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PubMed1979

The influence of deviant maternal input on the development of language during the preschool years.

Language development of five two-year-old hearing children of deaf parents was studied longitudinally. These results were compared with the normal language developmental literature, and analyzed in relation to the form of the mothers' oral input. Three of the deaf mothers were less than 15% intelligible and their MLU was less than 2.0. The children spent less than 20 hours weekly with normal speakers. Frequency and proportion measurements were used to compare these children's utterances with those of children from normal-hearing households studied by Lois Bloom and Roger Brown. The observed children's utterances contained similar categories of semantic-syntactic relations and as many syntactic utterance types as children from hearing households. Furthermore, the children were appropriately acquiring grammatical morphemes in relation to their MLU. The overwhelming majority of the children's utterances adhered to a subject-verb-object order of constituents, and discourse interaction (the ability to add information to another's utterance) was developing. The results indicate that children, when cognitively ready, need little exposure to the normal model language to learn to speak during the early stages of development.

Child Development↗
PubMed2026

Effectiveness of Caregiver-Mediated Spoken Language Interventions for Children Under Five at Risk of Developmental Language Disorder: A Systematic Review and Meta-Analysis.

BACKGROUND AND AIMS: Caregiver-mediated interventions are commonly used by Speech and Language Therapists to support early language development. Developmental Language Disorder (DLD) is associated with reduced quality of life throughout the lifespan. Understanding factors that predict intervention success is essential for developing appropriate, cost-effective therapy provision for the approximately 12% of preschool children who present with early markers for Developmental Language Disorder (DLD). This systematic review and meta-analysis examined the effectiveness of caregiver-mediated spoken language interventions for under-fives at risk of DLD, and factors influencing intervention effectiveness. METHODS: A systematic review following PRISMA guidelines was conducted. Five electronic databases were searched to identify experimental studies comparing caregiver-mediated spoken language interventions to control conditions in under-fives presenting with risk factors for DLD. Risk factors included prematurity, socioeconomic factors, caregiver language development concerns, and formal or informal language screening or assessment scores. Twenty-six experimental studies with 1407 child participants were included in qualitative synthesis. Meta-analysis was performed on nine Randomised Controlled Trials involving 947 children. RESULTS: Effectiveness was examined for outcomes including child language gains, child wellbeing, inclusion and attainment. Meta-analysis indicated a significant effect of caregiver-mediated spoken language interventions on language outcomes compared to treatment-as-usual, non-language intervention or waitlist control conditions. Non-language outcomes were evaluated via qualitative synthesis. Interventions significantly improved language development trajectories for under-fives presenting with risk factors or early markers for DLD. CONCLUSION AND IMPLICATIONS: This review contributes to the growing evidence base demonstrating that caregiver-mediated interventions can positively impact language development and wellbeing outcomes for children under five at risk of DLD. These findings support the implementation of caregiver-mediated environmental language interventions in clinical practice to maximise accessibility and cost-effectiveness while delivering optimal outcomes for vulnerable populations. WHAT THIS PAPER ADDS: What is already known on this subject Previous research on caregiver-mediated spoken language interventions has highlighted gaps in the evidence regarding the impact of risk factors, demographic characteristics, dosage and intervention components on child language outcomes. Developmental Language Disorder has relatively high population prevalence, estimated at 7%. Prevalence is associated with risk factors including low household socioeconomic status (SES), prematurity and late language emergence. In contrast to its prevalence, there is low public and professional awareness of DLD and a low diagnostic rate. Therefore, a strengthened evidence base and additional insights into the factors affecting success of family-based interventions is important in order to increase the effectiveness of service provision and care planning for this underserved population. Timely and effective intervention with young children presenting with early markers for DLD has the potential to offer lifelong improvement to their wellbeing, inclusion and attainment outcomes. Recent systematic reviews of the effectiveness of caregiver-mediated language interventions had differences in population age range and diagnostic inclusion criteria. What this paper adds to existing knowledge Our review examines the effectiveness of caregiver-mediated early spoken language interventions on child language, attainment and wellbeing, and on caregiver self-efficacy and adherence to language support strategies. Our population was children under five presenting with risk factors for Developmental Language Disorder, in the absence of other neurodevelopmental or genetic conditions such as intellectual disability or autism. This review adds depth and detail to the evidence base supporting the effectiveness of caregiver-mediated spoken language interventions in improving outcomes for this population of young children, and factors that influence their success. What are the potential or actual clinical implications of this work? The high prevalence of Developmental Language Disorder, estimated at around 7% of the population, and the strong association with risk factors including low SES, prematurity and late language emergence, coupled with the low awareness of DLD and low diagnostic rate, mean that a strengthened evidence base and additional insights into the factors affecting success of family-based interventions can increase the effectiveness of service provision and care planning for this population. Timely and effective intervention in this group of young children has the potential to improve wellbeing and attainment outcomes across the lifespan. This review contributes to our understanding of how to implement cost-effective, socially valid and maximally engaging partnership working with families of young children at risk for DLD.

