimental study provide evidence for the efficacy of a usage-based intervention on expressive language outcomes for preschool children with low language abilities. There is also evidence to support the inclusion of sign as an active ingredient, and so efforts to train interventionists in its use are worthwhile. Patterns of findings across outcomes suggest signing of content and morphology may support the development of abstract linguistic representations and accelerate language learning. Given these positive results and the scale of this study, a fully powered randomized controlled trial is warranted. What is already known on the subject Robust language skills are crucial for positive social, emotional, academic and economic outcomes across the lifespan. There is a paucity of robustly evaluated interventions for preschool children with language difficulties. The development of such interventions is crucial for ameliorating language difficulties and promoting positive educational and psychosocial outcomes. What this study adds to the existing knowledge This paper evaluates BEST, a novel usage-based language intervention targeting children with language difficulties in the early years. Findings indicate that a usage-based intervention is efficacious for treating language difficulties. In particular, BEST benefited expressive language development, bringing benefits to both treated and untreated language structures and improving standard scores. The role of sign as an active ingredient is also supported. Further evaluation is warranted. What are the practical and clinical implications of this work? Findings suggest that BEST may be effective for targeting children who have been identified as having language difficulties. In particular, expressive language may be improved when the intervention is delivered as it was originally manualized, including a signing system to represent content and grammatical morphology. More broadly, these findings also provide preliminary evidence that the use of a signing system does not hinder oral language development in children with language difficulties and may conversely support their expressive language. Future research exploring the role and underpinning mechanisms of sign in language intervention is warranted.

Determining an Effective Language Sample Elicitation Strategy for Early Language Learners Who Speak Using Augmentative and Alternative Communication.

This study evaluates three different language sample elicitation strategies to determine a valid elicitation strategy for early language learners who speak using augmentative and alternative communication (AAC). Ten children who speak using AAC participated in this study. Language samples were elicited from each participant using three strategies: the Communication and Symbolic Behavior Scales (CSBS), a generic play-based elicitation strategy, and automatic data logging. Samples were transcribed and coded. Additionally, each participant's school speech-language pathologist completed a Communication Matrix. Data from coded language samples were correlated with Communication Matrix results to determine the elicitation strategy that yielded the most valid language sample in comparison to Communication Matrix results. Both the CSBS and the play-based strategy yielded clinically relevant information. Because the log lacked communicative context, resulting data from the log was limited. An analysis of variance revealed significant differences in the amount of information elicited from each elicitation strategy. The CSBS repeatedly elicited the most data, followed by the play-based strategy and then the log. Generic play-based strategy results yielded the most correlations with Communication Matrix data. This preliminary data suggest that the play-based elicitation strategy elicited the most valid language sample when compared to the Communication Matrix from early language learners who speak using AAC. Additionally, results suggest that the CSBS may be an effective tool to measure the limits of this population's expressive language abilities.

Cerebral perfusion in post-stroke aphasia and its relationship to residual language abilities.

Stroke alters blood flow to the brain resulting in damaged tissue and cell death. Moreover, the disruption of cerebral blood flow (perfusion) can be observed in areas surrounding and distal to the lesion. These structurally preserved but suboptimally perfused regions may also affect recovery. Thus, to better understand aphasia recovery, the relationship between cerebral perfusion and language needs to be systematically examined. In the current study, we aimed to evaluate (i) how stroke affects perfusion outside of lesioned areas in chronic aphasia and (ii) how perfusion in specific cortical areas and perilesional tissue relates to language outcomes in aphasia. We analysed perfusion data from a large sample of participants with chronic aphasia due to left hemisphere stroke (n = 43) and age-matched healthy controls (n = 25). We used anatomically defined regions of interest that covered the frontal, parietal, and temporal areas of the perisylvian cortex in both hemispheres, areas typically known to support language, along with several control regions not implicated in language processing. For the aphasia group, we also looked at three regions of interest in the perilesional tissue. We compared perfusion levels between the two groups and investigated the relationship between perfusion levels and language subtest scores while controlling for demographic and lesion variables. First, we observed that perfusion levels outside the lesioned areas were significantly reduced in frontal and parietal regions in the left hemisphere in people with aphasia compared to the control group, while no differences were observed for the right hemisphere regions. Second, we found that perfusion in the left temporal lobe (and most strongly in the posterior part of both superior and middle temporal gyri) and inferior parietal areas (supramarginal gyrus) was significantly related to residual expressive and receptive language abilities. In contrast, perfusion in the frontal regions did not show such a relationship; no relationship with language was also observed for perfusion levels in control areas and all right hemisphere regions. Third, perilesional perfusion was only marginally related to language production abilities. Cumulatively, the current findings demonstrate that blood flow is reduced beyond the lesion site in chronic aphasia and that hypoperfused neural tissue in critical temporoparietal language areas has a negative impact on behavioural outcomes. These results, using perfusion imaging, underscore the critical and general role that left hemisphere posterior temporal regions play in various expressive and receptive language abilities. Overall, the study highlights the importance of exploring perfusion measures in stroke.