Expressive Language Subscales Research Articles

A - 46 Relationship between Working Memory and Externalizing Behaviors in Children from a Clinical Population: an Exploration of the Role of Expressive Language

Abstract Objective Externalizing behaviors affect children’s functioning in different domains. Previous studies revealed the impact of working memory, mainly through its role in goal keeping, goal-related search, and response selection. This study explored the role of expressive language in the relationship between working memory and externalizing behaviors in children. Method The data were collected from 50 children at a private practice agency (male: 76%; Age M = 4.16, SD = 1.13). All participants were diagnosed with at least one neurodevelopmental disorder. Their index score on the Externalizing Problems from Behavior Assessment System for Children, 3rd Edition, index score on the Working Memory from Stanford-Binet Intelligence Scales, 5th Edition, and expressive language subscale score from Vineland Adaptive Behavior Scales, 3rd Edition were collected. A mediation analysis was performed. Results The mediation analysis results showed a significant indirect effect (B = −0.081, 95% CI [−0.172, −0.015]) of working memory on externalizing behaviors through expressive language. It suggested that poorer working memory was associated with less expressive language, which then resulted in more externalizing behaviors. The direct effect between working memory and externalizing behavior was statistically significant (B = −0.331, p < 0.001), indicating that expressive language only partially mediated the relationship between working memory and externalizing behaviors. Conclusions The study provided empirical support for the mediating effect of expresive langaguge on the relationship between working memory and externaizing behaviors in children from a clinical population. It informs that the use of evidence-based interventions on expressive langauge skills might potentially help address externalizing behaviors in children.

Temporal stability of parent-reported behavior problems in late talkers over 2 years: a prospective case-control study from toddlerhood to preschool age

BackgroundLate talking (LT) in toddlers is a risk factor for language weakness that may interfere with the development of using language to regulate behavior and emotion and contribute to the development of behavior problems from early childhood. This study examined the temporal stability of parent-reported behavior problems among Mandarin-speaking LT toddlers from ages 2 to 4 in Taiwan.MethodsThirty-one LT and 31 typical language development (TLD) toddlers were assessed for their vocabulary production at age 2 with the Words and Sentences Forms of the MacArthur-Bates Communicative Developmental Inventories Toddler Form (Taiwan version). Additionally, participants’ receptive and expressive language abilities were assessed using the receptive and expressive language subscales of the Bayley Scales of Infant and Toddler Development, Third Edition. At age 4, the Child Language Disorder Scale-Revised was applied and included the two core subtests for auditory comprehension and expressive communication. At ages 2 and 4 years, behavior problems were assessed with the Child Behavior Checklist.ResultsThere was a higher percentage of participants with persistent behavior problems among LT toddlers than among TLD toddlers. Moreover, toddlers with larger vocabularies were less likely to develop withdrawal behaviors by preschool age.ConclusionsThis study supported the temporal stability of parent-reported behavior problems among LT toddlers across early childhood. Early identification of and intervention for behavior problems associated with LT in toddlerhood is essential to alleviate their behavior problems later in preschool years.

Exposure to electronic media was negatively associated with speech and language development at 18 and 24 months

This study evaluated early speech and language development at 18 and 24months, and associated factors, based on parental reports. We followed up the CHILD-SLEEP birth cohort of 1667 Finnish-speaking families, who were randomly recruited in 2011-2013 during routine visits to maternity clinics in the Pirkanmaa Hospital District of Finland. The women were approximately 32weeks' pregnant at enrolment. Parents reported the size of their child's expressive vocabulary, word combinations, intelligibility, finger-pointing and adherence to instructions. A subsample was studied using the Expressive Language subscale of the Bayley Scales of Infant and Toddler Development, Third Edition. The children's vocabulary was smaller than previously reported. At 18months of age, 68.8% of the 997 children had a vocabulary of 20 words or less and 35.7% used about five words at most. At 24months, 32.4% of the 822 children had a vocabulary of 50 words or less and 18.4% used about 20 words at most. Longer child and parental exposure to electronic media was negatively associated with the size of the child's expressive vocabulary. Vocabulary size at 18 and 24months was smaller than previously reported and negatively associated with exposure to electronic media.

