Search

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.

For children with normal hearing (NH), early communication skills predict vocabulary, a precursor to grammar. Growth in early communication skills of infants with cochlear implants (CIs) was investigated using the Early Communication Indicator (ECI), a play-based observation measure. Multilevel linear growth modelling on data from six ECI sessions held at three-monthly intervals revealed significant growth overall, with a non-significant slower growth rate than that of children with NH (comparison age centred at 18 months). Analyses of gesture use and of nonword vocalisations revealed the CI group used significantly more of each, with more rapid growth. In contrast, the CI group used significantly fewer single words and multiword utterances, and with slower growth. Maternal education and time to achieve consistent CI use impacted significantly on growth for the CI sample. The results indicate that progression to vocabulary by young CI users can be supported by encouraging their use of prelinguistic communication.

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.

We compared loss and gain in communication from 1 to 2 years in children later diagnosed with autism spectrum disorder (n = 41), language impairment (n = 110) and in children with typical language development at 7 years (n = 831). Participants were selected from a prospective population cohort study of child language (the Early Language in Victoria Study). Parent-completed communication tools were used. As a group, children with autism spectrum disorder demonstrated slower median skill gain, with an increasing gap between trajectories compared to children with typical development and language impairment. A proportion from all groups lost skills in at least one domain (autism spectrum disorder (41%), language impairment (30%), typical development (26%)), with more children with autism spectrum disorder losing skills in more than one domain (autism spectrum disorder (47%), language impairment (15%, p = 0.0003), typical development (16%, p < 0.001)). Loss was most common for all groups in the domain of "emotion and eye gaze" but with a higher proportion for children with autism spectrum disorder (27%; language impairment (12%, p = 0.03), typical development (14%, p = 0.03)). A higher proportion of children with autism spectrum disorder also lost skills in gesture (p = 0.01), sounds (p = 0.009) and understanding (p = 0.004) compared to children with typical development but not with language impairment. These findings add to our understanding of early communication development and highlight that loss is not unique to autism spectrum disorder.

Prospective questionnaire data from a longitudinal population sample on children with autism spectrum disorders (ASD), developmental delay, specific language impairment, or typical development (TD), were collected at ages eight, 12 and 24 months, via the Communication and Symbolic Behavior Scale Developmental Profile (CSBS)--Infant Toddler Checklist, and the Actions and Gesture section of the MacArthur-Bates Communicative Development Inventory (CDI):Words and Gestures. The four groups were compared at four years of age to identify whether any early behaviours differentiated the groups. While children with ASD differed from TD children on most social communicative measures by 12 months of age, the only social communication characteristic which could differentiate the children with ASD from the other groups were gesture scores on the CDI at 12 months and the CSBS at 24 months. Significant markers of ASD were identifiable in this community sample at an early age, although discrimination between clinical groups was rarely evident. (Contains 7 tables.)

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.)

Infants' auditory processing abilities have been shown to predict subsequent language development. In addition, poor auditory processing skills have been shown for some individuals with specific language impairment. Methods used in infant studies are not appropriate for use with young children, and neither are methods typically used to test auditory processing skills in specific language impairment (SLI). The objective in this study was to develop an appropriate way of testing auditory processing skills in children in the 4-5 year age range. We report data from 49 children aged 4-5 years (mean age 58.57 months) tested on five tasks with tones and synthesized syllables. Frequencies and inter-stimulus intervals were varied in the tone tasks; the second formant transitions between consonant and vowel were varied in the syllable tasks. Consistent with past research, variability was found in children's auditory processing abilities. Significant correlations in discrimination thresholds for the tasks were found. The results from two regression analyses showed that the children's auditory processing abilities predicted significant amounts of variance for receptive and expressive language. (Contains 5 tables, 2 figures, and 2 footnotes.)

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.)

