Long-term outcomes of Hanen’s Target Word program

How much of a long-term impact does parent-implemented speech–language therapy have on late talkers? That’s an important question. Most studies have focused on short- or medium-term outcomes and have not looked into long-term follow-up results.

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These researchers wanted to know the medium- and long-term effects of a low-dosage parent program for late talkers. To do this, they provided the Hanen’s Target Word program to 30 parents of 24-month-old late talkers, and followed a different set of 30 parents–child pairs that did not receive the program. The program included five group sessions and two individual video-feedback sessions over the span of three months. They then tested parents’ use of the strategies at 36 months, and language skills at 36 and 48 months.

They found that the program accelerated the vocabulary growth for the late talkers, but by age 4, there were no longer any differences between the two groups’ expressive vocabularies and both had reached age-appropriate scores. Both groups, however, continued to fall behind their peers in syntax and grammar.

The parents who participated in the study followed their child’s lead more and put less communicative pressure on their child; however, the parents did not significantly improve in how often they responded to their child’s communication or in how much linguistic stimulation they provided their child. Through analysis, the researchers found the strategy of reducing communicative pressure to be specifically associated with children’s language growth.

Here are some important considerations and takeaways from the study:

  • Null long-term results don’t mean that the intervention wasn’t worthwhile. As we know, increasing two year olds’ vocabularies can help ease the frustration of not being able to communicate which is an important goal of early intervention.

  • Dosage and coaching style play an important role in treatment outcomes. The authors discuss how the parent results of this study differed sharply from the Roberts and Kaiser (2015) study in which the researchers taught parents Enhanced Milieu Teaching (EMT) strategies, and parents were able to learn all of them. One of the reasons why is that the intervention dosage was much higher for the EMT study (four workshops and 24 hour-long sessions, compared to two), giving parents more opportunity for practice and feedback. Adjusting the dosage or coaching style of the Target Word program may be one option for increasing its long-term effectiveness.

  • Reducing communicative pressure may be an especially important strategy for parents. This is a simple strategy to teach parents, and these results demonstrate how powerful it can be for supporting language growth in toddlers.

  • Ongoing monitoring is important for late-talkers. Nearly one third of the children who participated still had language scores below the normal range at four years of age, but fewer than half of those children received speech–language therapy after the study. Monitoring is important to ensure that these children don’t fall through the cracks when language demands as they grow older.

One final note: this isn’t a replication study of Hanen’s Target Word program, but rather it’s a study that tested its effectiveness in real-world contexts. That’s awesome for two reasons: (1) authors aren’t tied to Hanen, which helps eliminate bias, and (2) real-world contexts = more like what we SLPs face = more clinically applicable! 

Want more? These authors also published a study of Hanen’s Target Word program (so popular!) This retrospective study (looking back at client charts) similarly showed gains in communicative participation and vocabulary for children who participated in the program.

 

Kruythoff-Broekman, A., Wiefferink, C., Rieffe, C., Uilenburg, N. (2019). Parent-implemented early language intervention programme for late talkers: parental communicative behaviour change and child language outcomes at 3 and 4 years of age. International Journal of Language & Communication Disorders. doi: 10.1111/1460-6984.12451

Go long! Go deep! Storybook reading intervention to target breadth and depth of word knowledge in preschool-age children

One of the most fun and, quite honestly, easiest contexts that we can use in therapy with toddlers and preschoolers is shared book reading. And, it’s kind of a no brainer that we can and should be using interactive read alouds to target one of the key areas of language development that’s lacking in our 2-, 3-, and 4-year-old clients: receptive and expressive vocabulary*.

In this intervention study of 226 preschoolers, they found that:

  • Kids who had a high initial level of vocabulary knowledge were able to increase their understanding and use of words through exposure alone.

  • However, for kids with the weakest initial vocabulary levels, exposure and repetition isn’t enough.

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So what helps? Explicit instruction. Their explicit intervention activities included: pictures, clear child-friendly definitions, and being encouraged to act out, use, and explain target words. They found that in order to go beyond breadth (the number of words that you know) to depth (how much you know about a word), explicit instruction of word meaning and interactive activities that extend understanding beyond how the words are depicted in the book, helped. Ultimately, going long and going deep is key if we want to have a long-term impact on vocabulary development.

*This isn’t the first time we’ve discussed the topic of word learning during shared book reading. See this review, too.

