Outcomes of Early Language Delay: I. Predicting Persistent and Transient Language Difficulties at 3 and 4 Years

Communication Sciences and Disorders, University of Missouri-Columbia, 65211, USA.
Journal of Speech Language and Hearing Research (Impact Factor: 2.07). 07/2003; 46(3):544-60.
Source: PubMed


Parent-based assessments of vocabulary, grammar, nonverbal ability, and use of language to refer to post and future (displaced reference) were obtained for 8,386 twin children at 2 years of age. Children with 2 year vocabulary scores below the 10th centile were designated the early language delay (ELD) group, and their outcomes at 3 and 4 years were contrasted with the remainder of the sample, the typical language (TL) group. At 3 and 4 years old, children were designated as language impaired if their scores fell below the 15th centile on at least 2 of the 3 parent-provided language measures: vocabulary, grammar, and use of abstract language. At 3 years, 44.1% of the ELD group (as compared to 7.2% of the TL group) met criteria for persistent language difficulties, decreasing slightly to 40.2% at 4 years (as compared to 8.5% of the TL group), consistent with previous reports of frequent spontaneous resolution of delayed language in preschoolers. Although relations between language and nonverbal abilities at 2 years and outcome at 3 and 4 years within the ELD group were highly statistically significant, effect sizes were small, and classification of outcome on the basis of data on 2-year-olds was far too inaccurate to be clinically useful. Children whose language difficulties persisted were not necessarily those with the most severe initial difficulties. Furthermore, measures of parental education and the child's history of ear infections failed to substantially improve the prediction.

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Available from: Philip S Dale, Jan 24, 2015
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    • "For instance, substantial proportions of late talkers have been reported to spontaneously overcome their language learning difficulties completely (e.g. Dale et al., 2003; Rescorla et al., 2000). In contrast, a series of research findings attest to late talkers' continuing speech and language difficulties through the preschool years (see Paul & Roth, 2011). "
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    ABSTRACT: Limited expressive vocabulary skills in young children are considered to be the first warning signs of a potential Specific Language Impairment (SLI) (Ellis & Thal, 2008). In bilingual language learning environments, the expressive vocabulary size in each of the child's developing languages is usually smaller compared to the number of words produced by monolingual peers (e.g. De Houwer, 2009). Nonetheless, evidence shows children's total productive lexicon size across both languages to be comparable to monolingual peers' vocabularies (e.g. Pearson et al., 1993; Pearson & Fernández, 1994). Since there is limited knowledge as to which level of bilingual vocabulary size should be considered as a risk factor for SLI, the effects of bilingualism and language-learning difficulties on early lexical production are often confounded. The compilation of profiles for early vocabulary production in children exposed to more than one language, and their comparison across language pairs, should enable more accurate identification of vocabulary delays that signal a risk for SLI in bilingual populations. These considerations prompted the design of a methodology for assessing early expressive vocabulary in children exposed to more than one language, which is described in the present chapter. The implementation of this methodological framework is then outlined by presenting the design of a study that measured the productive lexicons of children aged 24-36 months who were exposed to different language pairs, namely Maltese and English, Irish and English, Polish and English, French and Portuguese, Turkish and German as well as English and Hebrew. These studies were designed and coordinated in COST Action IS0804 Working Group 3 (WG3) and will be described in detail in a series of subsequent publications. Expressive vocabulary size was measured through parental report, by employing the vocabulary checklist of the MacArthur-Bates Communicative Development Inventory: Words and Sentences (CDI: WS) (Fenson et al., 1993, 2007) and its adaptations to the participants' languages. Here we describe the novelty of the study's methodological design, which lies in its attempt to harmonize the use of vocabulary checklist adaptations, together with parental questionnaires addressing language exposure and developmental history, across participant groups characterized by different language exposure variables. This chapter outlines the various methodological considerations that paved the way for meaningful cross-linguistic comparison of the participants' expressive lexicon sizes. In so doing, it hopes to provide a template for and encourage further research directed at establishing a threshold for SLI risk in children exposed to more than one language.
    Assessing multilingual children: Disentangling bilingualism from language impairment, 1st edited by Sharon Armon-Lotem, Jan de Jong, Natalia Meir, 01/2015: chapter Using parent report to assess early lexical production in children exposed to more than one language: pages 151-195; Multingual Matters., ISBN: 978-1-78309-213-0
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    • "There are marked variations among normal children in the rate of development of the comprehension of words, production of single words, and use of combinational forms within the first 2-3 years of life. Up to 20% of a 2-year-old children have delayed expressive language2,3), which resolves by 4 to 5 years of age in about 50%-60% of cases4,5). Children with speech and language impairment persisting at age 5 years were at high risk for language, literacy, and educational difficulties throughout childhood and into adolescence6,7). "
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    ABSTRACT: Purpose This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.
    Korean Journal of Pediatrics 08/2014; 57(8):363-9. DOI:10.3345/kjp.2014.57.8.363
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    • "Moreover, some very early language assessments (at age 18– 24 months) have shown poor sensitivity and specificity in predicting language outcomes only a year later. Some 2-year-olds turn out to be " late bloomers, " and a fair proportion of others who had age-appropriate language at age 2 meet the criteria for language delay at age 3 (Dale et al., 2003; Henrichs et al., 2011). One option is to begin testing a little later, around 3 years of age, and follow up with subsequent testing of oral and written language proficiency thereafter. "
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    ABSTRACT: Mastery of language can be a struggle for some children. Amongst those that succeed in achieving this feat there is variability in proficiency. Cognitive scientists remain intrigued by this variation. A now substantial body of research suggests that language acquisition is underpinned by a child's capacity for statistical learning (SL). Moreover, a growing body of research has demonstrated that variability in SL is associated with variability in language proficiency. Yet, there is a striking lack of longitudinal data. To date, there has been no comprehensive investigation of whether a capacity for SL in young children is, in fact, associated with language proficiency in subsequent years. Here we review key studies that have led to the need for this longitudinal research. Advancing the language acquisition debate via longitudinal research has the potential to transform our understanding of typical development as well as disorders such as autism, specific language impairment, and dyslexia.
    Frontiers in Psychology 08/2012; 3:324. DOI:10.3389/fpsyg.2012.00324 · 2.80 Impact Factor
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