Persistent Language Delay Research Articles

Children With Persistent Versus Transient Early Language Delay: Language, Academic, and Psychosocial Outcomes in Elementary School.

Purpose The objective of this study was to compare children with persistent versus transient preschool language delay on language, academic, and psychosocial outcomes in elementary school. Method Children with persistent language delay (n = 30), transient language delay (n = 29), and no language delay (controls; n = 163) were identified from a population-based sample of twins. They were compared on language skills, academic achievement, and psychosocial adjustment in kindergarten and Grades 1, 3, 4, and 6. Results Children with persistent language delay continued to show language difficulties throughout elementary school. Furthermore, they had academic difficulties, in numeracy, and psychosocial difficulties (attention-deficit/hyperactivity disorder behaviors, externalizing behaviors, peer difficulties) from Grade 1 to Grade 6. Children with transient language delay did not differ from controls on language and academic performance. However, they showed more externalizing behaviors in kindergarten and peer difficulties in Grade 1 than controls. Conclusion Difficulties at school age are widespread and enduring in those with persistent early language delay but appear specific to psychosocial adjustment in those with transient language delay.

Predicting Literacy Skills at 8 Years From Preschool Language Trajectories: A Population-Based Cohort Study.

Purpose This article explored the predictive values of three main language delay (LD) trajectories (i.e., persistent, late onset, and transient) across 3-5 years on poor literacy at 8 years. Additionally, the effect of gender was assessed, using both gender-neutral and gender-specific thresholds. Method The data comprised mother-reported questionnaire data for 8,371 children in the Norwegian Mother, Father, and Child Cohort Study. Analyses were conducted using binary logistic regression in SPSS to make predictions about risk. Results LD reported at preschool age was associated with excess risk of poor literacy at 8 years with odds ratios ranging from 3.19 to 9.75 dependent on trajectory, persistent LD being the strongest predictor. The odds ratio of transient LD was similar to that of late-onset LD. Gender was not found to play an important role in the association between oral language and literacy, as the gender difference disappeared when gender-specific deficit criterion was used. Conclusion Our study supports the longitudinal association between preschool oral language and school-aged literacy skills and highlights the importance of different LD trajectories across preschool ages in predicting later literacy. Furthermore, practitioners are recommended to consider gender-specific cutoffs in relation to language and literacy measures.

Measures of early social communication and vocabulary production to predict language outcomes at two and three years in late-talking toddlers

BackgroundLate talkers are a heterogeneous group of toddlers and reliable predictors of persistent language delay have been elusive. The purpose of this study was to determine the extent to which early social communication and vocabulary production predicted variance in language outcomes at 2 and 3 years of age. MethodsParticipants were 408 typically developing and late-talking toddlers who completed the Communication and Symbolic Behavior Scales Caregiver Questionnaire and Behavior Sample (CSBS CQ and CSBS BS) at a mean of 20 months, the Language Development Survey (LDS) at a mean of 24 months, and the Mullen Scales of Early Learning (MSEL) at a mean of 25 months. A subgroup of 198 children completed a second MSEL at 3 years of age. Associations among the LDS, CSBS CQ, CSBS BS, and MSEL were examined using correlational and hierarchical linear regression analyses. Logistic regression was used to examine each measure’s contribution to predicting language delay at 2 and 3 years. ResultsModerate to large correlations were observed among all variables. The LDS, CSBS CQ, and CSBS BS added unique contributions to the prediction of 2- and 3-year expressive and receptive language outcomes. Measures of speech and vocabulary production were the strongest predictors of language outcomes at age 2. At age 3, social and symbolic communication played a more significant role in accounting for variance in expressive and receptive language outcome. A similar pattern emerged for the categorical prediction of language delay. ConclusionsMeasures of social communication between 18–21 months added important information to predicting language outcomes at 2 and 3 years, above and beyond parent-reported expressive vocabulary production measured at 24 months, with small effect sizes overall. Implications for identifying younger children who are at risk for continued language delay and recommendations for referral to early intervention programs are discussed.