Development of infants presented with congenital syphilis in their first months of life

ABSTRACT Purpose: to evaluate the cognitive, language, and motor development of infants with congenital syphilis in their first months of life. Methods: a sample of 52 infants, from 21 to 112 days of age, born in public maternity hospitals, divided into a study group of 28 infants with congenital syphilis and a control group 24 infants without risk indicators for hearing loss. They underwent the Neonatal Hearing Screening Protocol with automated Brainstem Auditory Evoked Potential. The research instrument was the Bayley-III Scale, consisting of the cognitive, language (receptive and expressive), and motor (fine and gross) subscales. The raw scores were entered into the software that accompanies the Bayley-III scale kit to calculate the scores (scaled and composite) and perform qualitative analysis. The Mann-Whitney test and the Wilcoxon test was applied and used a 5% significance level. Results: a similarity between groups for the demographic parameters, maternal education level, and socioeconomic level, was seen. There was no statistically significant difference between groups when comparing the cognitive, receptive language, expressive language, fine motor, and gross motor subscales. Conclusion: infants with congenital syphilis treated at birth have a cognitive, language, and motor development within that expected for their age group in their first months of life.

Early-auditory intervention in children with hearing loss and neurodevelopmental outcomes: cognitive, motor and language development.

To date, studies have mostly focused on the language outcome of early-auditory interventions including amplification for congenital hearing loss within the first 6 months. We aimed to examine the effect of early-auditory intervention in patients with congenital hearing loss on cognitive, motor and language outcomes, and determine the clinical variables that affect developmental outcomes. The medical records of 104 patients were retrospectively reviewed. Children were evaluated by the Bayley Scales of Infant and Toddler Development, Third Edition. The median ages of confirmation of hearing loss, amplification, starting auditory-verbal intervention and cochlear implantation were 9, 10, 13 and 19 months, respectively. Of the patients, 26% received a hearingaid fitting ≤6 months of age. Fifty-one children (49%) had additional disabilities. The median cognitive, language and motor scores of children with no additional disabilities were 95 (65-115), 68 (47-103) and 97 (58- 130), respectively and children with early-auditory intervention (≤6 months) demonstrated higher cognitive, receptive and expressive language subscale scores than late-auditory intervention group (p < 0.05) whereas there was no significant difference in motor scores (p > 0.05). A significant negative correlation was found between additional disability and cognitive, language and motor outcomes (r=-0.78, r=-0.54 and r=-0.75, respectively p < 0.01). There was a significant negative correlation between language outcomes and the degree of hearing loss (r=-0.20, p < 0.05). Multiple regression analyses revealed that additional disability and early-auditory intervention showed a significant amount of variance in cognitive and language scores. The early intervention did not make a significant, independent contribution on motor outcomes whereas additional disability did. Presence of additional disability was the strongest significant variable on developmental outcomes in hearing-impaired children. In children with no additional disability, significantly better cognitive and language scores were associated with the early-auditory intervention. Motor skills were not affected by the early-auditory intervention.

Measuring Change in the Communication Skills of Children With Austim Spectrum Disorder Using the Communication Complexity Scale.

Changes in minimal verbal communication by children with autism spectrum disorder (ASD) were measured with the Communication Complexity Scale (CCS) and other communication assessments. The CCS measures complexity of preverbal and beginning verbal communication used to communicate behavior regulation and joint attention. The purpose was to investigate if the CCS was responsive to changes associated with a behavioral intervention aimed at improving communication skills. Changes were detected with CCS scores, rates of initiating joint attention, and the Mullen Scales of Early Learning (MSEL) Expressive Language subscale. Significant changes in CCS scores were also detected for a subgroup of participants who did not show significant changes on the MSEL Expressive Language subscale, demonstrating that CCS scores are sensitive to changes associated with a behavioral intervention.

The Predictive Value of Language Scales: Bayley Scales of Infant and Toddler Development Third Edition in Correlation With Korean Sequenced Language Scale for Infant.

