Language Outcomes In Children Research Articles

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.

Early Identification of Hearing Loss and Language Development at 32 Months of Age.

This study examines the relationship between the early identification of hearing loss and language outcomes for deaf/hard of hearing (D/HH) children, with bilateral or unilateral hearing loss and with or without additional disabilities. It was hypothesized that hearing loss identified by 3 months of age would be associated with better language outcomes. Using a prospective, longitudinal design, 86 families completed developmental instruments at two time points: at an average age of 14.8 months and an average age of 32.1 months. Multiple regression examined how hearing loss identified by 3 months of age contributed to later language outcomes while controlling for developmental level at the first time point. Hearing loss identified by 3 months of age was positively associated with better language outcomes for D/HH children at 32 months of age; however, D/HH children still exhibited language delays, compared to normative scores for same-aged hearing peers for reported measures. Language outcomes of children with unilateral hearing loss were not better than those of children with mild-to-moderate bilateral hearing loss. Children with additional disabilities and more severe bilateral hearing loss had lower language scores than those without.

Immersion in dual-language programs does not impede children's native language processing.

The benefits of dual-language immersion (DLI) versus English-only classrooms for minority-language speakers' acquisition of English have been well documented. However, less is known about the effect(s) of DLI on majority-language speakers' native English skills. Prior studies largely used accuracy-focused measures to index children's language skills; it is possible that processing-based tasks are more sensitive to the effects of DLI experience. Thirty-three monolingual native English-speaking children attending English-only classrooms and thirty-three English-speaking children attending English-Spanish DLI matched in age, gender, nonverbal IQ, and socio-economic status were tested twice, 1 year apart, on standardized and processing-based measures of English vocabulary and morphosyntax. We ran linear mixed-effects models to examine the extent to which group and time would predict scores on knowledge-based measures of vocabulary and morphosyntactic knowledge, as well as accuracy and reaction times on processing-based measures of English vocabulary and morphosyntax. Results revealed comparable levels of growth in English for both groups. A subtle effect of DLI was observed on a lexical-decision task: bilinguals were slower in Year 1 but both groups were equally efficient in Year 2. These results indicate that DLI programs have minimal impact on majority-language speakers' native-language skills in the age-range tested. This study is the first to longitudinally examine processing-based native language outcomes in bilingual children in DLI classrooms. We do not find evidence that DLI exposure carries a cost to native language development, even when indexed by processing measures. This should reassure parents, educators, and policymakers in that there are no downsides to DLI.

Early predictors of language outcomes in Down syndrome: A mini-review.

As children with Down syndrome (DS) typically manifest significant delays in language development, the research has pointed out the predictors of later language skills for this clinical population. The purpose of this study was to systematically explore the evidence for early predictors of language outcomes in infants and toddlers with DS from studies published between 2012 and 2022. After the search, nine studies met the inclusion criteria. The results indicated that maternal educational level, adaptive level of functioning, cognitive function, attention skills, communicative intent of the child, early vocalizations, gestures, baby signs, parents’ translation of their children’s gestures into words, and vocabulary level are significant predictors of language outcomes in children with DS. These findings provide a timely and warranted summary of published work that contributes to current understanding of the development of language and communication in DS. They are therefore useful to researchers, clinicians, and families.

Specific parenting behaviors link maternal education to toddlers' language and social competence.

Maternal sensitive parenting behavior has been shown to account, at least partially, for the relation between family background and children's language and behavioral outcomes. Yet, as previous studies often used a rather global or domain-general measure of maternal sensitivity, it remains an open question whether different domains of child development are influenced by the different facets of maternal sensitivity. Thus, this study investigated whether specific parenting behaviors differentially mediated the association between maternal education and children's language and social competence. Drawing on 2,478 mother-child dyads from the German National Educational Panel Study, we distinguished mothers' sensitive parenting behavior as cognitive-verbally stimulating and socioemotionally supportive parenting behaviors. These two observed specific parenting behaviors at 26 months were modeled as separate pathways linking maternal education and children's language outcomes at 26 months as well as children's social competence at 38 months. All analyses controlled for family net income, single parenthood, migration background, mother's depressive feelings, and child's negative affectivity. The results indicated that the mother's cognitive-verbally stimulating parenting behavior was specifically related to the children's language skills, whereas mother's socioemotionally supportive parenting behavior specifically predicted children's later social competence. Furthermore, these two separable parenting behaviors differentially mediated the association between maternal education and toddler's language and social competence. Most notably, children's language additionally mediated the relation between maternal education and children's social competence. The findings suggest that domain-specific intervention programs have the potential to promote early language and social development efficiently. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cross-Modal Reorganization From Both Visual and Somatosensory Modalities in Cochlear Implanted Children and Its Relationship to Speech Perception.

