Language Outcomes Research Articles

Early nap cessation in young children as a correlate of language and psychosocial outcomes: Evidence from a large Canadian sample

ObjectivesMost children stop napping between 2 and 5years old. We tested the association of early nap cessation (ie, children who stopped before their third birthday) and language, cognition functioning and psychosocial outcomes. MethodsData were from a national, longitudinal sample of Canadian children, with three timepoints. Children were 0-to-1 year old at T1, 2-to-3 years old at T2, and 4-to-5 years old at T3. Early nap cessation was tested as a correlate of children’s psychosocial functioning (cross-sectionally and longitudinally), cognitive function (longitudinally), and language skills (longitudinally). There were 4923 children (50.9% male; 90.0% White) and their parents in this study who were included in the main analyses. Parents reported on demographics, perinatal and developmental variables, child functioning, and child sleep. Children completed direct assessments of receptive language and cognitive ability. Nap cessation, demographic, and developmental-control variables were tested as correlates of cross-sectional and longitudinal outcomes using linear regression (with a model-building approach). ResultsEarly nap cessation correlated with higher receptive language ability (β = 0.059 ± 0.028) and lower anxiety (β = −0.039 ± 0.028) at T3, after controlling for known correlates of nap cessation, nighttime sleep, and other sociodemographic correlates of the outcomes. Cognitive ability, hyperactivity-inattention, and aggression were not correlated with nap cessation. ConclusionsEarly nap cessation is related to specific benefits (ie, better receptive language and lower anxiety symptoms). These findings align with previous research. Future research should investigate differences associated with late nap cessation and in nap-encouraging cultures, and by ethnicity.

Effectiveness of Blended Learning Programs/Models in English Instruction in Saudi Universities: A Systematic Review of Literature

This systematic review of literature examines the effectiveness of blended learning programs in the instruction of the English language in Saudi universities. The aim of this review is to critically analyse current studies on the efficacy of BL programs in teaching English language courses in Saudi universities. The review draws attention to impact of blended learning models on English education in Saudi universities and offers insight on how to enhance the use of these models in English language instruction at the tertiary level. Seven research databases were searched, generating 132 studies. Studies published before 2010, not written in English, non-peer reviewed, non-journal, not evidence-based, without abstracts, non-BL focused, and not focused on English learning or university education were excluded, leaving 56 full articles which were then coded based on the data type they presented. The coding model employed was inductively formulated based on a preliminary review of the articles selected together with the most frequent groupings and hence no specific theoretical model guided the process. For each respective coding group, the number of articles that showed BL models were more effective in teaching English courses in Saudi universities was added to the number of articles that showed the approach led to better English language outcomes. The total number of the articles whose findings did not precisely indicate the effectiveness of BL was also obtained. Results show a significant proportion of the studies suggested BL programs positively affected English language learning in Saudi universities. This is evidenced by significant improvements in language skills and the general course learning outcomes.

Cochlear Implantation in Children Under 9 Months of Age: Safety and Efficacy.

To assess the safety of cochlear implants (CIs) in children under 9 months of age to better understand expected postoperative complication rates, and to provide a preliminary look at efficacy. Single-center retrospective review. Tertiary referral center. Children 5 to 8 months of age who received a CI between 2011 and 2021. Therapeutic-CI. The primary outcome was 6-month postoperative complication rate. Secondary outcomes included length of stay, device explantation/reimplantation, rehabilitation supports, and hearing and language outcomes. Complications of children implanted under than 9 months of age was compared with a cohort of children implanted 9 to 18 months of age between the years 2011 and 2016 using a chi-squared test ( p < 0.05). One hundred six children under 9 months of age were implanted (204 CIs) at a mean age of 6.6 months (range: 5-8). Postoperative complications occurred in 28 patients (26%) and were often minor. There were no mortalities. There was no statistically significant difference in complications, including reimplantation rates, between patients implanted under 9 months of age and those implanted 9 to 18 months of age. Speech discrimination outcomes were excellent, and mean spoken language outcomes were near normative for typically developing children. Cochlear implantation can be a safe and effective treatment option for children 5 to 8 months of age. Early hearing screening and referral for infants to receive appropriate intervention will continue to play a critical role in optimizing speech and language outcomes.

