Altered lateralization of dorsal language tracts in 6‐week‐old infants at risk for autism

Altered structural connectivity has been identified as a possible biomarker of autism spectrum disorder (ASD) risk in the developing brain. Core features of ASD include impaired social communication and early language delay. Thus, examining white matter tracts associated with language may lend further insight into early signs of ASD risk and the mechanisms that underlie language impairments associated with the disorder. Evidence of altered structural connectivity has previously been detected in 6‐month‐old infants at high familial risk for developing ASD. However, as language processing begins in utero, differences in structural connectivity between language regions may be present in the early infant brain shortly after birth. Here we investigated key white matter pathways of the dorsal language network in 6‐week‐old infants at high (HR) and low (LR) risk for ASD to identify atypicalities in structural connectivity that may predict altered developmental trajectories prior to overt language delays and the onset of ASD symptomatology. Compared to HR infants, LR infants showed higher fractional anisotropy (FA) in the left superior longitudinal fasciculus (SLF); in contrast, in the right SLF, HR infants showed higher FA than LR infants. Additionally, HR infants showed more rightward lateralization of the SLF. Across both groups, measures of FA and lateralization of these pathways at 6 weeks of age were related to later language development at 18 months of age as well as ASD symptomatology at 36 months of age. These findings indicate that early differences in the structure of language pathways may provide an early predictor of future language development and ASD risk.     

Fine motor skill predicts expressive language in infant siblings of children with autism

We investigated whether fine motor and expressive language skills are related in the later‐born siblings of children with autism (heightened‐risk, HR infants) who are at increased risk for language delays. We observed 34 HR infants longitudinally from 12 to 36 months. We used parent report and standardized observation measures to assess fine motor skill from 12 to 24 months in HR infants (Study 1) and its relation to later expressive vocabulary at 36 months in HR infants (Study 2). In Study 1, we also included 25 infants without a family history of autism to serve as a normative comparison group for a parent‐report fine motor measure. We found that HR infants exhibited fine motor delays between 12 and 24 months and expressive vocabulary delays at 36 months. Further, fine motor skill significantly predicted expressive language at 36 months. Fine motor and expressive language skills are related early in development in HR infants, who, as a group, exhibit risk for delays in both. Our findings highlight the importance of considering fine motor skill in children at risk for language impairments and may have implications for early identification of expressive language difficulties.     

Attachment security differs by later autism spectrum disorder: A prospective study

Although difficulties with social relationships are key to autism spectrum disorder (ASD), no previous study has examined infant attachment security prior to ASD diagnosis. We prospectively assessed attachment security at 15 months in high‐risk infants with later ASD (high‐risk/ASD, n = 16), high‐risk infants without later ASD (high‐risk/no‐ASD, n = 40), and low‐risk infants without later ASD (low‐risk/no‐ASD, n = 39) using the Strange Situation Procedure. High‐risk/ASD infants were disproportionately more likely to be classified as insecure (versus secure) and more likely to be classified as insecure‐resistant (versus secure or avoidant) than high‐risk/no‐ASD and low‐risk/no‐ASD infants. High‐risk infants with insecure‐resistant attachments were over nine times more likely to receive an ASD diagnosis than high‐risk infants with secure attachments. Insecure‐resistant attachment in high‐risk infants suggests a propensity toward negative affect with the parent in conditions of stress. Insecure‐resistant attachment may prove useful as a potential early index of propensity toward ASD diagnosis in high‐risk siblings, while insecure‐resistant attachment in the context of emergent autism may contribute to difficulties experienced by children with ASD and their families.     