Developmental changes in brain response to speech perception in late-talking children: A longitudinal MMR study

This study used a longitudinal design to examine the development of mismatch responses (MMRs) to Mandarin lexical tones, an index of neural speech discriminative responses, in late talkers and typical controls at 3, 5, and 6 years of age. Lexical tones are phonetic suprasegments that distinguish the lexical meanings of syllables in tonal languages. The 2 year-old late talkers were later divided into persistent language delay and late bloomer groups according to their performance on standardized language tests at 4 years. Results showed that children with persistent language delay demonstrated more positive mismatch responses than the typical controls at 3 years of age. At the age of 5, no group difference were found in the amplitude of MMRs, but the maturation of MMRs could be observed in the change of topography, with more prominent negative response in the frontal sites only in the typical group. Correlations were found between the index of MMRs at 3 years and children’s language performance outcome at 6 years. Our results indicate that the development of fine-grained tone representations is delayed in late-talking children between 3 and 5 years and may be one of the underlying mechanisms which associated with later language performance.

Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation.

The purpose of the present investigation is to differentiate children using cochlear implants (CIs) who did or did not achieve age-appropriate language scores by midelementary grades and to identify risk factors for persistent language delay following early cochlear implantation. Children receiving unilateral CIs at young ages (12-38 months) were tested longitudinally and classified with normal language emergence (n = 19), late language emergence (n = 22), or persistent language delay (n = 19) on the basis of their test scores at 4.5 and 10.5 years of age. Relative effects of demographic, audiological, linguistic, and academic characteristics on language emergence were determined. Age at CI was associated with normal language emergence but did not differentiate late emergence from persistent delay. Children with persistent delay were more likely to use left-ear implants and older speech processor technology. They experienced higher aided thresholds and lower speech perception scores. Persistent delay was foreshadowed by low morphosyntactic and phonological diversity in preschool. Logistic regression analysis predicted normal language emergence with 84% accuracy and persistent language delay with 74% accuracy. CI characteristics had a strong effect on persistent versus resolving language delay, suggesting that right-ear (or bilateral) devices, technology upgrades, and improved audibility may positively influence long-term language outcomes.

Language emergence in early-implanted children

This study develops a model to differentiate early-implanted children with preschool language delays that persist into the elementary grades from children who achieve normal language as they gain auditory, linguistic, and academic experience. A nationwide sample of 60 children with congenital profound deafness, auditory-oral education, and early cochlear implantation (12–36 months) was assessed at average ages of 3.5, 4.5, and 10.5 years. Children were classified with: Normal Language Emergence (NLE: N = 19), Late Language Emergence (LLE: N = 22), or Persistent Language Delay (PLD: N = 19) based on standardized language test scores. Children with PLD did not differ from children with LLE on a number of variables that have previously been associated with post-implant outcome, including pre-implant hearing, age at first CI, gender, maternal education and nonverbal intelligence. Logistic regression analysis identified variables that predicted whether children with early language delay would catch up with hearing age-mates: (1) preschool speech and language level, (2) ear placement of first CI, (3) upgrades in speech processor technology, and (4) CI aided thresholds. A majority of the 60 children in this study reached age-appropriate levels of language, reading, and verbal reasoning and were placed in primary grades with hearing age-mates.

Early Language Delay Phenotypes and Correlation with Later Linguistic Abilities

Objectives: The present study focused on examining the continuity and directionality of language skills in late talkers (LTs) and identifying factors which might contribute to language outcomes at the age of 3 years. Methods: Subjects were 23 Cypriot-Greek-speaking toddlers classified as LTs and 24 age-matched typically developing peers (TDs). Participants were assessed at 28, 32 and 36 months, using various linguistic measures such as size of receptive and expressive vocabulary, mean length of utterance (MLU) of words and number of consonants produced. Data on otitis media familial history were also analyzed. Results: The ANOVA results indicated parallel developmental profiles between the two groups, with a language lag characterizing LTs. Concurrent correlations between measures showed that poor phonetic inventories in the LT group at 28 months predicted poor MLU at the ages of 32 and 36 months. Significant cross-lagged correlations supported the finding that poor phonetic inventories at 28 months served as a good predictor for MLU and expressive vocabulary at the age of 32 and for MLU at 36 months. Conclusions: The results highlight the negative effect of early language delay on language skills up to the age of 3 years and lend support to the current literature regarding the universal linguistic picture of early and persistent language delay. Based on the current results, poor phonetic inventories at the age of intake might serve as a predictive factor for language outcomes at the age of 36 months. Finally, the findings are discussed in view of the need for further research with a focus on more language-sensitive tools in testing later language outcomes.