Focuses on the influence of language specific properties in the acquisition of locative expressions. Some of the claims from literature on the acquisition of locative expressions are discussed and data from the acquisition of Warlpiri are presented and discussed in terms of these claims. (Author/CB)

Describes a part of a study on children's acquisition of Warlpiri, an aboriginal language spoken in central Australia, which aimed to find out at what age the children respond consistently to particular word orders and case frames for simple transitive sentences. Makes comparisons with the acquisition of Turkish transitive clauses. (SED)

Background: Language is foundational for neurodevelopment and quality of life, but an estimated 10% of children have a language disorder at age 5. Many children shift between classifications of typical and low language if assessed at multiple times in the early years, making it difficult to identify which children will have persisting difficulties and benefit most from support. This study aims to identify a parsimonious set of preschool indicators that predict language outcomes in late childhood, using data from the population‐based Early Language in Victoria Study (n = 839). Methods: Parents completed surveys about their children at ages 8, 12, 24, and 36 months. At 11 years, children were assessed using the Clinical Evaluation of Language Fundamentals 4th Edition (CELF‐4). We used random forests to identify which of the 1990 parent‐reported questions best predict children's 11‐year language outcome (CELF‐4 score ≤81 representing low language) and used SuperLearner to estimate the accuracy of the constrained sets of questions. Results: At 24 months, seven predictors relating to vocabulary, symbolic play, pragmatics and behavior yielded 73% sensitivity (95% CI: 57, 85) and 77% specificity (95% CI: 74, 80) for predicting low language at 11 years. [Corrections made on 5 May 2023, after first online publication: In the preceding sentence 'motor skills' has been corrected to 'behavior' in this version.] At 36 months, 7 predictors relating to morphosyntax, vocabulary, parent–child interactions, and parental stress yielded 75% sensitivity (95% CI: 58, 88) and 85% specificity (95% CI: 81, 87). Measures at 8 and 12 months yielded unsatisfactory accuracy. Conclusions: We identified two short sets of questions that predict language outcomes at age 11 with fair accuracy. Future research should seek to replicate results in a separate cohort. [ABSTRACT FROM AUTHOR]

Through a cross-sectional community study of 2044 children aged 2 years, we (1) examine the impact of hearing loss on early spoken expressive vocabulary outcomes and (2) investigate how early intervention-related factors impact expressive vocabulary outcomes in children with hearing loss predominantly identified through universal newborn hearing screening. We used validated parent/caregiver-reported checklists from two longitudinal cohorts (302 children with unilateral or bilateral hearing loss, 1742 children without hearing loss) representing the same population in Victoria, Australia. The impact of hearing loss and amplification-related factors on vocabulary was estimated using g-computation and multivariable linear regression. Children with versus without hearing loss had poorer expressive vocabulary scores, with mean scores for bilateral loss 0.5 (mild loss) to 0.9 (profound loss) standard deviations lower and for unilateral loss marginally (0.1 to 0.3 standard deviations) lower. For children with hearing loss, early intervention and amplification by 3 months, rather than by 6 months or older, resulted in higher expressive vocabulary scores. Children with hearing loss demonstrated delayed spoken expressive vocabulary despite whole-state systems of early detection and intervention. Our findings align with calls to achieve a 1-2-3 month timeline for early hearing detection and intervention benchmarks for screening, identification, and intervention. [ABSTRACT FROM AUTHOR]

Purpose: To examine (1) the association between low language (LL) and caregiver's health-related quality of life (HRQoL), (2) whether persistent LL affects caregiver's HRQoL and (3) whether child social-emotional-behavioural (SEB) difficulties attenuates the association between LL and caregiver's HRQoL. Method: Data were from the Early Language in Victoria Study (ELVS) and the Longitudinal Study of Australian Children (LSAC). Caregiver's HRQoL was measured using the EuroQoL-5 dimensions and the Assessment of Quality of Life-8 dimensions. Language ability was determined using the Clinical Evaluation of Language Fundamentals (CELF)-Preschool-2nd or 4th edition (ELVS) and the Peabody Picture Vocabulary Test-3rd edition or CELF-4 recalling sentences subscale (LSAC). Child SEB difficulties were measured using the Strengths and Difficulties Questionnaire. Multivariable linear regression was used for the analysis. Result: At 11–12 years, an association between LL and reduced caregiver's HRQoL was found in LSAC, but not in ELVS. Persistent LL from 4–11 years seemed to not affect caregivers' HRQoL in either cohort. Child SEB difficulties attenuated the association between caregiver's HRQoL and LL. Conclusion: Both LL and SEB difficulties contributed to reduced caregiver's HRQoL at children age 11–12 years. Interventions supporting children with LL should consider caregiver's well-being in provision of care that meets families' needs. [ABSTRACT FROM AUTHOR]