Determinants of Functional Outcome after Pediatric Hemispherotomy.

We aimed to evaluate determinants of functional outcome after pediatric hemispherotomy in a large and recent multicenter cohort. We retrospectively investigated the functional outcomes of 455 children who underwent hemispherotomy at 5 epilepsy centers in 2000-2016. We identified determinants of unaided walking, voluntary grasping with the hemiplegic hand, and speaking through Bayesian multivariable regression modeling using missing data imputation. Seventy-five percent of children were seizure-free, and 44% stopped antiseizure medication at a 5.1-year mean follow-up (range = 1-17.1). Seventy-seven percent of children could walk unaided, 8% could grasp voluntarily, and 68% could speak at the last follow-up. Children were unlikely to walk when they had contralateral magnetic resonance imaging (MRI) abnormalities (40/73, p = 0.04), recurrent seizures following hemispherotomy (62/109, p = 0.04), and moderately (50/61, p = 0.03) or severely impaired (127/199, p = 0.001) postsurgical intellectual functioning, but were likely to walk when they were older at outcome determination (p = 0.01). Children were unlikely to grasp voluntarily with the hand contralateral to surgery when they had Rasmussen encephalitis (0/61, p = 0.001) or Sturge-Weber syndrome (0/32, p = 0.007). Children were unlikely to speak when they had contralateral MRI abnormalities (30/69, p = 0.002) and longer epilepsy duration (p = 0.01), but likely to speak when they had Sturge-Weber syndrome (29/35, p = 0.01), were older at surgery (p = 0.04), and were older at outcome determination (p < 0.001). Etiology and bilaterality of structural brain abnormalities were key determinants of functional outcome after hemispherotomy. Longer epilepsy duration affected language outcomes. Not surprisingly, walking and talking ability increased with older age at outcome evaluation. ANN NEUROL 2024;95:377-387.

Measuring Digital Learning Trends and Accessibility Convenience in Enhancing Early Childhood Literacy and Language Proficiency: The Role of Smart Book Media from the Perspective of Banten Javanese Language

This study explores the relationships between digital learning trends, accessibility convenience, smart book media, early childhood literacy, and language proficiency in Banten Javanese Language. Using a quantitative approach with 140 young learners (aged 10-12), we assessed how digital learning trends and accessibility convenience impact smart book media, early childhood literacy, and language proficiency. Results show that digital learning trends notably affect smart book media’s functionality, contributing to developing early childhood literacy and language skills. Additionally, accessibility convenience is crucial in enhancing smart book media’s utility, fostering early childhood literacy and language proficiency. However, while smart book media significantly influence language skills and early childhood literacy, they don’t mediate the connections between digital learning trends, accessibility convenience, and these language-related outcomes. Educators and stakeholders can utilize these findings to shape culturally sensitive language education strategies, incorporating technology and resource accessibility. This research enriches the theoretical understanding of digital learning trends and accessibility convenience’s impact on language outcomes. It highlights the practical potential of smart book media in language education, aiding educators and policymakers in aligning strategies with contemporary trends and cultural nuances. While limited to Banten Javanese Language, the study prompts further exploration through qualitative and longitudinal studies. Future research should explore cultural influences and intervention programs for optimizing language development. By uniquely merging digital learning trends, accessibility convenience, smart book media, and language outcomes, this study contributes valuable insights to the discourse on language education and technology integration within the distinct context of Banten Javanese Language.

Pengaruh Model Pembelajaran Make A Match Terhadap Hasil Belajar Bahasa Indonesia Pada Siswa Kelas II MIN 2 Kota Tangerang

This research aims to determine the influence of using the make a match learning model on the learning outcomes of Indonesian language for second-grade students at MIN 2 Kota Tangerang. The research method employed is a Quasi-Experiment with a Nonequivalent Control Group design. The study involves two classes, namely the experimental class and the control class. The sample consists of all students in class II A (experimental class) and students in class II B (control class). In the experimental class, students are treated with the make a match learning model, while in the control class, students are treated with the lecture learning model. Data collection is conducted through pre-tests and post-tests, as well as observations of learning activities. The results of this research indicate a positive and significant influence on the application of the make a match learning model on the learning outcomes of second-grade students at MIN 2 Kota Tangerang in the subject of Indonesian language. The influence can be seen from the difference in learning outcomes between the experimental class and the control class.

