Understanding Mexican culture to inform clinical practice

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Understanding the culture of the clients we serve is always crucial to implementing effective evidence-based practice. This article is a great one for learning about the impact of Mexican culture on language and learning.

This study of 35 Mexican mothers of toddlers is one of the most well-done and dense (in a good way) descriptions of the associations between culture, language, and learning we’ve seen in a while. There is a lot in here; so, honestly, if you have a large proportion of Mexican children on your caseload, this study warrants a full read!

But, of course, we’ll give you a couple big take-aways, to give you something to consider right away! Two primary ones from this article were:

  1. Consider the developmental relevance of activities other than play. When coaching a parent on how to stimulate language naturally, you must know what activities that adult participates in most with the child. For Mexican mothers, this is often mealtime and caregiving routines, and less often things like pretend play.

  2. Consider communication partners other than the mother. Mexican families tend to value the roles of everyone in the family—older siblings, dad, extended family members— in teaching and raising the child. Perhaps most notable is the role of older siblings, who not only play a lot with the younger siblings but also teach them how to behave and participate productively in the family. Basically, if you’re only looking at coaching mom, you’re likely not looking broadly enough, and need to consider the diverse and integral roles of all family members.

Cycyk, L.M., & Hammer, C. (2019). Beliefs, values, and practices of Mexican immigrant families towards language and learning in toddlerhood: Setting the foundation for early childhood education. Early Childhood Research Quarterly. doi:10.1016/j.ecresq.2018.09.009

Spanish and English in the classroom: Does it matter?

In this study of nearly 2000 dual-language learners (almost all Latinx) ages 18 months to age 5, in Educare/Head Start programs across the U.S., the researchers asked—does classroom language matter? 

Children were observed in each of three classroom categories:

  • English w/ No Spanish

  • English w/ Some Spanish

  • English & Spanish

The researchers found that all three classrooms supported English growth, but the English + Spanish classroom best supported Spanish growth. So to support Spanish growth, we may need more balanced bilingual instruction.

The authors further state, “… DLL children learn English at equal (and advanced) rates regardless of L2 classroom exposure, when in high-quality classrooms”, and thus “… Spanish use in the classroom at varying levels does not impede English acquisition.”

Surprising to most Informed SLPs? Probably not. But this is a great article to share with others if you’re trying to explain the impact of dual language instruction.

 

Raikes, H. H., White, L., Green, S., Burchinal, M., Kainz, K., Horm, D., ... Esteraich, J. (2019). Use of the home language in preschool classrooms and first- and second-language development among dual-language learners. Early Childhood Research Quarterly. doi:10.1016/j.ecresq.2018.06.012.

Why a Spanish word list won’t necessarily work for all Spanish speakers

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Gonzalez & Nelson remind us of the need to consider the cultural background of Spanish–English bilingual infants when administering the MacArthur Inventario del Desarrollo de Habilidades Comunicativas: Primeras Palabras y Gestos (IDHC), also known as the Spanish form CDI. The IDHC was originally created and normed using a monolingual Mexican sample from Southern California and Mexico. But Spanish isn’t exactly the same across all Spanish-speaking countries. As result, many of the words on the IDHC reflect Mexican Spanish and may be unknown or uncommon to children from other Latinx communities. While there are adaptations of the IDHC for use with Cuban, Chilean, and Columbian children, this still doesn’t represent the cultural–linguistic diversity we’ll see, especially when many Latinx children come from mixed-nationality homes.

The authors of this study administered the Mexican-normed IDHC to 27 Spanish–English bilingual infants of mixed Latinx backgrounds. The Spanish vocabulary scores for the infants of mixed Latinx backgrounds were significantly lower than the scores of the Mexican norming sample. Further analysis revealed that the parents of mixed Latinx backgrounds reported significantly lower comprehension for a subset of 16 words on the IDHC. It turns out these words were often described by parents as words they themselves didn’t know or words they didn’t commonly use at home. This highlights a potential issue with roughly 4% of the 428 words on the IDHC. When these words were removed, the bilingual mixed Lantinx group continued to have lower scores than the monolingual Mexican group, but the difference in scores was no longer significant. You can check out a complete list of the unknown/uncommon IDHC words in Appendix A.

Unfortunately, we don’t have updated and more inclusive norms for the IDHC to account for these unfamiliar words yet. BUT there is a silver lining here. Using a total vocabulary score (i.e., Spanish IDHC + English CDI) closed the gap between the mixed Latinx and Mexican groups. *Does happy dance* Even with the potentially problematic words on the IDHC, the impact appears to be minimized when both Spanish and English results are combined. This finding reiterates the importance of assessing bilingual children in both languages to get a more complete picture of overall language development.

