Predict Language Outcomes Research Articles

Preschool language variation, growth, and predictors in children on the autism spectrum.

There is wide variation in language abilities among young children with autism spectrum disorders (ASD), with some toddlers developing age-appropriate language while others remain minimally verbal after age 5. Conflicting findings exist regarding predictors of language outcomes in ASD and various methodological issues limit the conclusions that can be drawn about factors associated with positive language growth that could provide insights into more effective intervention approaches for increasing communication skills. Language development was investigated in 129 children with ASD participating in four assessments from mean age 2½years (Visit 1) through 5½years (Visit 4). Language ability was measured by a clinician-administered test of comprehension and production. Hierarchical linear modeling was used to identify predictors of language ability. Stability of language status was examined in subgroups of Preverbal versus Verbal children identified at Visit 1. Discriminant function analysis was used to classify another subset of cases according to Low Language (minimally verbal) versus High Language outcome at Visit 4. ASD severity was a significant predictor of growth in both language comprehension and production during the preschool period, while cognition predicted growth in production. For the highest and lowest language performers at Visit 4, cognition, maternal education, and response to joint attention correctly classified over 80% of total cases. The vast majority of children who were preverbal at 2½years attained some level of verbal skills by 5½years. Findings indicate that it is possible, by 2½years, to predict language growth for children with ASD across the preschool years and identify factors that discriminate between children who remain minimally verbal at 5½years from those with high language proficiency. Results suggest that early intervention focused on reducing core ASD symptoms may also be important for facilitating language development in young children with ASD.

Presurgery resting-state local graph-theory measures predict neurocognitive outcomes after brain surgery in temporal lobe epilepsy.

This study determined the ability of resting-state functional connectivity (rsFC) graph-theory measures to predict neurocognitive status postsurgery in patients with temporal lobe epilepsy (TLE) who underwent anterior temporal lobectomy (ATL). A presurgical resting-state functional magnetic resonance imaging (fMRI) condition was collected in 16 left and 16 right TLE patients who underwent ATL. In addition, patients received neuropsychological testing pre- and postsurgery in verbal and nonverbal episodic memory, language, working memory, and attention domains. Regarding the functional data, we investigated three graph-theory properties (local efficiency, distance, and participation), measuring segregation, integration and centrality, respectively. These measures were only computed in regions of functional relevance to the ictal pathology, or the cognitive domain. Linear regression analyses were computed to predict the change in each neurocognitive domain. Our analyses revealed that cognitive outcome was successfully predicted with at least 68% of the variance explained in each model, for both TLE groups. The only model not significantly predictive involved nonverbal episodic memory outcome in right TLE. Measures involving the healthy hippocampus were the most common among the predictors, suggesting that enhanced integration of this structure with the rest of the brain may improve cognitive outcomes. Regardless of TLE group, left inferior frontal regions were the best predictors of language outcome. Working memory outcome was predicted mostly by right-sided regions, in both groups. Overall, the results indicated our integration measure was the most predictive of neurocognitive outcome. In contrast, our segregation measure was the least predictive. This study provides evidence that presurgery rsFC measures may help determine neurocognitive outcomes following ATL. The results have implications for refining our understanding of compensatory reorganization and predicting cognitive outcome after ATL. The results are encouraging with regard to the clinical relevance of using graph-theory measures in presurgical algorithms in the setting of TLE.

Maternal responsiveness predicts child language at ages 3 and 4 in a community-based sample of slow-to-talk toddlers.

Maternal responsiveness has been shown to predict child language outcomes in clinical samples of children with language delay and non-representative samples of typically developing children. An effective and timely measure of maternal responsiveness for use at the population level has not yet been established. To determine whether a global rating of maternal responsiveness at age 2 years predicts language outcomes at ages 3 and 4 in a community sample of slow-to-talk toddlers. In an Australian population-based study, at child age 1:6 years, 301 slow-to-talk toddlers (scoring ≤20th percentile on a parent-reported expressive vocabulary checklist) were invited to take part in a 15-min free-play video of mother-child interaction at 2:0 years. Each free-play video was rated for maternal responsiveness using a five-point global rating scale, where 1 is 'very low' responsiveness and 5 is 'very high' responsiveness. Language skills were measured at 3:0 years using PLS-4 and at 4:0 years using the CELF-P2. In adjusted linear regression models (potential confounders: gender, maternal education, socioeconomic status) maternal responsiveness strongly predicted receptive, expressive and total language standard scores at ages 3 (coefficient = 5.9, p < 0.001; coefficient = 5.4, p < 0.001; coefficient = 6.2, p < 0.001, respectively) and 4 years (coefficient = 4.6, p < 0.001; coefficient = 3.1, p = 0.004; coefficient = 4.0, p < 0.001, respectively). Slow-to-talk toddlers of mothers with higher global ratings of responsiveness have higher language scores at 3 and 4 years of age. This global measure of maternal responsiveness could be further developed as a clinical tool for identifying which slow-to-talk toddlers are most in need of early intervention.