Behavioural markers for autism in infancy: Scores on the Autism Observational Scale for Infants in a prospective study of at-risk siblings

We investigated early behavioural markers of autism spectrum disorder (ASD) using the Autism Observational Scale for Infants (AOSI) in a prospective familial high-risk (HR) sample of infant siblings (N = 54) and low-risk (LR) controls (N = 50). The AOSI was completed at 7 and 14 month infant visits and children were seen again at age 24 and 36 months. Diagnostic outcome of ASD (HR-ASD) versus no ASD (HR-No ASD) was determined for the HR sample at the latter timepoint. The HR group scored higher than the LR group at 7 months and marginally but non-significantly higher than the LR group at 14 months, although these differences did not remain when verbal and nonverbal developmental level were covaried. The HR-ASD outcome group had higher AOSI scores than the LR group at 14 months but not 7 months, even when developmental level was taken into account. The HR-No ASD outcome group had scores intermediate between the HR-ASD and LR groups. At both timepoints a few individual items were higher in the HR-ASD and HR-No ASD outcome groups compared to the LR group and these included both social (e.g. orienting to name) and non-social (e.g. visual tracking) behaviours. AOSI scores at 14 months but not at 7 months were moderately correlated with later scores on the autism diagnostic observation schedule (ADOS) suggesting continuity of autistic-like behavioural atypicality but only from the second and not first year of life. The scores of HR siblings who did not go on to have ASD were intermediate between the HR-ASD outcome and LR groups, consistent with the notion of a broader autism phenotype.     

Natural reference: A phylo‐ and ontogenetic perspective on the comprehension of iconic gestures and vocalizations

The recognition of iconic correspondence between signal and referent has been argued to bootstrap the acquisition and emergence of language. Here, we study the ontogeny, and to some extent the phylogeny, of the ability to spontaneously relate iconic signals, gestures, and/or vocalizations, to previous experience. Children at 18, 24, and 36 months of age (N = 216) and great apes (N = 13) interacted with two apparatuses, each comprising a distinct action and sound. Subsequently, an experimenter mimicked either the action, the sound, or both in combination to refer to one of the apparatuses. Experiments 1 and 2 found no spontaneous comprehension in great apes and in 18‐month‐old children. At 24 months of age, children were successful with a composite vocalization‐gesture signal but not with either vocalization or gesture alone. At 36 months, children succeeded both with a composite vocalization‐gesture signal and with gesture alone, but not with vocalization alone. In general, gestures were understood better compared to vocalizations. Experiment 4 showed that gestures were understood irrespective of how children learned about the corresponding action (through observation or self‐experience). This pattern of results demonstrates that iconic signals can be a powerful way to establish reference in the absence of language, but they are not trivial for children to comprehend and not all iconic signals are created equal.     

Infants’ intentionally communicative vocalizations elicit responses from caregivers and are the best predictors of the transition to language: A longitudinal investigation of infants’ vocalizations,gestures and word production

What aspects of infants’ prelinguistic communication are most valuable for learning to speak, and why? We test whether early vocalizations and gestures drive the transition to word use because, in addition to indicating motoric readiness, they (a) are early instances of intentional communication and (b) elicit verbal responses from caregivers. In study 1, 11 month olds (N = 134) were observed to coordinate vocalizations and gestures with gaze to their caregiver's face at above chance rates, indicating that they are plausibly intentionally communicative. Study 2 tested whether those infant communicative acts that were gaze‐coordinated best predicted later expressive vocabulary. We report a novel procedure for predicting vocabulary via multi‐model inference over a comprehensive set of infant behaviours produced at 11 and 12 months (n = 58). This makes it possible to establish the relative predictive value of different behaviours that are hierarchically organized by level of granularity. Gaze‐coordinated vocalizations were the most valuable predictors of expressive vocabulary size up to 24 months. Study 3 established that caregivers were more likely to respond to gaze‐coordinated behaviours. Moreover, the dyadic combination of infant gaze‐coordinated vocalization and caregiver response was by far the best predictor of later vocabulary size. We conclude that practice with prelinguistic intentional communication facilitates the leap to symbol use. Learning is optimized when caregivers respond to intentional vocalizations with appropriate language.     

