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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., (© 2018 Royal College of Speech and Language Therapists.)

Background: Targeted interventions during early childhood can assist families in providing strong foundations that promote children's health and wellbeing across the life course. There is growing recognition that longer follow-up times are necessary to assess intervention outcomes, as effects may change as children develop. The Early Home Learning Study, or 'EHLS', comprised two cluster randomized controlled superiority trials of a brief parenting intervention, smalltalk, aimed at supporting parents to strengthen the early childhood home learning environment of infants (6-12 months) or toddlers (12-36 months). Results showed sustained improvements in parent-child interactions and the home environment at the 32 week follow-up for the toddler but not the infant trial. The current study will therefore follow up the EHLS toddler cohort to primary school age, with the aim of addressing a gap in literature concerning long-term effects of early childhood interventions focused on improving school readiness and later developmental outcomes., Methods: 'EHLS at School' is a school-aged follow-up study of the toddler cluster randomized controlled trial (n = 1226). Data will be collected by parent-, child- and teacher-report questionnaires, recorded observations of parent-child interactions, and direct child assessment when children are aged 7.5 years old. Data linkage will provide additional data on child health and academic functioning at ages 5, 8 and 10 years. Child outcomes will be compared for families allocated to standard/usual care (control) versus those allocated to the smalltalk program (group program only or group program with additional home coaching)., Discussion: Findings from The Early Home Learning Study provided evidence of the benefits of the smalltalk intervention delivered via facilitated playgroups for parents of toddlers. The EHLS at School Study aims to examine the long-term outcomes of this initiative to determine whether improvements in the quality of the parent-child relationship persist over time and translate into benefits for children's social, academic and behavioral skills that last into the school years., Trial Registration: 8 September 2011; ACTRN12611000965909 (for the original EHLS).

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]

Abstract: Background: There is growing evidence that specific styles of parent–child interaction benefit child development, particularly child language development. Direct observational techniques help clarify the behaviours and styles within parent–child interactions that may influence child language outcomes; however, these techniques tend to be labour‐intensive and costly. We report on the development of a replicable, low‐burden mechanism for observing and coding specific maternal linguistic behaviours in a population‐based cohort of 2‐year‐olds. Methods: The coding scheme was developed as part of a prospective, longitudinal study examining the associations between maternal responsive behaviours and child language outcomes in slow‐to‐talk toddlers. In the first phase of the study, three coding systems were tested by coding five sample parent–toddler interactions and then comparing them based on (a) the ease of method and thus likely intrarater and interrater reliability and (b) the number of data points. The second phase was to demonstrate how the chosen method could be used in practice with a large at‐risk group of toddlers. Results: Of the three coding systems explored, the Observer® XT software was selected for ease of use and because detailed coding of free‐play videos could be achieved in close to real time. Intrarater and interrater reliability were established in 251 mother–child free‐play videos, producing high intraclass correlation coefficients of 0.95 to 0.99 for the six behaviours. Conclusions: The study provides evidence that numerous parent–child interactions can be rigourously yet efficiently coded without substantial information loss. The observational mechanism in the current study has been fully developed and is shown to be feasible for research purposes focusing on parent–toddler interactions. However, further testing of the observational mechanism is required to examine whether the same results could be produced if coding was conducted “live” and for shorter duration thereby making it readily useable for clinicians. [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: 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]

Variations in parenting have been suggested as contributing to a higher prevalence of language difficulties in children experiencing economic, environmental, and social adversity. Within these cohorts, the contribution of responsive and intrusive parenting to child language has been investigated; s pecific responsive and intrusive behaviors encapsulated within these parenting styles have yet to be fully examined. Additionally, the role of the mother-child dynamic in moderating mother-child associations has also not been explored. This study aimed to augment current research by identifying specific responsive and intrusive maternal behaviors associated with child language in a cohort experiencing adversity, as well as exploring the role of the fluency and connectedness of mother-child conversation in moderating associations ( n = 249). Specific behaviors and the fluency and connectedness of the mother-child interaction were coded from free-play videos at child age 12 months. Child language measures were derived from transcripts of free play at 24 months. Linear regression models were used to examine maternal-child associations. The moderating role of fluency and connectedness was then explored. Maternal imitations were positively associated with the child's total words; successful redirectives were negatively associated with the child's mean length of turn. Both associations were moderated by the fluency and connectedness of the interaction. [ABSTRACT FROM AUTHOR]

• 594 parents and children completed a play-based observation at home. • Families resided in 148 different postcodes, of varying socioeconomic status. • Observations were rated on parent sensitive responding and parent–child mutuality. • Greater neighbourhood disadvantage was associated with less sensitive responding. • Parenting supports tailored to local community are required. Neighbourhood-level factors can exert unique influence on children's development, independent of individual parent, child, and family factors. We investigated the contribution of neighbourhood socioeconomic status (using government-generated definitions) to directly-observed parent–child interactions among 596 Australian parents and their 7–8-year-old children. Parents' sensitive responding and parent–child positive mutuality were rated according to the SCARP:7 – 8 Years (Short Coding of Attachment-Related Parenting). Adjusting for individual family characteristics, multilevel modelling revealed evidence of an association between neighbourhood socioeconomic status and sensitive responding (β =.10, p=.004) but not for parent–child positive mutuality (β =−.01, p =.90). Tailored, evidence-based parenting supports according to local community need are warranted. [ABSTRACT FROM AUTHOR]