 

Gonzalez, S.L., & Nelson, E.L. (2018). Measuring Spanish comprehension in infants from mixed hispanic communities using the IDHC: A preliminary study on 16-month-olds. Behavioral Sciences. Advance online publication. doi: 10.3390/bs8120117

Language delay and behavior problems: How can we help?

It’s not much of a surprise to EI SLPs that language problems and behavior problems can be pretty intertwined (e.g., here), and parenting style can be associated with both behavior and language outcomes. We also know that well-designed parent-implemented interventions can be wonderfully effective (they had better be if entire states are re-vamping their early intervention programs to promote the coaching model). So—can we support these things simultaneously?

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Garcia et al. implemented the Infant Behavior Program (IBP) with a group of mother–child pairs. The Infant Behavior Program was adapted from the Child-Directed Interaction (CDI) component of Parent-Child Interaction Therapy (PCIT). Programs like PCIT and Triple P- Positive Parenting Program have been shown to help children reduce negative behaviors, but no one has really studied what how (or if) those parent implemented behavior interventions affect language development. While PCIT training and certification is geared toward mental health professionals, the components of CDI and IBP will sound familiar to EI SLPs. The intervention guides parents to interact with their children using positive parenting skills, avoiding negative parenting skills, and ignoring unwanted behavior, and consisted of 5–7 weekly visits of 60–90 minutes. Parents were then asked to continue using the taught parenting skills in 5-minute increments throughout the day.

“Do” (Positive parenting skills)

  • Imitating

  • Describing

  • Reflecting

“Don’t” (Negative parenting skills)

  • Negative talk

  • Questions

  • Commands

Researchers found that change in parenting style was associated with an increase in the children’s total number of utterances. (Note: this effect was seen at six months after the intervention ended; the kids didn’t show a difference in total number of utterances at three months, or number of different utterances at either time they were tested). But the authors cautioned that presence of negative parenting skills did not change the toddlers’ number of utterances for better or for worse, so definitely don’t interpret this to mean we should throw out questions and commands.

So if an EI SLP is called in on a case where both language and behavior are concerns, but parent priority is behavior, maybe we start with those “positive” responsive techniques (labeling, imitating, and reflecting) before we jump in with questions and commands, because it looks like these positive behavior strategies can also help with language development!

 

Garcia, D., Hungerford, G. M., Hills, R. M., Barroso, N. E., & Bagner, D. M. (2019). Infant language production and parenting skills: A randomized controlled trial. Behavior Therapy. Advance online publication. doi:10.1016/j.beth.2018.09.003

And more...

  • Dai et al. found that bilingual caregivers of children with ASD and DD can communicate with their children in both languages without adverse effect on their children’s language functioning. (Feel like you already knew that? Well here’s a citation for ya!)

  • Fusaroli et al. found that parents’ language complexity predicted the complexity of their toddler with ASD’s language four months down the road. This finding suggests that modeling grammatically rich and complex language for toddlers with ASD may benefit their language development (as opposed to over-simplified telegraphic speech). While we need an intervention study to tell us if that is truly the case, research has already demonstrated this for toddlers with language delays (which you can read about in a previous review here).

  • To get a better feel for how underserved and under-identified families access health information about development, Gallagher et al. conducted focus groups of parents of typically developing and children with disabilities who lived in an urban area and experienced low income and low literacy skills. The authors found that while these parents knew about a variety of sources of information, they experienced and reported barriers to health literacy resources (e.g., printed materials were too dense, or not literal enough). The parents in the focus groups offered suggestions for making developmental health information accessible to a more diverse audience. This is a good read if you are ever in a position to develop marketing or awareness materials.

  • EI SLPs sometimes encounter (and experience!) mom-guilt when serving families whose mothers work. This study was exploratory but offers us a bit of information we can share when the need arises. Laing and Bergelson found that 17-month-olds’ vocabulary measures of noun type and token did not differ significantly between toddlers of full-time working and stay-at-home mothers. Interestingly, toddlers who experienced mixed care (so their moms worked part time, or stayed home early and went back to work as their children got older), did have more noun types and tokens than kids who experienced one type of care.

