Prelinguistic communication complexity predicts expressive language in initial minimally verbal autistic children.

BACKGROUND: Prelinguistic communication complexity refers to the use of different communication forms such as eye gaze, gestures and vocalisations and the degree to which these forms are coordinated and how directed to a communication partner. To date, little is known about the relationship between prelinguistic communication complexity and expressive language in minimally verbal autistic children. AIMS: To test the hypothesis that prelinguistic communication complexity predicts expressive language 12 months later in autistic children and explore whether there are any differences in specific prelinguistic intentional communicative behaviours that are related to later expressive language levels. METHODS & PROCEDURES: This longitudinal study examined 37 minimally verbal autistic children (29-71 months old). The Communication Complexity Scale (CCS) was used to measure participants' prelinguistic communication behaviours, which were extracted from a semi-structured play interaction at Time 1. The Chinese Communicative Development Inventory (CCDI) was used to examine participants' expressive language at Time 1 and Time 2 (12 months later). According to Time 2 vocabulary size, participants were divided into two groups: Low CCDI, between 0 and 62 words, and High CCDI, more than 100 words. Linear regression was used to examine the relationship between early prelinguistic communication complexity and later expressive language. Binary logistic regression was used to determine which of the early communication behaviours were uniquely significantly related to later expressive language levels. OUTCOMES & RESULTS: There was a significant positive relationship between prelinguistic communication complexity and expressive language 12 months later, even after controlling for age and concurrent language. Findings revealed a group difference in the frequency of gesture and vocalisation combinations between the Low and High CCDI groups at Time 1. Gesture-vocalisation combinations also predicted better expressive language levels at Time 2. CONCLUSIONS & IMPLICATIONS: Our findings suggest that it may be beneficial to incorporate different complex communication behaviours into prelinguistic intervention targets for minimally verbal autistic children. The CCS hierarchies can be used as a reference for the intervention goals of minimally verbal autistic children. These findings highlight the importance of targeting gesture and vocalisation combinations when autistic children transition from single prelinguistic communication behaviours to multimodal behaviours. WHAT THIS PAPER ADDS: What is already known on this subject Children use eye gaze, gestures and vocalisations to communicate with others before they learn spoken language. There is strong evidence suggest that the frequency of prelinguistic communication predicts later linguistic achievements in autistic children. However, less is known about whether prelinguistic communication complexity also predicts later language and which specific behaviours are most predictive of language outcomes. What this study adds Minimally verbal autistic children who exhibit more complex prelinguistic communication behaviours have better expressive language 12 months later. Gestures combined with vocalisations predict better expressive language in minimally verbal autistic children. What are the clinical implications of this work? When identifying intervention targets for minimally verbal autistic children, the clinicians may reference the prelinguistic communication behaviours from the CCS. The gesture and vocalisation combinations are the key behaviours when targets transit from single form to two-form behaviours.

Language Skills Influence Transition Planning in Adolescents With Fragile X Syndrome.

Individuals with fragile X syndrome (FXS) and their parents have a range of experiences navigating the crucial transition period between adolescence and adulthood. Semistructured interviews of 47 mothers of adolescents with FXS (mean child age = 15.89 years) were analyzed to identify mothers' changing expectations during the adolescent period and parent goals related to work and postsecondary education. Mothers' work and education goals were explored in relation to child factors such as language skills and autism characteristics. Lower language skills were associated with lower likelihood of reporting vocational goals. Results suggest that adolescents with FXS with lower language ability are less likely to have vocational plans for adulthood during this critical period and may need greater transition planning assistance.

Exploring individual differences in musical rhythm and grammar skills in school-aged children with typically developing language.

A growing number of studies have shown a connection between rhythmic processing and language skill. It has been proposed that domain-general rhythm abilities might help children to tap into the rhythm of speech (prosody), cueing them to prosodic markers of grammatical (syntactic) information during language acquisition, thus underlying the observed correlations between rhythm and language. Working memory processes common to task demands for musical rhythm discrimination and spoken language paradigms are another possible source of individual variance observed in musical rhythm and language abilities. To investigate the nature of the relationship between musical rhythm and expressive grammar skills, we adopted an individual differences approach in N = 132 elementary school-aged children ages 5-7, with typical language development, and investigated prosodic perception and working memory skills as possible mediators. Aligning with the literature, musical rhythm was correlated with expressive grammar performance (r = 0.41, p < 0.001). Moreover, musical rhythm predicted mastery of complex syntax items (r = 0.26, p = 0.003), suggesting a privileged role of hierarchical processing shared between musical rhythm processing and children's acquisition of complex syntactic structures. These relationships between rhythm and grammatical skills were not mediated by prosodic perception, working memory, or non-verbal IQ; instead, we uncovered a robust direct effect of musical rhythm perception on grammatical task performance. Future work should focus on possible biological endophenotypes and genetic influences underlying this relationship.

