Narrative skills and language comprehension in preschool children with cochlear implants: A comparison with children with Developmental Language Disorder or typical development.

INTRODUCTION: The narrative skills of children with cochlear implants (CIs) are fragile, but the factors at play and whether these difficulties could be similar to those detected in language impairment are not clear. The present study aims to assess, at the microstructural level, narrative skills, comparing children with CIs with children with Developmental Language Disorder (DLD) or Typical Development (TD). Furthermore, the relationship between verbal (lexical and morphosyntactic) comprehension and narrative skills across groups is investigated. METHODS: The narratives of 19 children with CIs (Mage = 62.42 months, SD = 6.83), 13 children with DLD (Mage = 65.38 months, SD = 4.27), and 18 preschool children with TD (Mage = 63.67 months, SD = 4.31) were assessed in a standardized task. Articles, prepositions, pronouns, gender and number agreement, accuracy in the use of verbs, and number of arguments in each sentence were analysed. Lexical and morphosyntactic comprehension were also assessed. Performance was compared across groups using ANOVAs or Kruskal-Wallis tests. The role of lexical and morphosyntactic comprehension in predicting each morphological and syntactic element in the narrative task was examined using linear regressions. RESULTS: Data analysis showed that both children with CIs and DLD had fragilities in narration, both in the morphological and syntactic components. Although some differences between children with CIs and those with DLD emerged in descriptive analyses, these were not statistically significant. Regressions showed that morphosyntactic comprehension predicted the number of pronouns produced only in the TD group. CONCLUSIONS: The scarce differences between CI and DLD groups and the absence of an effect of morphosyntactic comprehension on pronoun production may be due to their low production of these elements in the narrative task and/or to a difficulty in managing pronouns in an expressive task regardless of their ability to comprehend them. Potential implications of these results are discussed.

I-MovE. An intervention to promote movement at childcare centers: Benefits for motor cognitive and socio-emotional development.

The present contribution aimed to analyze the effects of a motor program intervention (i.e., I-MovE intervention) implemented indoors and outdoors at nursery school, on children's motor, socio-emotional, and cognitive skills. The study uses a non-randomized pre-post test design. Participants were children attending twenty nursery schools in the North of Italy. The intervention activities were adapted to age: Level 1 activities were addressed to children between 6 and 12 months, and Level 2 activities were addressed to children between 13 and 43 months. Within each level, one group of children developed the intervention indoors (IN-group; Level 1: n = 10; Level 2: n = 104) and another group developed the intervention outdoors (OUT-Group; Level 1: n = 12; Level 2: n = 66). Finally, one additional group was involved as the control group (CONT-Group; Level 1: n = 15; Level 2: n = 98). Children's motor, cognitive, and socio-emotional skills were assessed before and after the intervention by nursery school teachers. The main results showed that the motor intervention promoted children's motor skills development in both groups (i.e., groups implementing Levels 1 and 2 activities) and the cognitive and socio-emotional skills in the older group (i.e., group implementing Level 2 activities), especially the group that performed the intervention outdoors.

Competing views on interventions for pragmatic language skills in persons with pragmatic language impairment: An umbrella review.

This umbrella review aimed to evaluate the effectiveness of pragmatic language interventions and existing competing views in improving pragmatic language skills in persons with pragmatic language impairment (PLI). A comprehensive search was conducted to identify qualitative and quantitative systematic reviews that included diagnostic criteria, features, development and course, risk and prognostic factors, differential diagnosis of PLI, and existing interventions, views, and arguments to improve the pragmatic language abilities/skills of persons with PLI. Syntheses were critically appraised by two independent reviewers using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. This umbrella review was registered with PROSPERO on 9th December 2022 under the registration number CRD42022378690. Out of 3,609 studies, 42 reviews were included in this umbrella review. The extracted findings were categorized based on theoretical intervention perspectives, which included behavioral, social-pragmatic, and cognitive-linguistic approaches. The studies revealed that pragmatic language interventions had a positive impact on improving pragmatic language skills in persons with PLI. However, competing views on pragmatic language interventions were also identified, suggesting the need for a more comprehensive approach that includes both behavioral and cognitive-linguistic components. In conclusion, cognitive-linguistic approach was the most documented intervention method, and suiting intervention methods to the complex nature of PLI is crucial. The documented intervention methods reflected competing views on the nature of PLI, highlighting the need for tailored interventions.

