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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. WHAT THIS PAPER ADDS: What is already known on this subject: There is extensive evidence consistently demonstrating the important contribution of aspects of parent–child interaction, specifically responsive parental behaviours, to children's language development. What this paper adds to the existing knowledge: Understanding the cumulative benefit of responsive parent–child interactions across the very early years may help to inform preventive interventions and service delivery models for supporting young children's language development. This study demonstrates in a large, population‐based cohort the contribution of consistency of responsive parental behaviours during infancy and toddlerhood to school‐age language outcomes, accounting for other child, family and environmental factors. Capturing regular parent behaviours via self‐report during the early years may be a more efficient and less costly method than parent–child interaction observations to monitor the home language‐learning environment during routine developmental checks. What are the potential or actual clinical implications of this work?: Findings support the need for surveillance of children and families in the early years, ensuring that intervention occurs when families need it most, that is, support is responsive to changing needs and that nuanced advice and support strategies are provided to activate positive developmental cascades. Capturing both parent behaviours and child language may assist clinicians to identify those families who may benefit from parent–child interaction intervention. [ABSTRACT FROM AUTHOR]

Background: The cultural and language diversity across many European countries presents a range of challenges and opportunities for speech and language therapists and other practitioners working with children with developmental language disorders (DLD) and their families. Objective: The aim of this study was to explore practitioners' perceptions of cultural and linguistic differences in response to children with DLD across different countries. Methods: A survey was developed by practitioners and researchers working with children with DLD across Europe and beyond as part of the work of Cost Action IS1406. Data from 1,358 practitioners from 8 European countries – Ireland, UK, Bulgaria, Poland, Croatia, Spain, Norway and Sweden – and 2 neighbour countries – Turkey and Lebanon – were included in the present analyses, which address two groups of questions. The first focuses on practitioners' perceptions of the way that parents think about cultural differences and their relationship to language development in their children. The second concerns the extent to which practitioners consider themselves to have the skills to work with children from other cultures and using different languages. Results/Conclusions: Most countries present a similar profile with intermediate results about their perception of cultural issues, but Lebanon and Turkey are the group with the most positive responses. In terms of bilingual issues most practitioners indicated that they only worked in their country's primary language. The only country where this was not the case was Lebanon. Professionals from Spain and Lebanon form a subgroup in terms of their confidence to work with different cultural/language groups. The paper highlights both the universal importance of cultural and linguistic competence in managing young children's needs and indicates that in most cases professionals do not think they have the necessary expertise to work with cultural and linguistic diversity. [ABSTRACT FROM AUTHOR]

A cross-sectional online survey was completed by 219 speech-language therapists (SLTs) to explore their views and practices when working with children and adolescents who have literacy difficulties. They were recruited via 11 workshops hosted by Speech Pathology Australia, held across Australia and completed the survey prior to attending their respective workshop. Participants reported overwhelming support for SLTs to work with students struggling to learn literacy and supported not only a role for SLTs to work with children in the preschool years to promote readiness to learn to read at school, but also a role for services to students beyond the early years of school. While SLTs valued specific clinical and collaborative activities, a significant gap was found between their perceived feasibility of those activities and their perceived value. Results show SLTs are less confident providing written support to students than they are in providing phonological awareness and vocabulary interventions. While SLTs clearly value their role in the literacy domain, this study highlights evident gaps in preservice training in this area, as well as a need for improved SLT and teacher knowledge exchange, and collaboration in supporting children and adolescents with literacy difficulties. [ABSTRACT FROM AUTHOR]