Purpose: To extend our knowledge about factors influencing early vocabulary development for infants with cochlear implants (CIs), we investigated the impact of positive parenting behaviors (PPBs) from the Indicator of Parent Child Interaction, used in parent–child interactions during everyday activities. Method: Implantation age for the sample recruited from CI clinics in Australia ranged from 6 to 10 months for 22 children and from 11 to 21 months for 11 children. Three observation sessions at three monthly intervals were coded for use of PPBs. Children’s productive vocabulary, based on the MacArthur–Bates Communicative Development Inventories parent checklist, was collected approximately 6 and 9 months later. A repeated-measures negative binomial generalized linear mixed-effects model was used to investigate associations between the total PPBs per session, covariates (maternal education, gender, and time since implant), and the number of words produced. In follow-up analyses with the PPBs entered separately, variable selection was used to retain only those deemed informative, based on the Akaike information criterion. Results: As early as Session 1, associations between the PPBs and vocabulary were identified. Time since implant had a positive effect. For different sessions, specific PPBs (descriptive language, follows child’s lead, and acceptance and warmth) were identified as important contributors. Conclusions: Complementing previous findings, valuable information was identified about parenting behaviors that are likely to impact positively the early vocabulary of infants with CIs. Of importance is providing parents with information and training in skills that have the potential to help create optimal contexts for promoting their child’s early vocabulary development. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the contribution of early life factors and preschool- and school-aged language abilities to children's 11-year language and academic outcomes. METHODS: Participants (N = 839) were from a prospective community cohort study of 1910 infants recruited at 8 to 10 months of age. Early life factors included a combination of child (prematurity, birth weight), family (socioeconomic disadvantage, family history of language difficulties), and maternal factors (education, vocabulary, and age). Language (standardized assessment of receptive and expressive skills) and academic (national assessment) outcomes at 11 years were predicted by using a series of multivariable regression models. RESULTS: Early life factors explained 11% to 12% of variance in language scores at 11 years. The variance explained increased to 47% to 64% when language scores from 2 to 7 years were included. The largest increase in variance explained was with 4-year language scores. The same early life factors explained 13% to 14% of academic scores at 11 years, with increases to 43% to 54% when language scores from 2 to 11 years were included. Early life factors adequately discriminated between children with typical and low language scores but were much better discriminators of children with typical and low academic scores. When earlier language scores were added to models then the area under the curve increased to 0.9 and above. CONCLUSIONS: Children's language outcomes at 11 years are accurately predicted by their 4-year language ability and their academic outcomes at 11 years are predicted by early family and home environment factors. Children with low language abilities at 11 years consistently performed more poorly on national assessments of literacy and numeracy. [ABSTRACT FROM AUTHOR]