 

Dickinson, D. K., Nesbitt, K. T., Collins, M. F., Hadley, E. B., Newman, K., Riveria, B. L., …Hirsh-Pasek, K. (2019). Teaching for breadth and depth of vocabulary knowledge: Learning from explicit and implicit instruction and the storybook texts. Early Childhood Research Quarterly. doi:10.1016/j.ecresq.2018.07.012

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

A (free) decontextualized vocabulary test for toddlers

If only we had a crystal ball to predict late talkers’ later language skills (ok, those would be nice in so many areas of our field!). As SLPs we are always trying to get an accurate picture of how many words a child uses and understands. But because we don’t have a dedicated assessment of toddlers’ early vocabulary, we often do this through parent report, either formally (like an MCDI) or informally. However, researchers have found that parents' report of their child's vocabulary doesn't do as good of a job when we try to use it to predict later language. It seems that parent report may not be giving us all of the information that we need about a child’s vocabulary in order to predict their later language abilities.

We know that there’s a continuum of what “knowing a word” entails for a toddler. When they first learn to say the word “milk,” they may only know it within the context of breakfast. The word “dog” however, they may use all day long whenever they see a dog or a picture of one. A parent would rightly conclude that a child knows both “milk” and “dog,” even though the child’s “level of knowing” varies between the two words. Contrast this with a picture ID vocabulary assessment, in which all of the words are presented out of context. For a toddler to correctly identify a word during the assessment, he would have to have a strong understanding of what that word really means without all of the support that context provides.

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Because of this, Friend et al. (2018) set out to create a picture ID test for young children and test if it could better predict preschool language abilities than parent report. They developed the Computerized Comprehension Test (CCT) in which children are asked to identify decontextualized pictures from a field of two. They then tested it with 16-, 23-, and 36-month-old children. At 16 months, parent report continued to best predict preschool language abilities. However once the child reached 23 months, the CCT was a stronger predictor of later language abilities with great psychometric properties.

While the CCT is still in its early phases, it shows promise of becoming a useful instrument for EI SLPs to get a more accurate picture of toddlers’ vocabulary, especially after age two. In its current state, it could serve to complement other assessments already in your toolkit, such as an MCDI. And while we’ll never have a crystal ball to tell us what a child’s language will be like years down the road, assessments such as this may give clues to help us make more informed decisions about assessment and treatment.  

Note: The authors have published all of their CCT materials online, including the computerized assessment, training videos/instructions, and data sheets. I tested out the program myself, and while there was a learning curve, it didn’t prove to be too challenging! Let’s all take a moment and cheer for these scientists giving us access to the materials we need!

 

Friend, M., Smolak, E., Patrucco-Nanchen, T., Poulin-Dubois, D., & Zesiger, P. (2018). Language Status at Age 3: Group and Individual Prediction From Vocabulary Comprehension in theSecond Year. Developmental Psychology. Advance online publication. doi: 10.1037/dev0000617

Want to increase generalization? Try matrix training

Let’s talk about matrix training. It’s a language intervention that’s been around for a while (e.g., Goldstein, 1983), and there’s quite a bit of evidence to demonstrate that it can be used as a framework to teach vocabulary and functional language skills. But, probably more importantly, kids can learn new and untrained language targets by participating in matrix training. Tell me more, right?

Well, the way that it works is that language targets (for instance, adjectives and nouns) are written on the vertical and horizontal axes of a table—aka: matrix. The targets can be either all unknown words or a combination of known and unknown depending on the client. Then, those targets are used to create various combinations. So, if you’re focusing on increasing your client’s understanding of adjectives and nouns, your matrix could look like this:

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Matrix training is based on the idea of recombinative generalization (Goldstein, 1983)—which basically means that if we teach a word combination {brown + bear} and then expose the child to one of the same words again but in a new combination {brown + bird}, the child can generalize their understanding or use of untrained, related targets {brown + horse}.

So, the matrix essentially serves as a visual guide that can be used to identify the sequence for instruction by making it easy for you to see which treatment targets are related. For instance, if you choose targets that are in the yellow diagonal cells (brown bear, red bird, blue horse, yellow duck, green fish) as well as the teal cells just above them (brown bird, red horse, blue duck, yellow fish), many of the same adjectives and nouns will be repeated in your intervention. By doing this, your client can then generalize their understanding to related, untrained targets (such as, brown horse, brown duck, red duck, brown fish, red fish, blue fish).

In this study, matrix training was used as a framework for intervention with three children between the ages of 22 and 35 months with severe language delays and/or ASD. The training focused on teaching the toddlers simple, one-step directions (e.g., shake) that included animals (e.g., dog). Three individual matrices were created based on each child’s knowledge of the target actions and animals before the training began. The intervention targeted six (or, 30%) of the one step action–object instructions with each child, and included components of discrete trial training (antecedent, responses, and consequences) as well as verbal and physical prompts and reinforcement. After training, the other 70% of the action-object combinations that weren’t directly taught were probed, and each of the three children demonstrated some level of generalization to these unknown targets (and, one of the toddlers demonstrated understanding of all of the untrained action-object combos!). 