ObjectiveTo compare the relationship of the Bayley Scales of Infant and Toddler Development 3rd Edition (K-BSID-III) language score and the Sequenced Language Scale for Infant (SELSI) score and evaluate the sensitivity and specificity of K-BSID-III language score and optimal cutoff value with receiver operator characteristic (ROC) curve analysis in infants and toddlers with delayed language development.MethodsA total of 104 children with suspected language developmental delay were included in this retrospective study. Subjects were tested using the K-BSID-III and SELSI and subdivided into several groups according to the severity of language scores. ROC curve analysis was performed to assess K-BSID-III for delayed language development.ResultsReceptive and expressive language subscales of the K-BSID-III showed markedly significant correlation with the SELSI scores (p<0.001). ROC analysis showed an area under the curve of 0.877 (p<0.001) in SELSI receptive score and 0.935 (p<0.001) in SELSI expressive score. The optimal cutoff value where sensitivity of 85% and specificity of 81% were achieved with the K-BSID-III receptive score was 1.50 (between average and low average) in the SELSI receptive score. The optimal cutoff value where sensitivity of 96% and specificity of 82% were achieved with the K-BSID-III expressive score was also 1.50 in the SELSI expressive score.ConclusionIn this study, the correlations between K-BSID-III and SELSI language scores were statistically significant. However, the interpretation should be considered carefully in low average group due to tendency of underestimation of delayed language development.

Supporting Play, Exploration, and Early Development Intervention (SPEEDI) for preterm infants: A feasibility randomised controlled trial in an Australian context

BackgroundAn early intervention that enhances early development in infants born preterm, called ‘Supporting Play, Exploration and Early Development Intervention’ (SPEEDI) has been shown to be feasible in Virginia, United States, in a pilot study. Infants receive 10 therapy sessions until 3 months' corrected age (CA) (Phase 1[5 hospital sessions] and Phase 2[5 home-based sessions]) in addition to usual care. AimsTo determine the feasibility of SPEEDI for very preterm infants in an Australian context. Study designProspective pilot feasibility randomised controlled trial. SubjectsInfants born <30 weeks' gestation (GA), recruited between 34 and 38+6 weeks' postmenstrual age. Outcome measuresPrimary outcome was feasibility of SPEEDI, including recruitment rate, participant retention, sessions delivered, and therapy fidelity. Secondary outcome measures were developmental outcomes, including the Bayley Scales of Infant and Toddler Development – 3rd Edition (BSID-III) at 4 months' CA. ResultsOf 19 eligible infants, 17 consented, SPEEDI n = 8 and usual care n = 9 (mean GA = 26.7 weeks [SD 1.4], male n = 10). All participants completed the study, with 80% of SPEEDI therapy sessions completed (90% Phase 1; 72% Phase 2). On average, therapists and parents used 78% and 77% of SPEEDI strategies in each session respectively. Infants in the SPEEDI group had higher scores on the BSID-III for gross motor, and expressive and receptive language subscales at 4 months' CA. ConclusionsSPEEDI is a feasible intervention to deliver, and preliminary results suggest that SPEEDI may lead to improved motor and language outcomes at 4 months' CA, with results supporting future larger clinical trials.

Comparison of the neurocognitive outcomes in term infants treated with levetiracetam and phenobarbital monotherapy for neonatal clinical seizures

PurposeThis study aims to compare the neurocognitive outcome in term infants who were treated using phenobarbital (PB) and levetiracetam (LEV) monotherapy for neonatal clinical seizures. MethodsTerm infants who were treated using PB or LEV monotherapy as the first-line anti-epileptic treatment for neonatal clinical seizures and followed-up in a pediatric neurology outpatient clinic were enrolled in this study. Neurodevelopmental outcome assessments were carried out using the Bayley Scales of Infant Development, third edition (BSID-III), including cognitive, receptive language, expressive language, fine motor and gross motor subscales. ResultsThe study group consisted of 62 infants who received monotherapy with PB monotherapy (n = 22) and LEV (n = 40). The mean duration of monotherapy treatment was 8 ± 6 months. There was no statistically significant difference between PB and LEV monotherapy groups concerning each outcome parameter on the BSID-III. There was also no statistically significant difference between PB and LEV monotherapy subgroups excluding the infants with neurodevelopmental impairment with a BSID-III scale score<7 or a composite score<85. ConclusionOur findings suggest that both LEV and PB therapy can be equally safe as monotherapy for neonatal clinical seizures for the neurodevelopmental outcome assessment with BSID-III.

