Risk For Language Impairment Research Articles

Resting Frontal Gamma Power is Associated with Both Expressive Language and Non-verbal Cognitive Abilities in Young Autistic Children.

Previous research links resting frontal gamma power to key developmental outcomes in young neurotypical (NT) children and infants at risk for language impairment. However, it remains unclear whether gamma power is specifically associated with language or with more general cognitive abilities among young children diagnosedwith autism spectrum disorder (ASD). The current study evaluates differences in resting frontal gamma power between young autistic and NT children and tests whether gamma power is uniquely associated with individual differences in expressive language, receptive language and non-verbal cognitive abilities in autistic and NT children. Participants included 48 autistic children and 58 age- and sex-matched NT children (ages 22-60months). Baseline electroencephalography (EEG) recordings were acquired from each participant. Children also completed the Mullen Scales of Early Learning (MSEL). We found thatfrontal gamma power at rest did not differ between autistic and NT children. Among autistic children, reduced frontal gamma power was significantly associated with both higher expressive language skills and higher non-verbal cognitive skills, controlling for age and sex. The interaction between frontal gamma power and diagnostic status no longer explained unique variance in expressive language skills after controlling for variance associated with non-verbal cognitive skills across autistic and NT children. Together, these findings suggest that reduced gamma power is associated with both better expressive language and non-verbal cognitive skills among young autistic children. Moreover, associations between high frequency neural activity and cognition are not specific to verbal abilities but reflect neural mechanisms associated with general higher-order cognitive abilities in ASD.

More efficient formation of longer-term representations for word forms at birth can be linked to better language skills at 2 years

Infants are able to extract words from speech early in life. Here we show that the quality of forming longer-term representations for word forms at birth predicts expressive language ability at the age of two years. Seventy-five neonates were familiarized with two spoken disyllabic pseudowords. We then tested whether the neonate brain predicts the second syllable from the first one by presenting a familiarized pseudoword frequently, and occasionally violating the learned syllable combination by different rare pseudowords. Distinct brain responses were elicited by predicted and unpredicted word endings, suggesting that the neonates had learned the familiarized pseudowords. The difference between responses to predicted and unpredicted pseudowords indexing the quality of word-form learning during familiarization significantly correlated with expressive language scores (the mean length of utterance) at 24 months in the same infant. These findings suggest that 1) neonates can memorize disyllabic words so that a learned first syllable generates predictions for the word ending, and 2) early individual differences in the quality of word-form learning correlate with language skills. This relationship helps early identification of infants at risk for language impairment.

Congenital Zika Infection and the Risk of Neurodevelopmental, Neurological, and Urinary Track Disorders in Early Childhood. A Systematic Review.

It was late 2015 when Northeast Brazil noticed a worrying increase in neonates born with microcephaly and other congenital malformations. These abnormalities, characterized by an abnormally small head and often neurological impairment and later termed Congenital Zika Syndrome, describe the severity of neurodevelopmental and nephrological outcomes in early childhood, and the implication of microcephaly at birth. The purpose of the study was to describe the neurodevelopmental outcomes in children exposed to Zika virus during fetal life, with and without microcephaly at birth. The systematic review included research studies about the neurodevelopmental outcomes with and without microcephaly, as well as nephrological outcomes in early childhood. We searched PubMed, Crossref, PsycINFO, Scopus, and Google Scholar publications and selected 19 research articles published from 2018 to 2021. Most studies have linked the severity of microcephaly in childbirth to the neurodevelopmental and urinary outcomes in early childhood. However, most children without microcephaly at birth develop typically, while others may be at risk for language impairment.

Identifying Bilingual Children at Risk for Language Impairment: The Implication of Children's Response Speed in Narrative Contexts.