The Language ENvironment Analysis system (LENA): A validation study with Italian-learning children.

This study is a validation of the LENA system for the Italian language. In Study 1, to test LENA's accuracy, seventy-two 10-minute samples extracted from daylong LENA recordings were manually transcribed for 12 children longitudinally observed at 1;0 and 2;0. We found strong correlations between LENA and human estimates in the number of Adult Word Count (AWC) and Child Vocalisations Count (CVC) and a weak correlation between LENA and human estimates in Conversational Turns Count (CTC). In Study 2, to test the concurrent validity, direct and indirect language measures were considered on a sample of 54 recordings (19 children). Correlational analyses showed that LENA's CVC and CTC were significantly related to the children's vocal production, a parent report measure of prelexical vocalizations and the vocal reactivity scores. These results confirm that the automatic analyses performed by the LENA device are reliable and powerful for studying language development in Italian-speaking infants.

Examining pragmatic language development in preschoolers with and without neurodevelopmental disorders: A cross-sectional study.

This cross-sectional study examined the relationship between gender, age, and pragmatic language development in n = 77 Italian preschool children (49-84 months) with and without neurodevelopmental disorders. The sample included 62 children without psychiatric history (n = 34 females, n = 27 males) and n = 15 children with psychiatric history (2 females, n = 13 males). Eight cases (n = 6 males, n = 2 females, 59-75 months) were matched for age and gender. The neurodevelopmental disorder group used the Targeted Observation of Pragmatics in Children's Conversations (TOPICC) tool. Pragmatic language skills were assessed with the Pragmatic Language Abilities (APL), Children's Communication Checklist-Version 2 (CCC-2), and TOPICC scales. Results showed no significant relationship between gender and pragmatic language development subscales, except for a marginally significant relationship with figurative metaphor scores. Age was positively correlated with verbal metaphor, metaphor, implied meaning, and overall pragmatic language skills, but not with figurative metaphor or situations scores. Paired samples t-tests and Wilcoxon tests compared matched groups, revealing significant differences between children with and without neurodevelopmental disorders on the TOPICC, APL, and CCC-2 tools. The findings highlight the importance of early identification and intervention for children with pragmatic language impairment (PLI) and the need for further research with larger samples.

Infant looking preferences towards dynamic faces: A systematic review.

Although the pattern of visual attention towards the region of the eyes is now well-established for infants at an early stage of development, less is known about the extent to which the mouth attracts an infant's attention. Even less is known about the extent to which these specific looking behaviours towards different regions of the talking face (i.e., the eyes or the mouth) may impact on or account for aspects of language development. The aim of the present systematic review is to synthesize and analyse (i) which factors might determine different looking patterns in infants during audio-visual tasks using dynamic faces and (ii) how these patterns have been studied in relation to aspects of the baby's development. Four bibliographic databases were explored, and the records were selected following specified inclusion criteria. The search led to the identification of 19 papers (October 2021). Some studies have tried to clarify the role played by audio-visual support in speech perception and early production based on directly related factors such as the age or language background of the participants, while others have tested the child's competence in terms of linguistic or social skills. Several hypotheses have been advanced to explain the selective attention phenomenon. The results of the selected studies have led to different lines of interpretation. Some suggestions for future research are outlined.

Vocabulary production in toddlers from low-income immigrant families: evidence from children exposed to Romanian-Italian and Nigerian English-Italian.

