Search

Data from children with ASD who are learning Indo-European languages indicate that (a) they vary hugely in their expressive language skills and (b) their pragmatic/socially-based language is more impaired than their structural language. We investigate whether similar patterns of language development exist for Mandarin-exposed children with ASD. Parent report data of the Putonghua Communicative Development Inventory-Toddler Form were collected from 160 17-83-month-old children with ASD. These children with ASD demonstrated similar levels of variability as Western children with ASD. In particular, they could be divided into three distinct subgroups (high verbal, middle verbal, low verbal), all of which manifested relative strengths in lexical and grammatical language compared to pragmatic usage of decontextualized language.

Aim: This study identified whether children who had screened positive for either developmental language disorder (DLD) or autism spectrum disorder (ASD) at the age of 2.5 years had neurodevelopmental assessments five years later., Methods: Our study cohort were 288 children born from 1 July 2008 to 20 June 2009 who screened positive for DLD and, or, ASD at 2.5 years. Of these, 237 children were referred to, and assessed, at the Paediatric Speech and Language Pathology clinic (n = 176) or the Child Neuropsychiatry Clinic (n = 61) at the Queen Silvia Children's Hospital, Gothenburg, Sweden. Clinical registers covering all relevant outpatient clinics were reviewed five years later with regard to established diagnoses., Results: When the 237 were followed up five years later, 96 (40%) had established neurodevelopmental disorders or problems, often beyond DLD and ASD. Co-existing problems were common in this cohort and multidisciplinary assessments were indicated. The other 60% did not appear in subsequent clinic records. It is likely that this 40% was a minimum rate and that more children will be referred for developmental problems later., Conclusion: Five years after they had been screened positive for DLD and, or autism at 2.5 years, 40% of our cohort had remaining or other developmental problems., (©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Background:  South Africa presents with high preterm birth (PTB) and low birth weight (LBW) rates (14.17%). Numerous conditions characterised by language impairment are associated with LBW and/or PTB. Speech-language therapists may fail to identify older children whose language impairment may have originated from LBW and/or PTB., Objective:  To describe the frequency of LBW and/or PTB, in comparison with full-term birth, and associated conditions in children at an early communication intervention (ECI) clinic., Methods:  Retrospective data of 530 children aged 3-74 months were analysed, with 91.9% presenting with language impairment., Results:  Almost 40% had LBW and/or PTB, and late PTB was the largest category. Factors associated with LBW and/or PTB were prenatal risks, including small-for-gestational age, perinatal risks, including caesarean section, and primary developmental conditions. Secondary language impairment was prevalent, associated with genetic conditions and global developmental delay., Conclusion:  The frequency of LBW and/or PTB was unexpectedly high, drawing attention to the origins of language impairment in almost 40% of the caseload at the ECI clinic.

Despite improved survival of preterm infants, there has not been an equivalent improvement in long-term neurodevelopmental outcomes. Adverse neurodevelopmental outcome rates and severity are inversely related to the degree of prematurity, but only 1.6% are born very preterm and the motor, cognitive, behavioral, and psychiatric disabilities in the large moderate and late preterm population have a greater impact. The disability-free preterm adult has a lower educational achievement and income but similar health-related quality of life to term controls. Reducing the long-term neurodevelopmental impact of prematurity is the next frontier of neonatal care., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Technological advances in neonatal-perinatal medicine have led to a steady increase in the survival of preterm infants. Although the increase in survival is a remarkable success, children born preterm remain at high risk for brain injury and long-term neurodevelopmental deficits. Children born preterm may have abnormal muscle tone or movements, cognitive deficits, language impairments, and behavioral problems. This article reviews neurodevelopmental outcomes and factors that influence outcomes in preterm children during early childhood., (Copyright © 2018 Elsevier Inc. All rights reserved.)

We examined whether hypotension in very low birth weight infants aged⩽1 week was associated with hospital morbidities and overall mortality. Further, we studied whether hypotension was associated with poor neurodevelopmental outcomes in these patients at the corrected age of 18 months. A total of 166 very low birth weight infants were studied during this period. Hospital outcomes and neurodevelopmental outcomes at the corrected age of 18 months were evaluated. Among the 166 very low birth weight infants, 95 patients (57.2%) experienced hypotension at⩽1 week and were associated with an increased incidence of morbidities and mortality. At the corrected age of 18 months, hypotension of the⩽1 week group had significantly lower scores in all three - cognitive, language, and motor - composites of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) screening tests. In addition, a multivariable logistic regression analysis showed that longer mechanical ventilation and periventricular leukomalacia were additionally associated with worse cognitive and language neurodevelopmental outcomes. Hypotension in very low birth weight infants within 1 week of life was associated with increased morbidities and overall mortality. It was also associated with an increased risk of cognitive and language outcomes.

This study evaluated the claim that auditory processing deficits are a cause of reading and language difficulties. We report a longitudinal study of 245 children at family risk of dyslexia, children with preschool language impairments, and control children. Children with language impairments had poorer frequency-discrimination thresholds than controls at 5.5 years, but children at family risk of dyslexia did not. A model assessing longitudinal relationships among frequency discrimination, reading, language, and executive function skills showed that frequency discrimination was predicted by executive skills but was not a longitudinal predictor of reading or language skills. Our findings contradict the hypothesis that frequency discrimination is causally related to dyslexia or language impairment and suggest that individuals at risk for dyslexia or who have language impairments may perform poorly on auditory processing tasks because of comorbid attentional difficulties.

Introduction: Language development delay is a frequent challenge for pediatricians and other health care providers. The main objective of this study was to establish its prevalence among children attending a health care center., Population and Methods: The expressive vocabulary of 24-month-old children attending a health care center was assessed using the Spanish language MacArthur-Bates Communicative Development Inventories, short form (Argentine version). The association between language delay and demographic, socioeconomic, behavioral/emotional, and parental stress characteristics was analyzed. In children with expressive language delay, receptive vocabulary was assessed and possible underlying causes were studied (non-verbal cognitive delay, autistic spectrum disorders, middle ear pathology, and hearing impairment)., Results: Language development delay was observed in 16 out of 138 participants (11.6%; 95% confidence interval: 6.2-17%), significantly associated with a family history of language delay, parental stress, and problem behavior. Receptive vocabulary compromise was identified in 13 out of 16 children with language development delay, and 7 were suspected of autistic spectrum disorder, overall developmental delay, or both. A middle ear pathology was observed in 5 out of 9 studied children. The 9 participants who had an audiometry did not have pathological results based on this study's criteria., Conclusions: Language development delay is a prevalent condition in our population and has been mainly associated with behavioral problems and a family history of language delay., (Sociedad Argentina de Pediatría.)