Talk about more getting a little more bang for your buck, am I right?!

Although this study only included 3 participants, the findings suggest that matrix training is a simple framework to implement that has the potential to cut down on time spent on teaching language targets in intervention. This is particularly exciting news for our youngest clients who demonstrate the most significant language delays.

Curiel, E.S.L., D. M., Sainato, D. M., & Goldstein, H. (2018). Matrix training for toddlers with Autism Spectrum Disorder and other language delays. Journal of Early Intervention40(3), 268–284.

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

Cultural differences in conversational turn-taking

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I think we’re all aware that amount and type of talk that young children are exposed to can have a big impact on their language development. But what about the influence of culture on caregiver–child interactions? Understanding this factor as it relates to the language development of each child that we work with is necessary if we’re committed to providing culturally sensitive, appropriate services and recommendations to families.

This study used the Language ENvironment Analysis (LENA) system to analyze conversational turn-taking between parents and two- and three-year-old Canadian and Vietnamese children with and without hearing loss. Main findings:

  • Vietnamese families verbally interacted significantly less than Canadian families, regardless of hearing status

  • Hearing status didn’t impact the amount of talk in the homes of Canadian or Vietnamese children

This study emphasizes the importance of placing culture at the forefront of our focus when it comes to identifying language delays and appropriate recommendations for families of young children with and without hearing loss. Findings from this study suggest that direct observations of parent–child interactions in a natural setting can provide important insight regarding cultural expectations and norms.


Ganek, H., Smyth, R., Nixon, S., & Eriks-Brophy. (2018). Using the Language Environment Analysis (LENA) system to investigate cultural differences in conversational turn count. Journal of Speech, Language, and Hearing Research, 61, 2246–2258.

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.

Parent training: vocabulary growth for toddlers with hearing loss

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Toddlers with hearing loss do not gain vocabulary at the same rate as toddlers with normal hearing. Some of the reasons for this delay are out of our control as therapists. We cannot change a child’s speech perception or the age at which the child received amplification. What we can do is manipulate the child’s environment to promote vocabulary growth.

Lund trained six parents of toddlers with hearing loss in two strategies: transparent naming and linguistic mapping.

Transparent naming is using a new vocabulary word while visually signaling (pointing) to the referent. This has been found to increase children’s vocabulary skills (groundbreaking, I know).  All six parents were able to increase their use of transparent naming with just two 45-minute training sessions.

Linguistic mapping is a little more complex. It involves overlaying words on a child’s communicative act after that child has initiated intentional communication. This is not simply narrating the actions of a child. It requires the communication partner to correctly interpret a child’s communicative attempt and quickly generate an appropriate utterance to go with it.  Only half of parents were able to adequately demonstrate linguistic mapping after two training sessions, which suggests that a little more time might be needed to teach parents this particular skill.

After training sessions were completed, four out of six children increased their rate of word learning. If you have any tots on your caseload with hearing loss, or who are struggling with word learning, you might consider training parents in transparent naming and linguistic mapping.

Lund, E. (2018). Effects of parent training on vocabulary scores of young children with hearing loss. American Journal of Speech-Language Pathology, 1–13. Advance online publication. doi: 10.1044/2018_AJSLP-16-0239

What, who, when, or how: What matters in shared book reading?

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We all know reading books with our kids and clients is wonderful for language development, but what about shared reading makes it so beneficial to learning vocabulary? This meta-analysis included 38 studies to determine what elements of shared book reading contribute to word learning in typically developing* children ages 33 months–12 years. Good news, shared book reading works! The authors found that children learned almost half of the words they were exposed to during shared reading, but some factors seemed to matter more than others. For example, more exposures to target words was better for word learning, and a dialogic reading style helped children learn 1.22 more words on average than non-dialogic styles. In other words, interactive reading styles with many opportunities to hear and use new words contribute to word learning. No surprise there! What was surprising is that it didn’t matter who read the book. Across studies, children did just as well on word learning measures after shared reading with their parents as they did with researchers or teachers. And the length of time between reading and testing did not affect word learning, so either immediacy wasn’t an important factor for these children, or they retained knowledge of the words they learned during reading. So, if you aren’t already, try incorporating story books into your sessions, and include dialogic reading as part of a home program or coaching session!

*Note: This meta-analysis only included studies on typically developing children, but there are studies out there on implementing therapy techniques into dialogic reading: try here and here for some ideas, and here for more on dialogic reading!

This review appears in both our Early Intervention and Preschool & School-Age sections this month!

Flack, Z. M., Field, A. P, & Horst, J. (2017). The effects of shared storybook reading on word learning: a meta-analysis. Developmental Psychology. Advance online publication. doi: 10.1037/dev0000512.