  • McLeod et al. examined teacher–child interactions during Enhanced Milieu Teaching (EMT) sessions. All children in the study had DLD and attended Head Start. Two teacher inputs were linked to greater usage of target vocabulary words by children during EMT sessions: (1) following the child’s attentional or communicative lead and (2) providing vocabulary supports to teach or clarify the meanings of target words. We’ve written about parent-implemented EMT for children with DLD before. For more descriptive info about teacher input and child vocabulary go check out the article.

  • Can you screen “everybody” (e.g. via routine pediatricians’ checkups) and reliably catch autism early, between 14–36 months, without over-identification? Yes, probably! This meta-analysis by Sanchez-Garcia provides quantitative data in support of universal toddler screenings for ASD.

  

Dai, Y.G., Burke, J.D., Naigles, L., Eigsti, I.M., & Fein, D.A. (2018). Language abilities in monolingual- and bilingual- exposed children with autism or other developmental disorders. Research in Autism Spectrum Disorders. Advanced online publication. doi: 10.1016/j.rasd.2018.08.001.

Fusaroli, R., Weed, E., Fein, D., & Naigles, L. (2019). Hearing me hearing you: Reciprocal effects between child and parent language in autism and typical development. Cognition183, 1–18.

Gallagher, P. A., Greenberg, D., Campbell, J. M., Stoneman, Z., & Feinberg, I. Z. (2018). Early identification and connection to services among urban parents who have low income and low-literacy skills. Focus on Autism and Other Developmental Disabilities. Advance online publication. doi: 10.1177/1088357618794913.

Laing, C. & Bergelson, E. (2019). Mothers’ work status and 17-month olds’ productive vocabulary. Infancy, 24(1), 101–109.

McLeod, R.H., Kaiser, A.P., & Hardy, J.K. (2018). The relation between teacher vocabulary use in play and child vocabulary outcomes. Topics in Early Childhood Special Education. Advance online publication. doi: 10.1177/0271121418812675

Sánchez-García, A.B., Galindo-Villardón, P., Nieto-Librero, A.B. et al. (2019). Toddler Screening for Autism Spectrum Disorder: A Meta-Analysis of Diagnostic Accuracy. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s10803-018-03865-2.

Culturally congruent interventions for Latino families

When working with families from diverse backgrounds, it is imperative to make sure that our interventions are consistent with the family’s culture and values. Guiberson & Ferris studied caregiver interaction style in Latino families to identify interventions that would be culturally appropriate for the Latino population.  

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European–American families tend to use an independent style of interaction with their children: emphasizing the child’s individuality, following the child’s lead, and allowing the child to explore toys in different ways. This study found that the majority (75%) of Latino families interacted with their children using a more interdependent style. An interdependent interaction style emphasizes the child’s relationships and belonging to the family and cultural group. Caregivers who use an interdependent interaction style are more likely to direct the child’s attention, teach explicitly, show children how to play with toys, and use more commands and directives in their language.

Considering how Latino families tend to interact with their children, EI approaches that emphasize following a child’s lead may not be culturally appropriate for all Latino families. When working with families who use an interdependent interaction style, consider using the following interventions: 

  • Explicit teaching combined with attention directions

  • Modeling

  • Focused stimulation

  • Dialogic reading

Because these interventions give the caregiver more of an authoritative role in the interaction, they may feel more natural for Latino parents and therefore be more likely to be implemented. Latino mothers reported feeling more comfortable with a didactic style in which the parent gives commands, directs the child’s behavior, and explicitly teaches children how to complete tasks.

Check out the original article for more in-depth descriptions of these interventions and information on Latino caregiver preferred activities.  

 

Guiberson, M. M., & Ferris, K. P. (2018). Identifying culturally consistent early interventions for Latino caregivers. Communication Disorders Quarterly. Advance online publication. doi: 10.1177/1525740118793858.

And more...

  • Bilgin et al. found that infants with difficulties regulating their feeding, sleeping, and crying have an increased risk of attention problems later in childhood. And many adults who had regulatory problems as infants still demonstrated attentional difficulties throughout adulthood.

  • Bontinck et al. used observations in the home setting to compare interactions between 2-year-olds and their older sibling with ASD with interactions between 2-year-olds and their older, typically developing sibling. Findings suggested that the 2-year-olds whose sibling had ASD attempted to initiate social interactions less frequently, demonstrated fewer positive responses to their sibling’s attempt to communicate or interact, and attempted to imitate their older sibling with ASD less frequently. And, when the researchers looked at total interactions—both positive and negative—between the sibling pairs, they found that higher levels related to more parent-reported ASD characteristics. What does this mean? Well, it suggests that younger siblings of children with ASD might be learning positive and negative behaviors. And, given that siblings provide the earliest form of social interaction, paired with the fact that siblings of children with ASD are at high risk for receiving the same diagnosis, findings from this study suggest that examining social interactions between siblings may provide insight into the development of young children whose sibling has ASD.

