Preverbal Communication Research Articles

Phenotyping variability in early socio-communicative skills in young children with autism and its influence on later development.

Children with autism spectrum disorder (ASD) often face challenges in early social communication skills, prompting the need for a detailed exploration of specific behaviors and their impact on cognitive and adaptive functioning. This study aims to address this gap by examining the developmental trajectories of early social communication skills in preschoolers with ASD aged 18-60 months, comparing them to age-matched typically developing (TD) children. Utilizing the early social communication scales (ESCS), the research employs a longitudinal design to capture changes over time. We apply a principal component analysis (PCA) to ESCS variables to identify underlying components, and cluster analysis to identify subgroups based on preverbal communication profiles. The results reveal consistent differences in early social communication skills between ASD and TD children, with ASD children exhibiting reduced skills. PCA identifies two components, distinguishing objects-directed behaviors and social interaction-directed behaviors. Cluster analysis identifies three subgroups of autistic children, each displaying specific communication profiles associated with distinct cognitive and adaptive functioning trajectories. In conclusion, this study provides a nuanced understanding of early social communication development in ASD, emphasizing the importance of low-level behaviors. The identification of subgroups and their unique trajectories contributes to a more comprehensive understanding of ASD heterogeneity. These findings underscore the significance of early diagnosis, focusing on specific behaviors predicting cognitive and adaptive functioning outcomes. The study encourages further research to explore the sequential development of these skills, offering valuable insights for interventions and support strategies.

Infants’ use of the index finger for social and non-social purposes during the first two years of life: A cross-cultural study

The emergence of the pointing gesture is a major developmental milestone in human infancy. Pointing fosters preverbal communication and is key for language and theory of mind development. Little is known about its ontogenetic origins and whether its pathway is similar across different cultures. The goal of this study was to examine the theoretical proposal that social pointing is preceded by a non-social use of the index finger and later becomes a social-communicative gesture. Moreover, the study investigated to which extent the emergence of social pointing differs cross-culturally. We assessed non-social index-finger use and social pointing in 647 infants aged 3- to 24 months from 4 different countries (China, Germany, Japan, and Türkiye). Non-social index-finger use and social pointing increased with infants’ age, such that social pointing became more dominant than non-social index-finger use with age. Whereas social pointing was reported across countries, its reported frequency differed between cultures with significantly greater social pointing frequency in infants from Türkiye, China, and Germany compared to Japanese infants. Our study supports theoretical proposals of the dominance of non-social index-finger use during early infancy with social pointing becoming more prominent as infants get older. These findings contribute to our understanding of infants’ use of their index finger for social and non-social purposes during the first two years of life.

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.

Effects at 12 months of a primary care intervention using finger puppets to support early language promotion: A pilot study

ObjectiveTo determine if introducing finger puppets in the primary care setting during infancy improves parenting and language outcomes at 12 months. MethodsIntervention cohorts were enrolled at ages 2 (early) and 6 (late) months, given a puppet, and followed two weeks later to assess dosage. High dosage was defined as using the puppet daily. At 12 months, a usual care cohort was enrolled and outcome measures were collected for all participants, including maternal depression (PHQ-9), the cognitive home environment (StimQ-T), preverbal skills (CSBS-DP-IT), and vocabulary development (CDI SF). ResultsOf 413 families screened, 248 (60%) were eligible, 180 (73%) enrolled, and 154 (86%) completed the 12-month visit. Most children (84%) were on government-sponsored insurance. There were no differences between early and late intervention outcomes. In intention-to-treat analysis, the intervention cohorts scored better than usual care on the Availability of Learning Materials (ALM) (5.50 vs. 5.02, p = 0.04) and Parental Involvement in Developmental Advance (PIDA) (8.30 vs. 7.58, p = 0.02) StimQ-T subscales and receptive vocabulary (CDI SF English) (61.0 vs. 50.1, p = 0.05). In per protocol analysis, high dosage scored better than low dosage and usual care on the StimQ-T ALM (5.83, 5.08, 5.02, p = 0.01), preverbal communication (CSBS-DP-IT) (72.3, 57.2, 59.2, p = 0.01), and receptive vocabulary (CDI SF English) (73.4, 56.1, 50.1, p = 0.0002). ConclusionsFinger puppets distributed in infancy were associated with an enhanced cognitive home environment and better preverbal and receptive language at 12 months, especially for families using the puppet daily. Additional study should determine if impacts are generalizable and maintained.

Beyond the familial: The development of emotional communication with mothers, fathers, and strangers.