The effects of cognitive-linguistic interventions to treat aphasia in the first 90 days post-stroke: A systematic review

ABSTRACT Background Cognitive-linguistic interventions for aphasia are behavioural-based approaches to therapy that aim to treat language impairment skills post-acquired brain injury. The purpose of cognitive-linguistic intervention is to restore and rehabilitate language impairment skills through targeting phonologic, semantic and syntactic systems, which may support goals to improve everyday communication. Aims The aim of this systematic review was to investigate the effects of cognitive-linguistic interventions on language processing for aphasia in the first 90 days post-stroke. Secondary aims include the investigation of the effects of these interventions on functional communication and quality of life. Methods A systematic search was conducted across six databases. Twenty-one studies met the predefined eligibility criteria and were included in the review. Studies were rated for methodological quality and data extracted. A narrative synthesis was completed and conducted for all included studies. Four studies were suitable for meta-analysis. Main Contribution Evidence for the effects of cognitive-linguistic intervention for aphasia in the first 90 days post-stroke is inconclusive. Intervention approaches included constraint-induced intervention, melodic intonation therapy and study specific cognitive-linguistic intervention. Multiple studies investigated the use of computers as a mode of intervention delivery or to increase the frequency of intervention or session duration. Improvement on language outcomes was associated with positive effects on functional communication, regardless of the specific intervention. There were mixed results for quality-of-life outcomes. Conclusions Further research is required to guide aphasia intervention the first 90 days post stroke, a time critical period for recovery and rehabilitation. Research reports should include adequate description of participant characteristics and consistent use of intervention protocols and outcome measures. Providing a clear description of theoretical underpinnings and detailed information regarding the components of intervention will also facilitate future research synthesis.

Language assessment in EMI: unravelling the implicit-explicit dichotomy

Abstract English Medium Instruction (EMI) is a content-focused approach in which language learning seems to have been sidelined. However, there appear to be some inconsistencies between EMI language objectives and actual practices that are reflected in the assessment phase. The literature has revealed that an implicit-explicit dichotomy is being used to explain the role of language in EMI; here explicit refers to the declared language outcomes as opposed to implicit, meaning implied but not stated. In this study, the description of a Linguistics course taught through the medium of English, the final assignment and its evaluative rubric are critically examined. The overall aim is to discuss discrepancies between language objectives and language assessment and identify a theoretical framework that could explain the implicit-explicit dichotomy in EMI. The present study raises the possibility that the discrepancies between language objectives and assessment criteria could be described in terms of teacher practices and beliefs that diverge from the declared language policy. Findings further indicate that the implicit-explicit dichotomy depends on academic literacies constructs, which have implications for the students’ development of linguistic tacit knowledge, which is learnt experientially but cannot be easily codified.

Educational and developmental gains in early childhood (EDGE) study protocol: investigating the impact of funded three-year-old kindergarten

ABSTRACT This paper describes the research protocol for the Educational and Developmental Gains in Early Childhood (EDGE) Study, which will examine the implementation of two years of funded kindergarten prior to the first year of school in Victoria, Australia. EDGE will examine whether children’s language, cognitive, social-emotional, and behavioural outcomes are improved after two years of kindergarten compared to one year. The experiences of (and impacts on) teachers, service leaders, and families will also be examined. The study includes a cross-sectional cohort of 95 early childhood education and care (ECEC) services, and an embedded longitudinal observational cohort of children attending these services. Case studies of 15–20 ECEC services will also be collected, in addition to interviews with policy stakeholders.

It takes a village: Caregiver diversity and language contingency in the UK and rural Gambia