  • Typical disfluencies (e.g. revisions, phrase repetitions, filled pauses) are a normal part of preschoolers’ speech, and “appear at times of rapid language growth”. Generally, while children are learning new words and new sentence structures, typical disfluency rates can increase (see article for review). So how would this play out for bilingual children? That’s unknown, and the aim of Brundage & Rowe. In this study, they examined young (30-month-old) simultaneous Spanish–English bilingual children (with roughly 50-50 exposure to English and Spanish at home). They found slightly lower disfluency rates in Spanish, and lower disfluency rates, overall, compared to similar studies. Because their data is a bit unexpected compared to similar research on monolinguals, it’s difficult to know how to interpret this data. But, maybe that’s exactly the point? That it’s different for bilinguals? Future research should help clarify that.

  • After English, Spanish is the most common language spoken in the homes of U.S. children who are deaf or hard of hearing (DHH). Yet, we know very little about language and, specifically, vocabulary outcomes for this population. de Diego-Lázaront et al. looked at a variety of demographic, hearing-, and intervention-related factors to determine which might have a relationship with Spanish expressive vocabulary skills in 8 to 36-month-olds who are DHH. Results suggested that degree of hearing loss, range of functional hearing, and chronological age and age of intervention separately and combined predicted Spanish expressive vocabulary development. And, more specifically, the researchers found that the children who began receiving therapy early—by 6 months of age—received significantly higher scores on expressive vocabulary measures in Spanish.

  • Donegan-Ritter & Van Meeteren coached Early Head Start teachers on language strategies using video self-reflection and focused feedback. Teachers were able to increase their use of questioning, back and forth exchanges, and parallel talk with both infants and toddlers. Practice-based coaching may be an effective method for training teachers to increase their use of language strategies.

  • Dowd et al. looked at how young toddlers responded when a parent or experimenter got “hurt” (e.g., adults faked injuries when playing with a toy or fiddling with a clipboard) and suggest that we can see signs of social impairments by about 15 months. While we usually consider social concepts like empathy and emotional thinking to be later developing skills, the study’s results show us that we can start to see impairment fairly early in development.

  • Within a child’s first few years, the total number of words he produces often reigns king with regards to assessing his language level. When a child comes to us with a small vocabulary, one of our primary goals is generally to increase the total vocabulary.  However, Galeote et al. explain that a more nuanced approach than “total number of words” is important for fully capturing a child’s language and creating meaningful intervention plans.  We need to make sure that we are considering the makeup of a child’s word classes so that we can understand the child’s strengths and weaknesses and plan our intervention appropriately. With that understanding, if a child’s vocabulary was made up almost entirely of nouns, we would know to target verbs more intensively in intervention.

  • Infants as young as six months old can adapt their communication behaviors to their social environments! Ganea et al. found that non-blind infants of blind parents interact differently with their blind parents compared to non-blind adults.

  • Greenslade et al. provide further data that decreased initiation of joint attention, expressive language, and social communication behaviors during the infant and toddler years can predict pragmatic communication difficulties in the school years, even if a child does not meet criteria for a diagnosis of ASD.

  • Noyes-Grosser et al. offer a program review of New York State’s Part C services, and more specifically how children with ASD and their families respond to services. We can’t apply the results of this review to all of our readers, because Part C is interpreted and services are delivered differently state-by-state and even county-by-county, but the article offers a great overview of why we do things some of the things we do (e.g., COS statements). The authors also over some good tools for program evaluation (see here for Record Review Protocol and here for an EI Family Survey). For SLPs working in Part C programs, you might want to keep this citation handy to offer to your EI coordinators and/or supervisors.

  • Severini et al. implemented the Stay-Play-Talk (SPT) routine with two children with Down Syndrome who used high-tech AAC as their primary mode of communication. They found when peers were trained to use SPT strategies during free play there was an increase in stay and play behaviors for both children. (Sound familiar? We’ve written about Stay–Play–Talk before for children with ASD who use AAC, here and here.)