The purpose of the study was to examine whether monolingual adults can identify the bilingual children with LI on the basis of children’s response speed to the examiner. Participants were 37 monolingual English-speaking young adults. Stimuli were 48 audio clips from six sequential bilingual children (48 months) who were predominately exposed to Cantonese (L1) at home from birth and started to learn English (L2) in preschool settings. The audio clips for each child were selected from an interactive story-retell task in both Cantonese and English. Three of the children were typically developing, and three were identified as having a language impairment. The monolingual adult participants were asked to judge children’s response times for each clip. Interrater reliability was high (Kalpha = 0.82 for L1; Kalpha = 0.75 for L2). Logistic regression and receiver operating characteristic curves were used to examine the diagnostic accuracy of the task. Results showed that monolingual participants were able to identify bilingual children with LI based on children’s response speed. Sensitivity and specificity were higher in Cantonese conditions compared to English conditions. The results added to the literature that children’s response speed can potentially be used, along with other measures, to identify bilingual children who are at risk for language impairment.

Early language delay and risk for language impairment

Early language delay and risk for language impairment

Language after childhood hemispherectomy: A systematic review.

To conduct a systematic review on language outcomes after left and right hemispherectomy in childhood, a surgical procedure that involves removing or disconnecting a cerebral hemisphere. We searched MEDLINE, Embase, and PsycInfo for articles published between January 1, 1988, and May 16, 2019. We included (1) all types of observational studies; (2) studies in which hemispherectomy was performed before age 18 years; and (3) studies with standardized scores measuring receptive vocabulary, expressive vocabulary, sentence comprehension, and/or sentence production. We calculated mean z scores after left and right hemispherectomy in the whole group and within etiology-specific subgroups. Our search identified 1,096 studies, of which 17 were eligible. The cohort added up to 205 individuals (62% left hemispherectomy) assessed 1 to 15 years after surgery. In the left surgery group, all language skills were impaired (z scores <-1.5) except sentence comprehension. In the right surgery group, language performance was in the borderline range (z scores ∼ -1.5). Children with cortical dysplasia showed the worst outcomes irrespective of surgery side (z scores <-2.5). Individuals with left vascular etiology and right-sided Rasmussen syndrome showed the best outcomes. Evidence based on the largest patient cohort to date (205 participants) suggests that the risk of language impairment after hemispherectomy is high, with few exceptions. Etiology plays a major role in postsurgical plasticity. We recommend specialist evaluation of language skills soon after surgery to identify intervention targets. Large-scale studies examining outcomes in consecutive cases are still needed.

Vocabulary Growth: Dual Language Learners at Risk for Language Impairment.

Purpose This research project examined the vocabulary growth patterns of typically developing (TD) Cantonese-English dual language learners (DLLs) and their peers who are at risk for language impairment. Method Two studies were done. Study 1 examined the concurrent validity of a pilot vocabulary screening measure, the Kai Ming Vocabulary Test, that was designed for Cantonese-English preschool DLLs. Participants were 53 preschool children who learned Cantonese as their first language (L1) and English as a second language (L2). Their scores on the Kai Ming Vocabulary Test were examined in relation to their language sample measures, including number of different words and mean length of utterance, in L1 and in L2. Study 2 examined the vocabulary growth patterns of 24 TD Cantonese-English DLL preschoolers and 24 DLLs who are at risk for language impairment (At-Risk group). Each child was tested 3 times during an academic year. Results Results of Study 1 showed that children's vocabulary scores (n = 53) were significantly correlated with their language sample measures in each language. In Study 2, hierarchical linear models were used to compare the TD and At-Risk groups. Results showed that children in the At-Risk group had lower L1 receptive vocabulary scores and children in the TD group had relatively higher L2 expressive vocabulary gains. Conclusions Children who are at risk are likely to continue to have lower vocabulary knowledge compared to their TD peers. The growth trajectories of DLLs provide valuable information for early identification and intervention.