Vocabulary Gain Among Children With Language Disorders: Contributions of Children’s Behavior Regulation and Emotionally Supportive Environments

Behavior regulation is a positive predictor of language outcomes for children with typically developing language skills, and children with language disorders are at greater risk for difficulties with behavior regulation. This study investigated the unique role of behavior regulation on vocabulary gain for children receiving language therapy in the public schools as well as the unique and moderating influence of emotional support within therapy sessions on outcomes. A total of 121 kindergarten and 1st-grade students with language disorders, nested within 42 speech-language pathologists (SLPs), participated in the study. Direct child measures, indirect child measures, and therapy session videotapes were used for all analyses. Hierarchical linear modeling indicated a positive association between children's behavior regulation and vocabulary gain. The emotional support of therapy sessions was not a significant predictor of vocabulary gain. Results from this study suggest that children's behavior regulation is a significant predictor of vocabulary gain for children with language disorders; children with higher behavior regulation gain more over the academic year than do peers with lower behavior regulation. Findings highlight the importance of SLPs considering children's behavior regulation when planning and implementing therapy.

Measuring maternal responsiveness in a community-based sample of slow-to-talk toddlers: a cross-sectional study.

Maternal responsiveness is important in early language development, but its measurement by direct observation has to date been unrealistic in community settings because of training and time constraints. We report on the development and cross-sectional comparison of a global rating of maternal responsiveness against a detailed measure of responsiveness at age 24 months. The community-based sample comprised 246 toddlers and their mothers, identified as being slow-to-talk at age 18 months within the Let's Learn Language population-based randomized controlled trial. At age 24 months, mother-child dyads were videotaped during 15 minutes of free-play and children undertook a standardized language assessment. Videos were blindly rated on both the new global measure, comprising a single rating of responsiveness on a five-point Likert scale, and a detailed rating of responsiveness known to predict language outcomes, comprising a sum of specific maternal responsive behaviours. The global rating scale required relatively little training and ratings could be conducted in real time. The global and detailed ratings of maternal responsiveness showed moderate correlation (r = 0.44; P < 0.001). Small positive correlations were found between the global rating and expressive (r = 0.23; P < 0.001), receptive (r = 0.28, P < 0.001) and total language (r = 0.28; P < 0.001) at age 24 months. The global rating scale was efficient and moderately effective as a measure of maternal responsiveness. It is possible that, combined with other risk measures including concurrent language skills, it could strengthen prediction of which children will and will not go on to experience lasting language difficulties.

An Irish Cohort Study of Risk and Protective Factors for Infant Language Development at 9 Months

This nationally representative study of Irish infants explores whether the set of child and environmental factors established as predicting language outcomes aged 3 years would also predict language and communication development as early as age 9 months. Associations between infant and environmental characteristics and infant language outcomes at 9 months, as measured on the ASQ 10‐month communication questionnaire, were explored in a series of bivariate logistic regression models and in a fully adjusted multivariable logistic regression model. Infant gender, health, birthweight and temperament were significantly associated with passing the ASQ communication measure at 9 months. Being an only child and having some experience of relative childcare predicted positive communication outcomes. Infants of older mothers and mothers who spoke less to the child while doing other things were significantly less likely to pass. Infants of mothers with the lowest educational level were more likely than their peers to pass at 9 months. Unlike language outcomes at 3 years, low maternal education does not appear to be a risk factor for poorer outcomes at 9 months. This study adds significantly to the infant language development literature by focussing on communication outcomes in early infancy and identifying protective and risk factors at such an early stage. Copyright © 2014 John Wiley &amp; Sons, Ltd.

