Expressive Language Outcomes Research Articles

DNA methylation signatures of prenatal socioeconomic position associated with 36-month language outcomes

BackgroundSocioeconomic position (SEP), which reflects one’s position in society and access to resources, is strongly tied to neurodevelopment and is associated with epigenetic changes. AIM: This study examined whether DNA methylation signatures of prenatal SEP, measured in birth samples, are associated with child neurodevelopmental outcomes at 36 months of age. METHODS: Prenatal SEP DNA methylation scores were derived using 97 placenta and 127 cord blood biospecimens in the Early Autism Risk Longitudinal Investigation cohort. Participants completed the Mullen Scales of Early Learning (MSEL) and Vineland Adaptive Behavior Scales (VABS) at 36 months of age. Generalized regression analyses, adjusting for maternal age and race, were performed to test the association between SEP methylation score, for each birth biospecimen type, and MSEL and VABS scores. RESULTS: Significant associations were observed between placenta SEP methylation score and MSEL Expressive Language outcomes (beta = −2.7, p = 0.046, 95 % CI [- 5.43, −0.05]) and Receptive Language outcomes (beta = −2.5, p = 0.037, 95 % CI [-4.82, −0.16]). In cord blood, methylation-SEP scores were significantly associated with Receptive Language outcomes (beta = −2.0, p = 0.037, 95 % CI [-3.85, −0.12]). No significant associations were observed with VABS scores. CONCLUSION: Our results confirm associations between prenatal SEP and early childhood language development using a novel empiric DNA methylation measure of exposure.

Parenting stress in infancy was associated with neurodevelopment in 24-month-old children with congenital heart disease.

Having a child with congenital heart disease (CHD) is stressful for parents, but research on the impact this stress can have on child development has been lacking. We investigated the associations between parenting stress when children were infants and neurodevelopmental outcomes in toddlers with CHD. This study was carried out at the Neurocardiac Clinic at the Sainte-Justine University Hospital in Montréal, Canada. Patients born from 2012 to 2019 and followed up to 24 months of age were recruited. Parenting stress levels were measured when the child was 4-6 months and 24 months and the child's neurodevelopment was assessed at 24 months. Multiple linear regressions analyses were carried out. We studied 100 children (56% boys) with CHD. Most of the parenting stress scores were below the clinical threshold. However, they accounted for a significant part of the variance in the children's cognitive (15%-16%), receptive language (14%-15%) and gross motor outcomes (15%-18%). They had no impact on the children's expressive language or fine motor outcomes. Higher parenting stress was associated with poorer neurodevelopmental outcomes in toddlers with CHD. Early screening of parenting stress in CHD clinics is necessary to provide individualised intervention for parents and optimise neurodevelopmental outcomes in children.

Language outcomes of preschool children who are HIV-exposed uninfected: An analysis of a South African cohort.

There are approximately 16 million children who are HIV-exposed and uninfected (CHEU) worldwide. Studies suggest that CHEU are at risk for developmental impairment in infancy, particularly in language domains. However, there is limited research examining neurocognitive function in CHEU older than 2 years, including important pre-school years. This study aimed to investigate associations between HIV exposure without infection and neurocognitive outcomes and to determine risk factors for neurodevelopment in CHEU at age 3-4 years. The Drakenstein Child Health Study is a South African population-based birth cohort which enrolled women in pregnancy with ongoing follow up. Neurocognitive outcomes were assessed in children at 3.5 years by trained assessors blinded to HIV status including general cognitive function, language, and memory, measured using the Kaufmann Assessment Battery for Children, Second Edition (KABC-II). Data were compared between CHEU and children who were HIV-unexposed uninfected (CHUU) using multivariable logistic and linear regression, including testing for effect modification; sex-stratified risk factor analyses were performed. A total of 497 children were included (97 [20%] CHEU; 400 [80%] CHUU; 50% male), with a mean age of 3.5 years (range 3.4-3.6). Groups had similar birth and household characteristics, although mothers of CHEU were older, on average. Overall, CHEU had lower expressive language scores compared to CHUU on unadjusted and adjusted analyses (effect size: -0.23 [95% CI -0.45, -0.01]). There were no group differences in general cognitive or memory function (p>0.05). On sex-stratified analyses, male CHEU were found to have higher odds of suboptimal cognitive development compared to male CHUU (aOR 2.28 [95% CI 1.06, 4.87], p = 0.034). Several other factors including birthweight, maternal education, maternal ART duration and HIV viral load during pregnancy were associated with cognition, memory, or expressive language outcomes in CHEU, dependent on child sex. The findings suggest that perinatal HIV exposure continues to be associated with impaired language development across the preschool years, highlighting the importance of targeting early interventions to optimise language outcomes. Further, the results suggest the importance of demographic, biological and HIV-related variables influencing developmental outcomes in CHEU. The greater risk of suboptimal cognitive development in male CHEU requires investigation around sex-specific mechanisms.

