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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.

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.

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.

Purpose: For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. Method: This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and environmental measures and first-degree relative history of stuttering. Comorbidities examined at 7 years included temperament, language, nonverbal cognition, and health-related quality of life. Results: The recovery rate by the age of 7 years was 65%. Girls with stronger communication skills at the age of 2 years had higher odds of recovery (adjusted OR = 7.1, 95% CI [1.3, 37.9], p = 0.02), but similar effects were not evident for boys (adjusted OR = 0.5, 95% CI [0.3, 1.1], p = 0.10). At the age of 7 years, children who had recovered from stuttering were more likely to have stronger language skills than children whose stuttering persisted (p = 0.05). No evident differences were identified on other outcomes including nonverbal cognition, temperament, and parent-reported quality of life. Conclusion: Overall, findings suggested that there may be associations between language ability and recovery from stuttering. Subsequent research is needed to explore the directionality of this relationship.

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.

The paper reports on a study designed to develop a risk model that can best predict single-word spelling in seven-year-old children when they were aged 4 and 5. Test measures, personal characteristics and environmental influences were all considered as variables from a community sample of 971 children. Strong concurrent correlations were found between single-word spelling and single-word reading while expressive language and, to a lesser extent, receptive language were less strongly correlated. Predictors of single-word spelling at ages 4 and 5 were dominated by child-related factors such as letter knowledge, a history of speech impairment and expressive language along with maternal word reading ability. Based on the strength of the predictive factors identified at both age 4 and 5, our results provide initial support for using a targeted model for screening pre-schoolers at risk of not mastering spelling in a timely manner.

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.

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.)

This paper reports on school readiness (SR) and its predictors in five- to six-year-old children from a prospective, longitudinal study of children from eight months to seven years (the Early Language in Victoria Study--ELVS). The ELVS children came from a representative sample of children recruited though the State Government Infant and Child Health Centres at the age of eight months who were studied at yearly intervals with a combination of parent surveys and face-to-face assessments. The study had a focus on language, pre-literacy and behavioural development. In pre-school and preparatory grade, teachers of the children completed a brief questionnaire rating SR characteristics, including cognitive, language and personal/social competencies. The data bank on these children provided a set of hypothesised child and family predictors of the SR score which were tested via factor analysis and regression analyses. Significant predictors of SR in the equation were evident from two years of age, and were all related to language and pre-literacy factors from two to six years. Twelve per cent of the children showed language impairment (LI) at five years according to their scores on the Clinical Evaluation of Language Fundamentals, 4th edition (CELF-4). In an additional analysis we found that these children were significantly lower on SR; they were also of lower social class compared with the remainder of the sample. The most influential factors in readiness for school were child language competencies and pre-literacy capacities, including phonemic awareness and letter knowledge. Preparation for school involving systematic emphasis on language and pre-literacy enrichment is recommended for all children before school entry and particularly for children at risk, including those coming from socio-economic disadvantage and those with delayed and impaired early language development. This addition to pre-school programmes can have lasting positive effects into pre-school and beyond, and prevent early school failure. (Contains 1 table.)

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.)

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]

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 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]

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]

Presents an abstract on the optimism and quality of life among aged individuals in Australia.

Presents an abstract on the occupational status of independent consultants in Australia.