Background: Despite the public health implications of language difficulties associated with social disadvantage, there is a dearth of effectiveness studies investigating the effects of targeted speech and language programmes in this area. Aims: To determine the effects of a targeted selective community-based child language intervention programme (Happy Talk), which simultaneously engaged with parents and early childhood educators, in the Republic of Ireland. Methods & Procedures: A mixed methods methodology was applied with quantitative outcome and qualitative process data collected. Effectiveness was examined using a quasi-experimental single blind study design comparing Happy Talk with 'usual care' across four preschools. Qualitative process data were also gathered to examine the acceptability and feasibility of the Happy Talk approach in practice, and to identify factors to improve the probability of successful wider implementation. Child language (PLS-5) and quality-of-life measures were administered pre- and immediately post-the 11-week intervention. Responsiveness was assessed as the parental outcome, and the oral language environment of preschools was measured using the Communication Supporting Classroom Observation Tool (CSCOT). Retrospective acceptability was analysed with reference to the theoretical framework of acceptability (v 2). Outcomes & Results: Pre-/post-expressive and composite language scoreswere collected for 58 children, and receptive scores for 54 children. Multiple linear regression revealed significant intervention effects for comprehension and total language with large and moderate effect sizes, respectively (0.60 and 0.46 SD). No significant effect was shown for parental responsiveness. No effects were found for the preschool environment or children's quality of life. Preschool staff deemed the programme to be an acceptable method of enhancing children's speech and language skills and rated the intervention positively. Conclusions & Implications: The Happy Talk pilot effectiveness trial shows that comprehension can be improved (with a large effect) in preschool children from areas of social disadvantage, following an 11-week intervention, in which parents and preschool staff are simultaneously engaged. The ecological validity of the programme, as well as feasibility and acceptability to staff, make it a suitable programme to be delivered at scale. [ABSTRACT FROM AUTHOR]

Specific features of adult linguistic input may play a larger, or smaller role, at different child ages, across different language outcomes, in different cohorts. This prospective, longitudinal study explored associations between the quantity and quality (i.e. diversity and responsiveness) of maternal linguistic input and child language. This study was derived from an Australian population-based intervention trial. Participants were mother–child dyads at risk of experiencing social adversity (n = 136). Home visits were conducted at 24 and 36 months. At the 24-month visit, mother–child free-play videos were collected. Seven aspects of maternal linguistic input were measured from videos: imitations, expansions, wh-questions, labels, word types, word tokens and mean length of utterance (MLU). Child language was assessed using a standardized measure at 36 months. Maternal MLU and imitations were associated with overall language and expressive vocabulary scores; wh-questions were associated with receptive language scores. By exploring quantity and quality, we can appreciate the differential contribution of adult linguistic input to early language abilities in different groups of children. Our findings highlight how imitations of early words/sounds and asking children wh-questions may foster expressive and receptive language development. These findings may be helpful to consider when selecting strategies for use in parent-implemented language promotion activities. [ABSTRACT FROM AUTHOR]

Background: Early reading success is predicated on language and pre‐literacy skills. Children who are behind their peers in language and pre‐literacy development before formal schooling are less likely to be proficient beginner readers, and difficulties may persist throughout primary school and beyond. We know children experiencing adversity are at greater risk of early language and pre‐literacy difficulties; we do not know the prevalence of these difficulties in an Australian adversity context. Aims: To investigate the prevalence and co‐occurrence of language and pre‐literacy difficulties in a cohort of Australian 5‐year‐old children experiencing social adversity. Methods & Procedures: Data were drawn from a large Australian community‐based trial of nurse home visiting (right@home), which aimed to support women experiencing social adversity from pregnancy until their child turned 2 years of age. Social adversity was determined by two of more risk factors: young pregnancy, not living with another adult, no support, poorer health, current smoker, long‐term illness, anxious mood, not finishing high school, no household income and no previous employment. Children whose mothers were enrolled in the control group (receiving usual maternal and child healthcare) were included in the current study (n = 359). Language and pre‐literacy skills were measured at age 5 using the Clinical Evaluation of Language Fundamental Preschool—Second Edition (CELF‐P2) and the School Entry Alphabetic and Phonological Awareness Readiness Test (SEAPART). Language difficulties were defined as ≥ 1.25 standard deviations (SD) below the Australian normative mean on CELF‐P2 Core Language scores. Pre‐literacy difficulties were defined as children scoring in the Beginner (versus Developing or Competent) criterion‐referenced level on the SEAPART First Sound Identification and/or Alphabet Letter Identification subtests. Co‐occurrence of language and pre‐literacy difficulties was also determined. Outcomes & Results: At the 5‐year follow‐up, 201/359 (56%) children were assessed (mean age = 5.1 years, SD = 0.1). Mean Core Language score for this cohort (91.8, SD = 15.9) was 0.54 SD below the normative mean (100, SD = 15). The proportion of children presenting with language difficulties was 24.9%. Regarding pre‐literacy skills, 43.8% of children were 'Beginner' for identifying first sounds and 58.6% for identifying alphabet letters/sounds. There was also considerable overlap whereby 76.7% of children with language difficulties also exhibited pre‐literacy difficulties. Conclusions & Implications: This is the first empirical Australian‐based study highlighting the high prevalence and co‐occurrence of language and pre‐literacy difficulties in preschool children experiencing social adversity. Clinicians should be aware of co‐morbid language and pre‐literacy difficulties in disadvantaged populations and consider both areas during assessment and intervention planning. What this paper addsWhat is already known on the subjectThe prevalence of language and literacy difficulties is substantially higher in cohorts experiencing social adversity when compared with more advantaged families. There is some evidence that adversity also contributes to pre‐literacy difficulties, but less is known here.What this paper adds to existing knowledgeThis study presents new prevalence data showing high rates of language and pre‐literacy difficulties for 5‐year‐old children experiencing adversity within an Australian context. It is the first to explore these skills in a large cohort of pre‐schoolers recruited from community settings in Australia.What are the potential or actual clinical implications of this work?In this cohort experiencing adversity, most children who presented with language difficulties likewise exhibited pre‐literacy difficulties. This concordance reflects how early oral language and pre‐literacy skills develop together. Clinicians should assess both skills in preschool populations—especially those working with children experiencing adversity—to ensure all children have strong foundations to become proficient beginner readers. [ABSTRACT FROM AUTHOR]