Abstract WP220: Structural Connectivity Injury is Associated With Poor Language Outcomes in Perinatal Stroke

Introduction: Perinatal stroke refers to brain injury sustained between 28 weeks of gestational age (GA) and 28 days of life. Stroke risk in the newborn period is significantly higher relative to other life stages, and over half of all survivors endure lifelong neurological sequalae. Language deficits are observed in many patients, can emerge at any stage in development, and are difficult to predict. Lesion laterality and location are not sufficient to explain language outcomes in a rapidly developing brain with capacities for reassignment of functions to non-injured structures. Structural connectivity studies describe a “rich club” organization of the brain with 6 bilateral highly connected anatomical structures that form the information backbone for all networks. This organization has been found to exist as early as 30 weeks GA. The effects of injury to this rich club have been studied in adult stroke patients with respect to stroke severity and outcome. Given that language is a network function, we hypothesized that injury to rich club regions - a measure of structural network disruption - is associated with poor language outcomes in perinatal stroke. Methods: Retrospective study that identified perinatal stroke patients in a pediatric stroke clinic database. Clinical and imaging data retrieved included brain MRI scans and longitudinal scores of standardized neuropsychological tests. Multiple linear regression models were created for the following variables: age, sex, Autism Spectrum Disorder diagnosis, lesion volume (cm 3 ), and number of rich clubs affected by the stroke. All analyses were conducted using the computing environment R. Significance was set at p < 0.05. Results: Cohort of 75 patients was identified. Median time to follow up was 7 years, and median time between the first and last test was 30 months. Lesion volume significantly influenced receptive language outcomes at younger ages (beta = -0.446), however the number of rich clubs affected by the injury was the only significant variable associated with a poor expressive language outcome at follow-up (beta = -0.699). Discussion: Number of rich clubs affected by injury, as a global measure of structural network disruption in the neonatal period, can be used to inform language outcome prognostication.

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.

Impact of auditory environments on language outcomes in children with a cochlear implant

Objectives To analyse the effects of auditory environments on receptive and expressive language outcomes in children with a CI. Design A single-institution retrospective review was performed. The auditory environments included Speech-Noise, Speech-Quiet, Quiet, Music, and Noise. Hearing Hour Percentage (HHP) and percent total hours were calculated for each environment. Generalised Linear Mixed Models (GLMM) analyses were used to study the effects of auditory environments on PLS Receptive and Expressive scores. Study Sample Thirty-nine children with CI Results On GLMM, an increase in Quiet HHP and Quiet percent total hours were positively associated with PLS Receptive scores. Speech-Quiet, Quiet, and Music HHP were positively associated with PLS Expressive scores, with only Quiet being significant for percent total hours. In contrast, percent total hours of Speech-Noise and Noise had a significant negative association with PLS Expressive scores. Conclusions This study suggests that more time spent in a quiet auditory environment positively influences PLS Receptive and Expressive scores and that more time listening to speech in quiet and music positively influences PLS Expressive scores. Time spent in environments recognised as Speech-Noise and Noise might negatively impact a child’s expressive language outcomes with a CI. Future research is needed to better understand this association.

