Specific Expressive Language Delay Research Articles

Markers for persistent specific expressive language delay in 3–4‐year‐olds

AbstractBackgroundIdentifying 3–4‐year‐olds who are most at risk of persisting language difficulties, and possibly specific language impairment (SLI), is difficult due to the natural variation of language in young children. In older children, markers for SLI have been identified that differentiate between children with and without SLI. It is not known whether these markers can be used at an earlier age to identify children most at risk of persisting language difficulties.AimsTo identify possible risk markers of current status that distinguish children who have specific expressive language delay (SELD) from the variation observed in normally developing children at age 3;0–4;0 and 4;0–5;0. To determine the most suitable measure(s) that would predict which children with SELD at age 3;0–4;0 were likely to have persistent expressive language delay (PELD) at age 4;0–5;0.Methods & ProceduresForty‐seven children with SELD and 47 children with typical language development (TLD) were assessed on language, nonverbal IQ and marker tasks at age 3;0–4;0 (baseline). Ninety‐one children were reassessed on the measures one year later (follow‐up). At both time points, the marker tasks were compared with a reference standard (Expressive Communication subscale (EC) of the Preschool Language Scale—3 (PLS‐3) (UK)) to determine the most useful marker for identifying children with SELD. Possible predictors were examined to determine the most suitable measure(s) that would predict which children with SELD at baseline were likely to have PELD at follow‐up.Outcome & ResultsA modified version of Recalling Sentences, a subtest of the Clinical Evaluation of Language Fundamentals (CELF)—Preschool UK, was the most useful marker for identifying children with SELD at baseline and at follow‐up. Thirty‐five (76.1%) of the 46 children with SELD at baseline had PELD at follow‐up. Performance on the Auditory Comprehension (AC) and EC subscales of the PLS‐3 (UK) and on modified Recalling Sentences at age 3;0–4;0 were predictors of PELD at age 4;0–5;0.Conclusions & implicationsA modified Recalling Sentences task was a good risk marker for SELD at age 3;0–4;0 and SELD at age 4;0–5;0. PLS‐3 AC, PLS‐3 EC and modified Recalling Sentences at baseline were the best predictors of PELD. The use of modified Recalling Sentences as a predictive marker requires confirmation.

Wayward words and watchful waiting: should clinicians be more proactive for the preschooler with uncomplicated expressive language delay?

Buschmann’s randomised controlled trial in which 2-year-old children with specific expressive language delay were exposed to an intervention with a parent based programme purports to demonstrate significant improvement and challenges...

Parent based language intervention for 2-year-old children with specific expressive language delay: a randomised controlled trial

Objective:The aim of this randomised controlled trial was to evaluate the effectiveness of a short, highly structured parent based language intervention group programme for 2-year-old children with specific expressive language...

Children with developmental language delay at 24 months of age: results of a diagnostic work‐up

The aim of this study was to evaluate if a diagnostic work-up should be recommended for 2-year-old children with developmental language delay (LD), or if the widely chosen 'wait and see' strategy is adequate. Children with LD were identified in paediatric practices during routine developmental check-ups using a German parent-report screening questionnaire (adapted from the MacArthur Communicative Development Inventories). A standardized German instrument and the Netherlands version of Bayley Scales of Infant Development (2nd ed.) were used to assess language ability and nonverbal cognitive development respectively in 100 children with LD (65 males, 35 females; mean age 24.7 mo [SD 0.9]) and a control group of 53 children with normal language development (33 males, 20 females; mean age 24.6 mo [SD 0.8]). Neurological and audiometric testing were also performed. Sixty-one per cent of the LD group had specific expressive LD and 17% specific receptive-expressive LD. In 22%, LD was associated with other neurodevelopmental problems, 6% showed significant deficits in nonverbal cognitive abilities, and in 12%, nonverbal cognitive abilities were borderline. Four per cent fulfilled the criteria of childhood autism. LD at 2 years proved to represent a sensitive marker for different developmental problems. Adequate early intervention requires a clear distinction between specific expressive or receptive-expressive LD and LD associated with other neurodevelopmental problems. Though catch-up development is to be expected in a substantial proportion of 'late talkers', our data demonstrate that a general 'wait and see' approach is not justified in young children with LD. A proposal for a rational diagnostic work-up is presented.