Domain-Specific Cognitive Stimulation and Maternal Sensitivity as Predictors of Early Academic Outcomes among Low-Income African American Preschoolers

Toni Harris Virginia State UniversityJohn Sideris University of North Carolina at Chapel HillZewelanji Serpell Virginia Commonwealth UniversityMargaret Burchinal University of North Carolina at Chapel HillChloe Pickett Virginia State UniversityIntroductionBy the end of preschool, many African American children from low-income families have demonstrable lags in early language, literacy, and mathematical skills (Denton Flanagan & McPhee, 2009; Hoffman & Llagas, 2003; Sbarra & Pianta, 2001). African American boys are particularly at-risk for poor early outcomes (Chatterji, 2006; Davis, 2003; Downer & Pianta, 2006; Kaiser, Cai, Hancock, & Foster, 2002; Stanton-Chapman et al., 2004) and research shows that with each increasing grade level African American girls outperform boys in all academic domains including math, language, and science (Roberts, Burchinai, & Durham, 1999). It has been suggested that African American children's family contexts be more closely examined to determine how they differentially influence African American children's academic achievement, in light of unique risk factors associated with race, gender, and socioeconomic status (SES, Thomas & Stevenson, 2009).There is a significant body of literature that has examined how cognitive stimulation and maternal sensitivity predicts language outcomes during early childhood (Davis, 2003; Roberts, Jurgens, & Burchinai, 2005); and among Canadian children, how domain-specific cognitive stimulation (e.g., mathematics stimulation) predicts mathematical skills during middle childhood (Blevins-Knabe & Musun-Miller, 1996; LeFevre et al., 2009). From these studies, one can ascertain that during early childhood maternal sensitivity and cognitive stimulation predict language outcomes, and that domain-specific stimulation should predict mathematics outcomes during early childhood as they have done in middle childhood.As previously stated, by kindergarten entry, African American children in general, and lowincome African American children in particular, continue to demonstrate lags in performance (i.e., achievement scores and grades) that are maintained throughout their academic careers (Jencks & Phillips, 1998; Lee, 2002) with African American males demonstrating the greatest lags. In spite of these outcomes, the literature has not closely examined how domain-specific parenting variables predict African American children's language and mathematics academic outcomes prior to kindergarten entry, nor has it closely examined predictors based on gender. The primary goal of the current study is to take a closer look at how maternal sensitivity and domain-specific cognitive stimulation predict applied problem-solving skills, letter-word identification, and vocabulary during early childhood, by gender, so that more precise recommendations for successful academic outcomes can be provided to low-income African American parents.The theoretical framework for the current study derives from ecological-developmental theories (Bronfenbrenner, 1994; Garcia Coll et al., 1996) that emphasize that development is best understood by examining the multiple ecologies of children and inputs from individuals that constitute them. All ecological-developmental theories contend that development depends, in part, on the degree of support provided by a child's environment, particularly the home environment. Garcia Coll and colleagues' (1996) integrative model adds cultural specificity to traditional ecological-developmental models by describing macrosystem variables (e.g., racism, discrimination, and history of oppression) that uniquely affect children from racial/ethnic minority groups. This integrative model posits that for African American children, developmental processes are affected first by social position variables such as race, social class, and gender.Much of the existing educational research examining early predictors of academic skills among African American children uses a comparative approach with middle-class Caucasians serving as the reference group (Lee, 2003). …

Predicting Language Outcomes for Children Learning Augmentative and Alternative Communication: Child and Environmental Factors

To investigate a model of language development for nonverbal preschool-age children learning to communicate with augmentative or alternative communication. Ninety-three preschool children with intellectual disabilities were assessed at Time 1, and 82 of these children were assessed 1 year later, at Time 2. The outcome variable was the number of different words the children produced (with speech, sign, or speech-generating devices). Children's intrinsic predictor for language was modeled as a latent variable consisting of cognitive development, comprehension, play, and nonverbal communication complexity. Adult input at school and home, and amount of augmentative or alternative communication instruction, were proposed mediators of vocabulary acquisition. A confirmatory factor analysis revealed that measures converged as a coherent construct, and a structural equation model indicated that the intrinsic child predictor construct predicted different words children produced. The amount of input received at home, but not at school, was a significant mediator. The hypothesized model accurately reflects a latent construct of Intrinsic Symbolic Factor (ISF). Children who evidenced higher initial levels of ISF and more adult input at home produced more words 1 year later. The findings support the need to assess multiple child variables and suggest interventions directed to the indicators of ISF and input.