The relationship between first and second language in early vocabulary acquisition in bilingual children is still debated in the literature. This study compared the expressive vocabulary of 39 equivalently low-SES two-year-old bilingual children from immigrant families with different heritage languages (Romanian vs. Nigerian English) and the same majority language (Italian). Vocabulary size, vocabulary composition and translation equivalents (TEs) were assessed using the Italian/L1 versions of the CDI. Higher vocabulary in Italian than in the heritage language emerged in both groups. Moreover, Romanian-Italian-speaking children produced higher proportions of TEs than Nigerian English-Italian-speaking children, suggesting that L1-L2 phonological similarity facilitates the acquisition of cross-linguistic synonyms.

Do motor skills impact on language development between 18 and 30 months of age?

Despite recent evidence on the relation between motor development and language development in infancy, this relation is still little explored in the late second and third year. This study investigated whether gross and/or fine motor skills affect language outcomes in this age range and whether any such effects narrow over time to specific language categories related to motor experience, such as spatial vocabulary. Thirty-six Italian monolingual toddlers (58% girls) participated, divided into two groups based on their age. They were assessed twice: the younger group at 18 (Time-1) and 24 months (Time-2); the older group at 24 (Time-1) and 30 months (Time-2). At Time-1 motor and language abilities were measured using the Griffiths Mental Development Scales. At Time-2, only language outcomes (three vocabularies: nouns, predicates, and spatial terms) were assessed, using the Picture Naming Game-PiNG. Hierarchical linear regressions show that motor skills affect language abilities also in the late second and third year, but the impact varies according to the type of motor skills (gross vs. fine) and children's age. At 18 months, controlling for linguistic abilities, a global score of gross motor skills predicted predicate production, and a specific gross-motor coordination skill: general dynamic coordination (GDC) predicted noun production at 24 months. At 24 months, controlling for linguistic abilities, GDC predicted predicate production, and a combination of fine- and gross-motor coordination skills (bilateral coordination and GDC) predicted spatial vocabulary comprehension at 30 months. Overall, results suggest that the relation between motor and language development is not simple or stable over time, but rather dynamic.

Tell Me about Loneliness: Interviews with Young People about What Loneliness Is and How to Cope with It.

BACKGROUND: loneliness is a common experience for adolescents, yet the voices of adolescents are missing from current conceptualisations of loneliness. That means, measures that have been created based on current conceptualisations may miss important contexts of adolescence, such as the roles of friendships, that determine the way loneliness is experienced. The current study aims to centre adolescent voices to identify how they conceptualise loneliness and what strategies they consider to be useful for adolescents to cope with loneliness. METHOD: thematic framework analysis (TFA) was conducted on qualitative interviews with young people aged 8-14 years in Belgium and Italy to identify salient themes in their conceptualisations of loneliness. RESULTS: Loneliness was conceptualised as a negative emotional state involving negative thinking patterns that occurs when an individual perceives they are missing out on a desired aspect in their social relationships. Coping strategies related to alleviating negative affect, and aiding social reconnection. CONCLUSIONS: friendships with peers were understood to be central to adolescent loneliness experiences. In line with that, loneliness was seen to be experienced at school. Age-related differences in friendship expectations were identified, highlighting how developmental needs relate to the loneliness experience.

Do Acoustic Environment Characteristics Affect the Lexical Development of Children With Cochlear Implants? A Longitudinal Study Before and After Cochlear Implant Activation.

Purpose This study investigates the acoustic environment of children with cochlear implants (CIs) and the relationship between exposure to speech, in noise and in quiet, and the children's lexical production up to 1 year after CI activation, while controlling for the effect of early individual differences in receptive vocabulary growth. Method Eighteen children with CIs were observed at 3, 6, and 12 months after CI activation. Children's spontaneous word production during interaction with their mothers (types and tokens) and their expressive and receptive vocabulary size were considered. The characteristics of the acoustic environments in terms of acoustic scenes (speech in noise or in quiet, quiet, noise, music, and other) and of loudness ranges were assessed using data logging of the children's devices. Results Data analysis showed that both the number of tokens and the number of types produced 1 year after CI activation were affected by the children's exposure to speech in quiet with a loudness range between 40 and 69 dB. Expressive vocabulary size and types were affected by the receptive vocabulary knowledge that the children achieved over the first 3 months after CI activation. Conclusions Our data support the role of speech environment and individual differences in early comprehension on lexical production. The importance of exposure to speech with particular characteristics for the lexical development of children with CIs and the implications for clinical practice are discussed.

