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Background: A wealth of evidence supports the important role high-quality parent-child interactions play in children's early language acquisition. However, the impact on later language outcomes remains unclear. Aims: To examine the associations between responsive parental behaviours across the early years and child language outcomes at age 7 years with families from an Australian longitudinal cohort study (N = 1148, 50% female). Methods & Procedures: At child ages 12, 24 and 36 months, parents completed a self-report measure of responsive parental behaviours. Child language was directly assessed at age 7 using the Clinical Evaluation of Language Fundamentals, 4th edition (CELF-4), Australian Standardisation. Linear regression was used to examine associations between responsive parental behaviours from 12 to 36 months (consistently high, inconsistent and consistently low responsive parental behaviours at the three time points) and language scores at age 7 years. Adjusted models were run, including the following potential confounders: child sex; birth weight; birth order; maternal education; socio-economic disadvantage; non-English-speaking background; family history of speech--language problems; mother's vocabulary score; maternal mental health score; and mother's age at birth of child. A final adjusted model was run, including the potential confounder variables as well as adjusting for children's earlier language skills. Outcomes & Results: Linear regression results showed children with parents who rated high on responsive parental behaviours at all three time points had higher mean language scores at age 7 than children whose parents reported low responsive parental behaviours across early childhood. This association attenuated after adjusting for earlier child language skills. Conclusions & Implications: Findings support the consistent use of responsive parental behaviours across the very early years of childhood to support long-term language outcomes. Findings also suggest that models of surveillance and support which monitor and assist families at multiple time-points over the early years are likely to be most effective for preventing ongoing language difficulties.

Background: Language outcomes for children with cochlear implants (CIs) vary widely, even for those implanted before 2 years of age. Identifying the main influencing factors that account for some of the variability is important in order to provide information to guide appropriate clinical and intervention services for young children with CIs. However, there is limited research focusing on the predictors of early vocabulary development for children implanted in infancy. Aims: To identify significant predictors of vocabulary (12-15 months post-implant) for a sample of 33 children with CIs, the majority implanted between 6 and 10 months of age, drawing on predictors of vocabulary reported for children with normal hearing. Of particular interest was the impact of pre-implant development and use of gestures. Methods & Procedures: Children with severe to profound hearing loss, and no other known disabilities, were recruited from CI clinics in Australia before receiving their CIs. Subscales from the Bayley Scales-III (receptive and expressive communication, gross and fine motor, and cognition) were used to assess their development at that time. Using the Macarthur-Bates Communicative Development Inventory (Words and Gestures) we documented the children's (1) use of gestures at six data-collection times 3 months apart; and (2) vocabulary at the last three time points. Time since implant and time to consistent use of the CIs were also included as potential predictors. Data were analysed using generalized linear models, assuming a negative binomial response with a log-link function. Stepwise variables selection was followed to retain a smaller number of the covariates. Outcomes & Results: A year after implantation, the significant predictors identified for vocabulary were pre-implant receptive communication and early gesture use. Together with fine motor and cognitive skills, these two variables were also significant predictors of vocabulary 3 months later. With maternal education entered into the models, higher vocabulary scores were significantly associated with higher maternal education 12 months post-implantation, but not 15 months. Conclusions & Implications: Pre-implant abilities are important in explaining some variability in the early vocabulary of infants with CIs, together with their use of early gestures post-implantation. That is, having a non-verbal means to express a concept can assist in their development of oral vocabulary. Identifying strategies to help develop fine motor skills for infants with CIs, and encouraging their use of gestures to communicate their needs/intentions, are likely to be of benefit.