Humans↗
PubMed1977

Influence of certain language and communication environments in early childhood on the development of language in deaf individuals.

Four groups of deaf subjects between the age of 10-0 and 18-11 years were tested, employing the Test of Syntactic Ability, and the language subtests of the Stanford Achievement Test, in a study of the influence of early language and communication environment on later syntactic language ability. The groups, 18 subjects in each, were dichotomized by whether the parents were hearing or deaf and further subgrouped by the language ability of the parents if the parents were deaf, and by the amount and intensity of oral preschool training provided by the parents if the parents were hearing. The groups were labeled by the type of language used with them in infancy and early childhood: manual English, average manual, intensive oral, and average oral. Results showed significant superiority of the manual English group over the two oral groups on five of the six major test structures of the Test of Syntactic Ability. On the Stanford Achievement Test, the manual English group performed significantly better than the other three groups on all four subtests. The two manual groups performed significantly better than the two oral groups on every test measure employed.

Achievement↗
PubMed1976

Linguistic performance in vulnerable and autistic children and their mothers.

The authors studied the language patterns of schizophrenic mothers and their 4-year-old children, and compared them with the speech of normal mothers and children and normal mothers with autistic children. They found that children of schizophrenic mothers showed lags in language development and language distortions less severe than but in some ways similar to those seen in autistic children. Schizophrenic mothers were more likely to produce more deficient and/or distorted language in interactions with their children. Mothers of autistic children produced language that was equal to or above that of mothers of normal children on most parameters and adjusted their language to the chronological rather than the linguistic age of the child.

Autistic Disorder↗
PubMed1976

A therapeutic milieu for establishing and expanding communicative behaviors in psychotic children.

This study describes a clinical intervention program that was used to facilitate development of receptive and expressive language skills in a group of four psychotic children. A group format utilizing an interactive language development teaching procedure combined with a therapeutic milieu was shown to be effective in establishing and expanding communicative behaviors in psychotic children. Nine diagnostic measures were utilized to assess children's performance prior to therapy and at the end of three-month and six-month intervals. Results indicated substantial reduction of delayed and immediate echolalia, jargon, inappropriate stress, pitch, and intonation. Substantial improvement was noted in expressive syntactic and morphological functioning and in the children's ability to generate novel utterances about day-to-day experiences, family, and toys. Increases in children's concept of body image and ego functioning paralleled their improvement in receptive and expressive language development.

Body Image↗
PubMed1979

Effect of middle-ear dysfunction and disease on hearing and language in high-risks infants.

The effect of middle-ear dysfunction and disease on hearing and language development at one year of age was evaluated for 143 high-risk infants. These infants were categorized as normal or abnormal based on otologic history, otoscopic examinations, and on tympanometric examinations. Language was significantly related to gestational age, being delayed by approximately the amount of prematurity. Language scores were therefore adjusted for gestational age. Speech-detection threshold was not related to gestational age, and was used as the measure of hearing. Hearing levels were negatively correlated with adjusted language quotients. Infants with abnormal otologic histories reported were not different from infants with normal histories in either hearing or language development. Infants with bilateral otoscopic abnormalities had significantly higher speech-detection thresholds, but did not differ in language development from those with bilaterally normal otoscopy. Infants who were abnormal bilaterally by tympanometric examination had significantly higher speech-detection thresholds as well as significantly delayed language development. A significant effect on both hearing and language was found among those infants bilaterally abnormal by tympanometry for whom evidence of middle-ear disease was not visualized by otoscopic examination. Implications of these findings are discussed.

Hearing Disorders↗
PubMed1979

Relational meaning encoded in the two-word utterances of stage 1 Down's syndrome children.

This study explored the early two-word utterances from four Down's syndrome children to determine if they encode the same relational meanings as children developing language normally. Nine semantic categories were established to classify the subject's two-word constructions. Absolute and proportional frequencies of relational types were then used to analyze the relational meanings. The results reveal that this classification system accounts for a combined 79% of the two-word utterances expressed by these Down's subjects. It is suggested that Down's children demonstrate as much diversity in their use of relational meanings as normals at the same linguistic stage. These findings are discussed with respect to what Down's children know about the world as they begin to produce two-word combinations.

Child↗