Inpatient Skin-to-skin Care Predicts 12-Month Neurodevelopmental Outcomes in Very Preterm Infants.

OBJECTIVE: To examine the relationship between inpatient skin-to-skin care rates and neurodevelopmental scores measured at 12 months in very preterm (VPT) infants. STUDY DESIGN: From a retrospective review of medical records of 181 VPT infants (<32 weeks gestational age [GA] at birth), we derived skin-to-skin care rate, ie, total minutes of skin-to-skin care each infant received over the number of days of hospital stay. We used scores on the Capute Scales from routine follow-up assessments at 12 months to measure neurodevelopmental outcomes. RESULTS: Families averaged approximately 17 minutes/day of skin-to-skin care (2 days/week, 70 minutes/session), although there was substantial variability. Variation in skin-to-skin rate was positively associated with outcomes at 12 months corrected age (r = 0.25, P < .001). Skin-to-skin rate significantly predicted 6.2% unique variance in 12-month neurodevelopmental outcomes, after adjusting for GA, socioeconomic status (SES), health acuity, and visitation frequency. A 20-minute increase in skin-to-skin care per day was associated with a 10-point increase (0.67 SDs) in neurodevelopmental outcomes at 12 months. GA and infant health acuity did not moderate these relations. CONCLUSION: VPT infants who experienced more skin-to-skin care during hospitalization demonstrated higher scores on 12-month neurodevelopmental assessments. Results provide evidence that skin-to-skin care confers extended benefits to VPT infants through the first year of life. Skin-to-skin care offers promise as a family-centered intervention designed to promote positive developmental outcomes in at-risk infants.

The role of translation equivalents in bilingual word learning.

Bilingual environments present an important context for word learning. One feature of bilingual environments is the existence of translation equivalents (TEs)-words in different languages that share similar meanings. Documenting TE learning over development may give us insight into the mechanisms underlying word learning in young bilingual children. Prior studies of TE learning have often been confounded by the fact that increases in overall vocabulary size with age lead to greater opportunities for learning TEs. To address this confound, we employed an item-level analysis, which controls for the age trajectory of each item independently. We used Communicative Development Inventory data from four bilingual datasets (two English-Spanish and two English-French; total N = 419) for modeling. Results indicated that knowing a word's TE increased the likelihood of knowing that word for younger children and for TEs that are more similar phonologically. These effects were consistent across datasets, but varied across lexical categories. Thus, TEs may allow bilingual children to bootstrap their early word learning in one language using their knowledge of the other language. RESEARCH HIGHLIGHTS: Bilingual children must learn words that share a common meaning across both languages, that is, translation equivalents, like dog in English and perro in Spanish. Item-level models explored how translation equivalents affect word learning, in addition to child-level (e.g., exposure) and item-level (e.g., phonological similarity) factors. Knowing a word increased the probability of knowing its corresponding translation equivalent, particularly for younger children and for more phonologically-similar translation equivalents. These findings suggest that young bilingual children use their word knowledge in one language to bootstrap their learning of words in the other language.

Early language processing efficiency and pre-literacy outcomes in children born full term and preterm.

Language processing efficiency-that is, the skill at processing language in real time-assessed in toddlerhood is associated with later language outcomes in children born full term (FT) and preterm (PT) during school age. No studies to date have assessed patterns of relations between early language processing efficiency and pre-literacy skills, such as print knowledge and phonological awareness, and whether relations are similar in FT and PT children. In this study, participants (N = 94, 49 FT and 45PT) were assessed in the looking-while-listening (LWL) task at 18 months of age (corrected for degree of prematurity), deriving measures of processing speed and accuracy. At 4½ years of age, children were assessed on standardized tests of print knowledge, phonological awareness, and expressive language. Processing speed and accuracy predicted both pre-literacy outcomes (r2 change = 7.8%-19.5%, p < .01); birth group did not moderate these effects. Relations were significantly reduced when controlling for expressive language. Thus, early language processing efficiency supports later expressive language abilities, which in turn supports developing pre-literacy skills. Processing speed and phonological awareness were also directly related, indicating an independent role for processing speed in literacy development. Mediation effects were not moderated by birth group, suggesting a similar developmental pathway in FT and PT children.

