Perpectives, tutorials, and more

Just one tutorial this month:

Neuromuscular Development in Neonates and Postnatal Infants: Implications for Neuromuscular Electrical Stimulation Therapy for Dysphagia

Can I use NMES (neuromuscular electrical stimulation) with infants?” This is a pretty popular question among SLPs treating pediatric dysphagia, but it can be hard to find a clear-cut answer. This tutorial (free for ASHA members) is worth a read because it summarizes the (pretty darn limited) research in this area. And, even better, it describes how NMES works and how this might affect an infant’s immature neuromuscular system differently than an adult’s.

And some more great empirical research!

  • Alper et al. found positive results for pre-literacy skills in children 2;6–4;0 from an evidence-based parent training program (based on this review). In an interesting twist, children of mothers who had an external locus of control (believe events in their lives are outside of their own control) made greater gains, possibly because mothers with an internal locus of control (so, they believe they can influence their environments/life outcomes) gave kids more literacy instruction at baseline, rather than waiting for teachers to introduce the material.

  • What is our best indicator of later language skills for an early communicator? Donnellan et al. found that the single best prelinguistic predictor of 11-month-olds’ expressive vocabulary at 24 months is how often they make intentional vocalizations. This may in part be because caregivers often respond to these intentional vocalizations with rich language. Further analysis supported this. They found that the best overall predictor of children’s vocabulary at 24 months is the winning combination of (1) how often they intentionally vocalize, and (2) how responsive their caregiver is to their communication. This highlights how responding to a child’s communicative vocalizations with appropriate language supports language growth.

  • A study by Edwards et al. of moderately preterm infants (gestational age at birth between 29 weeks and 33 weeks, 6 days) across 18 different facilities found that inadequate oral feeding is the most common reason that moderately preterm infants remain in the NICU after 36 weeks corrected age. Which of these infants were most likely to have ongoing oral feeding difficulties? Those with respiratory distress at birth, a patent ductus arteriosus (PDA) that required treatment, sepsis, bronchopulmonary dysplasia, and necrotizing enterocolitis. Being aware of these risk factors might help you anticipate which infants will need more support or to set realistic expectations with their families.

  • Hughes et al. examined gesture use in one-year-old children who: a) had Fragile X, b) were undiagnosed infant siblings of children with ASD, or c) were low risk, and found that while frequency of gesture use didn’t differ drastically among groups, the type of gestures did. Children with FXS and the infant sibling group (even though they didn’t have ASD) used fewer social interaction gestures than low risk children. Check this paper out for a review of different types of gestures!

  • We know that cochlear implants improve language outcomes for young kids who are Deaf/Hard-of-Hearing (DHH) and aren’t using sign language; but what age is best? Karltorp et al. found that when children were implanted before 9 months of age, they had stronger receptive and expressive language skills compared to those who were implanted later. Risk of complication after surgery was also about the same for infants as compared to older children. 

  • Parents are constantly translating children’s communicative gestures (e.g., child points to a cup) to speech (Do you want the cup?), and earlier work on monolingual children has found that doing this boosts children’s word learning. Limia et al. followed monolingual and bilingual (Spanish–English) children over time and found both parent groups were equally likely to translate gestures and all children (monolingual/bilingual) acquired words at about the same rate.

  • Moore et al. found that parents’ reports of their infants’ first words and steps were pretty close to researchers’ observations, but not so close for pointing. They also found that while pointing and vocabulary were related statistically, walking and vocabulary were not. Keep this one in your pocket for the next time you hear a well-meaning adult tell a parent, “Well, he just started walking, so his language is going to be delayed for a bit…” Results of this study indicate it doesn’t quite work that way. Instead, the authors suggest that “…within typical development, infants can make gains in one domain independently of precocity or delay in others.”

  • Two new meta-analyses (here and here) confirmed that parent-implemented interventions have a positive effect on language outcomes for children. The first found a positive association between parent training and language outcomes for children ages infant to six, especially those with developmental language disorder. The second found a positive effect on expressive language for children ages infant to eight with or at risk for primary or secondary language impairments. The interventions included in the studies all involved explicit training for parents on specific language facilitation strategies.

Alper, R.M., Hurtig, R.R., McGregor, K.K. (2019). The role of maternal psychosocial perceptions in parent-training programs: A preliminary randomized controlled trial. Journal of Child Language. doi: 10.1017/S0305000919000138.

Donnellan, E., Bannard, C., McGillion, M.L., Slocombe, K.E., & Matthews, D. (2019). Infants’ intentionally communicative vocalizations elicit responses from caregivers and are the best predictors of transition to language: A longitudinal investigation of infants’ vocalizations, gestures and word production. Developmental Science. doi: 10.1111/desc.12843.

Edwards, L., Cotten, C. M., Smith, P. B., Goldberg, R., Saha, S., Das, A., … Malcolm, W. F. (2019). Inadequate oral feeding as a barrier to discharge in moderately preterm infants. Journal of Perinatology. doi: 10.1038/s41372-019-0422-x.

Heidlage, J.K., Cunningham, J.E., Kaiser, A.P., Trivette, C.M., Barton, E. E., Frey, J. R., & Roberts, M.Y. (2019). The effects of parent-implemented language interventions on child linguistic outcomes. Early Childhood Research Quarterly. doi: 10.1016/j.ecr.

Hughes, K. R., Hogan, A. L., Roberts, J. E., & Klusek, J. (2019). Gesture frequency and function in infants with Fragile X Syndrome and infant siblings of children with Autism Spectrum Disorder. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2019_JSLHR-L-17-0491.

Karltorp, E., Eklof, M., Ostlund, E., Asp, F., Tideholm, B., & Kofkvist, U. (2019). Cochlear implants before nine months of age led to more natural spoken language development without increase surgical risks. Acta Paediatr. doi: 10.1111/apa.14954.

Limia, V., Özçalışkan, Ş., & Hoff, E. (2019). Do parents provide a helping hand to vocabulary development in bilingual children? Journal of Child Language. doi: 10.1017/S0305000918000594.

Moore, C., Dailey, S., Garrison, H., Amatuni, A., & Bergelson, E. (2019). Point, walk, talk: Links between three early milestones, from observation and parental report. Developmental Psychology. doi: 10.1037/dev0000738. 

Roberts, M.Y., Curtis, P.R., Sone, B.J., Hampton, L.H. (2019). Association of parent training with child language development: A systematic review and meta-analysis. JAMA Pediatrics. doi: 10.1001/jamapediatrics.2019.1197.