  • The parent-implemented Early Start Denver Model (P-ESDM; Rogers et al., 2012a) is an intervention that combines principles from Applied Behavioral Analysis (ABA) with a developmental, socially-focused approach to increase parent interactions that promote positive developmental outcomes for young children with ASD. Vismara et al. looked at whether the P-ESDM might also be an effective intervention for young children with fragile X syndrome (FXS) with and without a combined diagnosis of ASD. The first author of the study provided coaching to promote the use of the P-ESDM with four 1 ½ to 4-year-old children and their parents either in person or via video-conferencing. The parent-related outcomes were encouraging: all of the parents improved in their ability to accurately and consistently implement the P-ESDM intervention goals, and they found the coaching experience to be generally positive. The child-related outcomes (e.g., spontaneous communication and initiated joint attention) were more variable, indicating the need for more studies that examine the use of the P-ESDM with children with FXS with and without ASD.  

Bilgin, A., Baumann, N., Jaekel, J., Breeman, L.D., Bartmann, P., Bäuml, J.G. … Wolke. D. (2018). Early crying, sleeping, and feeding probelsm and trajectories of attention problems from childhood to adulthood. Child Development. Advance online publication. doi: 10.1111/cdev.13155.

Bontinck, C., Warreyn, P., Demurie, E., Bruyneel, E., Boterberg, S., Roeyers, H. (2018). Social Interactions Between 24-Month-Old Children and Their Older Sibling with Autism Spectrum Disorder: Characteristics and Association with Social-Communicative Development. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s10803-018-3660-4.

Brundage & Rowe (2018). Rates of Typical Disfluency in the Conversational Speech of 30-Month-Old Spanish–English Simultaneous Bilinguals. American Journal of Speech–Language Pathology, 27, 1287–1298.

De Diego-Lázaro, B., Restrepo, A., Sedey, A.L., Yoshinaga-Itano, C. (2018). Predictors of Vocabulary Outcomes in Children Who Are Deaf or Hard of Hearing From Spanish-Speaking Families. Language, Speech, and Hearing Services in Schools. Advance online publication. doi: 10.1044/2018_LSHSS-17-0148.

Donegan-Ritter, M., & Van Meeteren, B. (2018). Using practice-based coaching to increase use of language facilitation strategies in early head start and community partners. Infants & Young Children, 31(3), 215–230.

Dowd, A. C., Martinez, K., Davidson, B. C., Hixon, J. G., & Neal-Beevers, A. R. (2018). Response to distress varies by social impairment and familiarity in infants at risk for autism. Journal of Autism and Developmental Disorders, 48(11), 3885–3898.

Galeote, M., Checa, E., Sebastián, E., & Robles-Bello, M. A. (2018). The acquisition of different classes of words in Spanish children with Down syndrome. Journal of Communication Disorders, 75, 57–71.

Ganea, N., Hudry, K., Tucker, L., Charman, T., Johnson, M.H., & Senju, A. (2018). Development of adaptive communication skills in infants of blind parents. Developmental Psychology, 54(12), 2265–2273.

Greenslade, K. J., Utter, E. A., & Landa, R. J. (2018). Predictors of pragmatic communication in school-age siblings of children with ASD and low-risk controls. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s10803-018-3837-x

Noyes-Grosser, D. M., Elbaum, B., Wu, Y, Siegenthaler, K. M., Cavalari, R. S., Gillis, J. M., & Romanczyk, R. G. (2018). Early intervention outcomes for toddlers with autism spectrum disorder and their families. Infants & Young Children, 31(3), 177–199.

Severini, K.E., Ledford, J.R., Barton, E.E., & Osborne, K.C. (2018). Implementing stay-play-talk with children who use AAC. Topics in Early Childhood Special Education. Advance online publication. doi: 10.1177/0271121418776091.

Vismara, L.A., McCormick, C.E.B., Shields, R., & Hessl D. (2018). Extending the Parent-Delivered Early Start Denver Model to Young Children with Fragile X Syndrome. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s1

And more...

Normally we try to keep this section fairly brief for you all, but holy moly there was so much research this month!

  • Bradshaw, et al. examined differences in communication and play in groups of infants at high- and low-risk for ASD. High-risk 12-month-olds who were considered “prewalkers” (who didn’t stand or walk) showed significantly lower scores on the CSBS in terms of play skills, gesture use, word use, and behavior measures such as protesting. Even though both high-risk and low-risk groups had similar numbers of prewalkers, standers, and walkers, the authors suggest their results “confirm that the lower social communication scores observed in high-risk infant prewalkers are clinically significant and suggests that these infants may be at higher risk for social communication delays.” SLPs working in the PSP model could keep this information in mind while discussing intake and evaluation plans or while reviewing quarterly updates during teaming meetings. Note: the authors caution that the participants in their study were mostly white, highly educated families, and that results may not generalize to all populations.