Background: Variations in parenting, more specifically less responsive and more directive parenting, contribute to language difficulties for children experiencing adversity. Further investigation of associations between specific responsive and directive behaviours and child language is required to understand how behaviours shape language over time within different populations. As language is dyadic, further exploration of how mother–child interactions moderate associations is also important. Aims: To investigate associations between specific responsive and directive maternal behaviours, the quality of mother–child interaction (fluency and connectedness) and child language in a cohort experiencing adversity. Methods & Procedures: Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, videos of mother–infant free play were collected. Videos were coded for maternal behaviours and fluency and connectedness (n = 249). At 36 months, child language was measured using a standardized language test. Linear regression models were used to examine associations and the moderating role of fluency and connectedness was explored. Outcomes & Results: Responsive yes/no questions were positively associated with language scores. Unsuccessful redirectives were negatively associated with language scores. The moderation effect of fluency and connectedness was equivocal in the current data. Conclusions & Implications: Findings reproduce and extend previous research highlighting key features of mother–child interactions associated with child language trajectories. Findings also augment knowledge of risk and protective factors related to language for children experiencing adversity and highlight where targeted interventions might be successful. [ABSTRACT FROM AUTHOR]

Purpose: Evidence suggests that children living in adversity are at greater risk of poorer language than their peers with the quality of parental interactions potentially mediating this association. Studies typically measure the mediatory impact of generic interaction styles making it difficult to discern which particular aspects of the interaction are facilitating language. This study aims to bridge this gap by identifying specific maternal behaviours associated with concurrent infant communication, in a cohort of 12-month old infants and their mothers experiencing adversity. Method: A total of 249 mother-infant free-play videos were collected from women experiencing adversity in Victoria and Tasmania, Australia. From those videos, specific maternal behaviours, infant communication acts and the interaction quality were coded. Result: Maternal verbal imitations uniquely predicted concurrent use of infant vocalisations, total words and unique words. Furthermore, the more fluent and connected the mother-infant dyad, the stronger the association between imitations and all three infant measures. Conclusion: Frequent use of maternal imitations, within highly connected mother-infant dyads, may help mediate the impact of adversity on early communication. This information is important for early years professionals working with at-risk populations in augmenting current knowledge of risk and protective factors related to early language. [ABSTRACT FROM AUTHOR]