Atuação fonoaudiológica em projeto social: estudo preliminar

Introdução: Pesquisas vêm demonstrando a importância dos primeiros anos de vida no desenvolvimento do cérebro. Quando a criança não apresenta o desenvolvimento de linguagem esperado, poderá ter prejuízo em aquisições. Desta forma, a identificação precoce de alterações evita consequências educacionais e sociais desfavoráveis. Objetivo: propor projeto de intervenção fonoaudiológica em instituição de acolhimento de crianças; levantar dados acerca da linguagem das crianças antes e depois da intervenção fonoaudiológica; possibilitar a superação de alterações da linguagem. Métodos: Observação das crianças, em sala de atividades coletivas, por meio do formulário de observação. Em seguida, foram selecionadas crianças com risco para alteração de linguagem e estas foram submetidas a avaliação por meio da Avaliação do Desenvolvimento da Linguagem (ADL) e Avaliação Fonológica da Criança (AFC). As crianças foram estimuladas durante 12 encontros semanais, em grupos, e depois foram reavaliadas. Os dados foram tabulados e analisados comparando-se as avaliações antes e depois da estimulação e relatando-se os dados obtidos pelos questionários respondidos pelas cuidadoras. Resultados: As quatro crianças - 3 meninos e 1 menina - que participaram do estudo tiveram melhora nas avaliações da linguagem após o período de estimulação, 3 modificaram o grau de gravidade do distúrbio de linguagem, e uma superou as alterações de linguagem - “desenvolvimento normal da linguagem” - após a reavaliação. Conclusão: Os relatos das cuidadoras e resultados das reavaliações demonstraram que as intervenções surtiram efeitos positivos e foram relevantes para as crianças, caracterizando uma boa proposta de intervenção coletiva fonoaudiológica.

Association of Parent Training With Child Language Development

Training parents to implement strategies to support child language development is crucial to support long-term outcomes, given that as many as 2 of 5 children younger than 5 years have difficulty learning language. To examine the association between parent training and language and communication outcomes in young children. Searches of ERIC, Academic Search Complete, PsycINFO, and PsycARTICLES were conducted on August 11, 2014; August 18, 2016; January 23, 2018; and October 30, 2018. Studies included in this review and meta-analysis were randomized or nonrandomized clinical trials that evaluated a language intervention that included parent training with children with a mean age of less than 6 years. Studies were excluded if the parent was not the primary implementer of the intervention, the study included fewer than 10 participants, or the study did not report outcomes related to language or communication. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were applied to a total of 31 778 articles identified for screening, with the full text of 723 articles reviewed and 76 total studies ultimately included. Main outcomes included language and communication skills in children with primary or secondary language impairment and children at risk for language impairment. This meta-analysis included 59 randomized clinical trials and 17 nonrandomized clinical trials including 5848 total participants (36.4 female [20.8%]; mean [SD] age, 3.5 [3.9] years). The intervention approach in 63 studies was a naturalistic teaching approach, and 16 studies used a primarily dialogic reading approach. There was a significant moderate association between parent training and child communication, engagement, and language outcomes (mean [SE] Hedges g, -0.33 [0.06]; P < .001). The association between parent training and parent use of language support strategies was large (mean [SE] Hedges g, 0.55 [0.11], P < .001). Children with developmental language disorder had the largest social communication outcomes (mean [SE] Hedges g, 0.37 [0.17]); large and significant associations were observed for receptive (mean [SE] Hedges g, 0.92 [0.30]) and expressive language (mean [SE] Hedges g, 0.83 [0.20]). Children at risk for language impairments had moderate effect sizes across receptive language (mean [SE] Hedges g, 0.28 [0.15]) and engagement outcomes (mean [SE] Hedges g, 0.36 [0.17]). The findings suggest that training parents to implement language and communication intervention techniques is associated with improved outcomes for children and increased parent use of support strategies. These findings may have direct implications on intervention and prevention.

Teaching and Coaching Caregivers in a Guatemalan Orphanage to Promote Language in Young Children

AbstractProviding evidence-based early intervention (EI) to caregivers is an effective way to promote development in young children. EI services in the United States have decreased risk factors associated with language impairment (LI) as they help improve both short and long-term outcomes for both caregivers and children. The positive results for EI services in the U.S. may generalize to Latin American countries, namely Guatemala. Guatemala has one of the weakest education systems in its region as well as poor access to early childhood services for low-SES and other disadvantaged groups. The purpose of this study was to provide brief EI services to a Guatemalan orphanage by training caregivers to implement naturalistic language support strategies with the young children they care for who are at risk for language impairment. Results indicate a brief caregiver-implemented intervention program was effective for teaching caregivers to implement language support strategies. Recommendations are made for future research as well as implications for policy and practice. Additional research is needed to determine how to facilitate maintenance over time.