Developmental change in the neuropsychological functioning of very low birth weight infants

Research on very low birth weight (VLBW) infants has not carefully evaluated developmental patterns of neurological and neuropsychological functioning across time. This study reports on a broad range of developmental outcomes for VLBW infants of low (LR, n = 116) and high (HR, n = 84) medical risk compared to full term infants (FT, n = 120) across 6, 12, and 24 months of age. While low risk infants showed initial delays in most areas, faster rates of change in motor and neurological development resulted in catch-up by 2 years of age as compared to the FT infants. The lack of acceleration in development of mental skills demonstrates a persistent lag in this area. In contrast, HR infants showed initial delays in all areas as compared to both LR and FT infants with slower rates of change in mental and expressive language skills. Although faster rates of change were evident for HR infants in motor, neurological, and receptive language skills, scores in these areas remain lower than those for the LR and FT infants. The absence of accelerated rates of development for certain VLBW infants has implications for prognosis and patient access to early intervention services.     

Patterns of language and discourse comprehension skills in school‐aged children with autism spectrum disorders

Åsberg, J. (2010). Patterns of language and discourse comprehension skills in school‐aged children with autism spectrum disorders. Scandinavian Journal of Psychology 51, 534–539. The present study examined patterns of language and discourse comprehension skills in Swedish school‐aged children with autism spectrum disorders (ASD) (n = 16) as compared to a slightly younger group of typically developing children (n = 16) matched for non‐verbal cognitive ability. Results suggested significantly lower abilities in narrative discourse comprehension for the ASD group, but not in oral receptive vocabulary or reception of grammar. This difficulty with discourse‐level comprehension appeared to be of a general nature, as no evidence was found for the hypothesis that participants with ASD would find comprehension of inferential discourse information disproportionally more difficult than stated information, or for the hypothesis that discourse processing in ASD would be characterized by an elevated processing of explicitly stated narrative details. The study has clinical and educational implications, as the findings suggest that children with ASD would benefit from being offered specific support for discourse‐level comprehension.     

Multilingual assessment of early child development: Analyses from repeated observations of children in Kenya

In many low‐ and middle‐income countries, young children learn a mother tongue or indigenous language at home before entering the formal education system where they will need to understand and speak a country's official language(s). Thus, assessments of children before school age, conducted in a nation's official language, may not fully reflect a child's development, underscoring the importance of test translation and adaptation. To examine differences in vocabulary development by language of assessment, we adapted and validated instruments to measure developmental outcomes, including expressive and receptive vocabulary. We assessed 505 2‐to‐6‐year‐old children in rural communities in Western Kenya with comparable vocabulary tests in three languages: Luo (the local language or mother tongue), Swahili, and English (official languages) at two time points, 5–6 weeks apart, between September 2015 and October 2016. Younger children responded to the expressive vocabulary measure exclusively in Luo (44%–59% of 2‐to‐4‐year‐olds) much more frequently than did older children (20%–21% of 5‐to‐6‐year‐olds). Baseline receptive vocabulary scores in Luo (β = 0.26, SE = 0.05, p < 0.001) and Swahili (β = 0.10, SE = 0.05, p = 0.032) were strongly associated with receptive vocabulary in English at follow‐up, even after controlling for English vocabulary at baseline. Parental Luo literacy at baseline (β = 0.11, SE = 0.05, p = 0.045) was associated with child English vocabulary at follow‐up, while parental English literacy at baseline was not. Our findings suggest that multilingual testing is essential to understanding the developmental environment and cognitive growth of multilingual children.     

SOCIOEMOTIONAL AND BEHAVIORAL PROBLEMS IN TODDLERS WITH LANGUAGE DELAY

Toddlers with language delay are at risk for persistent developmental and behavioral difficulties; however, the association between socioemotional/behavior problems and language in young children is not well understood. This study explored socioemotional/behavior problems in a unique sample of toddlers with language delays using a measure developed explicitly for this age group. Toddlers identified by 18 months with receptive and expressive language delay (LD; n = 30) or typical development (TD; n = 61) were evaluated at 18 and 24 months of age using the Infant‐Toddler Social and Emotional Assessment (ITSEA) and the Mullen Scales of Early Learning. Compared to toddlers who had TD, toddlers with LD had significantly more concerning scores at 18 and 24 months on all ITSEA domains. The rate of “clinical concern” on most domains was not high in either group, except that >60% of LD toddlers were in the clinical concern range on the Competence domain. Socioemotional/behavioral problems were dimensionally related to receptive and expressive language, with greater language delay associated with more concerning ITSEA scores. Socioemotional and behavioral problems are related to receptive and expressive language abilities in 18‐ and 24‐month‐olds, indicating the need for screening of both types of concerns in toddlers identified with potential language delays.     