Abstract: Background: In a community sample of slow‐to‐talk toddlers, we aimed to (a) quantify how well maternal responsive behaviors at age 2 years predict language ability at age 4 and (b) examine whether maternal responsive behaviors more accurately predict low language status at age 4 than does expressive vocabulary measured at age 2 years. Design or Methods: Prospective community‐based longitudinal study. At child age 18 months, 1,138 parents completed a 100‐word expressive vocabulary checklist within a population survey; 251 (22.1%) children scored ≤20th percentile and were eligible for the current study. Potential predictors at 2 years were (a) responsive language behaviors derived from videotaped parent–child free‐play samples and (b) late‐talker status. Outcomes were (a) Clinical Evaluation of Language Fundamentals—Preschool Second Edition receptive and expressive language standard score at 4 years and (b) low language status (standard score > 1.25 standard deviations below the mean on expressive or receptive language). Results: Two hundred eight (82.9% of 251) participants were retained to age 4. In adjusted linear regression analyses, maternal expansions predicted higher receptive (p < 0.001, partial R2 = 6.5%) and expressive (p < 0.001, partial R2 = 7.7%), whereas labels predicted lower receptive (p = 0.01, partial R2 = 2.8%) and expressive (p = 0.007, partial R2 = 3.5%) language scores at 4. The logistic regression model containing only responsive behaviors achieved “fair” predictive ability of low language status at age 4 (area under curve [AUC] = 0.79), slightly better than the model containing only late‐talker status (AUC = 0.74). This improved to “good” predictive ability with inclusion of other known risk factors (AUC = 0.82). Conclusion: A combination of short measures of different dimensions, such as parent responsive behaviors, in addition to a child's earlier language skills increases the ability to predict language outcomes at age 4 to a precision that is approaching clinical value. Research to further enhance predictive values should be a priority, enabling health professionals to identify which slow‐to‐talk toddlers most likely will or will not experience later poorer language. [ABSTRACT FROM AUTHOR]

Abstract: Background: Parent‐reported measures of early communication have limitations for use with infants experiencing adversity. Observational measures of early non‐verbal and verbal communicative behaviours and mother–child turn‐taking may provide a complementary method of capturing early communication skills for these children. Aims: To explore the predictive validity of verbal and non‐verbal behaviours and mother–child conversational turn‐taking (fluency and connectedness) at child age 12 months in relation to language measures at 24 and 36 months in a cohort of infants experiencing adversity. Methods & Procedures: Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, 190 infants were videoed during mother–child free‐play. Verbal and non‐verbal communicative behaviours and fluency and connectedness were measured from the 12‐month videos. Predictive validity of 12‐month behaviours was calculated in relation to mean length of utterance and number of unique words at 24 months and Clinical Evaluation of Language Fundamentals Preschool—Second Edition (CELF‐P2) Core Language scores at 36 months. Outcomes & Results: All 12‐month behaviours had adequate specificity but poor sensitivity when compared with other predictive validity studies using published early language measures. However, in adjusted regression models, fluency and connectedness and verbal behaviours at 12 months predicted unique words at 24 months. Fluency and connectedness also predicted CELF‐P2 scores at 36 months. Conclusions & Implications: Findings reconfirm the difficulty in early identification of children at risk of later language difficulties. All 12‐month measures were more accurate at identifying those children who will have better language than those children who will not. As fluency and connectedness was the only measure to predict 24‐ and 36‐month language in adjusted regression models, it may be an important factor to consider when measuring early language skills for infants experiencing adversity. Future research could combine observational measures of early communication and fluency and connectedness with other predictors of language to try to increase prediction accuracy. [ABSTRACT FROM AUTHOR]