OBJECTIVES: To document the natural history of stuttering by age 4 years, including (1) cumulative incidence of onset, (2) 12-month recovery status, (3) predictors of stuttering onset and recovery, and (4) potential comorbidities. The study cohort was a prospective community-ascertained cohort (the Early Language in Victoria Study) from Melbourne, Australia, of 4-year-old children {n = 1619; recruited at age 8 months) and their mothers. METHODS: Outcome was stuttering onset by age 4 years and recovery within 12 months of onset, defined using concurrent monthly parent and speech pathologist ratings. Potential predictors: child gender, birth weight, birth order, prematurity, and twinning; maternal mental health and education; socioeconomic status; and family history of stuttering. Potential comorbidities: preonset and concurrent temperament, language, nonverbal cognition, and health-related quality of life. RESULTS: By age 4 years, the cumulative incidence of stuttering onset was 11.2% (95% confidence interval [CI]: 9.7% to 12.8%). Higher maternal education (P = .004), male gender (P = .02), and twinning (P = .005) predicted stuttering onset. At outcome, stuttering children had stronger language (mean [SD]: 105.0 [13.0] vs 99.6 [14.6]; mean difference 5.5, 95% CI: 3.1 to 7.8; P < .001) and nonverbal cognition (mean [SD]: 106.5 [11.4] vs 103.9 [13.7], mean difference 2.6, 95% CI: 0.4 to 4.8; P = .02) and better health-related quality of life but were otherwise similar to their nonstuttering peers. Only 9 of 142 children (6.3%; 95% CI: 2.9% to 11.7%) recovered within 12 months of onset. CONCLUSIONS: Although stuttering onset is common in preschoolers, adverse affects are not the norm in the first year after onset. [ABSTRACT FROM AUTHOR]

Background: Low language abilities are known to be associated with significant adverse long-term outcomes. However, associations between low language and health-related quality of life (HRQoL) are unclear. We aimed to (a) examine the association between low language and HRQoL from 4 to 13 years and (b) classify the children's trajectories of HRQoL and language and examine the association between language and HRQoL trajectories., Methods: Data were from an Australian community-based cohort of children. HRQoL was measured at ages 4-13 years using the parent-reported Pediatric Quality of Life Inventory 4.0. Language was assessed using the Clinical Evaluation of Language Fundamentals (CELF)-Preschool 2nd edition at 4 years and the CELF-4th edition at 5, 7 and 11 years. Multivariable linear regression and mixed effect modelling were used to estimate cross-sectional and longitudinal associations between low language and HRQoL from 4 to 13 years. A joint group-based trajectory model was used to characterize associations between HRQoL and language trajectories over childhood., Results: Children with low language had substantially lower HRQoL than children with typical language from 4 to 13 years. Higher language scores were associated with better HRQoL, particularly in social and school functioning. Three HRQoL trajectories were identified: stable-high (51% of children), reduced with slow decline (40%) and low with rapid decline (9%). Children with low language were less likely to follow a stable-high HRQoL trajectory (40%) while 26% and 34% followed the reduced with slow decline and low with rapid decline trajectories, respectively., Conclusions: Children with low language experienced reduced HRQoL from 4 to 13 years. More than half had declining trajectories in HRQoL highlighting the need to monitor these children over time. Interventions should not only aim to improve children's language ability but also address the wider functional impacts of low language., (© 2020 Association for Child and Adolescent Mental Health.)

Aim: To describe changes in infant prelinguistic communication skills between 8 and 12 months, and identify factors associated with those skills., Design: Parent questionnaire data for a prospective population-based cohort of infants in metropolitan Melbourne, Australia., Participants: 1911 infants born November 2002-August 2003., Outcome: Infant communication (Communication and Symbolic Behaviour Scales (CSBS)) at 8 and 12 months. Potential risk factors: sex; prematurity; multiple birth; sociodemographic indicators; maternal mental health, vocabulary and education; non-English speaking background; and family history of speech-language difficulties. Linear regression models were fitted to total standardised CSBS scores at 8 and 12 months., Results: Social communication, especially the use of gesture, developed rapidly from 8 to 12 months. Female sex, twin birth, and family history were strongly associated with CSBS scores. The combined model accounted for 5% and 6% of the total variation at 8 and 12 months, respectively. CSBS score at 8 months strongly predicted CSBS score at 12 months (coefficient = 0.56, partial R(2) = 37.0)., Conclusions: There is a dramatic increase in communication skills between 8 and 12 months, particularly the development of gesture, which (as in previous studies) predates and predicts future language development. Risk factors explained little variation in early communication trajectories and therefore, based on our findings, this developmental course is more likely to be biologically predetermined. Rather than focusing on risk factors, we suggest that language promotion activities in otherwise healthy young infants should either be universal or, if targeted, be based on the level of communication skills displayed.