IntroductionThere is substantial diversity within and between contexts globally in caregiving practices and family composition, which may have implications for the early interaction’s infants engage in. We draw on data from the Brain Imaging for Global Health (BRIGHT, www.globalfnirs.org/the-bright-project) project, which longitudinally examined infants in the UK and in rural Gambia, West Africa. In The Gambia, households are commonly characterized by multigenerational, frequently polygamous family structures, which, in part, is reflected in the diversity of caregivers a child spends time with. In this paper, we aim to 1) evaluate and validate the Language Environment Analysis (LENA) for use in the Mandinka speaking families in The Gambia, 2) examine the nature (i.e., prevalence of turn taking) and amount (i.e., adult and child vocalizations) of conversation that infants are exposed to from 12 to 24 months of age and 3) investigate the link between caregiver diversity and child language outcomes, examining the mediating role of contingent turn taking. MethodWe obtained naturalistic seven-hour-long LENA recordings at 12, 18 and 24 months of age from a cohort of N = 204 infants from Mandinka speaking households in The Gambia and N = 61 infants in the UK. We examined developmental changes and site differences in LENA counts of adult word counts (AWC), contingent turn taking (CTT) and child vocalizations (CVC). In the larger and more heterogenous Gambian sample, we also investigated caregiver predictors of turn taking frequency. We hereby examined the number of caregivers present over the recording day and the consistency of caregivers across two subsequent days per age point. We controlled for children’s cognitive development via the Mullen Scales of Early Learning (MSEL). ResultsOur LENA validation showed high internal consistency between the human coders and automated LENA outputs (Cronbach’s alpha’s all >.8). All LENA counts were higher in the UK compared to the Gambian cohort. In The Gambia, controlling for overall neurodevelopment via the MSEL, CTT at 12 and 18 months predicted CVC at 18 and 24 months. Caregiver consistency was associated with CTT counts at 18 and 24 months. The number of caregivers and CTT counts showed an inverted u-shape relationship at 18 and 24 months, with an intermediate number of caregivers being associated with the highest CTT frequencies. Mediation analyses showed a partial mediation by number of caregivers and CTT and 24-month CVC. DiscussionThe LENA provided reliable estimates for the Mandinka language in the home recording context. We showed that turn taking is associated with subsequent child vocalizations and explored contextual caregiving factors contributing to turn taking in the Gambian cohort.

Bilingual advantages in foreign language learning: evidence from primary-school pupils with developmental language disorder

IntroductionOne of the bilingual advantages often reported in the literature on typically-developing children involves advantages in foreign language learning at school. However, it is unknown whether similar advantages hold for bilingual pupils with learning disabilities. In this study, we compare the performance of monolingual and bilingual primary-school children with developmental language disorder (DLD) learning English as a school subject in special education schools in the Netherlands.MethodsThe participants were monolingual (N = 49) and bilingual (N = 22) children with DLD attending Grade 4−6 of special education (age 9–12). The bilingual participants spoke a variety of home languages. The English tests included a vocabulary task, a grammar test and a grammaticality judgement task. The Litmus Sentence Repetition Task and the Peabody Picture Vocabulary Test were used as measures of, respectively, grammatical ability and vocabulary size in Dutch (majority/school language). In addition, samples of semi-spontaneous speech were elicited in both English and Dutch using the Multilingual Assessment Instrument for Narratives. The narratives were analysed for fluency, grammatical accuracy, lexical diversity, and syntactic complexity. A questionnaire was used to measure amount of exposure to English outside of the classroom.Results and discussionThe results for Dutch revealed no differences between monolinguals and bilinguals on the narrative measures, but monolinguals performed significantly better on both vocabulary and grammar. In contrast, bilinguals outperformed monolinguals on all English measures, except grammatical accuracy of narratives. However, some of the differences became non-significant once we controlled for amount of out-of-school exposure to English. This is the first study to demonstrate that foreign language learning advantages extend to bilingual children with DLD. The results also underline the need to control for differences in out-of-school exposure to English when comparing bilingual and monolingual pupils on foreign language outcomes.

Comparison of Communication in Early and Late Identified Children with Hearing Impairment

Background: The significance of early detection and intervention in hearing impairment is well-documented, with substantial evidence suggesting improved language outcomes in children who are identified and receive intervention at an early age. Objective: To quantitatively compare the communicative abilities of children with hearing impairments identified early versus late and to evaluate the impact of the timing of intervention on their language development. Methods: In a cohort study of 104 children with hearing impairment, two groups were defined based on the age at identification: early (before 6 months) and late (after 6 months). Using the Communication Checklist-2, as well as standardized tests for receptive and expressive language, we assessed and compared their communication skills. Results: Early identified children demonstrated superior communication skills, with 47.1% using object pointing compared to 57.4% of late identified children. A significant contrast was observed in verbal communication, with early identified children exhibiting higher usage of creative one-word utterances at 33.3% against 31.5% in the late group. Receptive language scores were higher in the early group by an average of 12 points, while expressive language scores were higher by an average of 15 points. Late identified children showed a higher reliance on preverbal communication, with a 3.7% higher incidence of object self-injury and a 5.2% higher occurrence of object aggression. Conclusion: The findings emphasize the substantial advantage of early identification of hearing impairment for communication skills development. Early identified children not only show a greater propensity for verbal communication but also achieve higher receptive and expressive language scores, underscoring the need for prompt hearing loss detection and intervention.

