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BackgroundCerebral palsy (CP), which is the leading cause of motor disability during childhood, can produce sensory and cognitive impairments at different degrees. Most recent therapeutic interventions for these patients have solely focused on upper extremities (UE), although more than 60% of these patients present lower extremities (LE) deficits. Recently, a new therapeutic concept, Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE), has been proposed, involving the constant stimulation of UE and LE. Based on motor skill learning principles, HABIT-ILE is delivered in a day-camp setting, promoting voluntary movements for several hours per day during 10 consecutive week days. Interestingly, the effects of this intervention in a large scale of youngsters are yet to be observed. This is of interest due to the lack of knowledge on functional, neuroplastic and biomechanical changes in infants with bilateral CP. The aim of this randomized controlled study is to assess the effects of HABIT-ILE adapted for pre-school children with bilateral CP regarding functional, neuroplastic and biomechanical factors.MethodsThis international, multicentric study will include 50 pre-school children with CP from 12 to 60months of age, comparing the effect of 50h (2weeks) of HABIT-ILE versus regular motor activity and/or customary rehabilitation. HABIT-ILE presents structured activities and functional tasks with continuous increase in difficulty while the child evolves. Assessments will be performed at 3 period times: baseline, two weeks later and 3months later. The primary outcome will be the Gross Motor Function Measure 66. Secondary outcomes will include Both Hands Assessment, Melbourne Assessment-2, Semmes-Weinstein Monofilament Test, algometry assessments, executive function tests, ACTIVLIM-CP questionnaire, Pediatric Evaluation of Disability Inventory (computer adaptative test), Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, neuroimaging and kinematics.DiscussionThe results of this study should highlight the impact of a motor, intensive, goal-directed therapy (HABIT-ILE) in pre-school children at a functional, neuroplastic and biomechanical level. In addition, this changes could demonstrated the impact of this intervention in the developmental curve of each child, improving functional ability, activity and participation in short-, mid- and long-term.Name of the registryEvaluation of Functional, Neuroplastic and Biomechanical Changes Induced by an Intensive, Playful Early-morning Treatment Including Lower Limbs (EARLY-HABIT-ILE) in Preschool Children With Uni and Bilateral Cerebral Palsy (HABIT-ILE).Trial registrationNCT04017871Registration dateJuly 12, 2019., This protocol and trial is funded by La Fondation Paralysie Cerebrale (https://www.fondationparalysiecerebrale.org/).The funding body has reviewed this protocol during the selection process, but after this initial point, the Fondation Paralysie Cerebrale has not participated in the design study and will not participate in data collection, analysis, interpretation data or in writing the manuscript.

Background Cerebral palsy (CP) causes motor, cognitive and sensory impairment at different extents. Many recent rehabilitation developments (therapies) have focused solely on the upper extremities (UE), although the lower extremities (LE) are commonly affected. Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) applies the concepts of motor skill learning and intensive training to both the UE and LE. It involves constant stimulation of the UE and LE, for several hours each day over a 2-week period. The effects of HABIT-ILE have never been evaluated in a large sample of young children. Furthermore, understanding of functional, neuroplastic and biomechanical changes in infants with CP is lacking. The aim of this study is to carry out a multi-center randomized controlled trial (RCT) to evaluate the effects of HABIT-ILE in pre-school children with unilateral CP on functional, neuroplastic and biomechanical parameters. Methods This multi-center, 3-country study will include 50 pre-school children with CP aged 1-4 years. The RCT will compare the effect of 50 h (two weeks) of HABIT-ILE versus usual motor activity, including regular rehabilitation. HABIT-ILE will be delivered in a day-camp setting, with structured activities and functional tasks that will be continuously progressed in terms of difficulty. Assessments will be performed at 3 intervals: baseline (T0), two weeks later and 3 months later. Primary outcomes will be the Assisting Hand Assessment; secondary outcomes include the Melbourne Assessment-2, executive function assessments, questionnaires ACTIVLIM-CP, Pediatric Evaluation of Disability Inventory, Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, as well as neuroimaging and kinematics measures. Discussion We expect that HABIT-ILE will induce functional, neuroplastic and biomechanical changes as a result of the intense, activity-based rehabilitation process and these changes will impact the whole developmental curve of each child, improving functional ability, activity and participation in the short-, mid- and long-term. Name of the registry: Changes Induced by Early HABIT-ILE in Pre-school Children With Uni- and Bilateral Cerebral Palsy (EarlyHABIT-ILE)., This protocol and trial is funded by La Fondation Paralysie Cerebrale (https://www.fondationparalysiecerebrale.org/). The funding body has reviewed this protocol during the selection process, but after this initial point, the Fondation Paralysie Cerebrale has not participated in the design study and will not participate in data collection, analysis, interpretation data or in writing the manuscript.

While age of acquisition effects have been researched extensively in adult second language (L2) acquisition, there is less research focused on examining age of acquisition effects in child language learners. Importantly, for child learners, delays in exposure to language can occur not only for a second but also for a first language (L1). In regard to delays in exposure, it is a widespread assumption that these are detrimental to language outcomes, and that younger is always better for successful language learning. One of the aims of this special issue was to take a closer look at the evidence for this assumption with respect to language learning within the childhood years, both for delayed L1 and L2 exposure.

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This study investigated the role of age-of-acquisition in determining whether young bilingual children show a pattern of L2/nonnative English, precocious BE acquisition, or whether they show the L1/native English pattern of synchronous acquisition of BE and inflectional morphology. Two groups of children with age-of-acquisition before or after 4;0 and equivalent exposure to L2 English were given production and grammaticality-judgement tasks. The children in both age-of-acquisition groups showed the precocious BE pattern, regardless of L1 background and on both tasks. We conclude that, for this aspect of morphosyntax, bilingual children who begin to learn English after age 3;0 are best characterized as child L2 rather than bilingual L1 learners.

Purpose This study investigated whether past tense use could differentiate children with language impairment (LI) from their typically developing (TD) peers when English is children’s second language (L2) and whether L2 children’s past tense profiles followed the predictions of Bybee’s (2007) usage-based network model. Method A group of L2 children with LI (L2-LI) and a matched group of L2-TD peers were administered the past tense probe from the Test of Early Grammatical Impairment (Rice & Wexler, 2001) and the Peabody Picture Vocabulary Test (Dunn & Dunn, 1997). A representative input corpus provided distributional information for each verb used. Background information was obtained via parent questionnaire. Results The L2-LI group used fewer tense-marked verbs than did the L2-TD group. In both groups, vocabulary size and word frequency predicted accuracy with regular and irregular verbs. Children omitted regular past tense marking most often after alveolar stops, dropping the allomorph / i d/; L2-TD children omitted /t/ more often than /d/. Finally, first language typology predicted past tense accuracy. Conclusions Past tense use could potentially differentiate between English L2 children with and without LI. The impact of vocabulary, frequency, and phonological factors supported the network model and indicated profile differences between L2-LI and L2-TD children.

This study was designed to investigate the development of third-person singular (3SG) –s in children who learn English as a second language (L2). Adopting the usage-based perspective on the learning of inflection, we analyzed spontaneous speech samples collected from 15 English L2 children who were followed over a 2-year period. Assessing the contribution of a wide range of predictors, we show that word frequency, allomorph, lexicon size, inflectional properties of the first language (L1), and months of exposure to English all have impact on English L2 children's use of 3SG –s in obligatory contexts. This study enhances both our understanding of the development of 3SG –s and of child L2 acquisition. The outcomes support a usage-based approach to learning inflection and emphasize the importance of a multifactorial analysis of language development.