High rates of language impairment in vulnerable populations: the case for improving cross-sector awareness of Developmental Language Disorder.

High rates of language impairment in vulnerable populations: the case for improving cross-sector awareness of Developmental Language Disorder.

Using Kindergarten Language, Dialect Variation, and Child Behavior to Predict Second Grade Reading Ability in African American Children

Previous research has demonstrated mixed findings pertaining to the risk conferred by variation from Mainstream American English (MAE) for African American children in our education system. Based on the research on language, behavior, and reading, the present study sought to examine the relative and combined contributions of culturally appropriate measures of risk status for disordered language and density of dialect use and classroom behavior (both competencies and problems) in predicting reading ability in a sample of typically developing African American elementary school students. 53 African American Kindergartner's (27 boys, 26 girls) were followed up with two years later in 2nd grade. In Kindergarten, children were screened for density of dialect use and risk of language impairment; teachers rated each child on behavior, social/emotional adjustment, and academic performance. Reading achievement was assessed in 2nd grade. Risk for disordered language development was the best predictor of 2nd grade reading, outperforming density of dialect use. Positive classroom behaviors were more predictive of reading than negative behaviors. This research supports the notion that language, classroom behavior, and reading achievement are intertwined in a complex manner and that when designing interventions for one, the entire system must be considered.

Risk for Speech and Language Impairments in Preschool Age HIV-exposed Uninfected Children With In Utero Combination Antiretroviral Exposure.

Perinatally HIV-exposed but uninfected (HEU) children have elevated risk of late language emergence at 1 year of age, with possible links to in utero antiretroviral (ARV) exposure. We investigated possible risks for speech impairments (SIs) and language impairments (LI) in preschool monolingual HEU children in the United States. Speech and language assessments were conducted as part of the Pediatric HIV/AIDS Cohort Study Surveillance Monitoring of ART Toxicities study at ages 3 (N = 208) and 5 (N = 429) years. Domains of speech, overall language, vocabulary and grammar were assessed. SI and LI were defined by standardized scores <15th percentile and categorized as primary (normal nonverbal IQ ≥ 85 without hearing loss) and concomitant (low nonverbal IQ and/or presence of hearing loss). Logistic regression models were used to estimate odds of SI and LI for different ARV exposures, adjusted for confounding variables. The risk for language impairments in HEU children was higher than population norms; risk for SIs was not elevated. Risk factors for impairments included male sex, black race and other socioeconomic measures, although these varied by age, primary (P) versus concomitant (C) impairment and by speech or language measure. Adjusted logistic regression models revealed lower and increased risk for specific ARVs. Tenofovir exposure was associated with increased risk for SI at 3 years of age but was associated with decreased risk for concomitant language impairment at 5 years of age. Further investigation of combination ARV exposure and speech/language impairment among preschool children is needed to confirm associations.

A Multiyear Population-Based Study of Kindergarten Language Screening Failure Rates Using the Rice Wexler Test of Early Grammatical Impairment

The purpose of this study was to evaluate, over 2 separate school years, the school-district-wide failure rate of kindergartners on a screener of grammatical tense marking-the Rice Wexler Test of Early Grammatical Impairment (TEGI) Screening Test (Rice & Wexler, 2001)-composed of past tense (PT) and third-person singular (3S) probes. In the fall of 2 consecutive school years, consented and eligible kindergartners (n = 148 in Year 1, n = 126 in Year 2) in a rural southern school district were administered the TEGI Screening Test. Children who failed the screening test or either of the individual probes (PT or 3S) were administered the Primary Test of Nonverbal Intelligence. All children also completed the Test of Articulation Performance-Screen (Bryant & Bryant, 1983) and, in Year 2, the Get Ready to Read! emergent literacy screener (Whitehurst & Lonigan, 2001). The screening tool outcome most closely and consistently aligned with the recommended failure rate of approximately 30% (Oetting, Gregory, & Rivière, 2016; based on Tomblin et al., 1997) was the TEGI PT probe. TEGI Screening Test and 3S probe failure rates fell below the recommended level. Most children who failed the PT probe demonstrated nonverbal intelligence skills within the average range. In addition, most children who failed the PT probe would not have been readily identified on the basis of only the results of their articulation or emergent literacy screenings. The TEGI PT probe is an efficient and reliable screener that identifies children for monitoring or additional language assessment. Children with language vulnerabilities are not necessarily identified by articulation or emergent literacy screenings at entry to kindergarten. To identify children at risk for language impairment, it is therefore necessary to directly screen oral language.