Expressive language sampling and outcome measures for treatment trials in fragile X and down syndromes: composite scores and psychometric properties

The lack of psychometrically sound outcome measures has been a barrier to evaluating the efficacy of treatments proposed for core symptoms of intellectual disability (ID). Research on Expressive Language Sampling (ELS) procedures suggest it is a promising approach to measuring treatment efficacy. ELS entails collecting samples of a participant’s talk in interactions with an examiner that are naturalistic but sufficiently structured to ensure consistency and limit examiner effects on the language produced. In this study, we extended previous research on ELS by analyzing an existing dataset to determine whether psychometrically adequate composite scores reflecting multiple dimensions of language can be derived from ELS procedures administered to 6- to 23-year-olds with fragile X syndrome (n = 80) or Down syndrome (n = 78). Data came from ELS conversation and narration procedures administered twice in a 4-week test–retest interval. We found that several composites emerged from variables indexing syntax, vocabulary, planning processes, speech articulation, and talkativeness, although there were some differences in the composites for the two syndromes. Evidence of strong test–retest reliability and construct validity of two of three composites were obtained for each syndrome. Situations in which the composite scores would be useful in evaluating treatment efficacy are outlined.

Impact of Sociodemographic Disparities on Language Outcomes After Cochlear Implantation in a Diverse Pediatric Cohort.

We examined how sociodemographic and audiologic factors affect receptive and expressive language outcomes in children with cochlear implantation. Retrospective cohort study. A hearing loss (HL) clinic at a tertiary center. Sociodemographic variables, HLcharacteristics, age at implantation, and receptive language scores (Preschool Language Scale and the Clinical Evaluation of Language Fundamentals) were collected from patients with congenital HL who received their first implant by 4 years old after January 1, 2007. tTests, linear regression, Mann-Whitney, Cohen's d, and mediation analysis were used for descriptive statistics and hypothesis testing. Among 79 patients, 42 (53%) were females, 44 (56%) under-represented minorities, and 56 (71%) had public insurance. At least 1 year after implantation, the median receptive language score was 69 (range 50-117). Females (p = .005), having private insurance (p = .00001), having a Cochlear Implant Profile score below 4 (p = .0001), and receiving their implant at or before 12 months of age (p = .0009) were significantly associated with improved receptive language outcomes. Insurance type had a significant effect on receptive language outcomes, independent from age at first implantation (total effect: coef = -13.00, p = .02; direct effect: coef = -12.26, p = .03; indirect effect: coef = -0.75, p = .47). Sociodemographic variables had large effect sizes, with the Cochlear Implant Profile score having the largest effect size (d = 1.3). Sociodemographic factors have a large impact on receptive language outcomes. Public insurance is associated with worse receptive language, not mediated by later age at implantation, suggesting that other factors primarily impact language outcomes in publicly insured children with cochlear implants.

Fine motor skill and expressive language in minimally verbal and verbal school-aged autistic children.

Fine motor skill is associated with expressive language outcomes in infants who have an autistic sibling and in young autistic children. Fewer studies have focused on school-aged children even though around 80% have motor impairments and 30% remain minimally verbal (MV) into their school years. Moreover, expressive language is not a unitary construct, but it is made up of components such as speech production, structural language, and social-pragmatic language use. We used natural language sampling to investigate the relationship between fine motor and speech intelligibility, mean length of utterance and conversational turns in MV and verbal autistic children between the ages of 4 and 7 while controlling for age and adaptive behavior. Fine motor skill predicted speech production, measured by percent intelligible utterances. Fine motor skill and adaptive behavior predicted structural language, measured by mean length of utterance in morphemes. Adaptive behavior, but not fine motor skill, predicted social-pragmatic language use measured by number of conversational turns. Simple linear regressions by group corrected for multiple comparisons showed that fine motor skill predicted intelligibility for MV but not verbal children. Fine motor skill and adaptive behavior predicted mean length of utterance for both MV and verbal children. These findings suggest that future studies should explore whether MV children may benefit from interventions targeting fine motor along with speech and language into their school years.