Identification of biological and environmental risk factors for language delay: The Let's Talk STEPS study

The aim of this population-based study was to identify demographic factors for language delays at an early age. The risk analysis covered 11 biological and 8 environmental factors. The mothers’ concerns regarding language development were also examined. A total of 226 children from a Finnish cohort study were invited to participate in language assessments at 36 months. The test results for word finding and language comprehension were compared with parental questionnaires about children's vocabulary at 13 and 24 months.Regression analysis revealed that the father's social class (t = −2.79, p = 0.006) and working full time (t = −2.86, p = 0.005) significantly predicted children's language delay. In addition, language comprehension was significantly predicted by the mother's social class (t = −2.06, p = 0.041) and by gender, with an advantage to girls (t = −2.71, p = 0.008). Vocabulary at 24 months was a powerful predictor for lexical development (t = 4.58, p < 0.0001) and language comprehension (t = 4.85, p < 0.0001) at 36 months. Mothers’ concerns were correlated with children's limited lexicons as early as 24 months (r = 0.31, p < 0.0001) and poor language comprehension (r = −0.35, p < 0.0001) at 36 months. Mothers were especially concerned if the parents needed special education during school years.At the population-level, gender was the most powerful biological factor in predicting language delays. Similarly, both parents’ social status had predictive value for the child's language development. In addition, it was found that the mother's concern about her child's slow language acquisition should be taken into account when making decisions regarding special support.     

The cerebellum and language: Evidence from patients with cerebellar degeneration

Clinical and imaging studies suggest that the cerebellum is involved in language tasks, but the extent to which slowed language production in cerebellar patients contributes to their poor performance on these tasks is not clear. We explored this relationship in 18 patients with cerebellar degeneration and 16 healthy controls who completed measures of verbal fluency (phonemic and semantic), word stem completion, and oral naming speed. Cerebellar patients showed significantly slower response times when naming common nouns, which correlated with their degree of motor impairment. Patients were significantly impaired on both phonemic and semantic fluency measures compared to controls (p < 0.001), even when naming speed was entered as a covariate (p = 0.03). On the word stem completion task, patients were significantly less accurate (p < 0.001), had more errors due to non-responses (p = 0.008), and were slower to respond (p = 0.036) than controls; group effects were significant for overall accuracy, but not response time, when the effects of naming speed were covaried (p = 0.014). These findings suggest that cerebellar patients’ poorer performance on language tasks cannot be explained solely by slower language production, and that the integrity of cerebellar-prefrontal loops might underlie poorer performance on measures of executive function in cerebellar patients.     

SES differences in language processing skill and vocabulary are evident at 18 months

This research revealed both similarities and striking differences in early language proficiency among infants from a broad range of advantaged and disadvantaged families. English‐learning infants (n = 48) were followed longitudinally from 18 to 24 months, using real‐time measures of spoken language processing. The first goal was to track developmental changes in processing efficiency in relation to vocabulary learning in this diverse sample. The second goal was to examine differences in these crucial aspects of early language development in relation to family socioeconomic status (SES). The most important findings were that significant disparities in vocabulary and language processing efficiency were already evident at 18 months between infants from higher‐ and lower‐SES families, and by 24 months there was a 6‐month gap between SES groups in processing skills critical to language development.     