Background: There is variability in the language of children with autism, even those who are high functioning. However, little is known about how they process language structures in real time, including how they handle potential ambiguity, and whether they follow referential constraints. Previous research with older autism spectrum disorder (ASD) participants has shown that these individuals can use context to access rapidly the meaning of ambiguous words. The severity of autism has also been shown to influence the speed in which children with ASD access lexical information. Aims: To understand more about how children with ASD process language in real time (i.e., as it unfolds). The focus was the integration of information and use of referential constraints to identify a referent named in a sentence. Methods & Procedures: We used an eye-tracking task to compare performance between young, high-functioning children with autism (HFA) and children with typical development (TD). A large sample of 5-9-year-old children (mean age = 6;8 years), 48 with HFA and 56 with TD participated; all were attending mainstream schools. For each item participants were shown a display of four images that differed in two dimensions. Each sentence contained an adjective and noun that restricted the choice from four to two (the target and competitor), followed by a prepositional phrase (e.g., "the blue square with dots"); this added modifying information to provide a unique description of the target. We calculated looking time at the target, the competitor and the two distractors for each 200 ms time interval as children processed the sentence and looked at the display. Generalized estimating equations were used to carry out repeated-measures analyses on the proportion of looking time to target and competitor and time to fixate to target. Outcomes & Results: Children in both groups (HFA and TD) looked at the target and competitor more than at the distractors following the adjective and noun and following the modifying information in the prepositional phrase more at the target. However, the HFA group was significantly slower in both phases and looked proportionally less at the target. Across the sample, IQ and language did not affect the results; however, age and attention had an impact. The older children showed an advantage in processing the information as did the children with higher attention scores. Conclusions & Implications: The HFA group took longer than the TD group to integrate the disambiguating information provided in the course of processing a sentence and integrate it with the visual information, indicating that for the ASD group incremental processing was not as advanced as for children with ASD, and they were less sensitive to referential conventions. Training for young children with ASD on the use of referential conventions and available contextual clues may be of benefit to them in understanding the language they hear.

Background: Language impairment (LI) in the preschool years is known to vary over time. Stability in the diagnosis of LI may be influenced by children's individual variability, the measurement error of commonly used assessment instruments and the cut-points used to define impairment. Aims: To investigate the agreement between two different age-based versions of a language assessment instrument and the stability of the classification of LI using the two measures over a 12-month period. Methods & Procedures: A total of 945 participants completed the Clinical Evaluation of Language Fundamentals (CELF-Preschool 2 or 4th Edn) at 4 and 5 years of age. Agreement and stability were analysed using Bland-Altman plots, correlation and odds ratios. Sensitivity and specificity were calculated for two thresholds of the CELF-P2 using the diagnostic category on the child's subsequent CELF-4. Outcomes & Results: For all CELF scores, mean differences for the cohort between 4 and 5 years were within 1.5 scale score units. In contrast, at the individual level variability was found across the range of scores and was of a greater magnitude than previously reported. Stability in LI classification was low, with 36% of 5-year-olds with LI (defined as a standard score below -1.25) classified as typical at 4 years, even though odds ratios calculated from classifications at the two time points suggested that 4-year-olds with LI had 23 times greater odds than their typical peers to receive a diagnosis of LI at 5 years. The CELF-P2 did not demonstrate adequate levels of diagnostic accuracy for LI at 5 years: sensitivity of 64% and specificity of 92.9%. Conclusions: Substantial variability across the entire range of possible CELF scores was observed in this community cohort between the ages of 4 and 5 years. The stability of LI classification was lower than that reported in previous research conducted primarily on smaller clinical cohorts. The current study's results suggest that the variability observed in developmental language pathways is the result of a combination of limitations in measurement instruments, individual children's abilities and the arbitrary nature of the boundaries defining LI.

Background: Parent report instruments are frequently used for the identification of both "at-risk" children and to support the diagnosis of communication delay. Whilst the evidence is strong for the accuracy of parent report of vocabulary between 2 and 3 years, there are fewer studies that have considered the ability of parents to report on early communication behaviours in 12-month-old infants. Aims: To investigate the validity of the underlying structure of the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP) for each of the direct observation and parent reports of communication behaviour in infants at 12 months of age. Methods & Procedures: Participants were 1725 infants, already participating in a longitudinal study of language development, whose parents completed the Infant-Toddler Checklist from the CSBS-DP. Seven hundred and twenty-eight (728) of these infants also completed the Behaviour Sample from the CSBS-DP. The structure of the CSBS-DP was examined using confirmatory factor analyses (CFA) of the Behaviour Sample and the Infant-Toddler Checklist. Correlations between the Infant-Toddler Checklist and the Behaviour Sample on the total, composite, and subscale scores were also calculated. Outcomes & Results: Confirmatory factor analysis of the CSBS-DP Behaviour Sample replicated previous work conducted during the development of the instrument, but on a larger and younger cohort of Australian infants. The data provided support for at least three factors, broadly representing Social, Speech, and Symbolic communication skills, with some evidence that the speech factor could be further split into sub-factors representing Sounds and Words. There was support for a three-factor structure for the Infant-Toddler Checklist. Moderate correlations were found between results from the Behaviour Sample and the Infant-Toddler Checklist. Conclusions & Implications: As measures of early communication skill for young infants, the CSBS-DP Behaviour Sample and the Infant-Toddler Checklist are valid clinical tools for measuring constructs broadly representing Social, Speech, and Symbolic communication skills. The Speech composite in particular emerged as a strong factor under the Behaviour Sample. (Contains 1 figure, 8 tables, and 2 notes.)