  • In a study of over 1200 families in poor rural regions, Burchinal et al. confirmed the presence of a large gap in school readiness skills that emerges during the first five years of life. Specifically, children who experienced poverty before the age of two had more significant delays on their language, cognitive, social, and executive functioning. Self-regulation and executive functioning skills played an important role in school readiness at age five. Check out the original article for a more in-depth analysis of the relationship between poverty & school readiness.

  • If you’re an EI therapist, you’ve most likely evaluated a child who was born premature at one time or another, so you’re also most likely familiar with the idea of age correction. You may have corrected for age on one or more assessments, but you may have also wondered if that’s best practice. And, if it is, when should we stop correcting for age? Harel-Gardassi et al. used the Mullen Scales of Early Learning (MSEL) test to see how age correction impacted the scores of preterm infants at 1, 4, 8, 12, 18, 24, and 36 months of age. Not surprisingly, corrected age scores were found to be significantly higher than chronological scores at all ages, with factors such as gestational age and birth weight affecting the level of difference between the two scores. These findings also suggest that if you use the MSEL, you should be using age correction until the adjusted age of three, not the currently recommended age of two.

  • In terms of input, the large majority of what children, including infants, are exposed to on a day-to-day basis is connected speech, while isolated words are heard infrequently and inconsistently. So, do the single words that infants are exposed to have any kind of impact on their language development? This recent study by Keren-Portnoy et al. of 12-month-olds showed that isolated words, instead of words presented at the end of an utterance, were easier for the children to recognize and remember.

  • Lim and Charlop found that speaking a child’s heritage language during play-based intervention sessions seemed to help four bilingual children with ASD play in more functional and interactive ways. The experimenters followed scripts for giving play instructions, verbal praise, and making comments related to play in both English and each child’s heritage language (in this study, Korean or Spanish). None of the children played functionally or interactively before the intervention, but all of the children showed an increase in play during and after intervention sessions in both English and the heritage language, with more impressive gains seen in heritage language sessions. More research is needed, but SLPs should keep this in mind when working with bilingual children with ASD (note: study done on older children).

  • In a qualitative study by Núñez & Hughes, Latina mothers reported higher satisfaction with early intervention services when they had bilingual support through an interpreter or bilingual SLP, received clear explanations about services and paperwork, felt the SLP respected their wishes, and were provided with strategies to work on with their children outside of SLP sessions.

  • Rague et al. found that infants with Fragile X syndrome use fewer gestures than infants at both high and low risk for ASD. Children with Fragile X who used fewer gestures tended to have lower nonverbal abilities. A lack of early gesture use in infants with Fragile X may be an indicator of the child’s broad cognitive ability.  

  • Thrum et al. found that toddlers between 18 and 24 months with language delay had significantly more socioemotional and behavioral problems compared to toddlers without language delay. At 18 months, more than half of children with language delays had scores within the range of clinical concern! These results underscore the importance of early detection & treatment for children with language delays.

  • Torrisi et al. found that toddlers’ communication scores on the Ages and Stages Questionnaire (ASQCS) were not directly associated with mothers’ diagnoses of PTSD related interpersonal violence, but communication development was affected when mothers showed more controlling behavior and were less sensitive to their toddlers. Both of these qualities of maternal behavior were also correlated with severity of PTSD symptoms. This is important information to keep in mind when providing services to families at risk for experiencing or with a history of interpersonal violence.

  • Yu, et al measured 9-month-old typically-developing infants’ attention to objects and joint attention with their parents, to tease out what exactly contributes to vocabulary growth in the first year of life. They found that sustained attention with and without joint attention predicted vocabulary size at 12 and 15 months, but joint attention alone did not predict vocabulary growth. We need more research to figure out exactly how to use this information clinically, but in the meantime, we can always continue to help caregivers make the best use of their children’s interest and attention during play to support vocabulary growth.

 

Bradshaw, J., Klaiman, C., Gillespie, S., Brane, N., Lewis, M., & Saulnier, C. (2018). Walking ability is associated with social communication skills in infants at high risk for autism spectrum disorder. Infancy. Advance online publication. doi: 10.1111/infa.12242.