Attention to lexical stress and early vocabulary growth in 5-month-olds at risk for autism spectrum disorder

Typically developing infants differentiate strong–weak (trochaic) and weak–strong (iambic) stress patterns by 2 months of age. The ability to discriminate rhythmical patterns, such as lexical stress, has been argued to facilitate language development, suggesting that a difficulty in discriminating stress might affect early word learning as reflected in vocabulary size. Children with autism spectrum disorder (ASD) often have difficulty in correctly producing lexical stress, yet little is known about how they perceive it. The current study tested 5-month-old infants with typically developing older siblings (SIBS-TD) and infants with an older sibling diagnosed with ASD (SIBS-A) on their ability to differentiate the trochaic and iambic stress patterns of the word form gaba. SIBS-TD infants showed an increased interest in attention to the trochaic stress pattern, which was also positively correlated with vocabulary comprehension at 12 months of age. In contrast, SIBS-A infants attended equally to these stress patterns, although this was unrelated to later vocabulary size.     

Exploring cortical activation and connectivity in infants with and without familial risk for autism during naturalistic social interactions: A preliminary study

Behavioral signs of Autism Spectrum Disorder (ASD) are typically observable by the second year of life and a reliable diagnosis of ASD is possible by 2 to 3 years of age. Studying infants with familial risk for ASD allows for the investigation of early signs of ASD risk within the first year. Brain abnormalities such as hyper-connectivity within the first year may precede the overt signs of ASD that emerge later in life. In this preliminary study, we use functional near-infrared spectroscopy (fNIRS), an infant-friendly neuroimaging tool that is relatively robust against motion artifacts, to examine functional activation and connectivity during naturalistic social interactions in 9 high-risk (HR; older sibling with ASD) and 6 low-risk (LR; no family history of ASD) infants from 6 to 9 months of age. We obtained two 30-second baseline periods and a 5-minute social interaction period. HR infants showed reduced right and left-hemispheric activation compared to LR infants based on oxy (HbO₂) and deoxy (HHb) signal trends. HR infants also had greater functional connectivity than LR infants during the pre- and post-social periods and showed a drop in connectivity during the social period. Our findings are consistent with previous work suggesting early differences in cortical activation associated with familial risk for ASD, and highlight the promise of fNIRS in evaluating potential markers of ASD risk during naturalistic social contexts.     

Do you understand what I want to tell you? Early sensitivity in bilinguals' iconic gesture perception and production

Previous research has shown differences in monolingual and bilingual communication. We explored whether monolingual and bilingual pre‐schoolers (N = 80) differ in their ability to understand others' iconic gestures (gesture perception) and produce intelligible iconic gestures themselves (gesture production) and how these two abilities are related to differences in parental iconic gesture frequency. In a gesture perception task, the experimenter replaced the last word of every sentence with an iconic gesture. The child was then asked to choose one of four pictures that matched the gesture as well as the sentence. In a gesture production task, children were asked to indicate ‘with their hands’ to a deaf puppet which objects to select. Finally, parental gesture frequency was measured while parents answered three different questions. In the iconic gesture perception task, monolingual and bilingual children did not differ. In contrast, bilinguals produced more intelligible gestures than their monolingual peers. Finally, bilingual children's parents gestured more while they spoke than monolingual children's parents. We suggest that bilinguals' heightened sensitivity to their interaction partner supports their ability to produce intelligible gestures and results in a bilingual advantage in iconic gesture production.     

Gestural development and its relation to a child's early vocabulary

Gesture and language are tightly connected during the development of a child's communication skills. Gestures mostly precede and define the way of language development; even opposite direction has been found. Few recent studies have focused on the relationship between specific gestures and specific word categories, emphasising that the onset of one gesture type predicts the onset of certain word categories or of the earliest word combinations.The aim of this study was to analyse predicative roles of different gesture types on the onset of first word categories in a child's early expressive vocabulary. Our data show that different types of gestures predict different types of word production. Object gestures predict open-class words from the age of 13 months, and gestural routines predict closed-class words and social terms from 8 months. Receptive vocabulary has a strong mediating role for all linguistically defined categories (open- and closed-class words) but not for social terms, which are the largest word category in a child's early expressive vocabulary. Accordingly, main contribution of this study is to define the impact of different gesture types on early expressive vocabulary and to determine the role of receptive vocabulary in gesture-expressive vocabulary relation in the Croatian language.     

Number gestures predict learning of number words

When asked to explain their solutions to a problem, children often gesture and, at times, these gestures convey information that is different from the information conveyed in speech. Children who produce these gesture‐speech “mismatches” on a particular task have been found to profit from instruction on that task. We have recently found that some children produce gesture‐speech mismatches when identifying numbers at the cusp of their knowledge, for example, a child incorrectly labels a set of two objects with the word “three” and simultaneously holds up two fingers. These mismatches differ from previously studied mismatches (where the information conveyed in gesture has the potential to be integrated with the information conveyed in speech) in that the gestured response contradicts the spoken response. Here, we ask whether these contradictory number mismatches predict which learners will profit from number‐word instruction. We used the Give‐a‐Number task to measure number knowledge in 47 children (M_age = 4.1 years, SD = 0.58), and used the What's on this Card task to assess whether children produced gesture‐speech mismatches above their knower level. Children who were early in their number learning trajectories (“one‐knowers” and “two‐knowers”) were then randomly assigned, within knower level, to one of two training conditions: a Counting condition in which children practiced counting objects; or an Enriched Number Talk condition containing counting, labeling set sizes, spatial alignment of neighboring sets, and comparison of these sets. Controlling for counting ability, we found that children were more likely to learn the meaning of new number words in the Enriched Number Talk condition than in the Counting condition, but only if they had produced gesture‐speech mismatches at pretest. The findings suggest that numerical gesture‐speech mismatches are a reliable signal that a child is ready to profit from rich number instruction and provide evidence, for the first time, that cardinal number gestures have a role to play in number‐learning.     

Maturation constrains the effect of exposure in linking language and thought: evidence from healthy preterm infants

The power of human language rests upon its intricate links to human cognition. By 3 months of age, listening to language supports infants’ ability to form object categories, a building block of cognition. Moreover, infants display a systematic shift between 3 and 4 months – a shift from familiarity to novelty preferences – in their expression of this link between language and core cognitive processes. Here, we capitalize on this tightly‐timed developmental shift in fullterm infants to assess (a) whether it also appears in preterm infants and (b) whether it reflects infants’ maturational status or the duration of their postnatal experience. Healthy late preterm infants (N = 22) participated in an object categorization task while listening to language. Their performance, coupled with that of fullterm infants, reveals that this developmental shift is evident in preterm infants and unfolds on the same maturational timetable as in their fullterm counterparts.     

Adaptation of the Mullen Scales of Early Learning for use among infants aged 5‐ to 24‐months in rural Gambia

Infants in low‐resource settings are at heightened risk for compromised cognitive development due to a multitude of environmental insults in their surroundings. However, the onset of adverse outcomes and trajectory of cognitive development in these settings is not well understood. The aims of the present study were to adapt the Mullen Scales of Early Learning (MSEL) for use with infants in a rural area of The Gambia, to examine cognitive development in the first 24‐months of life and to assess the association between cognitive performance and physical growth. In Phase 1 of this study, the adapted MSEL was tested on 52 infants aged 9‐ to 24‐months (some of whom were tested longitudinally at two time points). Further optimization and training were undertaken and Phase 2 of the study was conducted, where the original measures were administered to 119 newly recruited infants aged 5‐ to 24‐months. Infant length, weight and head circumference were measured concurrently in both phases. Participants from both phases were split into age categories of 5–9 m (N = 32), 10–14 m (N = 92), 15–19 m (N = 53) and 20–24 m (N = 43) and performance was compared across age groups. From the ages of 10–14 m, Gambian infants obtained lower MSEL scores than US norms. Performance decreased with age and was lowest in the 20–24 m old group. Differential onsets of reduced performance were observed in the individual MSEL domains, with declines in visual perception and motor performance detected as early as at 10–14 months, while reduced language scores became evident after 15–19 months of age. Performance on the MSEL was significantly associated with measures of growth.