Trajectories of language delay from age 3 to 5: persistence, recovery and late onset

Knowledge is scarce on what contributes to whether children with early language delay (LD) show persistent, recovering or sometimes late-onset LD without a prior history of early LD in subsequent preschool years. To explore whether an integrative model of vital risk factors, including poor early communication skills, family history of language-related difficulties and male gender, predicts the development of persistent, recovering or late-onset LD trajectories from 3 to 5 years quantitatively and qualitatively differently. LD was assessed by maternal reports on the Ages and Stages Questionnaire at 3 and 5 years for 10 587 children in The Norwegian Mother and Child Cohort Study. Children were classified across time as having no, late onset, transient or persistent LD. Multinomial logistic regression analyses included the integrative model of vital risk factors and covariates. Across time, 3%, 5% and 6.5% of the children displayed persistent, transient and late-onset LD, respectively. The odds for persistent LD were doubled for boys and children with low language comprehension at 1.5 years; and tripled by late-talking familial risk. These same odds decreased for transient LD, and even further for late-onset LD. Familial risk for writing and reading difficulties especially increased the odds for late-onset and persistent LD, while familial risk of unintelligible speech increased the odds for transient LD. Although girls had on average far better language comprehension than boys, low language comprehension was a stronger risk factor for persistent LD in girls. Preschool LD trajectories were uniquely predicted from the integrative risk model of poor early communicative skills, family history and male gender. This might benefit identification of different LD trajectories by supporting broader severe vulnerability for persistent LD, milder vulnerability for transient LD, and possibly a specific risk for reading and learning difficulties for children with late-onset LD.

Language Skills in Cypriot-Greek Speaking Toddlers with Specific Language Delay

The current investigation examined longitudinally the emergence of specific linguistic parameters in toddlers with and without late onset of expressive language. The central aim of this investigation was to compare the linguistic skills of typically developing and late-talking toddlers while: (a) observing patterns of linguistic development between the two groups on specific parameters and (b) examining the impact of early language delay on language-specific parameters and comparing these with cross-linguistic data. The subjects were 18 Cypriot-Greek speaking toddlers classified as late-talkers (LTs), and 18 age-matched counterparts with normal course of language development (NLDs). Participants were assessed at 28 months, 32 months, and 36 months, using various linguistic measures such as receptive and expressive vocabulary, mean length of utterance as measured in words (MLU-W), and phonetic production. Overall, the two groups exhibited parallel developmental profiles, with a language lag favoring the LT group as compared to the NLD counterpart. The results of this study highlight the negative effect of early language delay on later language skills, even up to age three years and lend support to the current literature regarding the universal linguistic picture of early and persistent language delay. Finally, the findings are discussed in view of the need for further research with a focus on more language sensitive tools in testing later language outcomes.

Mild Conductive Hearing Loss and Language Development

Thirteen children aged 3 to 5 years with mild conductive hearing losses and histories of otitis media were pair-matched with audiologically normal children on age, sex, socioeconomic status, family intactness, and first language (English). The Test for Auditory Comprehension of Language, the Northwestern Syntax Screening Test, and the Developmental Sentence Scoring Procedure were administered. Phonology errors were tabulated from the spontaneous language sample. The language evaluation was repeated after a 1-year interval. All measures differentiated the groups at highly significant levels on the initial assessment. All tests except the Test for Auditory Comprehension of Language continued to show significant differences a year later. The results support the hypothesis that children who experience recurrent middle ear problems are at risk for persistent language delay.