Predictors in language proficiency of young children with presumed developmental language disorder within the setting of early language intervention

IntroductionIn the Netherlands, early language intervention is offered to children with presumed Developmental Language Disorder (DLD). The intervention is a combination of group language intervention, individual speech and language therapy and parent-implemented language intervention. During the intervention, some children show more language progress than others. It is unclear what might explain this variation. In this study, we therefore explored to what extent child, parental, and treatment factors were predictive for receptive and expressive language outcomes of young children with presumed DLD during early language intervention.MethodsFour multiple regression analyses were conducted with four child factors [pre-test receptive syntax, behavior (internalizing and externalizing), non-verbal cognitive ability and gender], one parental factor (parental stress) and one treatment factor (treatment duration) as predictors and receptive and expressive language post-test scores as outcomes. For each language post-test, the corresponding pre-test language measure was also added. Data of 183 children with presumed DLD were included.ResultsReceptive syntax problems were an important predictor of expressive language outcomes. Findings also showed a longer treatment duration to be a predictor of progress in expressive vocabulary. Internalizing behavior, externalizing behavior, non-verbal cognitive ability, gender and parental stress did not contribute to predicting language outcomes. Lower pre-intervention language scores led to lower corresponding post-intervention language scores.ConclusionsProfessionals may need to be aware that children with receptive problems may be indicative of more pervasive impairment and that it can be more difficult to improve their language problems. In fact, children with receptive language problems may need both more and different approaches. The finding that the level of the pre-intervention score has an essential influence on language outcomes underlines the importance of early diagnosis and early intervention, to prevent language problems increasing.

Pre-linguistic social communication skills and post implant language outcomes in deaf children with cochlear implants.

PurposeThis study investigates the relationship between pre-linguistic social communication skills and age of cochlear implant for future language outcomes in a large sample of deaf children. MethodA retrospective cohort study of records from 75 children. Pre-implant data included Age at Implant, pre-linguistic communication (social, symbolic and speech) skills, and non-verbal ability. Receptive and expressive language development data at 1 year, 2 years and 4 years post implant were analysed to investigate the relationships between pre-implant factors and language outcomes, in particular pre-linguistic social communication skills in early and late implanted children. ResultsAge at Implant was the strongest correlate of post implant expressive and receptive language outcomes. The sample was divided into early implanted (<18 month) and late implanted (>18 months) children. In the early implanted group, pre-linguistic social communication skills were the strongest pre-implant correlate of language outcomes four years post-implant. In the late implanted group, there were no significant pre-implant correlates of language outcomes. ConclusionsLong term language outcomes after cochlear implantation are the product of a set of communicative, cognitive and environmental factors. Early pre-implant social communication skills are an important consideration for clinicians who guide parents as to likely long-term outcomes post cochlear implantation. Social communication skills are particularly important for children who receive implants before the age of 18 months.

Expressive language in infancy and toddlerhood: The roles of child temperament and maternal parenting behaviors.

Prompt, appropriate, and contingent maternal behaviors play a role in early language acquisition, as do individual differences in children's temperament. However, little work has investigated the combined influence of maternal psychosocial and child biological factors on expressive language development. The purpose of this study was to evaluate the concurrent and longitudinal contributions of responsive/intrusive parenting and child temperament to multiple expressive language outcomes at 10 and 24 months of age. Participants included 407 mothers and children (209 girls). Mothers completed questionnaires about their infant's temperament and language, and maternal parenting was coded during mother–child interaction tasks. Dependent variables included (1) gestures at 10 months, (2) vocabulary at 24 months, (3) mean length of utterance at 24 months, and (4) sentence complexity at 24 months. After controlling for child sex and maternal education, child temperament was associated with language outcomes at 10 and 24 months, whereas intrusive, but not responsive, parenting related to only 24 month language outcomes. Longitudinally, infant negative affectivity predicted sentence complexity in toddlerhood. These findings elucidate the presence of both psychological and biological predictors as they differentially influence various aspects of expressive language development across the first two postnatal years.

Diagnosis and Treatment of Childhood Apraxia of Speech Among Children With Autism: Narrative Review and Clinical Recommendations.