We hypothesized that children with cochlear implants (CIs) who demonstrate cross-modal reorganization by vision also demonstrate cross-modal reorganization by somatosensation and that these processes are interrelated and impact speech perception. Cross-modal reorganization, which occurs when a deprived sensory modality's cortical resources are recruited by other intact modalities, has been proposed as a source of variability underlying speech perception in deaf children with CIs. Visual and somatosensory cross-modal reorganization of auditory cortex have been documented separately in CI children, but reorganization in these modalities has not been documented within the same subjects. Our goal was to examine the relationship between cross-modal reorganization from both visual and somatosensory modalities within a single group of CI children. We analyzed high-density electroencephalogram responses to visual and somatosensory stimuli and current density reconstruction of brain activity sources. Speech perception in noise testing was performed. Current density reconstruction patterns were analyzed within the entire subject group and across groups of CI children exhibiting good versus poor speech perception. Positive correlations between visual and somatosensory cross-modal reorganization suggested that neuroplasticity in different sensory systems may be interrelated. Furthermore, CI children with good speech perception did not show recruitment of frontal or auditory cortices during visual processing, unlike CI children with poor speech perception. Our results reflect changes in cortical resource allocation in pediatric CI users. Cross-modal recruitment of auditory and frontal cortices by vision, and cross-modal reorganization of auditory cortex by somatosensation, may underlie variability in speech and language outcomes in CI children.

Interactive Effects of Temperament and Family-Related Environmental Confusion on Spoken Language in Children Who Are Deaf and Hard of Hearing.

The aim of this study was to examine the influence of caregivers' reports of family-related environmental confusion-which refers to the level of overstimulation in the family home environment due to auditory and nonauditory (i.e., visual and cognitive) noise-on the relation between child temperament and spoken language outcomes in children who are deaf and hard of hearing (DHH) in comparison to age-matched children with typical hearing (TH). Two groups of families with children between 3 and 7 years of age (TH = 59, DHH = 58) were sequentially recruited from a larger longitudinal study on developmental outcomes in children who are DHH. Caregivers (all TH) completed questionnaires measuring three dimensions of child temperament (i.e., effortful control, negative affectivity, and surgency-extraversion) and family-related environmental confusion. A norm-referenced language measure was administered to children. Testing took place within the families' homes. For children who are DHH, effortful control was positively related to spoken language outcomes, but only when levels of family-related environmental confusion were low to moderate. Family-related environmental confusion did not interact with temperament to influence spoken language in children with TH. Homes with low-to-moderate levels of environmental confusion provide an environment that supports DHH children with better effortful control to harness their self-regulatory skills to achieve better spoken language comprehension than those with lower levels of effortful control. These findings suggest that efforts to minimize chaos and auditory noise in the home create an environment in which DHH children can utilize their self-regulatory skills to achieve optimal spoken language outcomes.

Word reading in monolingual and bilingual children with developmental language disorder

Many children with developmental language disorder (DLD) are reported to have word reading difficulties. However, previous research has focused mostly on monolingual children. The present study used two existing datasets to assess word reading outcomes of bilingual children with DLD. In Study 1, we compared word reading outcomes of monolingual and bilingual children with and without DLD (n = 93 monolingual DLD; n = 33 bilingual DLD, n = 42 monolingual TD; n = 74 bilingual TD). In Study 2, we compared those of monolingual (n = 91) and bilingual children with DLD (n = 51) on the basis of school record data. Findings from both studies show mean poor word reading outcomes and a high incidence of poor readers in the groups of children with DLD. Despite lower oral language outcomes of bilingual children in the mainstream language, reading outcomes of monolingual and bilingual children (with/without DLD) did not differ or outcomes were even better for the bilingual children. Overall, these findings indicate that DLD is a risk factor for word reading difficulties, while bilingualism is not.