Language disorder (LD) and social-emotional and behavioural (SEB) difficulties are common childhood problems that often co-occur. While there is clear evidence of these associations from clinical samples, less is known about community samples. This paper examines these associations in children aged 4-7 years from a community-based longitudinal study. 771 families provided questionnaire and assessment data at 4, 5 and 7 years. Parent-reported SEB difficulties were measured at each point (SDQ). Child language was directly assessed at 4 (CELF-P2), 5 and 7 years (CELF-4). Linear regression analysis was used to compare cross-sectional differences in mean SDQ scores between children with and without LD at each time point. Linear regression was then used to examine how patterns of language development (language disordered at three time points; never disordered; disordered at one or two time points, i.e. ‘unstable’ group) related to SEB difficulties at each age, adjusted for potential confounders, as in the previous analyses. Higher hyperactivity/inattention scores were associated with LD at each age. In fully adjusted models, there was little difference in mean emotional symptoms scores between children with and without LD. The ‘never’ LD group had lower mean SDQ scores at each time point than the ‘unstable’ group. Findings highlight that children with persistent LD from preschool to early primary school may be more likely to have concomitant SEB difficulties, particularly behavioural difficulties. Those with unstable LD may also have co-occurring SEB difficulties, showing a need for education and health professionals to monitor early language and SEB development. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Following a biopsychosocial model, the study investigated the role of child factors (gender, IQ), maternal factors (psychological distress, maternal education and vocabulary, maternal distress) and environmental factors (SES) in the relationship between language impairment and behaviour problems in preschool children. Participants were drawn from the Early Language in Victoria Study (ELVS) a prospective, longitudinal study examining the epidemiology and natural history of language impairment. The study reports on 1257 participants from the ELVS who completed questionnaires at 2 and 4 years and also completed face-to-face assessments at 4 years of age. Information was collected on child language, non-verbal cognition and social-emotional development; maternal vocabulary, maternal psychological distress and parent–child interaction; and SES. This study showed that language impairment is specifically associated with hyperactivity and peer problems but not anxiety and conduct problems at the preschool stage. Children with language impairment were at a higher risk for clinical levels of ‘abnormal’ behaviour which could lead to a psychiatric diagnosis than typically developing children. An examination of biopsychosocial variables associated with language and behaviour revealed that although language ability was a predictor of behaviour at both 2 years and 4 years of age, maternal distress was a stronger predictor of behaviour, with the association stronger for boys than for girls. Early intervention directed to children, especially boys, with language impairment deserves further attention, especially during the preschool period, in order to ameliorate the impact of language impairment on peer relationships and disruptive behaviour in later school years. [ABSTRACT FROM AUTHOR]

Purpose: The evidence of a deficit in working memory in specific language impairment (SLI) is of sufficient magnitude to suggest a primary role in developmental language disorder. However, little research has investigated memory in late talkers who recover from their early delay. Drawing on a longitudinal, community sample, this study compared the memory profiles of 3 groups of 5-year-olds: children with SLI who had been identified as late talkers, resolved late talkers (RLTs), and children with typical language development (TLD). Method: Participants were 25 children with SLI, 45 RLTs, and 32 children with TLD. Subtests from the Working Memory Test Battery for Children and the Children's Memory Scale plus recalling sentences and nonword repetition tasks were administered to test the components of Baddeley's working memory model. Results: The SLI group showed significantly poorer performance than the RLT and TLD groups on measures of the phonological loop and episodic buffer. The RLT and TLD groups scored similarly on all memory measures. Conclusions: The results support previous findings that sentence recall and nonword repetition are markers of SLI. Although residual effects of late-talking status may emerge over time, RLTs do not necessarily show memory deficits at 5 years of age despite delayed early vocabulary development. [ABSTRACT FROM AUTHOR]

Evans & Levinson (E&L) argue against Universal Grammar on the basis of language diversity. A related and fundamental issue is whether the language input provides sufficient information for a child to acquire it. I briefly discuss the more integrated approaches to language acquisition which focus on the mechanisms, and research showing that input cues provide valuable information for the language learner. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine at 7 years the language abilities of children, the salience of early life factors and language scores as predictors of language outcome, and co-occurring difficulties METHODS: A longitudinal cohort study of 1910 infants recruited at age 8 to 10 months. Exposures included early life factors (sex, prematurity, birth weight/order, twin birth, socioeconomic status, non-English speaking background,family history of speech/ language difficulties); maternal factors (mental health, vocabulary, education, and age); and child language ability at 2 and 4 years. Outcomes were 7-year standardized receptive or expressive language scores (low language: ≥1.25 SD below the mean), and co-occurring difficulties (autism, literacy, social, emotional, and behavioral adjustment, and health-related quality of life). RESULTS: Almost 19% of children (22/1204;18.9%) met criteria for low language at 7 years. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language scores at ages 2 and 4 were included. Early life factors moderately discriminated between children with and without low language (area under the curve: 0.68-0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85-0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioral difficulties, and limitations in school and psychosocial functioning. CONCLUSIONS: Child language ability at 4 years more accurately predicted low language at 7 than a range of early child, family, and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties. [ABSTRACT FROM AUTHOR]