Interaction with unfamiliar partners is a component of social life from infancy onward. Yet little is known about preverbal communication with strangers. This study compared the development of infant communication with strangers to communication with mothers and fathers and examined the contribution of temperament to partner-specific communication patterns. A sample of 58 infants was observed at four and eight months during separate home-based face-to-face interactions with three partners (mother, father, and stranger). Infant visual, facial, and vocal communication behaviors were coded microanalytically. Each parent reported on infant temperament at both ages. Multilevel regression analyses indicated that infants gazed longer at strangers than at fathers, exhibited less smiling to strangers than to mothers, and produced fewer vocalizations with strangers than with either parent. Both age and temperament moderated these differences. Vocal communication with fathers became more frequent at eight months; smiling to mothers was accentuated among infants with higher levels of temperamental surgency. Importantly, levels of communication behaviors with strangers were concurrently and longitudinally associated with those with mothers and fathers. Overall, findings suggest that infant emotional communication patterns are modulated by individual temperamental differences and are reproduced in and over time, though at different levels, when interacting with novel partners.

A Deep Learning-Based Approach to Classification of Baby Sign Language Images

Baby Sign Language is used by hearing parents to hearing infants as a preverbal communication which reduce frustration of parents and accelerated learning in babies, increases parent-child bonding, and lets babies communicate vital information, such as if they are hurt or hungry is known as a Baby Sign Language . In the current research work, a study of various existing sign language has been carried out as literature and then after realizing that there is no dataset available for Baby Sign Language, we have created a static dataset for 311 baby signs, which were classified using a MobileNet V1, pretrained Convolution Neural Network [CNN].The focus of the paper is to analyze the effect of Gradient Descent based optimizers, Adam and its variants, Rmsprop optimizers on fine-tuned pretrained CNN model MobileNet V1 that has been trained using customized dataset. The optimizers are used to train and test on MobileNet for 100 epochs on the dataset created for 311 baby Signs. These 10 optimizers Adadelta, Adam, Adamax, SGD, Adagrad, RMSProp were compared based on their processing time.

Assessing and Improving Preverbal Social Communication: Teacher-Led Naturalistic Behavioral Developmental Interventions

Assessing and Improving Preverbal Social Communication: Teacher-Led Naturalistic Behavioral Developmental Interventions

Communication skills predict social-emotional competencies

IntroductionStudies have shown that many children with early language difficulties also have delays in social-emotional competencies as well as social-emotional and behavioral problems. It is unclear if these conditions are causally related, if they share a common underlying etiology, or if there are bidirectional effects. Studies investigating these associations have mostly involved children who are already using words to communicate, but it is important to know whether delays in preverbal communication and language development have any effects on these associations. The aim of the present study was to examine associations between preverbal communication and early verbal skills in infancy and subsequent social-emotional competencies and ensuing social-emotional and behavioral problems in early toddlerhood. The role of background factors known to influence early language development was also examined. MethodsThe sample consisted of 395 children (51.6% boys) from the Finnish Steps Study cohort. Language was assessed at age 13 months (+ 1 month) with the MacArthur Communicative Development Inventory for Infants (CDI-I), and the social-emotional domain was assessed at age < 17 months with the Brief Infant–Toddler Social and Emotional Assessment (BITSEA). ResultsInfants with lower preverbal gestural communication and receptive language skills had a higher risk of delays in social-emotional competencies in toddlerhood than children with better communication skills, but not of elevated social-emotional and behavioral problems. ConclusionsThe results indicate that lower early communication skills can predict delays in the development of social-emotional competencies, which has been found to be a risk factor for later development of social-emotional and behavioral problems. It is important to monitor early communication skills to provide guidance to parents in supporting early pragmatic communication and language development in infancy, if needed.

Communication Development Report [CDR]: A parent report instrument for the early screening of communication and language development in Greek-speaking infants and toddlers

This study aimed to explore the main psychometric properties of the CDR, a new parent report instrument for the early screening of communication and language development of Greek-speaking children. Based on a representative sample of 1391 children aged 7 to 30 months (M= 19.45, SD= 6.91), results are presented on the sensitivity, internalconsistency, and convergent and divergent validity of its two major scales (‘Preverbal behaviors’ and ‘Verbal behaviors’) and their respective subscales (vocal and non-vocal preverbal communication, language comprehension, productive vocabulary, morphology and syntax). Results also illustrate the developmental patterns of the dimensions of communicative/linguistic development assessed, as well as the high and significant correlations among these dimensions of (pre)linguistic knowledge. Overall, results provide evidence on the functionality, validity and reliability of the CDR, and point to its use as a tool for the early screening of communication development in Greek-speaking children for clinical, educational and research purposes.

The Effects of an Early Family-centered Tele-intervention on the Preverbal and Listening Skills of Deaf Children Under tow Years Old

Objectives: Achieving optimal outcomes in deaf children’s communication skills depends on the availability of early specialized high-quality intervention services. Early intervention services through teletechnology could respond to this need. The development of teletechnology has led to the creation of new formats for family-centered services. Such measures could address the hearing, speech, and language needs of young deaf children. This study aimed to investigate the effects of teleintervention for providing early interventions to the families of newborns and deaf children. Methods: This was a quasi-experimental study with a pre-test/post-test and a control group design. In total, 30 deaf children aged 0-2 years, and their parents were selected by purposive sampling method. Then, they were randomly assigned to the experimental and control groups. The experimental group received the teleintervention program through the internet in 36 individual and group sessions (24 group sessions &amp; 12 individual sessions). The control group received the same intervention program directly at the rehabilitation centers for deaf children. To investigate the hearing and pre-verbal skills, the Preverbal Communication Skills Scale and the Listening Skills Scale were used. The obtained data were analyzed using Analysis of Covariance (ANCOVA). Results: The provided teleintervention program was effective in increasing the scores of hearing and pre-verbal skills in the studied samples. The intensity of the effect on hearing and pre-verbal skills were 0.57 and 0.28, respectively. Discussion: The present study demonstrated the effect of teleintervention program on hearing and pre-verbal skills in the explored subjects. It also indicated that the provided teleintervention was more effective than direct intervention. Therefore, implementing this program is recommended for therapists, the parents of deaf children, and rehabilitation centers for this population.

Preverbal Communication Complexity in Infants.

The development of prelinguistic communication in typically developing infants is marked by changes in complexity as well as frequency, yet most measures focus on frequency. In the current study we used the Communication Complexity Scale (CCS) to measure prelinguistic complexity of typically developing infants in a cross-sectional sample of 6-, 8-, 10- and 12-month-olds (N = 204) during semi-structured play interaction. For each toy/interactive episode, infants' highest level of communication complexity (ranging from 0 for no response to 12 for multi-word verbalization), for both joint attention (i.e., social) and behavior regulation (e.g., requesting) functions, was scored. In addition, the same interaction was coded for frequency of all prelinguistic communication acts. Results of multivariate models indicated age-related differences in prelinguistic complexity. Measures of prelinguistic complexity and frequency evidenced moderate to strong correlations, with age-related differences by function (joint attention and behavior regulation). Significant associations with parent-report communication questionnaires were observed for both complexity and frequency measures. Results indicate that evaluating complexity of infant preverbal communication skill with the CCS is a valuable approach that can meaningfully index developmental differences in prelinguistic and early linguistic communication.

Prewerbalne zachowania komunikacyjne dzieci z zespołem Cri du Chat w ocenie rodziców

Cri du Chat syndrome (CdC) is a rare disease characterized, among others, by decreased muscle tone, microcephaly, and high palate; underdevelopment of the mandible, abnormal structure and laryngeal function (somatic symptoms) and disorders of psychomotor development and intellectual disability (psychomotor symptoms). These children have a varied level of functioning and most of them do not use verbal speech. Describing the problem of preverbal communication behaviors, the following elements were taken into account: the level of behavior in the primary communication, sensory, auditory communication, organization of behavior and signaling needs. The purpose of this article is to describe the pre-verbal behavior of children with Cri du Chat syndrome. The following questions were formulated: What is the level of pre-verbal communication (primary, sensory and auditory) of a child with CdC syndrome? What are the communicative behaviors of the child with the CdC team and at what level of organization? What is the level of signaling your needs by a child with CdC? The preverbal communication behavior of children with the Cri du Chat team presented in the article indicate that they are diverse, ranging from indicating the gesture of what they need, to vocalizing in order to provoke contact with another person. The behavior of the daughter / son indicated by the parents may constitute the basis for the teaching process of preverbal communication.

Approaches to communication assessment with children and adults with profound intellectual and multiple disabilities.

Communication assessment of people with profound intellectual and multiple disabilities (PIMD) has seldom been investigated. Here, we explore approaches and decision making in undertaking communication assessments in this group of people. A questionnaire was sent to UK practitioners. The questionnaire elicited information about assessment approaches used and rationales for assessment choices. Fifty‐five speech and language therapists (SLTs) responded. Findings revealed that the Preverbal Communication Schedule, the Affective Communication Assessment and the Checklist of Communication Competence were the most frequently used published assessments. Both published and unpublished assessments were often used. Rationales for assessment choice related to assessment utility, sensitivity to detail and change and their applicability to people with PIMD. Underpinning evidence for assessments was seldom mentioned demonstrating the need for more empirical support for assessments used. Variability in practice and the eclectic use of a range of assessments was evident, underpinned by practice‐focused evidence based on tacit knowledge.

Nonverbal communication of trauma patients in a state of minimal consciousness.

In spite of the rapid development in various communication-support technologies for those waking up from a coma, studies describing the sole process of reconstructing communication in this group of patients are scarce. The aim of this study was to analyze communication reactions in a minimal state of consciousness and describe the nonverbal behaviours characteristic for each stages significant for the therapy of communication. 18 severely brain-injured patients in a minimal state of consciousness participated in the half-year observation study, which included people experiencing at least 4 weeks of consciousness disorder/coma. Age of patients 25±5 years. Psychological assessment included: observation of various attempts of communications undertaken by patients, caregivers and family interview, the Glasgow Coma Scale (GCS) and Individual Communication Sheet. Data analysis showed a significant increase in preverbal communication, both in primal and sensory areas when compared between Stage II (GCS=6-8 points) and Stage III (GCS=9-12 points). After a time, primary communication reached a high level. Patients produced communication attempts from the behaviour organization level, and an increase in the nonverbal communication level was noted. Based on observations, nonverbal communication profiles for each stage of waking up from a coma were introduced. It was found that in the process of waking up from a coma the patients communicate with the use of the preverbal level of primal communication, the sensory and behaviour organization activities. The characteristics of the communication reactions show that in Stage III there is a significant increase in two preverbal communication areas: primal and sensory acts, when compared with Stage II.

Developmental Trajectories of Hand Movements in Typical Infants and Those at Risk of Developmental Disorders: An Observational Study of Kinematics during the First Year of Life.

Highlights The kinematics of hand movements (spatial use, curvature, acceleration, and velocity) of infants with their mothers in an interactive setting are significantly associated with age in cohorts of typical and at-risk infantsdiffer significantly at 5–6 months of age, depending on the context: relating either with an object or a person.Environmental and developmental factors shape the developmental trajectories of hand movements in different cohorts: environment for infants with VIMs; stage of development for premature infants and those with West syndrome; and both factors for infants with orality disorders.The curvature of hand movements specifically reflects atypical development in infants with West syndrome when developmental age is considered.We aimed to discriminate between typical and atypical developmental trajectory patterns of at-risk infants in an interactive setting in this observational and longitudinal study, with the assumption that hand movements (HM) reflect preverbal communication and its disorders. We examined the developmental trajectories of HM in five cohorts of at-risk infants and one control cohort, followed from ages 2 to 10 months: 25 West syndrome (WS), 13 preterm birth (PB), 16 orality disorder (OD), 14 with visually impaired mothers (VIM), 7 early hospitalization (EH), and 19 typically developing infants (TD). Video-recorded data were collected in three different structured interactive contexts. Descriptors of the hand motion were used to examine the extent to which HM were associated with age and cohort. We obtained four principal results: (i) the kinematics of HM (spatial use, curvature, acceleration, and velocity) were significantly associated with age in all cohorts; (ii) HM significantly differed at 5–6 months of age in TD infants, depending on the context; (iii) environmental and developmental factors shaped the developmental trajectories of HM in different cohorts: environment for VIM, development for PB and WS, and both factors for OD and; (iv) the curvatures of HM showed atypical development in WS infants when developmental age was considered. These findings support the importance of using kinematics of HM to identify very early developmental disorders in an interactive context and would allow early prevention and intervention for at-risk infants.

Implicit Knowledge from Infancy to the Psychotherapeutic Relationship: The Contribution of Daniel Stern

ABSTRACTThe contribution of Daniel Stern regarding the theoretical definition of early preverbal communication, later reformulated using the cognitive conceptualization of implicit knowledge (Schacter, 1994), is discussed in this article. This perspective describes early interactions between infant and caregivers communicating with eye contact, vocalizations, postures, and gestures, whose rhythm is assimilated by the infant. Stern, from the beginning, considered relevant the clinical implications that were further developed. In this article, I clarify the relevance of implicit knowledge during infancy considering the contribution of Daniel Stern and the one of the more recent research (Ammaniti and Gallese, 2014), extending subsequently the focus of implicit relational exchange inside the psychotherapeutic relationship and illustrating it with a clinical vignette.

Standardised assessment of parent-infant communication in clinical practice: Reliability and application of the Munich Assessment Scales

The goal of the present study is to investigate the reliability of the modified Munich Assessment Scales for parent-infant communication (Münchner Klinische Kommunikationsskalen). The macro-analytical instrument assesses parent-infant communication in early infancy (age one to six months) and is mainly geared towards clinical application in diagnostics, counselling, and therapy. The construction of the scales is based on micro-analytical research of preverbal communication and clinical experience with regulatory disorders in early infancy. Three-minute videotapes of face-to-face interactions under standardised conditions are used for the assessment. The four scales offer detailed behavioural descriptions of both parent and infant, and the attunement of parental behaviour to the infant's state of readiness to interact. For the purposes of the current study, 25 parent-infant dyads were recruited from paediatric practices, parent-child groups, the mother-child unit of a psychiatric hospital, and an outpatient parent-infant counselling service. The control and clinical groups consist of 13 and 12 dyads respectively. Reliability analyses reveal high percentages of agreement ranging from 75% to 85%. The scales correlate among each other in theoretically predicted patterns. We conclude that the MKK is a reliable and suitable instrument for the assessment of parent-infant interactions. In the discussion, we recommend further adjustments of the instrument, highlight its diagnostic and therapeutic applicability, and encourage future research.

Mediating Parent Learning to Promote Social Communication for Toddlers with Autism: Effects from a Randomized Controlled Trial.

A randomized controlled trial was conducted to evaluate effects of the Joint Attention Mediated Learning (JAML) intervention. Toddlers with autism spectrum disorders (ASD) aged 16-30months (n = 144) were randomized to intervention and community control conditions. Parents, who participated in 32 weekly home-based sessions, followed a mediated learning process to target preverbal social communication outcomes (social visual synchrony, reciprocity, and responding and initiating forms of joint attention) throughout daily interactions. The analysis found post-intervention effects for all outcomes, with all except initiating joint attention sustaining 6months post-intervention. Findings support the value of very early intervention targeting explicitly social functions of preverbal communication and of promoting active engagement in the learning process for both toddlers and parents.

Learning to be affected: Maternal connection, intuition and “elimination communication”

Even when heterosexual couples have relatively egalitarian relationships prior to children, once children are born, mothers tend to take on more and more of the care tasks associated with the home and family. Mothers themselves often report an unwillingness to leave their infants in the care of others, even co-parents, for fear that the caregiver may not be able to read or intuit the needs of their infant. The aim of this paper is to examine the sociomaterial and embodied process by which mothers deliberately come to develop intuition – in this case around their infant's elimination needs. Using the experiences of practitioners of both the early infant toileting practice “elimination communication” and the equivalent Chinese practice of ba niao, I argue intuition can be deliberately cultivated through parenting practices that promote embodied and responsive connection. I describe how mothers and (a few) others “learn to be affected” (Latour, 2004b) by their infants preverbal communication, and conclude that the practice offers a way for other committed caregivers to develop a form of “maternal” intuition.

KAMUTHE video microanalysis system for use in Brazil: translation, cross-cultural adaptation and evidence of validity and reliability

&lt;b&gt;Background&lt;/b&gt;&lt;br /&gt; KAMUTHE is a video microanalysis system which observes preverbal communication within the music therapy setting. This system is indicated for children with autism spectrum disorder (ASD) or multiple disabilities. The purpose of this study was to translate, adapt to Brazilian Portuguese language and analyze some psychometric properties (reliability and validity evidence) of KAMUTHE administration in Brazil for individuals with ASD.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Participants and procedure&lt;/b&gt;&lt;br /&gt; Translation, back translation, analysis by judges, and pilot application were performed to obtain evidence of content and face validity. The second part of this study was to administer KAMUTHE in 39 consecutive children with ASD. An individual session of improvisational music therapy was applied to assess the different behaviors included in KAMUTHE. The intra-rater reliability, concurrent validity and convergent validity were analyzed.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Results&lt;/b&gt;&lt;br /&gt; Translation and cross-cultural adaptation were followed and some cultural adaptations were needed. Inter-rater reliability was very good (ICCs 0.95-0.99) for the three child’s behaviors analyzed. Criteria validity with a moderate negative association was found (r = –.38, p = .017) comparing the behavior “Gazes at therapist” and the level of ASD along with the Childhood Autism Rating Scale (CARS). Convergent validity was established between the behavior “Gazes at therapist” and the two nonlinguistic communication scales (social interaction and interests) of the Children’s Communication Checklist (CCC) with a moderate correlation (r = –.43, p = .005).&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Conclusions&lt;/b&gt;&lt;br /&gt; The administration of the KAMUTHE video microanalysis system showed positive results in children with ASD. Further studies are needed to improve the reliability and validity of the instrument in Brazil.