'Partnership with parents' a pilot project.

This paper looks at a controlled study which aimed to measure the efficacy of a parent programme. The parents involved were all parents of pre-school children with specific expressive language delay (SELD). A number of measures were used to identify changes in mother-child interaction and language development. Significant differences were noted in the experimental group while the control group remained stable over time. The results indicate the potential effectiveness of this type of intervention for children identified as having SELD.

Relationships Between Language and Gesture in Normally Developing and Late-Talking Toddlers

Seventeen toddlers with specific expressive language delay (14 boys and 3 girls between 18 and 33 months of age) were compared to two control groups, one matched for language production and the other matched for age and language comprehension, on measures of spontaneous and imitated gesture production. Late talkers performed like age/comprehension-matched controls on all experimental measures of gesture production and on production of later appearing, more symbolic gestures as reported by parents. Late talkers performed like language-matched controls on earlier appearing communicative gestures and gestural routines as reported by parents. All three groups produced more gestures in canonical imitation conditions than spontaneously. Results are discussed in the contexts of the Local Homology Model and characteristics of toddlers with specific expressive language delay.

The Continuity of Babble and Speech in Children With Specific Expressive Language Delay

A natural language sample of babble and words was obtained for 37 two-year-olds with severe specific expressive language delay. Variables derived from this sample were used to predict individual differences in expressive language scores 5 months later. The rate of word use was positively related to language outcome, whereas rate of vowel babble was negatively related to outcome. Together, these two variables accounted for 41% of the variance in language outcome test scores. The addition of one nonlinguistic variable, a measure of behavior problems, allowed the prediction equation to account for over 50% of the variance in expressive language outcome. The single strongest correlate of language outcome was the proportion of consonantal to vowel babble. The degree of social responsiveness of babble and the length of babble were not related to later language scores. These findings indicate that for children with specific expressive language delay, vowel babble competes with expressive language, consonantal babble facilitates expressive language, and the length and social responsiveness of babble are independent of expressive language. The continuity between babble and speech is multidimensional and multidirectional.

Outcome of toddlers with specific expressive language delay

ABSTRACTThis article describes a follow-up of 25 boys diagnosed as having specific expressive language delay (SELD) in the 24- to 31-month age period. At the time of diagnosis, all subjects had Bayley MDI scores above 85, Reynell Receptive Language Age scores within 4 months of their chronological age, and Reynell Expressive Language Age scores at least 5 months below chronological age; most had vocabularies of fewer than 50 words and few if any word combinations. At follow-up, 16 boys were 3 years old, 7 were 3½, and 2 were 4 years of age. When seen for follow-up, half the 25 boys still had very poor expressive language. These boys were speaking at best in short, telegraphic sentences, and many had moderately severe articulation disorders with quite poor intelligibility. The 12 boys with better outcome had a range of language skills. All spoke in sentences to some extent, and each displayed some mastery of early morphemes (prepositions, plurals, articles, progressive tense, and possessives). However, few if any of the children spoke in completely fluent, syntactically complex, and morphologically correct language. Problems with copula and auxiliary verbs, with past tense inflections, and with pronouns seemed especially common. This research suggests that children with SELD at 24 to 30 months are at considerable risk for continuing language problems.

SPECIFIC EXPRESSIVE LANGUAGE DELAY: A LONGITUDINAL STUDY

Specific expressive language delay (ELD) is a developmental disorder characterized by substantial delay in expressive language, with age-appropriate cognitive and receptive language skill. Opinions differ widely on the clinical significance of ELD and whether it warrants intervention. Although negative sequelae in school achievement and mental health are noted in language disordered populations, there are no prospective longitudinal studies of 2 to 3 year old ELD children. The present study followed the language growth of a carefully defined sample of ELD children over the period just after diagnosis. Standardized assessments of IQ and expressive and receptive language were completed at initial visit and again four months later. Results indicate that the early developmental course of ELD is highly variable; some children show moderate progress, some full recovery and some little change in expressive language skill. Comparison was made between degree of improvement in this sample and that of a group of ELD children in a home-based treatment program. The correlates that emerge from the study allow for better informed treatment decisions and highlight the relevance of longitudinal analysis of ELD.