Developmental Outcomes Among Young Children With Congenital Zika Syndrome in Brazil

Although birth defects in children with congenital Zika syndrome (CZS) are expected to result in significant intellectual disabilities, the extent of delay and profiles of development have yet to be fully described. To describe the neurodevelopmental profiles of children with CZS and to test whether prenatal and postpartum characteristics were associated with the severity of developmental delays. This is a case series of the trajectories of developmental, behavioral, and medical needs of 121 young children with CZS who were assessed at a specialized rehabilitation center in Recife, Brazil, beginning in January 2018 as part of 5-year longitudinal study. Children were included if they had serologic confirmation of Zika virus and met clinical criteria accompanied by parental report of suspected exposure to Zika virus during pregnancy. Prenatal Zika virus exposure. The Brazilian version of the Bayley Scales of Infant and Toddler Development, Third Edition, was administered by trained assessors as part of an initial comprehensive assessment battery. Caregiver interviews and medical record reviews were conducted to gather basic demographic information and medical comorbidities. Linear regression was used to identify potential factors for development. The sample included 121 young children (mean [SD] age, 31.2 [1.9] months; 61 [50.4%] girls). At age approximately 2.5 years, nearly all children in this sample demonstrated profound developmental delays across all domains of functioning, with a mean (SD) developmental age equivalent to approximately 2 to 4 months (eg, cognitive domain, 2.24 [3.09] months; fine motor subscale, 2.15 [2.93] months; expressive language subscale, 2.30 [2.52] months). A relative strength was found in receptive language, with scores on this scale significantly higher than most other domains (eg, cognition: t = 3.73; P < .001; fine motor: t = 6.99; P < .001). Head circumference at birth was the single strongest factor associated with outcomes across all developmental domains (eg, cognitive: β = 1.41; SE, 0.67; P = .04; fine motor: β = 1.36; SE, 0.49; P = .007). The findings of this study provide important information regarding the severity of disability that these children and their families will experience. The findings also establish an initial point from which to monitor developmental trajectories, medical comorbidities (eg, seizures), effectiveness of interventions, and cumulative consequences on families.

Maternal plasma vitamin B12 concentrations during pregnancy and infant cognitive outcomes at 2 years of age.

Evidence on long-term influences of maternal vitamin B12 deficiency or concentrations on infant cognition is limited. We examined associations between maternal plasma vitamin B12 and cognitive development in 24-month-old infants. Maternal plasma vitamin B12 concentrations were measured at 26-28 weeks' gestation; infant cognitive development was assessed with the Bayley Scales of Infant and Toddler Development-III at 24 months, for 443 mother-infant pairs from the Growing Up in Singapore Towards Healthy Outcomes cohort. Linear regressions adjusted for key confounders examined associations of maternal vitamin B12 with cognitive, receptive and expressive language, fine and gross motor subscales. Co-occurrence of maternal vitamin B12 with folate or vitamin B6 insufficiencies on child's cognition was explored. Average maternal plasma vitamin B12 concentrations was 220·5 ± 80·5 pmol/l; 15 % and 41 % of mothers were vitamin B12 deficient (&lt;148 pmol/l) and insufficient (148-220·9 pmol/l), respectively. Infants of mothers with vitamin B12 deficiency had 0·42 (95 % CI -0·70, -0·14) sd lower cognitive scores, compared with infants of mothers with sufficient vitamin B12. Co-occurrence of maternal vitamins B12 and B6 insufficiencies was associated with 0·37 (95 % CI -0·69, -0·06) sd lower cognitive scores in infants compared with infants of mothers sufficient in both vitamins. No significant associations were observed with other subscales. Study findings suggest the possible need to ensure adequate vitamin B12 during pregnancy. The impact of co-occurrence of maternal B-vitamins insufficiencies on early cognitive development warrants further investigation.

Neurodevelopmental outcome of Italian preterm children at 1 year of corrected age by Bayley-III scales: An assessment using local norms

BackgroundPremature birth is often associated with neurodevelopmental difficulties throughout childhood. In the first three years of life, the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) constitute one of the most used tools for assessing child development. Since Bayley-III original norms are based on United States (US) population, it remains uncertain whether their use in other countries (e.g., European) is appropriate. AimsThis research aimed to examine neurodevelopment of preterm infants and full-term infants, using Bayley-III US norms in comparison to Italian (IT) norms. Patterns of developmental outcomes for both infant groups were also explored. Methods104 preterm and 58 full-term infants were included in the study. Bayley-III was used for neurodevelopmental assessment at 1year of corrected age, considering both IT and US norms for scores computation. ResultsComparing scores obtained with IT vs US norms, differences in means were all significant across five subscales (p<0.05 at least) for preterm infants, whereas for full-term peers significant differences were found only for Receptive Language and Fine Motor subscales (p<0.001). Effect size (η2) ranged from 0.22 to 0.94. Within each group, significant discrepancies across subscales were found. Moreover, Italian preterm infants had significantly lower performances than full-term peers, excepting for Expressive Language and Gross Motor subscales. ConclusionsAs regards to Italian 1-year children, our study seems to provide evidence for the tendency of Bayley-III US norms to overestimate development compared to IT norms. These findings emphasize the need to early detect children at risk for developmental delay and to plan early intervention.

Adapting the Bayley Scales of infant and toddler development in Ethiopia: evaluation of reliability and validity.

BackgroundThere is a need for valid and reliable observational measures of early child development in low‐income and middle‐income country settings.MethodsThe aims of the study were to adapt the Bayley Scales of Infant Development (Bayley III) for a rural Ethiopian setting and evaluate reliability and validity. The study was carried out between January 2008 and January 2009 in the Butajira demographic surveillance site, south central Ethiopia. The Bayley III was adapted to be socioculturally appropriate for a rural Ethiopian context. Nurses and high school graduates were trained in administration of the measure for 10 days. Inter‐rater reliability was evaluated (n = 60). Content, construct and convergent validity was then examined on a population‐based cohort of children at the ages of 30 (n = 440) and 42 months (n = 456). Mokken scale analysis was used to determine the scalability of items in unidimensional, hierarchical sub‐scales. The mean score was compared by age of child and by stunting status (less than −2 z scores below the standard height‐for‐age).ResultsThe intra‐class correlations between raters were above 0.90 for all sub‐scales of the child development measure. Some scale items were not contextually relevant and showed poor scalability. However, the majority of items scaled onto the existing sub‐scales of the international measure to form adequate‐to‐strong hierarchical scales with good internal consistency (Cronbach's α above 0.70 except for gross motor and expressive language sub‐scales). Item‐scale coefficients were good. The mean score of all sub‐scales was significantly higher in the older group of children (33.02 higher total score; P < 0.001) and in the children who were stunted (total Bayley score 2.58 (95% confidence interval 0.07 to 5.10) points lower at 30 months and 3.87 (1.94 to 5.81) points lower at 42 months.ConclusionsAn adapted version of an international, observational measure of child development was found to be reliable, valid and feasible in a rural Ethiopian setting.

Prevalence of Developmental Delay and Contributing Factors Among Children With Sickle Cell Disease.

Children with sickle cell disease (SCD) are at higher risk for deficits in cognition compared to the general population, even at young ages. Disease severity has been co-assessed in earlier studies, but the home environment has not. The purpose of the current study was to investigate the development of young children with SCD and secondarily, the impact of environmental and family factors. The current study is a baseline cross-sectional evaluation of a prospective, single-center cohort. Children with SCD between the ages of 1 and 42 months and their primary caregiver were included. Participants lived within 30 miles of the site and spoke English. Children underwent developmental evaluation using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Home visits were completed and screened using the Home Observation for Measurement of the Environment (HOME). Over 3 years, 43 caregiver-child dyads consented and participated. Over 50% of children scored significantly below average on cognition and expressive language subscales. SCD severity was not associated with BSID-III scores. Socioeconomic status (SES) determined by the Diez-Roux method positively correlated (r = 0.401, P < 0.01) with the home environment. The HOME correlated (r = 0.360, P < 0.05) with the cognitive subscale on the BSID-III. Given the high prevalence of developmental delay in this population, identifying modifiable factors to maximize developmental progress is essential. The home environment would be a targeted method for intervention. Future research is needed to identify the benefits of home-based intervention for this population.

Early electrophysiological markers of atypical language processing in prematurely born infants

Because nervous system development may be affected by prematurity, many prematurely born children present language or cognitive disorders at school age. The goal of this study is to investigate whether these impairments can be identified early in life using electrophysiological auditory event-related potentials (AERPs) and mismatch negativity (MMN). Brain responses to speech and non-speech stimuli were assessed in prematurely born children to identify early electrophysiological markers of language and cognitive impairments. Participants were 74 children (41 full-term, 33 preterm) aged 3, 12, and 36 months. Pre-attentional auditory responses (MMN and AERPs) were assessed using an oddball paradigm, with speech and non-speech stimuli presented in counterbalanced order between participants. Language and cognitive development were assessed using the Bayley Scale of Infant Development, Third Edition (BSID-III). Results show that preterms as young as 3 months old had delayed MMN response to speech stimuli compared to full-terms. A significant negative correlation was also found between MMN latency to speech sounds and the BSID-III expressive language subscale. However, no significant differences between full-terms and preterms were found for the MMN to non-speech stimuli, suggesting preserved pre-attentional auditory discrimination abilities in these children. Identification of early electrophysiological markers for delayed language development could facilitate timely interventions.

The Impact of Surgery on the Developmental Status of Late Preterm Infants – A Cohort Study

Aims: Despite increasing evidence in the literature regarding the impact of late prematurity on subsequent developmental impairment, the developmental outcome of late preterm infants who undergo major surgery remains unclear. The aim of this study therefore was to determine the developmental outcome for a cohort of late preterm surgical population.Methods: Late preterm infants with a gestational age from 34-36 weeks inclusive who were enrolled in the state-wide prospective Development After Infant Surgery (DAISy) study and who had undergone non-cardiac major surgery within the first ninety days of life were eligible for inclusion. Infants were assessed at one and three years of ages.Results: Forty-six infants were enrolled in the study, of which 38 infants had a complete developmental assessment at one year of age. Of these infants, late preterm infants scored significantly lower than the standardized norms of the assessment on the expressive language and gross motor subscales. At three years of age 26 infants were reassessed: late preterm infants who underwent major surgery only scored significantly lower than the standardized norms on the cognitive subscale (p&lt;0.001).Conclusions: These data provide the evidence that late preterm infants who undergo major non-cardiac surgery are at risk of developmental impairment and consideration should be given to enrolling this cohort in multi-disciplinary developmental follow-up clinics.

The impact of surgery on the developmental status of late preterm infants - a cohort study.

Despite increasing evidence in the literature regarding the impact of late prematurity on subsequent developmental impairment, the developmental outcome of late preterm infants who undergo major surgery remains unclear. The aim of this study therefore was to determine the developmental outcome for a cohort of late preterm surgical population. Late preterm infants with a gestational age from 34-36 weeks inclusive who were enrolled in the state-wide prospective Development After Infant Surgery (DAISy) study and who had undergone non-cardiac major surgery within the first ninety days of life were eligible for inclusion. Infants were assessed at one and three years of ages. Forty-six infants were enrolled in the study, of which 38 infants had a complete developmental assessment at one year of age. Of these infants, late preterm infants scored significantly lower than the standardized norms of the assessment on the expressive language and gross motor subscales. At three years of age 26 infants were reassessed: late preterm infants who underwent major surgery only scored significantly lower than the standardized norms on the cognitive subscale (p less than 0.001). These data provide the evidence that late preterm infants who undergo major non-cardiac surgery are at risk of developmental impairment and consideration should be given to enrolling this cohort in multi-disciplinary developmental follow-up clinics.

Early pragmatic language difficulties in siblings of children with autism: implications for DSM-5 social communication disorder?

We evaluated early pragmatic language skills in preschool-age siblings of children with autism spectrum disorder (ASD), and examined correspondence between pragmatic language impairments and general language difficulties, autism symptomatology, and clinical outcomes. Participants were younger siblings of children with ASD (high-risk, n = 188) or typical development (low-risk, n = 119) who were part of a prospective study of infants at risk for ASD; siblings without ASD outcomes were included in analyses. Pragmatic language skills were measured via the Language Use Inventory (LUI). At 36 months, the high-risk group had significantly lower parent-rated pragmatic language scores than the low-risk group. When defining pragmatic language impairment (PLI) as scores below the 10(th) percentile on the LUI, 35% of the high-risk group was identified with PLI versus 10% of the low-risk group. Children with PLI had higher rates of general language impairment (16%), defined as scores below the 10(th) percentile on the Receptive or Expressive Language subscales of the Mullen Scales of Early Learning, relative to those without PLI (3%), but most did not evidence general language impairments. Children with PLI had significantly higher ADOS scores than those without PLI and had higher rates of clinician-rated atypical clinical best estimate outcomes (49%) relative to those without PLI (15%). Pragmatic language problems are present in some siblings of children with ASD as early as 36 months of age. As the new DSM-5 diagnosis of Social (Pragmatic) Communication Disorder (SCD) is thought to occur more frequently in family members of individuals with ASD, it is possible that some of these siblings will meet criteria for SCD as they get older. Close monitoring of early pragmatic language development in young children at familial risk for ASD is warranted.

Desenvolvimento cognitivo e linguagem em prematuros

Objetivo : Correlacionar os aspectos do desenvolvimento cognitivo e de linguagem em prematuros de 24 a 42 meses de idade cronológica. Métodos : Estudo quantitativo, de caráter analítico e transversal, realizado no período de fevereiro a dezembro de 2012. A amostra foi constituída por dez crianças prematuras, na faixa etária cronológica de 24 a 42 meses. As crianças foram submetidas à aplicação da Escala de Desenvolvimento Infantil de Bayley – III e avaliadas mediante as subescalas de cognição, linguagem receptiva e expressiva. Resultados : Observou-se significância estatística na correlação das idades cronológica e corrigida com as idades do desenvolvimento cognitivo e de linguagem. Na correlação da idade cronológica com as habilidades cognitiva e de linguagem, houve significância estatística quanto à capacidade de apreensão e manipulação de objetos e na construção e habilidade de permanência dos objetos. Na correlação da idade do desenvolvimento com as habilidades de cognição e linguagem, constatou-se significância estatística em todas as habilidades cognitivas. Não houve correlação significativa entre idade do desenvolvimento de linguagem expressiva e habilidades de linguagem receptiva. Conclusão : Confirmou-se correlação das idades cronológica e corrigida com a idade do desenvolvimento cognitivo e de linguagem. As habilidades de linguagem receptiva e expressiva mostraram-se com desenvolvimento distinto, todavia, dependentes da cognição.

Diagnostic validity of the Chinese Child Development Inventory in screening children with developmental language delay

ObjectivesThe Chinese Child Developmental Inventory (CCDI) is one of the most commonly used developmental screening tools. However, limited data are available regarding the diagnostic validity (sensitivity and specificity) of the CCDI in identifying children with developmental language disorders. The aim of this study was to determine how well the CCDI functions within a hospital-based setting when administered by clinicians. Materials and MethodsA hospital-based sample of 235 children (aged 15–78 months) with suspected developmental language delay was included for a validity test. The subscales of the CCDI examined in this study were expressive language (EL), comprehension conceptual (CC), situation comprehension (SC), self-help, personal–social (PS), and general development (GD). ResultsAcceptable high specificities (77.9–95.1%) were found for most of the subscales, except for the PS (57.6%). The EL subscale was the most suitable for the screening of children with language delay, but the sensitivity was only at the acceptable (66%) level. The EL and PS subscales were good predictors of autistic spectrum disorders with specificities of 70% and 76.2%, respectively. Rather high sensitivities were observed for the EL, CC, and SC subscales (71–80%) for children with developmental delay. ConclusionThe CCDI completed by parents is a valid screening tool for identifying children with risks of developmental language delay.