Comparing apples to manzanas and oranges to naranjas: A new measure of English-Spanish vocabulary for dual language learners.

The valid assessment of vocabulary development in dual-language-learning infants is critical to developmental science. We developed the Dual Language Learners English-Spanish (DLL-ES) Inventories to measure vocabularies of U.S. English-Spanish DLLs. The inventories provide translation equivalents for all Spanish and English items on Communicative Development Inventory (CDI) short forms; extended inventories based on CDI long forms; and Spanish language-variety options. Item-Response Theory analyses applied to Wordbank and Web-CDI data (n = 2603, 12-18 months; n = 6722, 16-36 months; half female; 1% Asian, 3% Black, 2% Hispanic, 30% White, 64% unknown) showed near-perfect associations between DLL-ES and CDI long-form scores. Interviews with 10 Hispanic mothers of 18- to 24-month-olds (2 White, 1 Black, 7 multi-racial; 6 female) provide a proof of concept for the value of the DLL-ES for assessing the vocabularies of DLLs.

Associations of Behavioral Problems and White Matter Properties of the Cerebellar Peduncles in Boys and Girls Born Full Term and Preterm.

Accumulating evidence suggests that the role of cerebellum includes regulation of behaviors; cerebellar impairment may lead to behavioral problems. Behavioral problems differ by sex: internalizing problems are more common in girls, externalizing problems in boys. Behavioral problems are also elevated in children born preterm (PT) compared to children born full term (FT). The current study examined internalizing and externalizing problems in 8-year-old children in relation to sex, birth-group, fractional anisotropy (FA) of the three cerebellar peduncles (superior, middle, and inferior), and interactions among these predictor variables. Participants (N = 78) were 44 boys (28 PT) and 34 girls (15 PT). We assessed behavioral problems via standardized parent reports and FA of the cerebellar peduncles using deterministic tractography. Internalizing problems were higher in children born PT compared to children born FT (p = .032); the interaction of sex and birth-group was significant (p = .044). When considering the contribution of the mean-tract FA of cerebellar peduncles to behavioral problems, there was a significant interaction of sex and mean-tract FA of the inferior cerebellar peduncle (ICP) with internalizing problems; the slope was negative in girls (p = .020) but not in boys. In boys, internalizing problems were only associated with mean-tract FA ICP in those born preterm (p = .010). We found no other significant associations contributing to internalizing or externalizing problems. Thus, we found sexual dimorphism and birth-group differences in the association of white matter metrics of the ICP and internalizing problems in school-aged children. The findings inform theories of the origins of internalizing behavioral problems in middle childhood and may suggest approaches to treatment at school age.

Spanish-speaking caregivers' use of referential labels with toddlers is a better predictor of later vocabulary than their use of referential gestures.

Variation in how frequently caregivers engage with their children is associated with variation in children's later language outcomes. One explanation for this link is that caregivers use both verbal behaviors, such as labels, and non-verbal behaviors, such as gestures, to help children establish reference to objects or events in the world. However, few studies have directly explored whether language outcomes are more strongly associated with referential behaviors that are expressed verbally, such as labels, or non-verbally, such as gestures, or whether both are equally predictive. Here, we observed caregivers from 42 Spanish-speaking families in the US engage with their 18-month-old children during 5-min lab-based, play sessions. Children's language processing speed and vocabulary size were assessed when children were 25 months. Bayesian model comparisons assessed the extent to which the frequencies of caregivers' referential labels, referential gestures, or labels and gestures together, were more strongly associated with children's language outcomes than a model with caregiver total words, or overall talkativeness. The best-fitting models showed that children who heard more referential labels at 18 months were faster in language processing and had larger vocabularies at 25 months. Models including gestures, or labels and gestures together, showed weaker fits to the data. Caregivers' total words predicted children's language processing speed, but predicted vocabulary size less well. These results suggest that the frequency with which caregivers of 18-month-old children use referential labels, more so than referential gestures, is a critical feature of caregiver verbal engagement that contributes to language processing development and vocabulary growth. RESEARCH HIGHLIGHTS: We examined the frequency of referential communicative behaviors, via labels and/or gestures, produced by caregivers during a 5-min play interaction with their 18-month-old children. We assessed predictive relations between labels, gestures, their combination, as well as total words spoken, and children's processing speed and vocabulary growth at 25 months. Bayesian model comparisons showed that caregivers' referential labels at 18 months best predicted both 25-month vocabulary measures, although total words also predicted later processing speed. Frequent use of referential labels by caregivers, more so than referential gestures, is a critical feature of communicative behavior that supports children's later vocabulary learning.