Background: Delays in expressive vocabulary have been associated with lower outcomes in reading., Aim: The aim is to conduct a long-term follow-up study to investigate if early expressive vocabulary delay (late talking) predicts reading development in participants age 16 and under. We examine further if the prediction is different in the presence of family risk for dyslexia (FR) and early receptive vocabulary delay., Methods: Expressive and receptive vocabulary skills were assessed at the age of 2-2.5 years, and reading skills in Grades 2, 3, 8 and 9 (age 8-16). The longitudinal sample consisted of 200 Finnish-speaking children, of which 108 had FR for dyslexia and 92 came from families without reading difficulties. We compared the reading development of five subgroups: 1) FR and no vocabulary delay; 2) FR and late talkers, 3) FR, late talkers and co-existing receptive vocabulary delay; 4) no FR and late talkers; and 5) no FR and no vocabulary delay., Results: The group with FR and expressive and receptive vocabulary delay had difficulties in reading comprehension, but not in reading fluency. The late talkers without receptive vocabulary difficulties tended to become typical readers., Conclusions and Implications: Delays in early vocabulary can lead to a reading comprehension deficit, with the specification that expressive vocabulary deficit alone can alleviate in time, whereas the combined deficit is a stronger risk marker., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background and Aims: Although children with cerebral palsy (CP) are at an increased risk for developing speech, language, and executive function (EF) impairments, little is known regarding the relationship among these risk factors. The current study examined how different profiles of speech and language impairment might be associated with impairments in EF skills in school-aged children with CP., Methods and Procedures: Forty-seven school-aged children with CP were included. Each child contributed between one and four data points for a total of 87 data points. Children were classified into speech and language profile groups at each data point. EF skills were examined using the Behavior Rating Inventory of Executive Function questionnaire., Outcomes and Results: Compared to a mean of 50 from a normative population of children, mean scores on all measures of EF were significantly elevated for all groups (p<.05). The proportion of children with CP with elevated EF scores was significantly higher for all groups compared to the expected proportion in a normal population of children (p<.05)., Conclusions and Implications: Children with CP who do not have impairments in speech or language may be at risk for EF difficulties which may negatively affect social communication, academic performance, and functional independence., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Aim: Retrospective analysis of the neurodevelopment in the first two years of life in patients with severe congenital heart disease., Patients and Methods: Out of 89 patients with severe congenital heart disease 19 were excluded due to a history of prematurity and/or chromosomopathy, four due to a history of ischemic stroke and two due to lack of medical history. Denver Test (DT) results at 2, 6, 12, 15 and 18 months, and results in motor, language and social interaction fields were achieved., Results: 59.4% were male and 40.6% female. The mean age of patients undergoing extracorporeal membrane oxygenation with pathological DT at 18 months was 3 months, compared to 11.88 months in those with normal DT. DT at 2 months was normal in 98.4% of patients, 87.5% at 6 and 12 months, 81.3% at 15 months and 85% at 18 months. Two patients with abnormal neurodevelopment normalized the DT before 24 months. The field of neurodevelopment most affected was language (15.6%), followed by motor (10.9%) and social interaction (8%)., Conclusions: Psychomotor development delay, especially in the area of language, is more frequent in patients with severe congenital heart disease. The presence of cyanosis and the need for extracorporeal membrane oxygenation were the variables that are most associated with this type of pathology.

Objective: To examine prenatal APAP exposure in relation to language development in offspring at 30 months of age., Method: A population-based pregnancy cohort study including 754 women who enrolled in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study in pregnancy week 8-13. Two exposure measures were used: (1) maternally reported number of APAP tablets taken between conception and enrollment; (2) APAP urinary concentration at enrollment. Language development at 30 months was assessed by nurse's evaluation and parental questionnaire, including the number of words the child used (<25, 25-50 and >50). Main study outcome; parental report of use of fewer than 50 words, termed language delay (LD)., Results: 59.2% of women enrolled in weeks 8-13 reported taking APAP between conception and enrollment. APAP was measurable in all urine samples and urinary APAP was correlated with the number of APAP taken during pregnancy (P<0.01). Language delay was more prevalent in boys (12.6%) than girls (4.1%) (8.5% in total). Both the number of APAP tablets and urinary APAP concentration were associated with greater LD in girls but not in boys. The adjusted odds ratio (OR) for LD among girls whose mothers reported >6 vs. 0 APAP tablets was 5.92 (95% confidence interval (CI) 1.10-31.94). The OR for LD in girls whose mothers' urinary APAP was in the highest compared to the lowest quartile was 10.34 (95% CI 1.37-77.86). While it cannot be ruled out, our available data do not support confounding by indication., Conclusions: Given the prevalence of prenatal APAP use and the importance of language development, these findings, if replicated, would suggest that pregnant women should limit their use of this analgesic during pregnancy., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objectives: To compare neurocognitive, language, executive function, academic achievement, neurologic and behavioral outcomes, and quality of life at age 10 years in children born extremely preterm who developed bronchopulmonary dysplasia (BPD) to children who did not develop BPD., Methods: The Extremely Low Gestational Age Newborns study population included 863 children born extremely preterm whose BPD status before discharge was known had an IQ (Differential Ability Scales II [DAS II]) assessment at 10 years. We evaluated the association of BPD with any cognitive (DAS II), executive function (NEuroPSYchological Assessment II), academic achievement (Wechsler Individual Achievement Test-III and Oral and Written Language Scales [OWLS]) as well as social dysfunctions (Social Responsiveness Scale). We used logistic regression models, adjusting for potential confounding factors, to assess the strength of association between the severity of BPD and each outcomes., Results: Three hundred and seventy-two (43%) children were oxygen-dependent at 36 weeks postconception age, whereas an additional 78 (9%) were also oxygen- and ventilator-dependent. IQ scores 2 or more SDs below the expected mean (ie, z scores ≤-2) occurred twice as commonly among children who had BPD as among those who did not. Children with severe BPD consistently had the lowest scores on DAS II, OWLS, Wechsler Individual Achievement Test-III, NEuroPSYchological Assessment II, and Social Responsiveness Scale assessments., Conclusions: Among 10-year-old children born extremely preterm, those who had BPD were at increased risk of cognitive, language, and executive dysfunctions; academic achievement limitations; social skill deficits; and low scores on assessments of health-related quality of life., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)