Home Language Activities and Expressive Vocabulary of Toddlers from Low-SES Monolingual Families and Bilingual Immigrant Families.

Children from low-SES (socioeconomic status) and minority language immigrant families are at risk of vocabulary difficulties due to the less varied and complex language in the home environment. Children are less likely to be involved in home language activities (HLA) in interaction with adults in low-SES than in higher-SES families. However, few studies have investigated the HLA variability among low-SES, minority language bilingual immigrant families. This longitudinal study analyzes the frequency and duration of HLA and their predictive roles for expressive vocabulary acquisition in 70 equivalent low-SES monolingual and bilingual toddlers from minority contexts. HLA and vocabulary were assessed at 24 and 30 months in the majority language (Italian) and in total (majority+minority language) using parent and teacher reports. The frequency and duration of HLA in interaction with adults in total, but not in the majority language, at 24 months were similar for the two groups. These activities uniquely accounted for expressive vocabulary at 30 months, after accounting for total vocabulary at 24 months, in both groups. In conclusion, a minority-majority language context is not an additional risk factor for vocabulary acquisition if HLA is considered in interaction with adults in both languages. HLA are proximal environmental protective factors for vocabulary acquisition.

Preverbal Production and Early Lexical Development in Children With Cochlear Implants: A Longitudinal Study Following Pre-implanted Children Until 12 Months After Cochlear Implant Activation.

Studies have shown that children vary in the trajectories of their language development after cochlear implant (CI) activation. The aim of the present study is to assess the preverbal and lexical development of a group of 20 Italian-speaking children observed longitudinally before CI activation and at three, 6 and 12 months after CI surgery (mean age at the first session: 17.5 months; SD: 8.3; and range: 10-35). The group of children with CIs (G-CI) was compared with two groups of normally-hearing (NH) children, one age-matched (G-NHA; mean age at the first session: 17.4 months; SD: 8.0; and range: 10-34) and one language-matched (G-NHL; n = 20; mean age at the first session: 11.2 months; SD: 0.4; and range: 11-12). The spontaneous interactions between children and their mothers during free-play were transcribed. Preverbal babbling production and first words were considered for each child. Data analysis showed significant differences in babbling and word production between groups, with a lower production of words in children with CIs compared to the G-NHA group and a higher production of babbling compared to the G-NHL children. Word production 1 year after activation was significantly lower for the children with CIs than for language-matched children only when maternal education was controlled for. Furthermore, latent class growth analysis showed that children with CIs belonged mainly to classes that exhibited a low level of initial production but also progressive increases over time. Babbling production had a statistically significant effect on lexical growth but not on class membership, and only for groups showing slower and constant increases. Results highlight the importance of preverbal vocal patterns for later lexical development and may support families and speech therapists in the early identification of risk and protective factors for language delay in children with CIs.

Mothers' emotional experiences related to their child's diagnosis of deafness and cochlear implant surgery: Parenting stress and child's language development.