Background: Narratives have been used by a number of researchers to investigate the language of children with specific language impairment (SLI). While a number of explanations for SLI have been proposed, there is now mounting evidence that children with SLI have limited memory resources. Phonological memory has been the focus of the research on memory with this population. However, the use of narrative tasks to investigate memory limitations in SLI has not previously been undertaken. Aims: The aims of the research were to investigate the narrative and memory abilities of 6-year-old children with SLI and the association between narrative skills and memory. Methods & Procedures: Two studies were conducted. In Study 1 the performance of the children with SLI was compared with that of their peers with typical language development (AM), and to that of a younger group (LM) matched on expressive language (about 2 years younger). Children were asked to recall ("story recall") and show comprehension of a narrative they had been told, and also to tell a story based on a series of pictures ("story generation"), to recall their story and to answer comprehension questions about it. In Study 2 the children with SLI from Study 1 and the AM children from Study 1 were tested on four working memory tasks: word and digit span, the Recalling Sentences task from the "Clinical Evaluation of Language Fundamentals--Third Edition", and a dual-processing task. An inhibition task and an attention task were also included. It was predicted that children with SLI would perform more poorly than the AM group on measures of narrative telling, but comparably with the LM group. It was also predicted that the SLI group would perform more poorly than the AM group on both literal and inferencing comprehension questions but comparably with the LM group. The third prediction was that there would be significant associations between children's performance on the narrative tasks and the tasks measuring working memory. Outcomes & Results: In Study 1 the children with SLI performed more like the younger group on recall of a narrative they had heard, but more like their peers when asked to generate and recall their own narrative based on a series of pictures. The children with SLI had difficulty with inferencing questions. In Study 2 the impaired group performed significantly worse on measures of memory, showing a lower working memory capacity. The children with SLI made more errors on the attention task, but no group differences were found on the inhibition task. In comparing results from Studies 1 and 2, significant correlations were found between performance on the narrative tasks and memory tasks, but the contribution of memory to the narrative task scores differed for the two stories. The Recalling Sentences memory task was found to be the best overall measure for predicting variance on story comprehension and recall. Conclusions: In support of previous research, the children with SLI showed problems with inferencing, linking directly observed or stated information to likely outcomes. They also showed a limited working memory capacity, and they were more likely to make errors in attention. A main finding was that the narrative abilities of the 6-year-old children were linked to their verbal working memory. The information the SLI group heard was harder to access than information they had been able to generate themselves based on a series of pictures. The findings suggest that children with SLI are likely to be at a disadvantage in classroom situations, particularly for information presented aurally and if the information is complex. The use of pictorial aids may help them encode the information. They would also benefit from having information broken into manageable units. (Contains 6 tables, 2 figures and 6 notes.)

Background: Despite somewhat spared structural language development in high-functioning autism, communicative comprehension deficits persist. Comprehension involves the integration of meaning: global processing is required. The Weak Central Coherence theory suggests that individuals with autism are biased to process information locally. This cognitive style may impair comprehension, particularly if inferencing is required. However, task performance may be facilitated by this cognitive style if local processing is required. Aims: The current study was designed to examine the extent to which the 'weak central coherence' cognitive style affects comprehension and inferential processing of spoken narratives. The children with autism were expected to perform comparatively poorer on inferences relating to event scripts and comparatively better on inferences requiring deductive reasoning. Methods & Procedures: Fourteen high-functioning children with autism were recruited from databases of various autism organizations (mean age = 6:7, 13 males, one female) and were matched on a receptive vocabulary and a picture-completion task with 14 typically developing children recruited from a local childcare centre (mean age = 4:10, seven males, seven females). The children were read short stories and asked questions about the stories. Outcomes & Results: Results indicated that the children with autism were less able to make inferences based on event scripts, but the groups did not differ significantly on inferences requiring deductive logical reasoning. Despite similar group performance on questions relating to the main idea of the stories, only for the typically developing group was good performance on extracting the main idea of the narratives significantly correlated with performance on all other comprehension tasks. Conclusions & Implications: Findings provide some support for the Weak Central Coherence theory and demonstrate that young children with autism do not spontaneously integrate information in order to make script inferences, as do typically developing children. These findings may help to explain communicative problems of young children with autism and can be applied to intervention programme development. More research on the link between a 'weak central coherence' cognitive style and communicative comprehension in autism will be valuable in understanding the comprehension deficits associated with autism. [ABSTRACT FROM AUTHOR]