Maternal reminiscing during middle childhood: Associations with maternal personality and child temperament from the Growing Up in New Zealand cohort study.

The way that mothers talk about the past (reminisce) with young children is linked to key memory, language, and socioemotional outcomes. The present research explored the role of a range of child, maternal, socioeconomic, and cultural factors that predict maternal reminiscing style, with a particular focus on maternal personality and child temperament. A total of 1,404 mother-child dyads from the prebirth longitudinal cohort study Growing Up in New Zealand (https://www.growingup.co.nz) participated in a reminiscing task about a negative event when children were 8 years old. This broader cohort is broadly representative of the New Zealand population in terms of maternal ethnicity and socioeconomic status. Conversations were scored using a revised version of the Elaborative Reminiscing Scale. Child temperament during infancy, but not childhood, uniquely predicted maternal reminiscing style. Maternal extraversion also predicted a more elaborative reminiscing style. Other maternal factors, including education, ethnicity, and age, were also identified as unique predictors of maternal reminiscing style. These findings fit well with an ecological systems view of maternal reminiscing as a function of child, maternal, and cultural factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Two Languages in One Mind: Biliteracy, Speech Connectedness and Reading in 5th Grade Bilingual Children

This study examined the effects of bilingual education and simultaneous biliteracy on children’s levels of speech connectedness and reading in Portuguese and English. Thirty-two 5th graders completed oral production tasks and took reading fluency and comprehension tests in L1 and L2. Our results show that, in general, children show connectedness and reading scores which are correlated in the two languages, that is, the languages follow different, but related paths in the time point they were assessed. We conclude that simultaneous biliteracy, in the case of the participants of this research, is not detrimental to the outcomes of either language. On the contrary, it promotes the concomitant use of languages, which, in turn, seems to guarantee support for both languages, L1 and L2, in a bidirectional fashion.

Oral language interventions can improve language outcomes in children with neurodevelopmental disorders: A systematic review and meta-analysis.

Young people who fail to develop language as expected face significant challenges in all aspects of life. Unfortunately, language disorders are common, either as a distinct condition (e.g., Developmental Language Disorder) or as a part of another neurodevelopmental condition (e.g., autism). Finding ways to attenuate language problems through intervention has the potential to yield great benefits not only for the individual but also for society as a whole. This meta-analytic review examined the effect of oral language interventions for children with neurodevelopmental disorders. The last electronic search was conducted in April 2022. Intervention studies had to target language skills for children from 2 to 18 years of age with Developmental Language Disorder, autism, intellectual disability, Down syndrome, Fragile X syndrome, and Williams syndrome in randomised controlled trials or quasi-experimental designs. Control groups had to include business-as-usual, waiting list, passive or active conditions. However, we excluded studies in which the active control group received a different type, delivery, or dosage of another language intervention. Eligible interventions implemented explicit and structured activities (i.e., explicit instruction of vocabulary, narrative structure or grammatical rules) and/or implicit and broad activities (i.e., shared book reading, general language stimulation). The intervention studies had to assess language skills in receptive and/or expressive modalities. The search provided 8195 records after deduplication. Records were screened by title and abstract, leading to full-text examinations of 448 records. We performed Correlated and Hierarchical Effects models and ran a retrospective power analysis via simulation. Publication bias was assessed via p-curve and precision-effect estimate. We examined 38 studies, with 46 group comparisons and 108 effects comparing pre-/post-tests and eight studies, with 12 group comparisons and 21 effects at follow-up. The results showed a mean effect size of d = 0.27 at the post-test and d = 0.18 at follow-up. However, there was evidence of publication bias and overestimation of the mean effects. Effects from the meta-analysis were significantly related to these elements: (1) receptive vocabulary and omnibus receptive measures showed smaller effect sizes relative to expressive vocabulary, grammar, expressive and receptive discourse, and omnibus expressive tests; and (2) the length of the intervention, where longer sessions conducted over a longer period of time were more beneficial than brief sessions and short-term interventions. Neither moderators concerning participants' characteristics (children's diagnosis, diagnostic status, age, sex, and non-verbal cognitive ability and severity of language impairment), nor those regarding of the treatment components and implementation of the language interventions (intervention content, setting, delivery agent, session structure of the intervention or total number of sessions) reached significance. The same occurred to indicators of study quality. The risk of bias assessment showed that reporting quality for the studies examined in the review was poor. In sum, the current evidence base is promising but inconclusive. Pre-registration and replication of more robust and adequately powered trials, which include a wider range of diagnostic conditions, together with more long-term follow-up comparisons, are needed to drive evidence-based practice and policy.