Background: This study examined language development in young children with hearing loss and different types of additional disabilities (ADs)., Method: A population-based cohort of 67 children who were enrolled in the Longitudinal Outcomes of Children with Hearing Impairment study took part. Language ability was directly assessed at 3 and 5 years of age using the Preschool Language Scale, Fourth Edition and the Peabody Picture Vocabulary Test, Fourth Edition. Standard scores were used to enable comparison with age-based expectations for typically developing children., Results: Analysis of variance showed that, across the total cohort, children's language scores remained stable over the 2-year period. However, this overall stability masked a significant difference between children with different types of ADs; in particular, children with autism, cerebral palsy and/or developmental delay showed a decline in standard scores, whereas children with other disabilities showed a relative improvement. In addition, larger improvements in receptive vocabulary were associated with use of oral communication only., Conclusions: The results suggest that type of AD can be used to gauge expected language development in the population of children with hearing loss and ADs when formal assessment of cognitive ability is not feasible., (© 2018 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Background and Aims: Delay and impairment in Speech and language are common developmental problems in younger populations. Hitherto, there has been minimal study of the association between common childhood infections (e.g. enterovirus [EV]) and speech and language. The impetus for evaluating this association is provided by evidence linking inflammation to neurodevelopmental disorders. Herein we sought to determine whether an association exists between EV infection and subsequent diagnoses of speech and language impairments in a nationwide population-based sample in Taiwan., Methods: Our study acquired data from the Taiwan National Health Insurance Research Database. The sample was comprised of individuals under 18 years of age with newly diagnosed EV infection during the period from January 1998 to December 2011. 39669 eligible cases were compared to matched controls and assessed during the study period for incident cases of speech and language impairments. Cox regression analyses were applied, adjusting for sex, age and other physical and mental problems., Results: In the fully adjusted Cox regression model for hazard ratios, EV infection as positively associated with speech and language impairments (HR = 1.14, 95% CI: 1.06-1.22) after adjusting for age, sex and other confounds. Compared to the control group, the hazard ratio for speech and language impairments was 1.12 (95% CI: 1.03-1.21) amongst the group of EV infection without hospitalization, and 1.26 (95% CI: 1.10-1.45) amongst the group of EV infection with hospitalization., Conclusions: EV infection is temporally associated with incident speech and language impairments. Our findings herein provide rationale for educating families that EV infection may be associated with subsequent speech and language problems in susceptible individuals and that monitoring for such a presentation would be warranted. WHAT THIS PAPER ADDS?: Speech and language impairments associated with central nervous system infections have been reported in the literature. EV are medically important human pathogens and associated with select neuropsychiatric diseases. Notwithstanding, relatively few reports have mentioned the effects of EV infection on speech and language problems. Our study used a nationwide longitudinal dataset and identified that children with EV infection have a greater risk for speech and language impairments as compared with control group. Infected children combined other comorbidities or risk factors might have greater possibility to develop speech problems. Clinicians should be vigilant for the onset of language developmental abnormalities of preschool children with EV infection., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: Maternal thyroid dysfunction during pregnancy is associated with neurodevelopmental impairment in the offspring. No data are currently available for the offspring of patients treated early for congenital hypothyroidism (CH). The aim of this study was to investigate motor and language milestones at one year of age in a population-based registry of children born to young women with CH., Design and Methods: We assessed 110 children born to mothers with CH, and 1367 children from the EDEN French population-based birth cohort study prospectively, at the age of one year, with identical questionnaires. Outcomes were assessed in terms of scores for childhood developmental milestones relating to mobility, motor coordination, communication, motricity and language skills., Results: After adjustment for confounding factors, children born to mothers with CH were found to have a higher risk of poor motor coordination than those of the EDEN cohort (OR: 4.18, 95% CI: 2.52-6.93). No differences were identified for the other four domains investigated. Children born to mothers with gestational diabetes have a higher risk of low motor coordination score than their peers (OR: 2.10, 95% CI: 1.21-3.66). Children born to mothers with TSH ≥ 10 IU/L during the first six months of pregnancy were more likely to have low motricity or communication skills scores than those born to mothers with lower TSH concentrations (56% vs 21% for each score, P  < 0.04)., Conclusions: Maternal CH may have slight adverse effects on some developmental milestones in the child at one year of age, particularly for children born to mothers with uncontrolled hypothyroidism. However, it remains unclear whether these adverse effects modify subsequent neurodevelopment., (© 2018 European Society of Endocrinology.)

Purpose: Kannada, one of the Dravidian languages, is the official language of Karnataka state of India. There is a need for a test using Kannada words that can assess visual aspects of reading independently of syntactic and semantic knowledge., Methods: A test of reading rate in Kannada was developed following the design principles of the Wilkins Rate of Reading Test (RRT). Fifteen high-frequency bisyllabic Kannada words were selected. Children were recruited from state and private schools that used Kannada or English as the medium of instruction. A total of 799 children from Grade 2 to 9 participated in the study. Reading rate was measured using the English RRT and the Kannada version twice in immediate succession during the first session. In 85 children, measurements using the Kannada RRT were repeated after an interval of 15 days., Results: Pearson product moment correlation between the two immediately successive tests was 0.95 for the Kannada RRT and 0.91 for the English RRT. The correlation for the tests separated by an interval of 15 days was 0.83. When Kannada was the medium of instruction, there was little difference between test scores for Kannada and English. When English was the medium of instruction, test scores were greater in English. Scores increased as expected with age (P < 0.0001), similarly for Kannada and English tests., Conclusion: The newly developed Kannada RRT is both reliable and valid and can be used as a tool for measuring the visual aspects of reading., Competing Interests: There are no conflicts of interest

Background: It has been reported that the inhabitants of the Chilean Robinson Crusoe Island have an increased frequency of specific language impairment (SLI) or developmental language disorder (DLD)., Aims: To explore the familial aggregation of DLD in this community., Methods & Procedures: We assessed the frequency of DLD amongst colonial children between the ages of 3 and 8;11 years (50 individuals from 45 nuclear families). Familial aggregation rates of language disorder were calculated by assessing all available first-degree relatives (n = 107, 77 parents, 25 siblings, five half-siblings) of the probands., Outcomes & Results: We found that 71% of the child population performed significantly below expected in measures of phonological production or expressive and receptive morphology. The majority of these children presented with severe expressive and/or receptive language difficulties. One-quarter of language-disordered probands primarily had phonological difficulties. Family members of affected probands experienced a higher risk of language disorder than those of typically developing probands. This increased risk was apparent regardless of non-verbal IQ., Conclusions & Implications: The study substantiates the existence of a familial form of speech and language disorder on Robinson Crusoe Island. Furthermore, we find that the familiarity is stable regardless of non-verbal IQ, supporting the recent movement to reduce the importance of non-verbal IQ criterion in DLD diagnoses., (© 2018 Royal College of Speech and Language Therapists.)

Objectives: The objective of this study was to describe language functioning at 13 years of age and examine its developmental trajectory from 2 to 13 years of age in children born very preterm (VP) compared with term controls., Methods: Two hundred and twenty-four children born VP (<30 weeks' gestation) and 77 term controls had language skills assessed by using performance-based and/or parent-report measures at 2, 5, 7, and 13 years of age. Regression models were used to compare verbal memory, grammar, semantics, and pragmatic skills between the VP and term groups at 13 years of age. Linear mixed effects regression models were used to assess language trajectories from 2 to 13 years of age., Results: Compared with term controls, children born VP had poorer functioning across all components of language (mean group differences ranged from -0.5 SD to -1 SD; all P < .05) at 13 years of age. At each follow-up age, the VP group displayed poorer language functioning than the term controls, with the groups exhibiting similar developmental trajectories (slope difference = -0.01 SD per year; P = .55)., Conclusions: Children born VP continue to display language difficulties compared with term controls at 13 years of age, with no evidence of developmental "catch-up." Given the functional implications associated with language deficits, early language-based interventions should be considered for children born VP., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)

The fetus undergoes a crucial period of neurodevelopment in utero. The maternal hair metabolome provides an integrated record of the metabolic state of the mother prior to, and during pregnancy. We investigated whether variation in the maternal hair metabolome was associated with neurodevelopmental differences across infants. Maternal hair samples and infant neurocognitive assessments (using the Bayley III Scales of Infant Development at 24 months) were obtained for 373 infant-mother dyads between 26-28 weeks' gestation from the Growing Up in Singapore Towards Healthy Outcomes cohort. The hair metabolome was analysed using gas chromatography-mass spectrometry. Intensity measurements were obtained for 276 compounds. After controlling for maternal education, ethnicity, and infant sex, associations between metabolites and expressive language skills were detected, but not for receptive language, cognitive or motor skills. The results confirm previous research associating higher levels of phthalates with lower language ability. In addition, scores were positively associated with a cluster of compounds, including adipic acid and medium-chain fatty acids. The data support associations between the maternal hair metabolome and neurodevelopmental processes of the fetus. The association between phthalates and lower language ability highlights a modifiable risk factor that warrants further investigation.

Introduction: Denial of pregnancy remains a phenomenon little known to healthcare professionals. Yet its repercussions are far from negligible. The aim of this study was to assess whether denial of pregnancy has an impact on the infant's development., Patients and Method: This prospective study included 51 full-term infants born in Nancy Regional Maternity Hospital between 1 January 2009 and 30 June 2015. In this study, the development of the children was followed longitudinally. We collected data during the neonatal period, at 9months, and at 2years of age from the infants' file and standardized medical certificates, and current data through a telephone questionnaire. Three fundamental aspects of the infants' development were analyzed: height and weight growth, psychomotor development, and the existence of pathologies. Given that this was a preliminary study aiming at exploring facts, no statistical tests were carried out., Results: The rate of denial of pregnancy was one birth in 300 during the study period. These infants showed proportional intrauterine growth restriction, which leveled out later, with their height and weight growth normal by month 9. The full-term perinatal mortality rate was 5%. The infants showed no sign of increased morbidity; 20% of them presented with delayed psychomotor development at 9months of age, with an increased impact as they grew older. The rate reached 30% after 24months, half of which were language disorders., Conclusion: The results of this preliminary study point out the need for thorough monitoring of these infants throughout infancy., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Background: Developmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes., Aims: To examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age-matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes?, Methods & Procedures: Participants included 84 individuals with DLD (67% males) and 88 age-matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income., Outcomes & Results: Those with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age-matched peers was in work full time. Participants with DLD were much more likely to be in non-professional occupations. However, when examining pay in relation to types of occupation, the groups' incomes were broadly comparable., Conclusions & Implications: At the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD., (© 2017 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Background: There is now substantial literature demonstrating that a disproportionate number of young people who come into contact with youth justice services evidence unidentified language difficulties. These young people, therefore, have received little or no professional input in this area. Conversely, there is a dearth of research pertaining to criminality outcomes among those individuals with identified developmental language disorders (DLD) who have received such interventions., Aims: To examine police-initiated contact and substance use outcomes of young adults with a history of identified DLD versus age-matched peers (AMP). Additionally, self-reported rule breaking behaviours and aggression are considered. We hypothesize that early identification/intervention reduces engagement with risky behaviour such as substance and alcohol use as well as offending-related behaviours., Methods & Procedures: Adversarial police-initiated contacts were examined in 84 young adults with a history of DLD and 88 AMP. Rule-breaking and aggression were evaluated using the Achenbach Adult Self-Report for ages 18-59 years., Outcomes & Results: Adults with a history of DLD who received targeted intervention during their school years reported less contact with their local police service compared with AMPs at age 24. Comparable proportions of both groups reported current alcohol consumption, but group differences were found relating to alcohol use. No group differences in rule-breaking behaviours were found, but the DLD group was found to have a statistically significant higher raw score on the aggressive behaviour scale., Conclusions & Implications: There is a need for early identification of children with DLD. Early intervention aimed at ameliorating such difficulties could possibly have distal outcomes in relation to offending., (© 2017 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Background: Many risk factors interact together during the critical period of development and govern the future phenotype of autism spectrum disorder (ASD). Furthermore, co-occurring abnormalities among individuals with ASD vary a lot so as their abilities., Aim of Work: To investigate possible risk factors and to determine the prevalence of coexisting abnormalities in a sample of Egyptian ASD children and their influence on the severity and their communication performance., Methods: The diagnosis and severity of ASD for participants (N=80) was performed by DSM-5, ADIR and CARS. They were investigated regarding the possible risk factors and coexisting abnormalities. A detailed history taking, clinical examination, the Arabic preschool language scale, cognitive abilities assessment and other additional instrumental measures such as EEG were used., Results: Caesarian section and neonatal jaundice were the most common risk factors. The severity of ASD was positively related to maternal and paternal ages. Developmental language disorder, intellectual disability, attention deficit hyperactivity disorder, sleep disorder and EEG changes were more frequently detected among studied cases. The CARS scores were significantly higher in ADHD and EEG changes groups. The most severely affected CARS items in the groups with these disorders were determined., Conclusion: High parental ages has an impact on the severity of ASD. ADHD, sleep disorder, and EEG changes seem to have an impact on certain elements of the adaptive behavior especially the communicative performance of ASD individuals. We recommend to seriously investigate co-morbid abnormalities and consider them during the process of management of ASD for proper intervention plans., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Purpose: The aim of this study is to determine if there is a specific association between motor delays and receptive and expressive language function, respectively, in prematurely born children., Method: Retrospective data review: 126 premature children ≤ 1,250-g birthweight from English-speaking families were evaluated on motor development (normal, mild delay, and moderate-severe delay) and the cognitive and language scales of the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley, 2006) at 18 months corrected age. Cognitive scores were categorized as normal, suspect, and abnormal. Gender, demographic, and perinatal variables were recorded and analyzed with respect to motor category., Results: Lower birthweight, chronic need for oxygen, severe intraventricular hemorrhage, and intestinal infection/inflammation were related to poorer motor development. On receptive language, the normal motor group attained significantly higher scores than the moderate-severe motor group but did not differ significantly from the mild delay motor group. On expressive language, the normal motor group had significantly higher scores than both the mild and moderate-severe groups. Girls performed better than boys on receptive and expressive language, but there was no significant interaction between gender and motor category on any of the Bayley scores. Cognitive, but not motor, category significantly contributed to variance of receptive language scores; cognitive and motor category each independently contributed to the variance in expressive language., Conclusion: Findings suggest that motor control areas of the brain may be implicated in expressive language development of premature children. Further research is needed to determine the underlying factors for the association between motor and expressive language function.

This study examined longitudinal growth in gestures and words in infants at heightened (HR) versus low risk (LR) for ASD. The MacArthur-Bates Communicative Development Inventory was administered monthly from 8 to 14 months and at 18 and 24 months to caregivers of 14 HR infants diagnosed with ASD (HR-ASD), 27 HR infants with language delay (HR-LD), 51 HR infants with no diagnosis (HR-ND), and 28 LR infants. Few differences were obtained between LR and HR-ND infants, but HR-LD and HR-ASD groups differed in initial skill levels and growth patterns. While HR-LD infants grew at rates comparable to LR and HR-ND infants, growth was attenuated in the HR-ASD group, with trajectories progressively diverging from all other groups.

Background: Methyl mercury (MeHg) is a well-known neurotoxin and evidence suggests that also low level exposure may affect prenatal neurodevelopment. Uncertainty exists as to whether the maternal MeHg burden in Norway might affect child neurodevelopment., Objective: To evaluate the association between prenatal mercury exposure, maternal seafood consumption and child language and communication skills at age five., Methods: The study sample comprised 38,581 mother-child pairs in the Norwegian Mother and Child Cohort Study. Maternal mercury blood concentration in gestational week 17 was analysed in a sub-sample of 2239 women. Prenatal mercury exposure from maternal diet was calculated from a validated FFQ answered in mid-pregnancy. Mothers reported children's language and communications skills at age five by a questionnaire including questions from the Ages and Stages Questionnaire (ASQ), the Speech and Language Assessment Scale (SLAS) and the Twenty Statements about Language-Related Difficulties (language 20). We performed linear regression analyses adjusting for maternal characteristics, nutritional status and socioeconomic factors., Results: Median maternal blood mercury concentration was 1.03μg/L, dietary mercury exposure was 0.15μg/kgbw/wk, and seafood intake was 217g/wk. Blood mercury concentrations were not associated with any language and communication scales. Increased dietary mercury exposure was significantly associated with improved SLAS scores when mothers had a seafood intake below 400g/wk in the adjusted analysis. Sibling matched analysis showed a small significant adverse association between those above the 90th percentile dietary mercury exposure and the SLAS scores. Maternal seafood intake during pregnancy was positively associated with the language and communication scales., Conclusion: Low levels of prenatal mercury exposure were positively associated with language and communication skills at five years. However, the matched sibling analyses suggested an adverse association between mercury and child language skills in the highest exposure group. This indicates that prenatal low level mercury exposure still needs our attention., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Zengin-Akkuş P, Çelen-Yoldaş T, Kurtipek G, Özmert EN. Speech delay in toddlers: Are they only `late talkers`?. Turk J Pediatr 2018; 60: 165-172. Speech delay is prevalent in toddlers. Although some children with speech delay are able to catch up with their peers with time, the delay might be part of a broader condition such as global developmental delay, which requires specific diagnostic work-up. The current study aimed to present the demographic features, developmental profiles of the first 100 preschool-aged children who were seen at Hacettepe University İhsan Doğramacı Children`s Hospital-Developmental Pediatrics Unit with parental concern of speech delay. Moreover, risk factors associated with speech delay, possible diagnosis and intervention strategies are documented. Thirty-one of 100 children were diagnosed with autism spectrum disorder (ASD) and global developmental delay (GDD). The current study presented that 4 out of 5 toddlers exceeded the recommended TV watching time. Moreover, almost one third of children had a poor linguistic home environment. Three parents whose children were diagnosed with ASD or GDD, refused to be reported as `autism spectrum disorder` or `intellectual disability` with the anxiety of labeling their child. As a result, these children were unable to receive special education paid for by the government. This study presented 31 of 100 children needed further diagnostic work up and early intervention. Therefore, pediatricians should not underestimate speech delay. On the other hand, due to the fact that, the regulations to receive special education and therapy often create anxiety for the parents, we think that this system needs to be updated and special education support should be determined by the special needs of each child.

Background: Autism spectrum disorder (ASD) is a developmental disorder with a wide variety of clinical phenotypes and co-occurrences with other neurodevelopmental conditions. Symptoms may change over time., Aims: The aim of the present study was to prospectively follow 96 children, initially assessed for suspected ASD at an average age of 2.9 years., Methods and Procedures: All children had been identified with autistic symptoms in a general population child health screening program, and had been referred to the Child Neuropsychiatry Clinic in Gothenburg, Sweden for further assessment by a multi-professional team at Time 1 (T1). This assessment included a broad neurodevelopmental examination, structured interviews, a cognitive test and evaluations of the child́s adaptive and global functioning. Two years later, at Time 2 (T2), the children and their parents were invited for a follow-up assessment by the same team using the same methods., Outcomes and Results: Of the 96 children, 76 had met and 20 had not met full criteria for ASD at T1. Of the same 96 children, 79 met full ASD criteria at T2. The vast majority of children with ASD also had other neurodevelopmental symptoms or diagnoses. Hyperactivity was observed in 42% of children with ASD at T2, and Intellectual Developmental Disorder in 30%. Borderline Intellectual Functioning was found in 25%, and severe speech and language disorder in 20%. The children who did not meet criteria for ASD at T2 had symptoms of or met criteria for other neurodevelopmental/neuropsychiatric disorders in combination with marked autistic traits. Changes in developmental profiles between T1 and T2 were common in this group of young children with ASD. The main effect of Cognitive level at T1 explained more than twice as much of the variance in Vineland scores as did the ASD subtype; children with IDD had significantly lower scores than children in the BIF and AIF group. Co-existence with other conditions was the rule., Conclusions and Implications: Reassessments covering the whole range of these conditions are necessary for an optimized intervention-adapted to the individual child's needs., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

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 (β quadratic = 0.08 [0.01, 0.15], p = .03, β cubic = -0.04 [-0.07, -0.02], p = .001), attenuating after adjusting for environmental confounders (β quadratic = 0.06 [-0.01, 0.13], p = .09, β cubic = -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., (© 2017 Royal College of Speech and Language Therapists.)

Working with individuals who are deaf in mental health settings can be complex work, necessitating consideration for the difference in language abilities. These differences include not only the language differences of American Sign Language (ASL) and English, but also the range of heterogeneity within the Deaf Community. Multiple influences such as mental illness, medical conditions, language deprivation and the etiology of deafness can impact how a person acquires and uses language. This article will discuss how various causes of deafness create the potential for specific language dysfluencies with individuals who are deaf in mental health settings. The article will also discuss the use of communication assessments to examine specific language dysfluency patterns and attempt to offer possible corresponding interventions.

Purpose: The purpose of this study was to explore the literature on predictors of outcomes among late talkers using systematic review and meta-analysis methods. We sought to answer the question: What factors predict preschool-age expressive-language outcomes among late-talking toddlers?, Method: We entered carefully selected search terms into the following electronic databases: Communication & Mass Media Complete, ERIC, Medline, PsycEXTRA, Psychological and Behavioral Sciences, and PsycINFO. We conducted a separate, random-effects model meta-analysis for each individual predictor that was used in a minimum of 5 studies. We also tested potential moderators of the relationship between predictors and outcomes using metaregression and subgroup analysis. Last, we conducted publication-bias and sensitivity analyses., Results: We identified 20 samples, comprising 2,134 children, in a systematic review. According to the results of the meta-analyses, significant predictors of expressive-language outcomes included toddlerhood expressive-vocabulary size, receptive language, and socioeconomic status. Nonsignificant predictors included phrase speech, gender, and family history., Conclusions: To our knowledge this is the first synthesis of the literature on predictors of outcomes among late talkers using meta-analysis. Our findings clarify the contributions of several constructs to outcomes and highlight the importance of early receptive language to expressive-language development., Supplemental Materials: https://doi.org/10.23641/asha.5313454.

Developmental language disorders (DLD) are common and have far-reaching developmental consequences. Nevertheless, public awareness of DLD is poor, and one goal of this special issue is to showcase a set of papers that provide a clear and coherent message about the nature and impact of DLD, and the potential of intervention to mitigate these impacts. In this editorial, we highlight seminal papers JCPP has published on language disorders over the last 40 years. Many of the issues raised then are still relevant now; however, the papers that comprise this special issue exemplify how far the field has come in achieving consensus on terminology and diagnostic criteria, and producing highly consistent findings on the stability and impact of DLD, and the potential for language change in response to targeted interventions. The editorial concludes with a road map for future research and clinical priorities that includes the need for randomised controlled trials that specifically address the impact of co-morbidities on response to treatment, impacts of intervention on broader developmental outcomes, and the experiences of adults with DLD., (© 2017 Association for Child and Adolescent Mental Health.)

Background: Little is known about the nature, range and prevalence of different subgroups in language trajectories extant in a population from 4 to 11 years. This hinders strategic targeting and design of interventions, particularly targeting those whose difficulties will likely persist., Methods: Children's language abilities from 4 to 11 years were investigated in a specialist language longitudinal community cohort (N = 1,910). Longitudinal trajectory latent class modelling was used to characterise trajectories and identify subgroups. Multinomial logistic regression was used to identify predictors associated with the language trajectories children followed., Results: Three language trajectory groups were identified: 'stable' (94% of participants), 'low-decreasing' (4%) and 'low-improving' (2%). A range of child and family factors were identified that were associated with following either the low-improving or low-increasing language trajectory; many of them shared. The low-improving group was associated with mostly environmental risks: non-English-speaking background, social disadvantage and few children's books in the home. The low-decreasing group was associated with mainly biological risks: low birth weight, socioemotional problems, lower family literacy and learning disability., Conclusions: By 4 years, services can be confident that most children with low language will remain low to 11 years. Using rigid cut-points in language ability to target interventions is not recommended due to continued individual variability in language development. Service delivery models should incorporate monitoring over time, targeting according to language abilities and associated risks and delivery of a continuum of interventions across the continuum of need., (© 2017 Association for Child and Adolescent Mental Health.)

Background: Population-based studies have found that early language delays are associated with poorer long-term outcomes in adolescence and adulthood. Few studies have explored the influence of change in language ability over time on adult outcomes., Aim: To examine the educational, vocational and mental health outcomes for adults accounting for different vocabulary developmental profiles over a 16-year period., Methods & Procedures: A total of 1914 participants of the Mater-University of Queensland Study of Pregnancy (MUSP) were categorized into four groups based on their vocabulary skills at 5 and 21 years: (1) persistently good (n = 1679), (2) persistently poor (n = 33), (3) improved (n = 160), and (4) deteriorated (n = 42). The associations between vocabulary group and educational, vocational, and mental health outcomes at 21 years were investigated., Outcomes & Results: Adults with deteriorated and persistently poor vocabulary skills were less likely to have completed secondary school; with the improved, deteriorated and persistently poor groups being less likely to be engaged in education, employment or training at the 21-year follow-up, compared with the persistently good group. Adults with deteriorated performance were at an increased risk of affective disorders, as well as substance and alcohol abuse/misuse., Conclusions & Implications: These findings provide evidence that impaired vocabulary skills in adulthood, regardless of whether the deficit was acquired early or later, are associated with adverse outcomes. Clinicians and educators need to be aware of these adversities and ensure they are supporting children and adolescents in whom language difficulties exist or emerge so as to prevent poor long-term outcomes from occurring., (© 2016 Royal College of Speech and Language Therapists.)

Background: Although many metrics for neurodevelopment in children with nonsyndromic craniosynostosis have been analyzed, few have directly examined early language acquisition and speech development. The authors characterized language acquisition and speech development in children with nonsyndromic craniosynostosis., Methods: The authors' institutional database was queried for nonsyndromic craniosynostosis from 2000 to 2014. Patients with an identified syndrome were excluded. Specific data elements included age, gender, velopharyngeal adequacy by means of the Pittsburgh Weighted Speech Scale, evaluation for anatomical motor delay, language acquisition delay/disorder, articulation or speech sound production delays/disorders, and whether speech therapy was recommended. Diagnosis of a submucous cleft palate was noted., Results: One hundred one patients met inclusion criteria, of which 57.4 percent were male. Average age at the time of the most recent speech evaluation was 6.1 years (range, 2.31 to 17.95 years); 43.6 percent had normal speech/language metrics and 56.4 percent had one or more abnormalities, including anatomical motor delay/disorder (29.7 percent), language acquisition delay/disorder (21.8 percent), articulation or speech production delay/disorder (4.0 percent), hypernasality (15.8 percent), and velopharyngeal insufficiency or borderline competency (23.8 percent). Average Pittsburgh Weighted Speech Scale score was 1.3 (range, 0 to 5), and 29.7 percent (n = 30) of patients were recommended to have speech therapy. In addition, 25.8 percent of patients were diagnosed with a submucous cleft palate., Conclusions: One in four patients with nonsyndromic craniosynostosis carried a diagnosis of submucous cleft palate. The authors found that abnormal speech and language development occurs in one in 1.7 patients with nonsyndromic craniosynostosis, and that speech therapy for such abnormal development is warranted in one in 3.4 of them-a prevalence two to five times higher compared with the general pediatric population.

Introduction: Although some studies have reported an association between early exposure to anesthesia and surgery and long-term neurodevelopmental deficit, the clinical phenotype of children exposed to anesthesia is still unknown., Methods: Data were obtained from the Western Australian Pregnancy Cohort Study (Raine) with neuropsychological tests at age 10 years measuring language, cognition, motor function, and behavior. Latent class analysis of the tests was used to divide the cohort into mutually exclusive subclasses of neurodevelopmental deficit. Multivariable polytomous logistic regression was used to evaluate the association between exposure to surgery and anesthesia and each latent class, adjusting for demographic and medical covariates., Results: In our cohort of 1444 children, latent class analysis identified 4 subclasses: (1) Normal: few deficits (n=1135, 78.6%); (2) Language and Cognitive deficits: primarily language, cognitive, and motor deficits (n=96, 6.6%); (3) Behavioral deficits: primarily behavioral deficits, (n=151, 10.5%); and (4) Severe deficits: deficits in all neuropsychological domains (n=62, 4.3%). Language and cognitive deficit group children were more likely to have exposure before age 3 (adjusted odds ratio [aOR], 2.11; 95% confidence interval [CI], 1.17-3.81), whereas a difference in exposure was not found between Behavioral or Severe deficit children (aOR, 1.00; 95% CI, 0.58-1.73, and aOR, 0.85; 95% CI, 0.34-2.15, respectively) and Normal children., Conclusions: Our results suggest that in evaluating children exposed to surgery and anesthesia at an early age, the phenotype of interest may be children with deficits primarily in language and cognition, and not children with broad neurodevelopmental delay or primarily behavioral deficits.

Objective: To provide audiologists with strategies to minimise confounding cognitive and language processing variables and accurately diagnose central auditory processing disorder (CAPD)., Design: Tutorial., Study Sample: None., Results: Strategies are reviewed to minimise confounding cognitive and language processing variables and accurately diagnose CAPD., Conclusions: Differential diagnosis is exceedingly important and can be quite challenging. Distinguishing between two or more conditions presenting with similar symptoms or attributes requires multidisciplinary, comprehensive assessment. To ensure appropriate interventions, the audiologist is a member of the multidisciplinary team responsible for determining whether there is an auditory component to other presenting deficits or whether one condition is responsible for the symptoms seen in another. Choice of tests should be guided both by the symptoms of the affected individual, as established in an in-depth interview and case history, the individual's age and primary language, and by the specific deficits reported to be associated with specific clinical presentations. Knowing which tests are available, their strengths and limitations, the processes assessed, task and response requirements, and the areas of the central auditory nervous system (CANS) to which each test is most sensitive provides the audiologist with critical information to assist in the differential diagnostic process.

Objective: This study examined the relationship between mothers' pragmatics and child language in autism spectrum disorder (ASD) and non-ASD language delay (LD) mother-child dyads., Methods: Participants consisted of 20 dyads of mothers and their toddlers aged 24 to 48 months, with ASD (n = 10) or non-ASD LD (n = 10). Groups were matched on child chronological age, language, and cognition. Maternal pragmatic language was qualified based on the degree of pragmatic violations during a semistructured interview, and was examined in relation to both child language, as measured by the Preschool Language Scale-4 and maternal use of language facilitation strategies during play., Results: Lower rates of maternal pragmatic violations were associated with higher expressive language scores in children with ASD, and with higher receptive language scores for children with non-ASD LD. Within ASD dyads, maternal pragmatic violations were negatively related to mothers' use of linguistic expansions., Conclusion: These findings indicate that parental pragmatics likely contribute to early language learning, and that the effects of maternal pragmatics on early language in ASD may be indirect (e.g., through parents' use of facilitative strategies). Parent-mediated language interventions for ASD should therefore consider parent pragmatics, especially given that pragmatic differences have been identified in unaffected family members of individuals with ASD.

Purpose: An increasing consumption of opioids in the general population has been reported in several countries also among pregnant women. Limited information is available regarding the effect of prenatal exposure to analgesic opioids on long-term neurocognitive function in children. The primary aim of the study was to determine the association between prenatal exposure to analgesic opioids and language competence and communication skills at 3 years of age., Methods: The Norwegian Mother and Child Cohort Study (MoBa) prospectively included pregnant women during the period from 1999 to 2008. Participants reported medication use at pregnancy weeks 17-18 and 30, and 6 months after birth. Children's language competence and communication skills were reported by mothers on validated scales., Results: A total of 45 211 women with 51 679 singleton pregnancies were included. The use of analgesic opioids was reported in 892 pregnancies (1.7%). In adjusted analyses, no association between opioid use and reduced language competence or communication skills was found, OR = 1.04 (95%CI: 0.89-1.22) and OR = 1.10 (95%CI: 0.95-1.27), respectively. Both pain and use of paracetamol were associated with a small reduction in communication skills. No such association was found for language competence., Conclusion: The use of analgesic opioids in pregnant women does not seem to affect language development or communication skills in children at 3 years of age. Copyright © 2017 John Wiley & Sons, Ltd., (Copyright © 2017 John Wiley & Sons, Ltd.)

Phelan-McDermid syndrome (PMS) is a single-locus cause of developmental delay, autism spectrum disorder, and minimal verbal abilities. There is an urgent need to identify objective outcome measures of expressive language for use in this and other minimally verbal populations. One potential tool is an automated language processor called Language ENvironment Analysis (LENA). LENA was used to obtain over 542 h of audio in 18 children with PMS. LENA performance was adequate in a subset of children with PMS, specifically younger children and those with fewer stereotypic vocalizations. One LENA-derived language measure, Vocalization Ratio, had improved accuracy in this sample and may represent a novel expressive language measure for use in severely affected populations.

Background: This study aimed to identify risk factors associated with specific language impairment (SLI)., Methods: In a nested case-control design, 253 children attending special needs schools for severe speech and language difficulties in the Netherlands were matched for sex and date of birth with 253 children attending mainstream education. Data on perinatal, maternal and family issues were retrieved from well-child care files registered shortly after birth., Results: Children with SLI had younger mothers than children in the control group (mean 30 years 9 months vs. mean 31 years 9 months) (P = 0.02). Children with SLI were less frequently breastfed directly after birth (55% vs. 71%) (P = 0.0007) and were less frequently firstborns (33.3% vs. 46.2%) (P = 0.002). No statistically significant differences were found for any of the other risk factors., Conclusions: A relationship was found between SLI and maternal age, being breastfed and place in the birth order. Perinatal risk factors do not seem to be strongly associated with SLI., (© 2017 John Wiley & Sons Ltd.)

Background: Given the significance of early language for later academic achievement, language development can be an important outcome measure in evaluation of early childhood intervention programmes. Language development may be challenging to assess in settings where trained personnel are hard to find; therefore, maternal report can be a reliable alternative measure., Aim: The aim of this study was to adapt a maternal report measure, the MacArthur Communicative Development Inventory II-Short Form, in the Sindhi language and to examine its psychometric properties as a measure of language outcome in 2-year-old children in rural Pakistan., Methods: A three-phase process was followed to produce a Sindhi adaptation of the tool comprising 100 words. The first phase was a review of the original 258 words through a focus group discussion with a team familiar with the context; the second phase was testing 258 words to compile a 100-word list of easy, moderate and difficult words. The third phase was a pilot of the 100-word list followed by administration in a larger intervention study population., Results: On administration with 1381 children, concurrent validity with the Bayley Scale of Infant Development III using the Pearson's correlation test showed a moderate association for comprehension (r = 0.45, p = 0.01, n = 1381) and good association for expression (r = 0.51, p = 0.01, n = 1381). Internal consistency was high with alphas of 0.98 for comprehension items and 0.96 for expression items., Conclusion: The authors conclude that the Sindhi adaptation of the MacArthur Communicative Development Inventory followed a feasible and rigorous methodology to create a reliable and sensitive tool to assess young children's language development for use in a child assessment battery for early childhood health, nutrition and development studies., (© 2017 John Wiley & Sons Ltd.)