Investigating Relations between the NICU Speech Environment and Weight Gain in Infants Born Very Preterm.

OBJECTIVE: Children born preterm, especially those born very preterm (<32 weeks of gestational age [GA]) are at risk for poor growth and adverse neurodevelopmental outcomes. Adverse growth and neurodevelopmental outcomes in preterm children have been attributed, in part, to the aversive sounds and relative speech paucity of the neonatal intensive care unit (NICU). Experimental studies that directly expose preterm infants to speech sounds in the NICU find significant improvements in health factors relevant to neurodevelopment. Few studies have examined whether natural variations in the speech environment of the NICU are related to short-term health outcomes in preterm infants. Such data are important for optimizing the sound environment of the NICU. Our objective was to examine relations between the NICU speech environment and the rate of weight gain during hospitalization. STUDY DESIGN: Participants were infants born very preterm (n = 20). The speech environment of each infant was assessed at 32 to 36 weeks of postmenstrual age using an automatic speech-counting device. Average rates of weight gain (g/kg/d) were ascertained over the same period. Calories were derived from charted intake (kcals/kg/d). Linear regressions examined caloric intake and speech counts as predictors of infant weight gain. RESULTS: Infant weight gain was significantly predicted by caloric intake and speech exposure, each uniquely accounting for approximately 27% variance (total R 2 = 60.2%; p < 0.001). Speech counts were uncorrelated with rates of family visitation, time in incubator, or health acuity. CONCLUSION: While future research should establish causality and direction of effects, enhancing speech exposure in the NICU may be beneficial for physical growth. NICU care plans should consider opportunities to increase speech exposure. KEY POINTS: · Preterm infants who experienced greater amounts of speech in the NICU gained significantly more weight than preterm infants who were exposed to lower amounts of speech during the same developmental period (32-36 weeks of postmenstrual age).. · Caloric intake and speech counts accounted for almost 60% of variance in infant weight gain between 32 and 36 weeks of postmenstrual age.. · Speech counts were not significantly correlated with family visitation, how long infants resided in incubators, or health acuity.. · Findings suggest that the NICU speech environment may play an important role in the physical health of preterm infants; however, more studies are needed to determine the directionality of the observed associations..

The BabyView camera: Designing a new head-mounted camera to capture children's early social and visual environments.

Head-mounted cameras have been used in developmental psychology research for more than a decade to provide a rich and comprehensive view of what infants see during their everyday experiences. However, variation between these devices has limited the field's ability to compare results across studies and across labs. Further, the video data captured by these cameras to date has been relatively low-resolution, limiting how well machine learning algorithms can operate over these rich video data. Here, we provide a well-tested and easily constructed design for a head-mounted camera assembly-the BabyView-developed in collaboration with Daylight Design, LLC., a professional product design firm. The BabyView collects high-resolution video, accelerometer, and gyroscope data from children approximately 6-30 months of age via a GoPro camera custom mounted on a soft child-safety helmet. The BabyView also captures a large, portrait-oriented vertical field-of-view that encompasses both children's interactions with objects and with their social partners. We detail our protocols for video data management and for handling sensitive data from home environments. We also provide customizable materials for onboarding families with the BabyView. We hope that these materials will encourage the wide adoption of the BabyView, allowing the field to collect high-resolution data that can link children's everyday environments with their learning outcomes.

Peekbank: An open, large-scale repository for developmental eye-tracking data of children's word recognition.

The ability to rapidly recognize words and link them to referents is central to children's early language development. This ability, often called word recognition in the developmental literature, is typically studied in the looking-while-listening paradigm, which measures infants' fixation on a target object (vs. a distractor) after hearing a target label. We present a large-scale, open database of infant and toddler eye-tracking data from looking-while-listening tasks. The goal of this effort is to address theoretical and methodological challenges in measuring vocabulary development. We first present how we created the database, its features and structure, and associated tools for processing and accessing infant eye-tracking datasets. Using these tools, we then work through two illustrative examples to show how researchers can use Peekbank to interrogate theoretical and methodological questions about children's developing word recognition ability.

Accuracy of the Language Environment Analyses (LENATM) system for estimating child and adult speech in laboratory settings.

Laboratory observations are a mainstay of language development research, but transcription is costly. We test whether speech recognition technology originally designed for day-long contexts can be usefully applied to this use-case. We compared automated adult word and child vocalization counts from Language Environment Analysis (LENATM) to those of transcribers in 20-minute play sessions with Spanish-speaking dyads (n = 104) at 1;7 and 2;2. For adult words, results indicated moderate associations but large absolute differences. Associations for child vocalizations were weaker with larger absolute discrepancies. LENA has moderate potential to ease the burden of transcription in some research and clinical applications.

Language nutrition for language health in children with disorders: a scoping review.

The quantity and quality of child-directed speech-language nutrition-provided to typically-developing children is associated with language outcomes-language health. Limited information is available about child-directed speech to children at biological risk of language impairments. We conducted a scoping review on caregiver child-directed speech for children with three clinical conditions associated with language impairments-preterm birth, intellectual disability, and autism-addressing three questions: (1) How does child-directed speech to these children differ from speech to typically-developing children? (2) What are the associations between child-directed speech and child language outcomes? (3) How convincing are intervention studies that aim to improve child-directed speech and thereby facilitate children's language development? We identified 635 potential studies and reviewed 57 meeting study criteria. Child-directed speech to children with all conditions was comparable to speech to language-matched children; caregivers were more directive toward children with disorders. Most associations between child-directed speech and outcomes were positive. However, several interventions had minimal effects on child language. Trials with large samples, intensive interventions, and multiple data sources are needed to evaluate child-directed speech as a means to prevent language impairment. Clinicians should counsel caregivers to use high quality child-directed speech and responsive communication styles with children with these conditions.

Off to a good start: Early Spanish-language processing efficiency supports Spanish- and English-language outcomes at 4½ years in sequential bilinguals.

Many Latino children in the U.S. speak primarily Spanish at home with few opportunities for exposure to English before entering school. For monolingual children, the strongest early predictor of later school success is oral language skill developed before kindergarten. Less is known about how early oral language skills support later learning in sequential bilingual children. A question with wide-reaching significance is whether skill in a child's first language (L1) supports later learning in a second language (L2). In this longitudinal study of sequential Spanish-English bilinguals, we assessed oral language skills in Spanish at 2 years through parent reports of vocabulary size and children's real-time language processing efficiency (Accuracy, RT) in the 'looking-while-listening' (LWL) task. At 4½ years, we assessed language outcomes in both Spanish and English using standardized tests. Reported relative exposure to each language was significantly correlated with language outcomes in Spanish and English. Within-language relations were observed between Spanish vocabulary size and processing efficiency at 2 years and later Spanish-language outcomes. Critically, across-language relations were also observed: Children with stronger Spanish-language processing efficiency at 2 years had stronger English-language skills at 4½ years, controlling for socioeconomic status and exposure to English. Children's early language processing efficiency in Spanish is associated with stronger real-time information processing skills that support maintenance of Spanish and learning in English when these children enter school. These results support the recommendation that primarily Spanish-speaking families should engage in activities that promote children's Spanish-language skills while also seeking opportunities for children to be exposed to English.

Real-time lexical comprehension in young children learning American Sign Language.

When children interpret spoken language in real time, linguistic information drives rapid shifts in visual attention to objects in the visual world. This language-vision interaction can provide insights into children's developing efficiency in language comprehension. But how does language influence visual attention when the linguistic signal and the visual world are both processed via the visual channel? Here, we measured eye movements during real-time comprehension of a visual-manual language, American Sign Language (ASL), by 29 native ASL-learning children (16-53 mos, 16 deaf, 13 hearing) and 16 fluent deaf adult signers. All signers showed evidence of rapid, incremental language comprehension, tending to initiate an eye movement before sign offset. Deaf and hearing ASL-learners showed similar gaze patterns, suggesting that the in-the-moment dynamics of eye movements during ASL processing are shaped by the constraints of processing a visual language in real time and not by differential access to auditory information in day-to-day life. Finally, variation in children's ASL processing was positively correlated with age and vocabulary size. Thus, despite competition for attention within a single modality, the timing and accuracy of visual fixations during ASL comprehension reflect information processing skills that are important for language acquisition regardless of language modality.

White matter properties associated with pre-reading skills in 6-year-old children born preterm and at term.

AIM: To assess associations between white matter properties and pre-reading skills (phonological awareness and receptive and expressive language) in children born preterm and at term at the onset of reading acquisition. METHOD: Six-year-old children born preterm (n=36; gestational age 22-32wks) and at term (n=43) underwent diffusion magnetic resonance imaging and behavioural assessments. Tracts were selected a priori based on findings from a study of 6-year-old children born at term: the left-hemisphere arcuate fasciculus and superior longitudinal fasciculus, and right-hemisphere uncinate fasciculus. Using linear regression, we assessed associations between fractional anisotropy of tracts and phonological awareness and receptive and expressive language scores. We investigated whether associations were moderated by prematurity. RESULTS: Fractional anisotropy of the left-hemisphere arcuate fasciculus contributed unique variance to phonological awareness across birth groups. The association between fractional anisotropy of the right-hemisphere uncinate fasciculus and receptive and expressive language was significantly moderated by prematurity. INTERPRETATION: A left-hemisphere tract was associated with phonological awareness in both birth groups. A right-hemisphere tract was associated with language only in the term group, suggesting that expressive and receptive language is mediated by different white matter pathways in 6-year-old children born preterm. These findings provide novel insights into similarities and differences of the neurobiology of pre-reading skills between children born preterm and at term at reading onset. WHAT THIS PAPER ADDS: White matter properties and pre-reading abilities were associated in children born preterm at the onset of reading. The neurobiology of phonological awareness was similar in children born preterm versus children born at term at 6 years. The neurobiology of language was different in children born preterm versus children born at term at 6 years.

Caregiver Talk and Medical Risk as Predictors of Language Outcomes in Full Term and Preterm Toddlers.

This study examined associations between caregiver talk and language skills in full term (FT) and preterm (PT) children (n = 97). All-day recordings of caregiver-child interactions revealed striking similarities in amount of caregiver talk heard by FT and PT children. Children who heard more caregiver talk at 16 months demonstrated better knowledge- and processing-based language skills at 18 months. The unique contributions of caregiver talk were tempered by medical risk in PT children, especially for processing speed. However, there was no evidence that birth status or medical risk moderated the effects of caregiver talk. These findings highlight the role of caregiver talk in shaping language outcomes in FT and PT children and offer insights into links between neurodevelopmental risk and caregiver-child engagement.

Validity of caregiver-report measures of language skill for Wolof-learning infants and toddlers living in rural African villages.

Valid indigenous language assessments are needed to further our understanding of how children learn language around the world. We assessed the psychometric properties and performance of two caregiver-report measures of Wolof language skill (language milestones achieved and vocabulary knowledge) for 500 children (ages 0;4 to 2;6) living in rural Senegal. Item response models (IRM) evaluated instrument- and item-level performance and differential function by gender. Both caregiver-report measures had good psychometric properties and displayed expected age and socioeconomic effects. Modest concurrent validity was found by comparing the caregiver-report scores to transcribed child language samples from a naturalistic play session. The caregiver-report method offers a valid alternative to more costly tools, such as direct behavioral assessments or language sampling, for measuring early language development in non-literate, rural African communities. Recommendations are made to further improve the performance of caregiver-report measures of child language skill in these settings.

Using Eye Movements to Assess Language Comprehension in Toddlers Born Preterm and Full Term.

OBJECTIVE: To assess language skills in children born preterm and full term by the use of a standardized language test and eye-tracking methods. STUDY DESIGN: Children born ≤32 weeks' gestation (n = 44) were matched on sex and socioeconomic status to children born full term (n = 44) and studied longitudinally. The Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) were administered at 18 months (corrected for prematurity as applicable). The Looking-While-Listening Task (LWL) simultaneously presents 2 pictures and an auditory stimulus that directs the child's attention to one image. The pattern of eye movements reflects visual processing and the efficiency of language comprehension. Children born preterm were evaluated on LWL 3 times between 18 and 24 months. Children born full term were evaluated at ages corresponding to chronological and corrected ages of their preterm match. Results were compared between groups for the BSID-III and 2 LWL measures: accuracy (proportion of time looking at target) and reaction time (latency to shift gaze from distracter to target). RESULTS: Children born preterm had lower BSID-III scores than children born full term. Children born preterm had poorer performance than children born full term on LWL measures for chronological age but similar performance for corrected age. Accuracy and reaction time at 18 months' corrected age displaced preterm-full term group membership as significant predictors of BSID-III scores. CONCLUSIONS: Performance and rate of change on language comprehension measures were similar in children born preterm and full term compared at corrected age. Individual variation in language comprehension efficiency was a robust predictor of scores on a standardized language assessment in both groups.

Caregiver talk to young Spanish-English bilinguals: comparing direct observation and parent-report measures of dual-language exposure.

In research on language development by bilingual children, the early language environment is commonly characterized in terms of the relative amount of exposure a child gets to each language based on parent report. Little is known about how absolute measures of child-directed speech in two languages relate to language growth. In this study of 3-year-old Spanish-English bilinguals (n = 18), traditional parent-report estimates of exposure were compared to measures of the number of Spanish and English words children heard during naturalistic audio recordings. While the two estimates were moderately correlated, observed numbers of child-directed words were more consistently predictive of children's processing speed and standardized test performance, even when controlling for reported proportion of exposure. These findings highlight the importance of caregiver engagement in bilingual children's language outcomes in both of the languages they are learning.

Wordbank: an open repository for developmental vocabulary data.

The MacArthur-Bates Communicative Development Inventories (CDIs) are a widely used family of parent-report instruments for easy and inexpensive data-gathering about early language acquisition. CDI data have been used to explore a variety of theoretically important topics, but, with few exceptions, researchers have had to rely on data collected in their own lab. In this paper, we remedy this issue by presenting Wordbank, a structured database of CDI data combined with a browsable web interface. Wordbank archives CDI data across languages and labs, providing a resource for researchers interested in early language, as well as a platform for novel analyses. The site allows interactive exploration of patterns of vocabulary growth at the level of both individual children and particular words. We also introduce wordbankr, a software package for connecting to the database directly. Together, these tools extend the abilities of students and researchers to explore quantitative trends in vocabulary development.

Using Parent Report to Measure Vocabulary in Young Bilingual Children: A Scoping Review.

A large number of children are exposed to more than one language. One well-established method of assessing early vocabulary development in monolingual children is parent report; however, its use in bilingual/multilingual contexts is less established and brings unique challenges. In this methodological scoping review, we reviewed studies of early vocabulary development using parent report with bilingual/multilingual children (January 1980-March 2022). A total of 576 articles were screened, yielding 101 studies for analysis. The number of studies on bilingual/multilingual vocabulary has grown in the last two decades; yet representation of the world's languages remains sparse. The majority of studies assessed bilingual/multilingual children's vocabulary in each language and used instruments adapted for linguistic and cultural characteristics. However, the field could benefit from standardized reporting practices regarding definitions of bi/multilingualism, selection of reporters, and tool development and is in critical need of studies that develop, validate, and norm parent report instruments specifically for the bilingual/multilingual case.