Applying a Developmental Model to Preliterate Aided Language Learning.

Childhood spoken language interventions and augmentative and alternative communication (AAC) interventions share a common purpose: maximizing communication and language outcomes. To ensure that interventions for children who require AAC also address expressive language acquisition, this clinical focus article focuses on how to apply a developmental model of language acquisition to guide AAC decision making for preliterate aided communicators, with a particular focus on vocabulary selection. A brief review of early expressive language development is presented, along with arguments for why relying on a developmental model to guide AAC decision making is so critical. A series of detailed examples of how to apply a developmental model to various AAC vocabulary selection approaches are provided, including analyses of how well each approach aligns with pragmatic, semantic, grammatical, and narrative development. No single AAC approach for preliterate AAC language learners adequately addresses both immediate and longer-term expressive language needs; every approach has both strengths and weaknesses. Clinical decision making requires an analysis of each approach to ensure that AAC service delivery teams clearly understand the inevitable linguistic gaps, with plans put into place to fill in those gaps with different approaches. Future efforts to improve preliterate AAC service provision should use a developmental model of language as a starting point, in combination with input from families, educators, and clinicians to ensure the feasibility of the chosen approaches.

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.

The quality of teaching behaviors in learning environments of DHH students.

Classrooms are complex learning environments, with instruction, climate, and teacher-student interactions playing important roles in students' academic progress. To investigate the learning environments of deaf and hard-of-hearing (DHH) students, we developed a new observational tool called the Quality of the Learning Environment-DHH rating scale (QLE-DHH) and rated 98 teachers of DHH students being educated in a range of classroom environments. The present study sought to (1) determine if the items on the QLE-DHH are good indicators of theoretically meaningful dimensions of classroom quality; (2) determine to what extent these dimensions predicted language and reading outcomes of DHH students; and (3) examine how teachers of DHH students were rated on the indicators of classroom quality. The findings suggested that the QLE-DHH has excellent structural validity. Ratings predicted student reading outcomes. Finally, the QLE-DHH was able to capture teachers' strengths and skills in need of improvement. The QLE-DHH appears to hold promise for use in both research and teacher preparation programs.

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.

Maternal depressive symptoms and child language development: Exploring potential pathways through observed and self-reported mother-child verbal interactions

Abstract Maternal depressive symptoms (MDS) in the postnatal period may impact children’s later development through poorer quality parent-child interactions. The current study tested a specific pathway from MDS (child age 9 months) to child receptive vocabulary (4 ½ years) through both self-reported and observed parent-child verbal interactions (at both 2 and 4 ½ years). Participants (n = 4,432) were part of a large, diverse, contemporary pre-birth national cohort study: Growing Up in New Zealand. Results indicated a direct association between greater MDS at 9 months and poorer receptive vocabulary at age 4 ½ years. There was support for an indirect pathway through self-reported parent-child verbal interactions at 2 years and through observed parent-child verbal interactions at 4 ½ years. A moderated mediation effect was also found: the indirect effect of MDS on child vocabulary through observed verbal interaction was supported for families living in areas of greater socioeconomic deprivation. Overall, findings support the potential role of parent-child verbal interactions as a mechanism for the influence of MDS on later child language development. This pathway may be particularly important for families experiencing socioeconomic adversity, suggesting that effective and appropriate supportive parenting interventions be preferentially targeted to reduce inequities in child language outcomes.