Linking Infant-Directed Speech and Face Preferences to Language Outcomes in Infants at Risk for Autism Spectrum Disorder

In this study, the authors aimed to examine whether biases for infant-directed (ID) speech and faces differ between infant siblings of children with autism spectrum disorder (ASD) (SIBS-A) and infant siblings of typically developing children (SIBS-TD), and whether speech and face biases predict language outcomes and risk group membership. Thirty-six infants were tested at ages 6, 8, 12, and 18 months. Infants heard 2 ID and 2 adult-directed (AD) speech passages paired with either a checkerboard or a face. The authors assessed expressive language at 12 and 18 months and general functioning at 12 months using the Mullen Scales of Early Learning (Mullen, 1995). Both infant groups preferred ID to AD speech and preferred faces to checkerboards. SIBS-TD demonstrated higher expressive language at 18 months than did SIBS-A, a finding that correlated with preferences for ID speech at 12 months. Although both groups looked longer to face stimuli than to the checkerboard, the magnitude of the preference was smaller in SIBS-A and predicted expressive vocabulary at 18 months in this group. Infants' preference for faces contributed to risk-group membership in a logistic regression analysis. Infants at heightened risk of ASD differ from typically developing infants in their preferences for ID speech and faces, which may underlie deficits in later language development and social communication.

Naming outcome prediction in patients with discordant Wada and fMRI language lateralization

ObjectiveInvestigations of the validity of fMRI as an alternative to Wada language testing have yielded Wada/fMRI discordance rates of approximately 15%, but almost nothing is known regarding the relative accuracy of Wada and fMRI in discordant cases. The objective of this study was to determine which of the two (the Wada test or the language fMRI) is more predictive of postoperative naming outcome following left anterior temporal lobectomy in discordant cases. MethodsAmong 229 patients with epilepsy who prospectively underwent Wada and fMRI language testing, ten had discordant language lateralization results, underwent left anterior temporal lobectomy, and returned for postoperative language testing. The relative accuracy of Wada and fMRI for predicting language outcome was examined in these cases. ResultsFunctional magnetic resonance imaging provided a more accurate prediction of language outcome in seven patients, Wada was more accurate in two patients, and the two tests were equally accurate in one patient. ConclusionsIn cases of discordance, fMRI predicted postsurgical naming outcome with relatively better accuracy compared to the Wada test.

Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance: An fMRI study

In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant.We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery.We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia.The key findings are:1)Both left and right TLE patients show decreased left lateralization compared to controls.2)Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.3)Left lateralization correlates with peri-ictal aphasia in left TLE patients.4)Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery.The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.

Respiratory sinus arrhythmia as a predictor of language outcomes in children with autism

Respiratory sinus arrhythmia as a predictor of language outcomes in children with autism

Properties of Dual Language Exposure That Influence 2-Year-Olds’ Bilingual Proficiency

The mothers of 29 Spanish English bilingual 25-month-olds kept diary records of their children's dual language exposure and provided information on their children's English and Spanish language development using the MacArthur-Bates inventories. Relative amount of exposure predicted language outcomes in English and Spanish. In addition, the number of different speakers from whom the children heard English and the percent of their English input that was provided by native speakers were unique sources of variance in children's English skills. These properties of children's dual language exposure and their bilingual proficiency varied as a function of whether the children's mother, father, or both parents were native Spanish speakers. Practical and theoretical implications are discussed.

C046 Can we predict language outcomes 7 years post-implant?

C046 Can we predict language outcomes 7 years post-implant?