Burchinal, M., Carr, R.C., Vernon-Feagans, L.V., Blair, C., Cox, M. (2018). Depth, persistence, and timing of poverty and the development of school readiness skills in rural low-income regions: Results from the family life project. Early Childhood Research Quarterly, 45, 115–130.

Harel-Gadassi, A., Friedlander, E., Yaari, M., Bar-Oz, B., Eventov-Friedman, S., Mankuta, D., & Yirmiya, N. (2018). Development assessment of preterm infants: Chronological or corrected age? Research in Developmental Disabilities, 80, 35–43.

Keren-Portnoy, T., Vihman, M., & Lindop Fisher R. (2018). Do infants learn from isolated words? An ecological study. Language Learning and Development. Advance online publication. doi: 10.1080/15475441.2018.1503542.

Lim, N. & Charlop, M. H. (2018). Effects of English versus heritage language on play in bilingually exposed children with autism spectrum disorder. Behavioral Interventions. Advance online publication. doi: 10.1002/bin.1644.

Núñez, G., & Hughes, M. T. (2018). Latina mothers’ perceptions and experiences of home-based speech and language therapy. Perspectives of the ASHA Special Interest Groups, 14(3), 40–56.

Rague, L., Caravella, K., Tonnsen, B., Klusek, J., & Roberts, J. (2018). Early gesture use in fragile X syndrome. Journal of Intellectual Disability Research, 62(7), 625–636.

Thurm, A., Manwaring, S.S., Jimenez, C.C., Swineford, L., Farmer, C., Gallo, R., Maeda, M. (2018). Socioemotional and behavioral problems in toddlers with language delay. Infant Mental Health Journal, 38(5), 569–580. 

Torrisi, R., Arnautovic, E., Pointet Perizzolo, V. C., Vital, M., Manini, A., Suardi, F., …, & Schechter, D. S. (2018). Developmental delay in communication among toddlers and its relationship to caregiving behavior among violence-exposed, posttraumatically stressed mothers. Research in Developmental Disabilities. Advance online publication. doi: 10.1016/j.ridd.2018.04.008.

Yu, C., Suanda, S. H., & Smith, L. B. (2018). Infant sustained attention but not joint attention to objects at 9 months predicts vocabulary at 12 and 15 months. Developmental Science. Advance online publication. doi: 10.1111/desc.12735.

Throwback (2014): English language development of toddlers from bilingual homes: What do older siblings have to do with it?

Those of us who have worked in early intervention with multilingual families know that the level of proficiency that young kids have in each language varies greatly. Although the factors that create this variability are less clear, one thing we do know is that amount of linguistic input has a strong relationship with how quickly young children develop proficiency in each of the languages that are spoken in the home (e.g., David & Wei, 2008; De Houwer, 2009; Gathercole & Hoff, 2007). To extend our understanding of the factors that create linguistic variability from child-to-child, the authors of this study looked at specific sources and contexts of input that might result in more robust language learning.

So, let’s first talk about input for just a minute before I go on to tell you more about this study. Anecdotally, it would be logical to assume that the adult who interacts with an infant or toddler on a daily basis (think: stay-at-home moms, stay-at-home dads, day care providers, nannies) provides the highest level of language input for that child, right? And, it would even be safe to assume that this would be the case for infants and toddlers who are learning English and another language (or, languages), am I right? This is exactly what I assumed before I read this article (And, there is research to back up this assumption, by the way. For example: Hoff-Ginsberg & Krueger, 1991). But, when Bridges and Hoff examined a different factor—influence of input from older siblings—and its relationship to young, multilingual children’s language learning, a different story emerged.

So, to back up for just a minute: why did they decide to specifically focus on older siblings? Well, the authors based their research on case studies of bilingual children (e.g., Caldas, 2006; Wang, 2008; Yip & Matthews, 2007) that suggested that because older siblings use English at school, they “[bring] English into the home” (p. 2). For instance, older, school-age siblings often provide a model of the dominant language (i.e., English) for the younger sibling, and prefer to use that language to interact with their younger brothers and sisters.

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The authors carried out two experiments to determine the influence that older siblings might have on 16- to 30-month-old children’s language learning. The first study looked at whether having an older sibling would influence the level of exposure to and development of English in toddlers learning English and another language (such as Spanish, French, and Hebrew). The second study focused on both Spanish and English by looking at potential differences in the amount that both languages were spoken in homes with and without a school-aged sibling, and the impact that an older sibling might have on bilingual toddlers’ development of both languages.