Using Motor Tempi to Understand Rhythm and Grammatical Skills in Developmental Language Disorder and Typical Language Development.

Children with developmental language disorder (DLD) show relative weaknesses on rhythm tasks beyond their characteristic linguistic impairments. The current study compares preferred tempo and the width of an entrainment region for 5- to 7-year-old typically developing (TD) children and children with DLD and considers the associations with rhythm aptitude and expressive grammar skills in the two populations. Preferred tempo was measured with a spontaneous motor tempo task (tapping tempo at a comfortable speed), and the width (range) of an entrainment region was measured by the difference between the upper (slow) and lower (fast) limits of tapping a rhythm normalized by an individual's spontaneous motor tempo. Data from N = 16 children with DLD and N = 114 TD children showed that whereas entrainment-region width did not differ across the two groups, slowest motor tempo, the determinant of the upper (slow) limit of the entrainment region, was at a faster tempo in children with DLD vs. TD. In other words, the DLD group could not pace their slow tapping as slowly as the TD group. Entrainment-region width was positively associated with rhythm aptitude and receptive grammar even after taking into account potential confounding factors, whereas expressive grammar did not show an association with any of the tapping measures. Preferred tempo was not associated with any study variables after including covariates in the analyses. These results motivate future neuroscientific studies of low-frequency neural oscillatory mechanisms as the potential neural correlates of entrainment-region width and their associations with musical rhythm and spoken language processing in children with typical and atypical language development.

Child language and autism diagnosis impact hierarchical temporal structure of parent-child vocal interactions in early childhood.

Timing is critical to successful social interactions. The temporal structure of dyadic vocal interactions emerges from the rhythm, timing, and frequency of each individuals' vocalizations and reflects how the dyad dynamically organizes and adapts during an interaction. This study investigated the temporal structure of vocal interactions longitudinally in parent-child dyads of typically developing (TD) infants (n = 49; 9-18 months; 48% male) and toddlers with ASD (n = 23; 27.2 ± 5.0 months; 91.3% male) to identify how developing language and social skills impact the temporal dynamics of the interaction. Acoustic hierarchical temporal structure (HTS), a measure of the nested clustering of acoustic events across multiple timescales, was measured in free play interactions using Allan Factor. HTS reflects a signal's temporal complexity and variability, with greater HTS indicating reduced flexibility of the dyadic system. Child expressive language significantly predicted HTS (ß = -0.2) longitudinally across TD infants, with greater dyadic HTS associated with lower child language skills. ASD dyads exhibited greater HTS (i.e., more rigid temporal structure) than nonverbal matched (d = 0.41) and expressive language matched TD dyads (d = 0.28). Increased HTS in ASD dyads occurred at timescales >1 s, suggesting greater structuring of pragmatic aspects of interaction. Results provide a new window into how language development and social reciprocity serve as constraints to shape parent-child interaction dynamics and showcase a novel automated approach to characterizing vocal interactions across multiple timescales during early childhood.

Infants' neural speech discrimination predicts individual differences in grammar ability at 6 years of age and their risk of developing speech-language disorders.

The 'sensitive period' for phonetic learning posits that between 6 and 12 months of age, infants' discrimination of native and nonnative speech sounds diverge. Individual differences in this dynamic processing of speech have been shown to predict later language acquisition up to 30 months of age, using parental surveys. Yet, it is unclear whether infant speech discrimination could predict longer-term language outcome and risk for developmental speech-language disorders, which affect up to 16 % of the population. The current study reports a prospective prediction of speech-language skills at a much later age-6 years-old-from the same children's nonnative speech discrimination at 11 months-old, indexed by MEG mismatch responses. Children's speech-language skills at 6 were comprehensively evaluated by a speech-language pathologist in two ways: individual differences in spoken grammar, and the presence versus absence of speech-language disorders. Results showed that the prefrontal MEG mismatch response at 11 months not only significantly predicted individual differences in spoken grammar skills at 6 years, but also accurately identified the presence versus absence of speech-language disorders, using a machine-learning classification. These results represent new evidence that advance our theoretical understanding of the neurodevelopmental trajectory of language acquisition and early risk factors for developmental speech-language disorders.

Using the Ecological Validity Model to adapt parent-involved interventions for children with Autism Spectrum Disorder in the Latinx community: A conceptual review.