Biological and Environmental Factors as Predictors of Language Skills in Very Preterm Children at 5 Years of Age

Language problems are thought to occur more frequently in very preterm children compared with healthy term born children. The primary aim of this study was to examine the contributions of biological and environmental risk factors to language outcomes in very preterm children at 5 years of age. A cohort of 227 very preterm infants (birth weight <1250 g or gestational age <30 weeks) were recruited at birth and followed up at 2 and 5 years of age (corrected for prematurity) in a prospective, longitudinal study in Melbourne, Australia. Outcomes at 5 years of age were the Expressive and Receptive Language Scales from the Kaufman Survey of Early Academic and Language Skills. A range of hypothesized biological and environmental factors identified from past research were examined as predictors of language outcomes at 5 years of age using linear regression models. Lower maternal education and poorer communication skills in the child at 2 years of age were predictive of poorer expressive and poorer receptive language outcomes at 5 years of age. Lower expressive language scores were also associated with the presence of moderate-severe white matter abnormalities on neonatal magnetic resonance imaging. Results support the role of both biological and environmental factors in the evolution of language difficulties and highlight the need to consider these factors in the follow-up of preterm infants.

Input and long-term effects of starting age in foreign language learning

This study explores the long-term effects of starting age and the effects of input in an instructed language learning setting. First, with respect to the effects of starting age, the findings suggest that in the long term and after similar amounts of input, starting age is not a predictor of language outcomes. Second, the study examines the effects of input using multiple measures derived from responses to an extended questionnaire. The analysis reveals modest but significant effects of input on participants' proficiency, confirming that input never ceases to play a role in an instructed language learning setting, in contrast with opposite claims from studies of naturalistic language learning.

Early onset of family centred intervention predicts language outcomes in children with hearing loss

Objective To investigate the impact of age at diagnosis and age at onset of intervention on language outcomes in children with hearing impairments. Methods Receptive and expressive language outcomes of a sample of 63 children (mean age 5;1 years) with hearing loss (mean 78 dB, SD 25.3) enrolled in the only specific early intervention program in Upper Austria were assessed. The sample can be regarded as representative for children with significant hearing loss. For 89% the hearing loss was congenital. Language results were related to age at diagnosis, age at first fitting of hearing aids and age at enrolment in the intervention program. Confounding variables such as IQ, degree of hearing loss and family parameters were controlled for in regression analyses. Results Early commencement of family centred intervention had a significant impact on language outcomes as opposed to age at diagnosis and age at fitting of hearing aids. Conclusion In managing intervention in children with hearing loss, time between diagnosis and onset of early intervention should be kept as short as possible. However, age of entry to early intervention explained only about 4% of the variance in language outcomes.

Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study

To quantify the contributions of child, family, and environmental predictors to language ability at 4 years. A longitudinal study was performed with a sample of 1910 infants recruited at 8 months in Melbourne, Australia. Predictors were child gender, prematurity, birth weight and order, multiple birth, socioeconomic status, maternal mental health, vocabulary, education, and age at child's birth, non-English-speaking background, and family history of speech/language difficulties. Outcomes were Clinical Evaluation of Language Fundamentals-Preschool, language scores, low language status (scores >1.25 SDs below the mean), and specific language impairment (SLI) (scores >1.25 SDs below the mean for children with normal nonverbal performance). A total of 1596 children provided outcome data. Twelve baseline predictors explained 18.9% and 20.9% of the variation in receptive and expressive scores, respectively, increasing to 23.6% and 30.4% with the addition of late talking status at age 2. A total of 20.6% of children (324 of 1573 children) met the criteria for low language status and 17.2% (251 of 1462 children) for SLI. Family history of speech/language problems and low maternal education levels and socioeconomic status predicted adverse language outcomes. The combined predictors discriminated only moderately between children with and without low language levels or SLIs (area under the curve: 0.72-0.76); this improved with the addition of late talking status (area under the curve: 0.78-0.84). Measures of social disadvantage helped explain more variation in outcomes at 4 years than at 2 years, but ability to predict low language status and SLI status remained limited.

Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study

Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study

The Effect of IQ on Spoken Language and Speech Perception Development in Children with Impaired Hearing

Cognitive ability, or Intelligence Quotient (IQ), has long been shown to have a significant effect on language development in preschool children with hearing loss. IQ has been reported to be the strongest predictor of language outcomes for children under 5 years of age with hearing loss (Mayne et al., 2000). Non-verbal cognitive ability continues to have a sustained effect on language development, literacy and academic outcomes throughout childhood (Geers et al., 2008). There is a need for a greater understanding of factors affecting speech perception and language development, and the most effective methods of improving language outcomes to enhance the educational and career prospects of children with hearing loss. The aims of this study were to examine: