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This study examined the effects of being born very preterm on children's early language development using prospective longitudinal data from a representative regional cohort of 90 children born very preterm (gestational age <33 weeks and/or birth weight <1,500 grams) and a comparison sample of 102 children born full term (gestational age 38-41 weeks). The MacArthur-Bates Communicative Development Inventory: Words and Sentences (CDI-WS) was used to assess children's language development at age 2;0 (corrected for gestational age at birth). Clear linear relationships were found between gestational age at birth and later language outcomes, with decreasing gestational age being associated with poorer parent-reported language skills. Specifically, children born extremely preterm (<28 weeks' gestation) tended to perform less well than those born very preterm (28-32 weeks' gestation), who in turn performed worse than children born full term (38-41 weeks' gestation). This pattern of findings was evident across a range of outcomes spanning vocabulary size and quality of word use, as well as morphological and syntactic complexity. Importantly, associations between gestational age at birth and language outcomes persisted after statistical control for child and family factors correlated with both preterm birth and language development. These findings demonstrate the presence of pervasive delays in the early language development of children born very preterm. They also highlight the importance of gestational age in predicting later language risk in this population of infants. [ABSTRACT FROM AUTHOR]

Background: Previous studies have explored the size and word type composition (nouns, predicates, etc.) of expressive vocabularies of preschool children with Down syndrome, both spoken and signed. Separately, overall preferences for modality of expression have also been explored., Aims: To extend previous findings by describing the relationships between expressive vocabulary size and both word type and modality of expression in the preschool period including changes to modality preference over time., Methods & Procedures: Mothers of 35 children with Down syndrome, aged 36-66 months and attending the same early intervention programme, completed a version - with both spoken word and sign options - of the New Zealand MacArthur-Bates Communicative Development Inventory (CDI): Words and Sentences. Most mothers completed the CDI on multiple occasions across the duration of the study. Completions (n = 114) were analysed cross-sectionally and longitudinally in terms of (1) word type relative to vocabulary size, (2) modality of expression relative to word type and vocabulary size, and (3) individual trajectories in vocabulary size and modality of expression., Outcomes & Results: (1) Word type relative to vocabulary size was similar to previous studies with a greater proportion of the SOCIAL words being present in the children's vocabularies throughout, followed by NOUNS, PREDICATES and CLOSED class words, with proportions converging as vocabulary sizes increase. (2) An initial spoken word preference for SOCIAL and CLOSED class words and sign preference for NOUNS and PREDICATES was found, with more spoken words in larger vocabularies overall. (3) Individual trajectories were highly variable and also revealed temporary points of regression in overall expressive vocabulary size in some children. Children who shifted from reliance on sign to predominantly spoken word expression did so at different ages and at different vocabulary sizes. At school entry, while most of the children used both modalities, some children continued to rely on sign for most vocabulary items whereas others used only spoken words., Conclusions & Implications: An appreciation of both the general trends and potential for individual variation in vocabulary structure, modality of expression and change over time will better position clinicians and education specialists to provide individually tailored support to both preschool and school-aged children with Down syndrome., What This Study Adds: What is already known on this subject Preschool children with Down syndrome have been shown to demonstrate developmental patterns in overall conceptual vocabulary size and word type development broadly similar to typical development. The use of signed vocabulary has also been explored, but independently from word type development and with less attention to individual trajectories in either vocabulary size development or modality preferences throughout the preschool period than is necessary for clinical use. What this paper adds to existing knowledge This study found interactions between word type and modality of expression in relation to vocabulary size as well as a few temporary vocabulary size regressions similar to those found in much younger typically developing children. An initial spoken word preference for social and closed class words, and sign preference for nouns and predicates, was followed by a general trend towards spoken words for all word types as vocabulary (with some fluctuations) increased over time. Children demonstrated considerable individual variation in size of vocabulary and age at which they pivoted from a signed to a spoken word preference. Moreover, while most children used both modalities at school entry, a few retained a sign-only vocabulary and others had moved fully onto spoken word-only expression. What are the potential or actual clinical implications of this work? An understanding of both the general trends and individual variation in vocabulary structure and modality of expression development will better position clinicians and educational specialists to provide individually tailored support to children with Down syndrome., (© 2022 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

While primary diagnosis is only one aspect of the presentation of a child with neurodevelopmental delay/disorder, the degree to which early expressive language reflects diagnostic divisions must be understood in order to reduce the risk of obscuring clinically important differences and similarities across diagnoses. We present original data from the New Zealand MacArthur-Bates Communicative Development Inventory (NZCDI) from 88 English-speaking children aged 2;6 to 5;6 years receiving multidisciplinary intervention within a single family-centered program. The children had one of six pediatrician-assigned genetic or behaviorally determined diagnoses: Down syndrome (DS); motor disorders (cerebral palsy and developmental coordination disorder); global development delay; disorders of relating and communicating (R&C); other genetically defined diagnoses; or language delay due to premature (PREM) birth. Morphological and lexical development were compared within and across diagnostic groups, using both data visualization and mixed-effects modeling. Groups varied in the amount of variation within and between them, but only prematurity reached significance, in interaction with age, as a predictor of morpho-lexical scores. Further analysis of longitudinal data available from a subset of the sample ( n = 62) suggested that individual trajectories of vocabulary growth could not be reliably predicted by diagnosis. Moreover, the distribution of word types (nouns, predicates, etc.) only distinguished PREM children with language delay from those with DS and those in the R&C group. There were strong similarities in early morpho-lexical development across these clinical populations, with some differences. These findings align with research and clinical approaches which accommodate individual variation within diagnosis, and broad similarities across diagnostic groups., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Foster-Cohen, Macrae and Newbury.)

Parent report data on 82 preschool children with complex neurodevelopmental disabilities including Down syndrome, dyspraxia, autism, and global developmental delay suggests communicative language use must reach a threshold level before vocabulary size becomes the best predictor of word combining. Using the Language Use Inventory and the MacArthur-Bates CDI (with sign vocabulary option), statistical modelling using regression trees and random forests suggests that, despite high linear correlations between variables, (1) pragmatic ability, particularly children's emerging ability to talk about things, themselves and others is a significantly better predictor of the earliest word combining than vocabulary size; and (2) vocabulary size becomes a better predictor of later word combining, once this pragmatic base has been established.

The effectiveness of expansion as a technique for facilitating children's language and conversational skills is well known (Scherer and Olswang, 1984). Expansion, however, can appear alone or in combination with other techniques. Using a repeated measures design, this study aimed to compare the effects of expansion alone (EA); expansion combined with wh-questions (EQ); and expansion followed by a cloze procedure (EC) on the conversational skills of eight preschool children with conversational difficulties. Results showed that while there were no significant differences in child verbal topic maintaining responses across all techniques, EA elicited a significantly higher number of topic extensions, more non-verbal topic maintaining responses and fewer 'non-relevant responses' from the children, than either EQ or EC. The positive effects of each technique on the pragmatic appropriateness in conversations suggest that they could be used strategically in language intervention to ensure greater therapeutic effect.

Background: Personal narratives are descriptions of past events experienced by the speaker and are one of the most commonly found forms of narration in children. The ability to tell personal narratives is considered critical for socio-emotional wellbeing and academic performance., Aims: This study investigated the personal narrative skills of 25 children with Down syndrome (age 5;11-13;1 years) who attended predominantly mainstream primary schools in New Zealand and were classified as beginning readers., Methods & Procedures: Personal narrative samples were elicited by the children's speech-language therapists using a standard protocol commonly used with New Zealand children. Children were shown a series of 11 photographs with scripted introductory prompts and were asked if anything like that ever happened to them. Transcribed samples were analysed on measures of mean length of utterance in morphemes (MLU-M), semantics (number of different words; NDW), and personal narrative quality (PNQ)., Outcomes & Results: Consistent with previous research, results showed wide variability in performance. Although 92% of the children produced at least 50 utterances in response to the prompts, in general MLU-M was very low (mean = 2.67, SD = 1.04). NDW ranged from 19 to 126 (mean = 61.52, SD = 25.39). Regression analyses showed no significant effect for age on MLU-M (p= 0.094), nor on PNQ. There was a significant effect for age on NDW (p= 0.03), with performance improving with age. Analysis of PNQ revealed that only four children (ages 9;11-12;7) were able to relate a personal narrative containing a high point. Correlational analyses indicated significant correlations between PNQ, MLU-M, NDW and performance on a standardized reading test., Conclusions & Implications: The findings highlight the difficulties children with Down syndrome have in producing personal narratives, despite exposure to a national English curriculum that encourages children to develop and convey 'personal voice'. Clinical implications of these findings will be presented., (© 2011 Royal College of Speech & Language Therapists.)

Background: Children with Down syndrome experience difficulty with both spoken and written language acquisition, however controlled intervention studies to improve these difficulties are rare and have typically focused on improving one language domain., Aims: To investigate the effectiveness of an integrated intervention approach on the speech, letter knowledge, and phonological awareness development of ten pre-school children with Down syndrome aged between 4;4 and 5;5., Methods & Procedures: A multiple single-subject design was used to evaluate treatment effectiveness. Baseline and intervention measures for speech and pre- and post-intervention measures for letter knowledge and phonological awareness were compared. The intervention comprised three components: a parent-implemented home programme; centre-based speech-language therapy sessions, and 'Learning through Computer' sessions with a total intervention time of 20 hours over 18 weeks. Letter knowledge and phonological awareness activities were linked to each child's speech targets., Outcomes & Results: Results indicated significant treatment effects on speech measures for all ten participants. Six of the ten participants showed increases on letter knowledge and nine showed increased awareness of initial phonemes in words but responses were not above binomial chance level (that is, 70% correct) for phonological awareness tasks. Individual results are presented and implications for parents and therapists are discussed., Conclusions and Implications: The findings of this study suggest an intervention approach that integrates speech, letter knowledge, and phonological awareness targets is effective in remediating speech error patterns at the single-word level in young children with Down syndrome. Phonological awareness and letter knowledge appeared to be stimulated through the intervention, but significant improvement above chance levels on untrained phonological awareness tasks was not evident. Follow-up investigation is necessary to determine longer-term outcomes.

This paper explores the interface between syntax and pragmatics, focusing on the binding of pronouns and the pragmatics of the paradigms used to test this aspect of syntactic knowledge. Reinhart's (1986) version of Binding Theory (which accords a specific role to pragmatics in processes of pronoun resolution) and Sperber & Wilson's (1986) Theory of Relevance are used to examine the syntax and pragmatics of pronoun interpretation. A set of predictions based on Relevance Theory are evaluated against published results of tests of Binding Theory. The paper concludes that Relevance Theory provides a means of understanding constraints on testing syntactic knowledge and argues that pragmatic factors must be systematically controlled in any evaluation of syntactic knowledge.