BACKGROUND: Parent involvement in interventions for children with Autism Spectrum Disorder (ASD) provides parents with education about ASD diagnosis and treatment, improves parent-child interactions, and offers access to cost-effective resources. The Latinx population represents the fastest growing minority population in the United States and a growing percentage of children seeking ASD intervention services. AIMS: Identify factors that impact Latinx parent involvement in interventions for children with ASD as an example of cultural considerations for diverse families and communities. METHODS AND PROCEDURES: In this conceptual overview, we synthesize literature on cultural considerations for intervention design/adaptation for Latinx families and parent involvement in interventions for children with ASD through the lens of the Ecological Validity Model. OUTCOMES AND RESULTS: Frameworks such as the Ecological Validity Model can be used when creating or adapting interventions for specific cultural groups. Parent-involved interventions for children with ASD in the Latinx community should consider language of intervention delivery, family make-up, community support, disability knowledge of the family, the therapeutic alliance, and methods of implementation. CONCLUSIONS AND IMPLICATIONS: Incorporating cultural components into parent-involved interventions will best support intervention implementation and dissemination in diverse communities. Research is needed into the process and outcomes of intervention programs in order to increase understanding of how specific cultural dimensions impact participation in and efficacy of parent-involved interventions for Latinx families of children with ASD.

Parental Responsiveness During Musical and Non-Musical Engagement in Preschoolers with ASD.

BACKGROUND: Parent-child play interactions offer an important avenue for supporting social development in children with autism spectrum disorder (ASD). Musical play is a natural and ubiquitous form of parent-child play. As a familiar, reinforcing, and predictable activity, musical play may support parent-child interactions by scaffolding children's attention to the play activities, while also providing parents with a familiar and accessible context to promote parental responsiveness. However, musical play may also impede interactions due to its sensory and repetitive components. METHOD: 12 parent-child dyads of preschoolers with ASD were video-recorded during a ten-minute play session that included musical and non-musical toys. Interactions were coded for parent and child musical engagement, as well as parental responsiveness. RESULTS: Parent-child dyads varied in their amount of musical engagement during play, which was not related to children's language level. Overall, parents showed similar levels of responsiveness to children's play across musical and non-musical activities, but type of parental responsiveness differed depending on the play context. Parents provided significantly more physical play responses and significantly fewer verbal responses during musical vs. non-musical engagement with their child. CONCLUSIONS: There are substantial individual differences in children with ASD's musical engagement during a parent-child free play. Children's musical engagement impacted type of parental responsiveness, which may relate to the familiarity, accessibility, and sensory nature of musical play/toys. Results suggest that musical play/toys can both support and hinder different types of parental responsiveness with implications for incorporation of musical activities into interventions.

Automated Phenotyping Tool for Identifying Developmental Language Disorder Cases in Health Systems Data (APT-DLD): A New Research Algorithm for Deployment in Large-Scale Electronic Health Record Systems.

Purpose Data mining algorithms using electronic health records (EHRs) are useful in large-scale population-wide studies to classify etiology and comorbidities (Casey et al., 2016). Here, we apply this approach to developmental language disorder (DLD), a prevalent communication disorder whose risk factors and epidemiology remain largely undiscovered. Method We first created a reliable system for manually identifying DLD in EHRs based on speech-language pathologist (SLP) diagnostic expertise. We then developed and validated an automated algorithmic procedure, called, Automated Phenotyping Tool for identifying DLD cases in health systems data (APT-DLD), that classifies a DLD status for patients within EHRs on the basis of ICD (International Statistical Classification of Diseases and Related Health Problems) codes. APT-DLD was validated in a discovery sample (N = 973) using expert SLP manual phenotype coding as a gold-standard comparison and then applied and further validated in a replication sample of N = 13,652 EHRs. Results In the discovery sample, the APT-DLD algorithm correctly classified 98% (concordance) of DLD cases in concordance with manually coded records in the training set, indicating that APT-DLD successfully mimics a comprehensive chart review. The output of APT-DLD was also validated in relation to independently conducted SLP clinician coding in a subset of records, with a positive predictive value of 95% of cases correctly classified as DLD. We also applied APT-DLD to the replication sample, where it achieved a positive predictive value of 90% in relation to SLP clinician classification of DLD. Conclusions APT-DLD is a reliable, valid, and scalable tool for identifying DLD cohorts in EHRs. This new method has promising public health implications for future large-scale epidemiological investigations of DLD and may inform EHR data mining algorithms for other communication disorders. Supplemental Material https://doi.org/10.23641/asha.12753578.