Intersensory matching of faces and voices in infancy predicts language outcomes in young children.

Parent language input is a well-established predictor of child language development. Multisensory attention skills (MASks; intersensory matching, shifting and sustaining attention to audiovisual speech) are also known to be foundations for language development. However, due to a lack of appropriate measures, individual differences in these skills have received little research focus. A newly established measure, the Multisensory Attention Assessment Protocol (MAAP), allows researchers to examine predictive relations between early MASks and later outcomes. We hypothesized that, along with parent language input, multisensory attention to social events (faces and voices) in infancy would predict later language outcomes. We collected data from 97 children (predominantly White and Hispanic, 48 males) participating in an ongoing longitudinal study assessing 12-, 18-, and 24-month MASks (MAAP) and parent language input (quality, quantity), and 18- and 24-month language outcomes (child speech production, vocabulary size). Results revealed 12-month intersensory matching (but not maintaining or shifting attention) of faces and voices in the presence of a distractor was a strong predictor of language. It predicted a variety of 18- and 24-month child language outcomes (expressive vocabulary, child speech production), even when holding traditional predictors constant: parent language input and SES (maternal education: 52% bachelor's degree or higher). Further, at each age, parent language input predicted just one outcome, expressive vocabulary, and SES predicted child speech production. These novel findings reveal infant intersensory matching of faces and voices in the presence of a distractor can predict which children might benefit most from parent language input and show better language outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A mediation analysis to disentangle relations between maternal education and early child development

Maternal education is associated with early child outcomes. However, the several mechanisms that may explain this relationship remain underexplored. Using data from 1,097 children aged 12–15 months in Chile, we estimate the maternal education gap across child cognitive and language outcomes. Following a bioecological perspective, we explore potential pathways by which maternal education might influence child development, such as child characteristics, the quantity and quality of mother–child interactions, and the availability of home stimulation. We found an average maternal education gap between children with mothers with the lowest and the highest educational levels of 0.36, 0.31, and 0.25 standard deviation in child cognition, expressive language, and receptive language, respectively. The mediational analysis showed that maternal stress and depression and the quality of the home environment mediated the relation between maternal education and child language and cognitive development.

Predictors of Early Language Outcomes in Children with Connexin 26 Hearing Loss across Three Countries.

GJB2-associated hearing loss (GJB2-HL) is the most common genetic cause of hearing loss in children. However, little is known about the clinical characteristics and early language outcomes in population-oriented samples including children with different degrees of hearing loss. Insight into these characteristics are relevant for the counselling of parents. Our sample consisted of 66 children at approximately 2 years of age (17–32 months) with bilateral hearing loss due to GJB2 from three population-based cohorts in Austria, Australia and the Netherlands. Predictors of early vocabulary, including demographic, audiological, genetic and intervention variables and the role of medical comorbidities and nonverbal cognition were examined. The vocabulary scores of children with GJB2-HL were approximately 0.7 standard deviations (SDs) below the norms of children with typical hearing. Age at access to family-centered early intervention and first-born position among siblings predicted language outcomes, whereas the degree of hearing loss and genetic subtype were not significantly correlated with expressive vocabulary. In children with GJB2-HL, early access to family-centered early intervention significantly affected language outcomes at the age of two.

Early home learning environment profiles and their contribution to child development in Chile

The home learning environment (HLE) is a significant factor in children's development. This study uses the Chilean Early Childhood Longitudinal Survey of children 6 months to 5 years old (n = 12,898) to address the role of the home learning environment. Factor scores from factor analysis were used in latent profile analysis to identify HLE profiles and predict children's general development, language and socio-emotional outcomes. Four home learning environment profiles were revealed: a low-interaction and low-resources group (Inattentive), a high-interaction and high-resources group (Nurturing), an average-interaction but low-resources group (Warm), and a low-interaction and high-resources group (Instructional). Very high and very low profiles yielded different child development results, but in mixed profiles, vulnerabilities in one dimension seemed to be compensated by strengths in another. Controlling for pretest scores and demographics, the profiles predicted a small portion of variance in children's development skills two years later.