Identifying risk for language impairment in children from linguistically diverse low-income schools

Purpose: To improve screening procedures for children in a linguistically diverse context, we combined tasks known to reveal grammatical deficits in children with language impairment (LI) with training to facilitate performance on a verb elicitation task.Method: Sixty-four first grade children participated. The objective grammatical measures included elicitation of 12 past tense regular verbs preceded by a teaching phase (teach-test), the sentence recall (SR) subtest of the Clinical evaluation of language fundamentals (CELF-4), and a tally of all conjugated verbs from a narrative retell task. Given the widespread reliance on teacher observation for the referral of children suspected of having LI, we compared our results to the spoken language portion of the CELF-4 teacher observational rating scale (ORS).Result: Using teacher observation as a reference for comparison, the past tense elicitation task and the SR task yielded strong discriminating power, but the verb tally was relatively weak. However, combining the three tasks yielded the highest levels of sensitivity (75%) and specificity (92%) than any single measure on its own.Conclusion: This study contributes to alternative assessment practices by highlighting the potential utility of adding a teaching component prior to administering informal grammatical probes.

Vocal and gestural productions of 24-month-old children with sex chromosome trisomies.

Children with sex chromosome trisomies (SCT) frequently show problems in language development. However, a clear description of the communicative patterns of these children is still lacking. To describe the first stages of language development in children with SCT in comparison with those in typically developing (TD) children. The purpose was to verify the existence of possible differences in communicative skills (in both vocal and gestural modality) and identify the presence of possible early predictors (i.e., low vocabulary size and low gesture production) of later language impairment in children with SCT. Fifteen 24-month-old children with SCT (eight males with Klinefelter syndrome (KS) and seven females with triple X syndrome (TX)) and fifteen 24-month-old TD children (eight males and seven females) participated in the study. Their spontaneous communicative productions were assessed during a semi-structured play session in interaction with a parent. In addition, their vocabulary size was assessed using a parental report (the Italian version of the MacArthur Communicative Development Inventories). With regards to their vocabulary size, 60% of children with SCT (75% of children with KS and 43% of children with TX) were at risk for language impairments (i.e., they had a vocabulary size smaller than 50 words). In addition, TD children showed better lexical and syntactic skills than children with SCT in their spontaneous communicative productions. However, the production of communicative gestures was higher in children with SCT than in TD children. Boys with KS appeared to differ from TD males in more aspects of communication than girls with TX differed from TD females. The study showed the importance of early detection of language risk factors in children with SCT, while also considering the use of compensatory strategies (e.g., the use of communicative gestures).

Machine learning\u2013XGBoost analysis of language networks to classify patients with epilepsy

Our goal was to apply a statistical approach to allow the identification of atypical language patterns and to differentiate patients with epilepsy from healthy subjects, based on their cerebral activity, as assessed by functional MRI (fMRI). Patients with focal epilepsy show reorganization or plasticity of brain networks involved in cognitive functions, inducing ‘atypical’ (compared to ‘typical’ in healthy people) brain profiles. Moreover, some of these patients suffer from drug-resistant epilepsy, and they undergo surgery to stop seizures. The neurosurgeon should only remove the zone generating seizures and must preserve cognitive functions to avoid deficits. To preserve functions, one should know how they are represented in the patient’s brain, which is in general different from that of healthy subjects. For this purpose, in the pre-surgical stage, robust and efficient methods are required to identify atypical from typical representations. Given the frequent location of regions generating seizures in the vicinity of language networks, one important function to be considered is language. The risk of language impairment after surgery is determined pre-surgically by mapping language networks. In clinical settings, cognitive mapping is classically performed with fMRI. The fMRI analyses allowing the identification of atypical patterns of language networks in patients are not sufficiently robust and require additional statistic approaches. In this study, we report the use of a statistical nonlinear machine learning classification, the Extreme Gradient Boosting (XGBoost) algorithm, to identify atypical patterns and classify 55 participants as healthy subjects or patients with epilepsy. XGBoost analyses were based on neurophysiological features in five language regions (three frontal and two temporal) in both hemispheres and activated with fMRI for a phonological (PHONO) and a semantic (SEM) language task. These features were combined into 135 cognitively plausible subsets and further submitted to selection and binary classification. Classification performance was scored with the Area Under the receiver operating characteristic curve (AUC). Our results showed that the subset SEM_LH BA_47-21 (left fronto-temporal activation induced by the SEM task) provided the best discrimination between the two groups (AUC of 91 ± 5%). The results are discussed in the framework of the current debates of language reorganization in focal epilepsy.