Abstract: Background: Identifying risk and protective factors for language development informs interventions for children with developmental language disorder (DLD). Maternal responsive and intrusive communicative behaviours are associated with language development. Mother–child interaction quality may influence how children use these behaviours in language learning. Aims: To identify (1) communicative behaviours and interaction quality associated with language outcomes; (2) whether the association between a maternal intrusive behaviour (directive) and child language scores changed alongside a maternal responsive behaviour (expansion); and (3) whether interaction quality modified these associations. Methods & Procedures: Language skills were assessed at 24, 36 and 48 months in 197 community‐recruited children who were slow to talk at 18 months. Mothers and 24‐month‐olds were video‐recorded playing at home. Maternal praise, missed opportunities, and successful and unsuccessful directives (i.e., whether followed by the child) were coded during a 10‐min segment. Interaction quality was rated using a seven‐point fluency and connectedness (FC) scale, during a 5‐min segment. Linear regressions examined associations between these behaviours/rating and language scores. Interaction analysis and simple slopes explored effect modification by FC. Outcomes & Results: There was no evidence that missed opportunities or praise were associated with language scores. Higher rates of successful directives in the unadjusted model and unsuccessful directives in the adjusted model were associated with lower 24‐month‐old receptive language scores (e.g., unsuccessful directives effect size (ES) = −0.41). The association between unsuccessful directives and receptive language was weaker when adjusting for co‐occurring expansions (ES = −0.34). Both types of directives were associated with poorer receptive and expressive language scores in adjusted models at 36 and 48 months (e.g., unsuccessful directive and 48‐month receptive language, ES = −0.66). FC was positively associated with 24‐, 36‐ and 48‐month language scores in adjusted models (e.g., receptive language at 24 months, ES = 0.21, at 48 months, ES = 0.18). Interaction analysis showed the negative association between successful directives and 24‐month receptive language existed primarily in poorly connected dyads with low FC levels. Conclusions & Implications: These findings illustrate the effects of the combined interaction between different maternal communicative behaviours and features of the interaction itself on child language development, and the need to consider both in research and practice. Whilst more intrusive directives were associated with poorer language scores, this association attenuated when adjusting for co‐occurring responsive expansions, and the association was strongest for children in lower quality interactions. This work may inform clinical practice by helping clinicians target the most appropriate communicative behaviours for specific mother–child dyads. [ABSTRACT FROM AUTHOR]

Background Evidence suggests that language and social, emotional and behavioural (SEB) difficulties are associated in children and adolescents. When these associations emerge and whether they differ by language or SEB difficulty profile is unclear. This knowledge is crucial to guide prevention and intervention programmes for children with language and SEB difficulties. Aims To determine whether receptive and expressive language skills are associated with internalizing and externalizing behaviours in slow-to-talk toddlers. Methods & Procedures In a community-based prospective study of 200 slow-to-talk children, language was measured at 24 and 36 months using Preschool Language Scale 4th Edition and at 48 months using Clinical Evaluation of Language Fundamentals-Preschool 2nd Edition. Internalizing and externalizing behaviours were measured by parent report at each age. Longitudinal data were analysed using repeated-measures regression, with up to three observations per child. Robust standard errors were used to account for non-independence of measures within participants. The shape of the associations were examined by fitting quadratic and cubic terms. The effects of confounders on the associations were examined. Outcomes & Results Receptive language had a negative linear association with internalizing behaviours after adjusting for confounders ( β = -0.16, 95% [CI = -0.26, -0.07], p = .001); and a negative curved association with externalizing behaviours after adjusting for biological confounders ( βquadratic = 0.08 [0.01, 0.15], p = .03, βcubic = -0.04 [-0.07, -0.02], p = .001), attenuating after adjusting for environmental confounders ( βquadratic = 0.06 [-0.01, 0.13], p = .09, βcubic = -0.03 [-0.06, -0.003], p = .03). The curvature suggests that the negative association with externalizing behaviours only existed for children with either very low or very high receptive language scores. After controlling for confounders, there was no evidence that expressive language scores were associated with internalizing ( β = -0.08, 95% [CI = -0.17, 0.01], p = .10) or externalizing behaviours ( β = 0.03, 95% [CI = -0.09, 0.18], p = .61). Tests of interaction revealed no evidence of a differential association by age. Conclusions & Implications In 24-48-month-old slow-to-talk children, lower receptive language scores were associated with higher internalizing behaviours. The magnitude of the association was small. For children with very poor receptive language scores, lower receptive language skills were associated with higher externalizing behaviours. Young children with low receptive language abilities may be at risk of internalizing difficulties; those with very low receptive language skills may be at particular risk of externalizing difficulties. This has clinical implications for interventions for young children with receptive language difficulties. [ABSTRACT FROM AUTHOR]

Background 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. Aims 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. Methods & Procedures 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. Outcomes & Results 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). Conclusions & Implications 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. [ABSTRACT FROM AUTHOR]