Purpose: This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in children's school readiness at 60 months., Method: We analyzed data from the Early Childhood Longitudinal Study, a population-based sample of 9,600 children. Data were gathered when the children were 9, 24, 48, and 60 months old., Results: The risk of being a late talker at 24 months was significantly associated with being a boy, lower socioeconomic status, being a nonsingleton, older maternal age at birth, moderately low birth weight, lower quality parenting, receipt of day care for less than 10 hr/week, and attention problems. Being a late talker increased children's risk of having low vocabulary at 48 months and low school readiness at 60 months. Family socioeconomic status had the largest and most profound effect on children's school readiness., Conclusions: Limited vocabulary knowledge at 24 and 48 months is uniquely predictive of later school readiness. Young children with low vocabularies require additional supports prior to school entry.

Background: Well-documented associations exist between socio-economic background and language ability in early childhood, and between educational attainment and language ability in children with clinically referred language impairment. However, very little research has looked at the associations between language ability, educational attainment and socio-economic background during adolescence, particularly in populations without language impairment., Aims: To investigate: (1) whether adolescents with higher educational outcomes overall had higher language abilities; and (2) associations between adolescent language ability, socio-economic background and educational outcomes, specifically in relation to Mathematics, English Language and English Literature GCSE grade., Method & Procedures: A total of 151 participants completed five standardized language assessments measuring vocabulary, comprehension of sentences and spoken paragraphs, and narrative skills and one nonverbal assessment when between 13 and 14 years old. These data were compared with the participants' educational achievement obtained upon leaving secondary education (16 years old). Univariate logistic regressions were employed to identify those language assessments and demographic factors that were associated with achieving a targeted A * -C grade in English Language, English Literature and Mathematics General Certificate of Secondary Education (GCSE) at 16 years. Further logistic regressions were then conducted to examine further the contribution of socio-economic background and spoken language skills in the multivariate models., Results & Outcomes: Vocabulary, comprehension of sentences and spoken paragraphs, and mean length utterance in a narrative task along with socio-economic background contributed to whether participants achieved an A * -C grade in GCSE Mathematics and English Language and English Literature. Nonverbal ability contributed to English Language and Mathematics. The results of multivariate logistic regressions then found that vocabulary skills were particularly relevant to all three GCSE outcomes. Socio-economic background only remained important for English Language, once language assessment scores and demographic information were considered., Conclusions & Implications: Language ability, and in particular vocabulary, plays an important role for educational achievement. Results confirm a need for ongoing support for spoken language ability throughout secondary education and a potential role for speech and language therapy provision in the continuing drive to reduce the gap in educational attainment between groups from differing socio-economic backgrounds., (© 2016 Royal College of Speech and Language Therapists.)

The current study examined delays in syntax and morphology, and vocabulary, in autism spectrum disorder (ASD). Children ages 4-6 years with ASD (n = 21) and typical development (n = 21), matched on nonverbal mental age, completed five language tasks. The ASD group had significant delays in both syntax and morphology, and vocabulary measures, with significant within-group heterogeneity; furthermore, syntactic and morphological measures were impaired even for subgroups matched on vocabulary. Children in the ASD group without early language delay showed syntactic and morphological impairment, with intact performance on vocabulary and sentence repetition. Findings indicate that syntactic and morphological impairments are a significant concern for high-functioning children with ASD, and may be overlooked if language evaluation focuses exclusively on vocabulary.

Background: This study considers the role of early speech difficulties in literacy development, in the context of additional risk factors., Method: Children were identified with speech sound disorder (SSD) at the age of 3½ years, on the basis of performance on the Diagnostic Evaluation of Articulation and Phonology. Their literacy skills were assessed at the start of formal reading instruction (age 5½), using measures of phoneme awareness, word-level reading and spelling; and 3 years later (age 8), using measures of word-level reading, spelling and reading comprehension., Results: The presence of early SSD conferred a small but significant risk of poor phonemic skills and spelling at the age of 5½ and of poor word reading at the age of 8. Furthermore, within the group with SSD, the persistence of speech difficulties to the point of school entry was associated with poorer emergent literacy skills, and children with 'disordered' speech errors had poorer word reading skills than children whose speech errors indicated 'delay'. In contrast, the initial severity of SSD was not a significant predictor of reading development. Beyond the domain of speech, the presence of a co-occurring language impairment was strongly predictive of literacy skills and having a family risk of dyslexia predicted additional variance in literacy at both time-points., Conclusions: Early SSD alone has only modest effects on literacy development but when additional risk factors are present, these can have serious negative consequences, consistent with the view that multiple risks accumulate to predict reading disorders., (© 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Purpose: Clinician-client relationships may influence treatment success in speech-language pathology, but there are no established tools for measuring these relationships. This study describes the development and application of a set of scales for assessing clinician-client relationships in children's speech-language treatment., Method: Twenty-two triads of participants completed a longitudinal study. Each triad had 1 school-age child enrolled in speech-language treatment, 1 caregiver, and 1 speech-language pathologist (SLP). The clinician-client relationship scales were administered to all 3 types of participants at study onset and again 2 weeks later. Treatment progress measures were collected 4 months later. Analyses established the reliability and validity of the clinician-client relationship scales., Results: Adequate internal consistency reliability and test-retest reliability were established for all 3 versions of the scale (child, caregiver, and SLP). Convergent validity was moderate between SLPs and children but lower when caregivers were included. Predictive validity analyses established significant relationships between caregiver and SLP ratings of the clinician-client relationship and future treatment progress., Conclusions: This exploratory study established the viability of the clinician-client relationship scales for further development and application. The importance of establishing and utilizing measures of the clinician-client relationship in speech-language pathology is discussed.

Objective: To investigate whether children born very preterm, moderate-late preterm, and term differ in their average level and individual-difference stability in language performance over time., Study Design: Language was assessed at 5 and 20 months and 4, 6, and 8 years of age in 204 very preterm (<32 weeks' gestation), 276 moderate-late preterm (32-36 weeks' gestation), and 268 term (37-41 weeks' gestation) children from the Bavarian Longitudinal Study., Results: Very preterm children consistently performed worse than term-born children, and moderate-late preterm children scored in between. Language performance was stable from 5 months through 8 years in all gestation groups combined, and stability increased between each succeeding wave. Stability was stronger between 5 months and 4 years in very preterm than moderate-late preterm and term groups, but this differential stability attenuated when covariates (child nonverbal intelligence and family socioeconomic status) were controlled., Conclusions: Preterm children, even moderate-late preterm, are at risk for poorer language performance than term-born children. Because individual differences in language performance are increasingly stable from 20 months to 8 years in all gestation groups, pediatricians who attend to preterm children and observe language delays should refer them to language intervention at the earliest age seen., Competing Interests: The authors declare no conflicts of interest., (Published by Elsevier Inc.)