Treatment for children with autism spectrum disorder (ASD) and low verbal ability is a largely neglected area of study. Existing research focuses on language abilities; however, a subset of children with ASD also has speech sound disorders (SSDs). The purpose of this tutorial is to provide clinicians with evidence-based recommendations to guide speech assessment and treatment among children with ASD, low verbal ability, and suspected childhood apraxia of speech (CAS). Multifaceted search procedures were used to identify studies that have assessed or treated speech sound production among children with ASD. A narrative review and synthesis of the literature is followed by practical clinical recommendations based on best available evidence. It is critically important to consider all possible hindrances to the development of functional communication ability for children with ASD. Speech sound production has been identified as a key predictor of expressive language outcomes, yet there are very few studies that address assessment and treatment of SSDs among children with ASD. Less is known about the presentation of CAS among children with ASD and low verbal ability. More research is needed to determine whether existing speech assessment and treatment methods are appropriate for children with ASD, if modifications are needed, or if new methods should be designed.

Diversity of Child and Family Characteristics of Children with Hearing Loss in Family-Centered Early Intervention in The Netherlands.

Background: Family-centered early intervention (FCEI) for children with hearing loss (HL) supports caregivers to promote their children’s language development. To provide FCEI services that are relevant and accessible to meet diverse needs, insight into the characteristics of children with HL is important. In the current study, various characteristics of children with HL and intervention-related factors are examined in relation to spoken language outcomes. Methods: Child and family characteristics, language outcomes and data on intervention were extracted from FCEI records for 83 children. Family involvement ratings were obtained from EI providers. Relations between characteristics, intervention, family involvement and language outcomes were analyzed and predictors for children’s language outcomes were investigated. Results: The characteristics of children with HL in FCEI are very diverse. Family involvement and the occurrence of additional disabilities were predictive for children’s receptive and expressive language abilities; the start of FCEI was not. Maternal education was predictive for expressive language outcomes only. Conclusions: The current study showed the diversity in characteristics of children with HL and their families in the degree of HL, etiology, cultural background, home language, family involvement and additional disabilities. We conclude that ’one size does not fit all’, and FCEI programs should acknowledge the unique strengths and challenges of every individual family.

Abstract WP173: Children’s Post-Stroke Expressive Language Outcomes Are Affected By Bilingual Exposure

Introduction: Approximately 2/3 of children face neurological deficits following arterial ischemic stroke (AIS). In neurotypical development, bilingualism is thought to confer certain linguistic and cognitive advantages. However, research on whether this may affect development in bilingual pediatric stroke patients is scarce. Objectives: To evaluate the effects of bilingual vs. monolingual exposure on language and cognitive outcomes in children following arterial ischemic stroke across two studies: (1) large-scale group analysis using the Pediatric Stroke Outcome Measure (PSOM); (2) exploratory case studies using neuropsychological measures. Methods: An institutional stroke registry and chart review were used to gather patient and stroke data, including the Pediatric Stroke Outcome Measure (PSOM) and standardized neuropsychological measures performed at several timepoints post-stroke in children with AIS. In Study 1, growth curve modeling based on PSOM subscales, predicted by age at stroke groups, language groups and their interactions was used. In Study 2, comparative case studies were conducted with a monolingual-bilingual pair, aged 7 and 8 at stroke onset. Results: In Study 1, 237 patients were identified (44%, bilingual patients). Patients were stratified based on age at stroke onset i.e. neonatal (&lt;28 days of life), first-year (28 days-12 months) and childhood (13 months - 18 years). On the PSOM’s language expression subscale, an interaction revealed better post-stroke outcomes among bilingual children aged 1-12 months at stroke (beta = -0.32, t =-2.33, p = 0.02). In Study 2, the bilingual’s performance on neuropsychological assessments corroborated findings of Study 1, favoring a recovery of expressive language. Conclusion: Overall, we found no negative consequences of a bilingual environment on post-stroke outcomes. Additionally, it is possible that bilingualism has a faciliatory effect on expressive language development post-stroke. Further research should evaluate linguistic advantage effects prospectively in bilingual children with stroke and a control group.

An Overview of the Effect of Age at Time of Cochlear Implantation on Language Outcomes in Jordan: A Retrospective Cohort Study.