So, what did they find? Well, the results definitely negated any of the assumptions that I had about sources of language input for the infant and toddler population! In general, the authors found that in multilingual families with school-aged children, younger siblings heard more English, their mothers spoke more English, and the toddlers had stronger English vocabulary and grammatical skills. (And, on the flip side, in the second study, the authors also found that toddlers without older siblings heard less English at home and were more proficient in Spanish.)

We spend a lot of time in our field focusing on training and utilizing parents as partners in therapy; particularly, when it comes to work with infants and toddlers in the home. (And, for good reason—it just makes sense, and there’s research to prove its effectiveness! In fact, we’ve reviewed some recent research that focuses on this here and here).

But, the results of this study seem to suggest that older, school-aged siblings may be an underutilized resource for SLPs working with young, bilingual children who are learning English. Given that they have the potential to provide the highest level of English input for infants and toddlers, maybe it’s time that we started thinking about training and utilizing older siblings, as we do with parents, when we work with infants and toddlers from multilingual homes.

*Note: The terms bilingual and multilingual were used interchangeably in this review to describe young children who are learning English and another language.

 

Bridges, K. & Hoff, E. (2014). Older sibling influences on the language environment and language development of toddlers in bilingual homes. Applied Psycholinguisticss, 35(2), 225–241.

Throwback Pub (2012): Training parents to support children with developmental language disorder

As SLPs working in EI, we know that developmental language disorder presents risk for later academic skills. We also know that parent-implemented language interventions can be effective (see Roberts & Kaiser, 2011, for a meta-analysis of parent-implemented language interventions). This study examined whether parent-implemented Enhanced Milieu Teaching (EMT) would impact receptive and expressive language growth in children with language disorder (with cognitive standard score > 80 and no other primary diagnoses; see article for full inclusion/exclusion criteria).

The researchers examined three groups of 24–42-month old children:

  • Typical language

  • Language disorder w/ no treatment, or a “wait-and-see” approach

  • Language disorder w/ parent-implemented Enhanced Milieu Teaching

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Families treatment group participated in parent training in 28 sessions (workshops, clinic, and home visits) over a three-month period. EMT strategies were trained in four phases: 1) setting a communicative context, 2) modeling and expanding communication, 3) time delay strategies, and 4) prompting strategies (see Table 5 for examples and description). During training at the clinic, therapists and parents practiced strategies using a specific set of toys. Home visits also included integrating strategies into functional family routines such as snack. All children were assessed with monthly language samples (MLU, total words, different words) plus the Preschool Language Scale, Fourth Edition (PLS-4), at the beginning and end of the study.

So what happened? Parent-implemented EMT was effective for improving language outcomes for children with LI, and parents in the treatment group used significantly more strategies than either other group! Parent use of strategies for typically-developing children and those with language disorder undergoing “wait and see” were about the same.

Children whose parents used EMT

  • significantly improved their PLS-4 Total and Expressive Communication scores and gained an average of 50 more words than untreated children with language disorder

  • gained an average of 15 more words per month compared to untreated children with language disorder

  • grew at about the same rate as children with typical language

Fantastic, right? But what about the kids with language disorder undergoing a “wait and see” approach? They showed significantly slower growth. Not only did those “wait and see” kids start out with lower language abilities, it looks like “waiting and seeing” might just hold them at a disadvantage when compared to those who have access to intervention. The authors stated, “Children in the LI-control group did not catch up but fell farther behind their peers with TL.”

How about a little extra info? The authors also looked at which child characteristics predicted language growth and outcomes. They examined risk at birth (e.g., a NICU stay), cognitive skills, and receptive skills (based on the Bayley-III scores). Risk at birth and cognitive skills were not predictive of expressive language analyses performed. However, “Receptive language at the start of the study predicted growth in language for all three groups of children after controlling for differences in IQ.”

The authors note that more research is needed to determine long-term outcomes. For example, how would these children progress over a period of 12 months? What kind of gains would come from 28 hours of traditional therapy in 3 months? Overall, parent-implemented EMT looks to be a promising model to add to our intervention options for young children with developmental language disorder.

Note: For our bilingual SLPs, see Peredo, Zelaya, & Kaiser, 2017 for a study on adapting parent-implemented EMT for Spanish-speaking families.

 

Roberts, M. Y., & Kaiser, A. P. (2012). Assessing the effects of a parent-implemented language intervention for children with language impairments using empirical benchmarks: A pilot study. Journal of Speech, Language, and Hearing Research55(6), 1655-1670.