Early gesture, early vocabulary, and risk of language impairment in preschoolers

BackgroundGesture precedes vocabulary development and may be an early marker of later language impairment. AimsUsing data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, this study examined the contribution of children’s (N=1064) early gestures and early vocabularies to their risk of language impairment in preschool years. Methods and proceduresAt age 15 months, maternal reports on children’s use of gestures and vocabulary comprehension and production skills were measured using the MacArthur Communicative Development Inventories. At age 3 and 4.5 years, children’s language skills were assessed using the Reynell Developmental Language Scale and Preschool Language Scale-3, respectively. Outcomes and resultsAfter controlling for child, maternal, and family sociodemographic factors, children at later risk for language impairment were found to exhibit significantly less early gesture use and vocabulary skills relative to their typically developing peers. Early use of gestures was also significantly correlated with early vocabulary skills. Conclusions and implicationsThe effect of early gesture on children’s later risk of language impairment was indirect and mediated by early vocabulary production. Early gesture may have the potential to serve as an early diagnostic tool and play a role in early intervention.

Parent report of early lexical production in bilingual children: a cross-linguistic CDI comparison

ABSTRACTThis paper compared the vocabulary size of a group of 250 bilinguals aged 24–36 months acquiring six different language pairs using an analogous tool, and attempted to identify factors that influence vocabulary sizes and ultimately place children at risk for language delay. Each research group used adaptations of the MacArthur-Bates Communicative Development Inventories: Words and Sentences and a specially designed developmental and language background questionnaire to gather information on risk factors for language impairment, demographic and language exposure variables. The results showed a wide range in vocabulary development which could be somewhat attributed to mothers’ education status, parental concerns about language development and amount of exposure to the second language. We looked at those children performing below the 10th and above the 90th percentile to determine what factors were related to their vocabulary size. Features of the entire group of lower performing children were fewer than 50 words and the absence of two-word combinations by 24 months, lower levels of parental education and parental concerns about language development. The implications for identifying bilingual children at risk for language impairment as well as the language enrichment that might be needed for young bilinguals are outlined.

Toddlers' Verb Lexicon Diversity and Grammatical Outcomes.

The goals of this study were to quantify longitudinal expectations for verb lexicon growth and to determine whether verb lexicon measures were better predictors of later grammatical outcomes than noun lexicon measures. Longitudinal parent-report measures from the MacArthur-Bates Communicative Development Inventory (Fenson et al., 2007) from ages 21 to 30 months from an archival database were used to model growth in common noun and verb lexicon size for 45 typically developing toddlers. Communicative Development Inventory growth coefficients and 24-month measures of lexical diversity from spontaneous language samples were used to predict 30-month grammatical outcomes on the Index of Productive Syntax (Scarborough, 1990). Average verb growth was characterized by 50.57 verbs at 24 months, with linear growth of 8.29 verbs per month and deceleration overall. Children with small verb lexicons or slow linear growth at 24 months accelerated during this developmental period. Verb lexicon measures were better predictors of grammatical outcomes than noun lexicon measures, accounting for 47.8% of the variance in Index of Productive Syntax scores. Lexical verb diversity in spontaneous speech emerged as the single best predictor. Measures of verb lexicon size and diversity should be included as part of early language assessment to guide clinical decision making with young children at risk for language impairment.