Procedural learning and school-age language outcomes in children with and without a history of late talking.

'Late talkers' (LTs) are toddlers with late language emergence that cannot be explained by other impairments. It is difficult to predict which of these children continue to present long-term restrictions in language abilities and will later be identified as having a developmental language disorder. Procedural memory weaknesses have been suggested to underlie developmental language disorders, but have not been investigated in LTs. We investigated the relationships between aspects of procedural memory and school-age language abilities in children with and without a history of LT. We hypothesized that children with a history of LT exhibit (1) restrictions in procedural memory when compared with children with typical early development (TED); and (2) a positive association between procedural memory and school-age language abilities. We recruited 79 children (7;5-10;5), 43 of whom had a history of LT. Aspects of procedural memory, procedural learning and motor planning were assessed using the serial reaction time and the end-state comfort tasks. School-age language abilities were measured using standardized tests. Counter to expectations, motor planning was not associated with a history of LT or school-age language abilities, and the children with TED did not show stronger procedural learning as compared with peers with a history of LT. However, weaker school-age language abilities were associated with weak procedural learning in TED group. Factors other than deficits in procedural memory are likely to underlie LT. Procedural learning shows promise as a potential predictor of language development in children that are not identified as LTs. What is already known on the subject Poor procedural learning has been associated with developmental language disorders and suggested to underlie language difficulties. However, to our knowledge, this study is the first to investigate procedural learning and its associations with language outcomes in LTs. What this paper adds to existing knowledge Consistent with prior research, we found an association between language abilities and procedural learning in school-aged children, but found no evidence for poor procedural learning in children with a history of LT. Furthermore, the school-age language outcomes were only associated with procedural learning in children with no history of LT. What are the potential or actual clinical implications of this work? Our findings suggest that factors other than limitations in procedural learning underlie LT. However, procedural learning could be a useful predictor for school-aged language outcomes in children not identified as LTs.

Children With Unilateral Hearing Loss After Newborn Hearing Screening in Taiwan.

We explored the intervention characteristics and language outcomes of children with unilateral hearing loss (UHL) in Taiwan after the implementation of universal newborn hearing screening (UNHS) to highlight changes in attitudes and actions toward hearing-related treatments. Data of 132 children with UHL in birth cohorts from 2012 to 2019 were included. This retrospective study examined differences in age at identification, hearing aid (HA) fitting, and seeking supportive services. Commonly requested attributes of services, reasons for HA rejection, and children's language performance were investigated. The age at identification decreased from 50.3 months in 2012 to 2.6 months in 2019. Similar trends of declining age were obtained for the age at HA fitting and age at first service contact. In addition, 40% of the parents did not seek support until the child became older (M = 30.5 months) and showed more noticeable behaviors related to hearing loss, and only 64% of the children were consistent HA users. Children with UHL enrolled in the intervention programs approximated the average language performance of the assessment norm; however, they showed depressed language levels when compared to the norm group at the 75th percentile. UNHS had a positive impact on early identification and intervention in children with UHL. Compared to parents of children with all types of hearing loss, parents of children with UHL seemed to be more uncertain about aural habilitation at the early stage.

Outcome of language therapy in bimodal-fit children versus unilateral cochlear implant children in bilateral sensorineural hearing impairment: a case-control study

BackgroundTreating hearing-impaired children aims not only to improve their hearing but also to enhance language acquisition capability. In our community, the CI usually performed on one side because of financial issues at least for a period of time. Consequently, the brain may neglect the unfitted ear. Contralateral hearing aid is an alternative solution when bilateral CI is unavailable. Our purpose is to evaluate the language outcome in bimodal-fit children who using cochlear implant (CI) and contralateral hearing aid (HA) compared to children using unilateral cochlear implant only.ResultsIn this case-control study, 15 children who are using binaural-bimodal stimulation by unilateral CI and contralateral HA and 15 children using monaural cochlear implant received auditory training and language therapy. All participants have been assigned randomly from the Phoniatrics and Audiology clinics. Filtering of patients was made to get the two groups matched regarding age, sex, family motivation, age of implantation, and age of hearing impairment. Evaluation and language therapy were performed in the Phoniatrics clinic. Language progress in each group was compared over different time-points. Also, it was compared between the two groups in each time-point. Both groups revealed significant language improvement over time with intensive auditory training and language therapy. In addition, the bimodal-fit children showed better language and speech outcomes than the unilateral CI children in receptive semantics, expressive semantics, word class, mean length of utterance, and speech intelligibility. The differences were significant with P-values 0.047, 0.034, 0.03, 0.016, and 0.028, respectively, after 9 months of rehabilitation.ConclusionBimodal-fit children showed better improvement in language than the unilateral CI group. The contralateral hearing aid may be complementary to the unilateral cochlear implant by covering wider speech frequency range. Also, it prevents auditory deprivation and enables binaural hearing with positive impact on language outcome.

Evaluating the dose–response relationship of the number of sessions of “It Takes Two to Talk®” in young children with language delay

Purpose To evaluate the dose–response relationship between the number of It Takes Two to Talk® (ITTT) sessions attended and the language outcomes of young children with language delay and their parent’s responsivity in a multicultural clinical population. Method A clinical caseload of 273 early language delayed children (mean age 29.2 months, SD 7.8) and their families participated in parent group workshops and individual coaching sessions of the parent responsivity program ITTT. The children’s vocabulary and early syntax, collected using the MacArthur-Bates Communicative Development Inventories and mean length of the three longest utterances respectively, were collated from pre- and post-intervention from pre-existing clinical data. Parental responsivity was evaluated utilising the Parent–Child Interaction checklist at three time points. Multilevel regression was used to determine the relationship between the number of sessions attended and outcomes, while accounting for covariates such as age and language spoken. Result ITTT dosage did not predict child language outcomes. Rather, vocabulary and early syntax outcomes were predicted by age, pre-scores and parent responsivity at the beginning of treatment. A higher dosage of ITTT did however positively predict parent responsivity, as did speaking only English at home. Socioeconomic status, gender and presence of receptive language difficulties did not contribute significantly to either child or parent outcomes. Conclusion A lower dosage of the intervention may be considered for parents and children with fewer known risk factors without significant implications.

Using Theory to Drive Intervention Efficacy: The Role of Dose Form in Interventions for Children with DLD.

‘Dose form’ is a construct that has evolved over the last number of years and is central to treating childhood language disorders. In this commentary, we present a framework of dose form that includes techniques, procedures, manner of instruction, and intervention context. We present key findings from a systematic review exploring the impact of intervention dose form on oral language outcomes (specifically morphosyntax and vocabulary learning) in children with DLD. We then discuss the hypothesized theoretical mechanisms of action underpinning these findings.

Access to Pediatric Audiological Evaluation Facilities: Urgent Needs and Why They Matter

Access to Pediatric Audiological Evaluation Facilities: Urgent Needs and Why They Matter

Considerations when using rating scales to support teacher professional development: A commentary on Weadman, Serry and Snow (2022)

While observational rating scales such as the Emergent Literacy and Language Early Childhood Checklist for Teachers (ELLECCT) have potential to support Early Childhood Teachers in improving their practice, the existence of a valid and reliable tool is no guarantee of success. A carefully constructed model of teacher professional development will be required to ensure benefits for instructional practice and child language outcomes. This commentary considers the evidence available to guide intelligent design of such a model.

Maternal responsive behaviours and child language outcomes in a cohort of mothers and children facing adversity

ABSTRACT Children facing adversity are at greater risk of experiencing language difficulties than their peers. This study aims to examine the association between specific maternal responsive behaviours at 24 months and language outcomes at the age of 5 years in a cohort of mothers and children facing adversity. Mother–child dyads (n = 138) facing adversity were observed and videoed at home at 24 months in mother–child free play. Four maternal responsive behaviours were coded from these videos: imitations, responsive questions, labels, and expansions. Child language was assessed using the CELF-4 at the age of 5 years. Linear regression was used to examine associations, in both adjusted and unadjusted models. In unadjusted models, imitations, responsive questions, and labels predicted better child language scores at age 5. Imitations continued to positively predict language scores after adjusting for confounding factors, including earlier communication skills. Findings demonstrate the importance of considering maternal responsive behaviours with respect to stages of child development.