Cochlear Implantation (CI) surgery has long been used as an effective treatment for children with bilateral profound sensorineural hearing loss who failed to benefit from the use of hearing aids. Among other factors, the age at which implantation is done is thought to have an effect on the speech progression outcome of patients postoperatively. The Jordanian CI Program has limited resources, and Jordan has an underdeveloped early screening and intervention program for deafness. In this study, we aimed to explore the effect of age at time of implantation on receptive and expressive language outcomes in Jordan, to guide funding and focus efforts on patient groups who would benefit most, thus reducing unnecessary longterm morbidity and disability, and improving cost efficiency. Data was gathered from all major sectors in Jordan on patients who underwent CI from 2006 to 2018 (a total of 1815 patients). We compared the language outcome 2 to 4 years after implantation for patients aged below 3 years, 3 to under 6, 6 to under 9 years, and 9 and older at the time of implantation. We found a statistically significant difference in language outcomes between patients aged below 6 years vs those 6 and older, with better receptive and expressive language outcomes in the younger age groups.

Shared Interactive Book Reading Interventions for Young Children With Disabilities: A Systematic Review

Purpose Shared interactive book reading (SIBR) is an evidence-based practice for young children who are typically developing and those with developmental disabilities or considered at risk for developmental delays. The purpose of this review was to provide a comprehensive examination of the evidence of using SIBR to facilitate growth in language skills for young children with developmental disabilities and/or delays. Specifically, authors examined the descriptive characteristics, study rigor, and effect sizes for language and literacy outcomes. Method We extracted data from studies meeting specified criteria (n = 23) published in peer-reviewed journals on a wide range of variables, including participant characteristics, setting, training/coaching, defined independent and dependent variables, study rigor, and overall outcomes. Descriptive and study rigor data were aggregated using descriptive statistics. Effect-size estimates were calculated for all child outcomes related to language. Results Descriptive data were variable across studies. Three single-case experimental design and three group design studies met design standards without reservations. Single-case experimental design studies overall showed positive effects on child language and communication. Within group design studies, expressive language outcomes showed the largest effect sizes. Conclusion A review of SIBR studies indicates this as a viable intervention to positively impact the language skills of young children with developmental disabilities and/or delays. Supplemental Material https://doi.org/10.23641/asha.16674355.

Children with ASD and Communication Regression: Examining Pre-Loss Skills and Later Language Outcomes Through the Preschool Years.

This study investigated receptive and expressive language outcomes in children with autism spectrum disorder (ASD) with and without a history of language/communication regression, employing three progressively less stringent definitions of regression. Data were derived from a large, longitudinal sample of children with ASD in which regression was assessed at approximately 30months. Results indicated poorer receptive language and larger discrepancies between receptive and expressive language in the regression group than the group without regression at 44months but not 66months. Number of words used before loss predicted receptive language at 44months. Overall, results suggest that a regression profile in ASD is associated with modest and transient impacts on language outcomes that are no longer discernable at school entry.

Preschool Language Development of Children Born to Women with an Opioid Use Disorder.

Increasing evidence suggests that prenatal exposure to opioids may affect brain development, but limited data exist on the effects of opioid-exposure on preschool language development. Our study aimed to characterize the nature and prevalence of language problems in children prenatally exposed to opioids, and the factors that support or hinder language acquisition. A sample of 100 children born to pregnant women in methadone maintenance treatment and 110 randomly identified non-exposed children were studied from birth to age 4.5 years. At 4.5 years, 89 opioid-exposed and 103 non-exposed children completed the preschool version of the Clinical Evaluation of Language Fundamentals (CELF-P) as part of a comprehensive neurodevelopmental assessment. Children prenatally exposed to opioids had poorer receptive and expressive language outcomes at age 4.5 years compared to non-opioid exposed children. After adjustment for child sex, maternal education, other pregnancy substance use, maternal pregnancy nutrition and prenatal depression, opioid exposure remained a significant independent predictor of children’s total CELF-P language score. Examination of a range of potential intervening factors showed that a composite measure of the quality of parenting and home environment at age 18 months and early childhood education participation at 4.5 years were important positive mediators.