Associations between early maternal behaviours and child language at 36 months in a cohort experiencing adversity.

BACKGROUND: Variations in parenting, more specifically less responsive and more directive parenting, contribute to language difficulties for children experiencing adversity. Further investigation of associations between specific responsive and directive behaviours and child language is required to understand how behaviours shape language over time within different populations. As language is dyadic, further exploration of how mother-child interactions moderate associations is also important. AIMS: To investigate associations between specific responsive and directive maternal behaviours, the quality of mother-child interaction (fluency and connectedness) and child language in a cohort experiencing adversity. METHODS & PROCEDURES: Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, videos of mother-infant free play were collected. Videos were coded for maternal behaviours and fluency and connectedness (n = 249). At 36 months, child language was measured using a standardized language test. Linear regression models were used to examine associations and the moderating role of fluency and connectedness was explored. OUTCOMES & RESULTS: Responsive yes/no questions were positively associated with language scores. Unsuccessful redirectives were negatively associated with language scores. The moderation effect of fluency and connectedness was equivocal in the current data. CONCLUSIONS & IMPLICATIONS: Findings reproduce and extend previous research highlighting key features of mother-child interactions associated with child language trajectories. Findings also augment knowledge of risk and protective factors related to language for children experiencing adversity and highlight where targeted interventions might be successful.

Predictive validity of verbal and non-verbal communication and mother-child turn-taking at 12 months on language outcomes at 24 and 36 months in a cohort of infants experiencing adversity: a preliminary study.

BACKGROUND: Parent-reported measures of early communication have limitations for use with infants experiencing adversity. Observational measures of early non-verbal and verbal communicative behaviours and mother-child turn-taking may provide a complementary method of capturing early communication skills for these children. AIMS: To explore the predictive validity of verbal and non-verbal behaviours and mother-child conversational turn-taking (fluency and connectedness) at child age 12 months in relation to language measures at 24 and 36 months in a cohort of infants experiencing adversity. METHODS & PROCEDURES: Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, 190 infants were videoed during mother-child free-play. Verbal and non-verbal communicative behaviours and fluency and connectedness were measured from the 12-month videos. Predictive validity of 12-month behaviours was calculated in relation to mean length of utterance and number of unique words at 24 months and Clinical Evaluation of Language Fundamentals Preschool-Second Edition (CELF-P2) Core Language scores at 36 months. OUTCOMES & RESULTS: All 12-month behaviours had adequate specificity but poor sensitivity when compared with other predictive validity studies using published early language measures. However, in adjusted regression models, fluency and connectedness and verbal behaviours at 12 months predicted unique words at 24 months. Fluency and connectedness also predicted CELF-P2 scores at 36 months. CONCLUSIONS & IMPLICATIONS: Findings reconfirm the difficulty in early identification of children at risk of later language difficulties. All 12-month measures were more accurate at identifying those children who will have better language than those children who will not. As fluency and connectedness was the only measure to predict 24- and 36-month language in adjusted regression models, it may be an important factor to consider when measuring early language skills for infants experiencing adversity. Future research could combine observational measures of early communication and fluency and connectedness with other predictors of language to try to increase prediction accuracy.

Realising economic and social rights for children with communication and swallowing disability: Sustainable Development Goals 1, 8 and 10.

PURPOSE: This commentary describes the economic disempowerment of children with communication and/or swallowing disability and outlines why attending to their economic and social needs is essential for the realisation of the United Nations' Agenda 2030. RESULT: Children with communication and/or swallowing disability encounter intersectional disempowerment on account of both their disability, and their status as children. In particular, they experience unique barriers to the realisation of their economic and social rights. This presents a number of challenges to the realisation of Agenda 2030, and its Sustainable Development Goals (SDGs). Drawing on the broader disability rights and child rights literature, we outline these issues, and describe four empowering solutions, within the scope of this special issue commentary. CONCLUSION: We describe that speech-language pathologists must interpret the discussion of these issues as a call to action for our profession. This commentary focusses on the Agenda 2030 Sustainable Development Goals of, No Poverty (SDG 1), Decent Work and Economic Growth (SDG 8), and Reduced Inequalities (SDG 10), and also addresses the goals of Zero Hunger (SDG 2), Good Health and Well-Being (SDG 3), Quality Education (SDG 4), Gender Equality (SDG 5) and Partnerships for the Goals (SDG 17).

The ASQ-TRAK: Validating a culturally adapted developmental screening tool for Australian Aboriginal children.

BACKGROUND: Developmental monitoring, performed using culturally relevant tools, is of critical importance for all young children. The ASQ-TRAK is the culturally and linguistically adapted Ages and Stages Questionnaire (ASQ-3), a developmental screening tool, for Australian Aboriginal children. While the ASQ-TRAK has been well received in practice, investigating its psychometric properties will enable professionals to make informed decisions about its use. AIMS: To conduct a rigorous validation study of the ASQ-TRAK by applying Kane's argument-based approach. SUBJECTS: The ASQ-TRAK, Bayley-III and/or BDI-2 were administered cross-sectionally to 336 Australian Aboriginal children aged 2-48 months across ten participating sites in the Northern Territory and South Australia. A sample of staff and caregivers completed feedback surveys about the ASQ-TRAK. RESULTS: ASQ-TRAK domain scores were moderately positively correlated with corresponding domain scores on the Bayley-III or BDI-2. Inter-rater and inter-instrument reliability were high. Sensitivity (83%), specificity (83%) and negative predictive value (99%) were acceptable. Staff and caregivers expressed high levels of satisfaction with the ASQ-TRAK. CONCLUSIONS: Regular developmental screening can provide important information about developmental vulnerability and the need for services. The ASQ-TRAK should be administered by trained Aboriginal community-based workers and the implementation approach carefully planned. Areas for future research include longitudinal follow-up of children, investigating existing norms and cut-off scores, and considering the appropriateness of the ASQ-TRAK with Aboriginal people from different locations. The ASQ-TRAK has the potential to fill an important gap by enabling better access to high-quality developmental monitoring and targeted early intervention.

Concurrent associations between maternal behaviours and infant communication within a cohort of women and their infants experiencing adversity.

PURPOSE: Evidence suggests that children living in adversity are at greater risk of poorer language than their peers with the quality of parental interactions potentially mediating this association. Studies typically measure the mediatory impact of generic interaction styles making it difficult to discern which particular aspects of the interaction are facilitating language. This study aims to bridge this gap by identifying specific maternal behaviours associated with concurrent infant communication, in a cohort of 12-month old infants and their mothers experiencing adversity. METHOD: A total of 249 mother-infant free-play videos were collected from women experiencing adversity in Victoria and Tasmania, Australia. From those videos, specific maternal behaviours, infant communication acts and the interaction quality were coded. RESULT: Maternal verbal imitations uniquely predicted concurrent use of infant vocalisations, total words and unique words. Furthermore, the more fluent and connected the mother-infant dyad, the stronger the association between imitations and all three infant measures. CONCLUSION: Frequent use of maternal imitations, within highly connected mother-infant dyads, may help mediate the impact of adversity on early communication. This information is important for early years professionals working with at-risk populations in augmenting current knowledge of risk and protective factors related to early language.