OBJECTIVES: The present study aims to assess the emotional experiences, specifically parenting stress, of mothers of children with cochlear implants (CIs), and their children's language development before surgery and at three and six months after CI activation. METHODS: Twenty mothers of children with CIs were interviewed before their children's surgery about their experiences in connection with the diagnosis of deafness, the surgery and the activation of the CI. The Parenting Stress Index questionnaire and the MacArthur-Bates-Communication Development Inventory were administered before the surgery and at 3 and 6 months after the CI activation. RESULTS: Analysis of the qualitative data resulting from the interviews showed that the mothers' emotional experiences before the CI surgery were complex. Mothers reported both positive and negative emotions related to deafness, diagnosis and surgery, benefits of the CI, coping strategies and future expectations. The mothers of children with more advanced lexical production six months after CI activation displayed a high frequency of themes related to positive emotions, thoughts and coping strategies before the surgery. Distress on the part of the mothers, perceptions of difficulties in their child and instances of parent-child dysfunctional interaction were negatively and significantly related to the child's language and communication development. CONCLUSIONS: The findings support the importance of assessing the mother's emotional experience in relation to diagnosis and CI activation before the surgery. IMPLICATIONS FOR CLINICAL PRACTICE ARE DISCUSSED: specifically, the importance of the support offered to the parents, aimed at enhancing both their awareness of their expectations about their child's rehabilitation process and their self-efficacy in supporting the child's adaptation to the use of the CI.

Impacts of a shared book-reading intervention for Italian-speaking children with developmental language disorder.

BACKGROUND: The regular practice of shared book reading (SBR) at home may play a key role in fostering the linguistic development of children with developmental language disorder (DLD). However, more evidence is needed of the benefits of home-based SBR interventions on the parents' conversational strategies and on the communicative and linguistic production of children with DLD. AIMS: To examine the impacts of a parent-based SBR intervention on the parent's use of conversational strategies, and on the engagement, conversational participation and linguistic production of Italian-speaking children with DLD. The mothers trained in the use of SBR strategies were expected to increase their use of these strategies. The children were expected to show gains in their level of engagement and conversational participation during SBR; in turn, moderate increments of the indices of language production were expected. METHODS & PROCEDURES: Thirty-two preschool children with DLD participated in the study; all were receiving speech language therapy. Using a non-randomized pre-post-test control trial, 20 mother-child dyads implemented an 8-week SBR programme (the SBR intervention group), while 12 dyads acted as a comparison group. Based on the 'dialogic reading' method, eight verbal and non-verbal SBR strategies were employed during individual and small-group parent training sessions. Speech-language therapists were involved in the individual parent training sessions to provide suggestions focused on the specific characteristics of each mother-child dyad. Measures of parents' intervention strategies, children's engagement, conversational participation and oral language were included. OUTCOMES & RESULTS: At post-test, mothers in the SBR intervention group used three of the eight SBR strategies-Shared Book Handling, Captivating Talking, and Utterances with a familiar topic-significantly more than the comparison group. Children whose mothers implemented the intervention showed significant gains in terms of time spent in engagement and amount of verbal production during shared reading. No effects were found for the children's communicative initiatives and answers, or for indices of language complexity and diversity. CONCLUSIONS & IMPLICATIONS: The present parent-based SBR intervention for Italian-speaking preschoolers with DLD showed effects, albeit modest, on both maternal and child communicative behaviours. The results suggest that extralinguistic strategies may be implemented successfully by parents and may be effective in enhancing children's engagement and language production in the short term. Further investigations are needed that provide a longer intervention period and examine the joint impact of therapist- and parent-based intervention for children with DLD.

Vocal production and novel word learning in the first year.

Previous studies have demonstrated an effect of early vocal production on infants' speech processing and later vocabulary. This study focuses on the relationship between vocal production and new word learning. Thirty monolingual Italian-learning infants were recorded at about 11 months, to establish the extent of their consonant production. In parallel, the infants were trained on novel word-object pairs, two consisting of early learned consonants (ELC), two consisting of late learned consonants (LLC). Word learning was assessed through Preferential Looking. The results suggest that vocal production supports word learning: Only children with higher, consistent consonant production attended more to the trained ELC images.

Lexical access and competition in bilingual children: The role of proficiency and the lexical similarity of the two languages.

Using a picture-auditory word recognition task, we examined how early child bilinguals access their languages and how the languages affect one another. Accuracy and response times in "false friends" (i.e., words with similar form but unrelated meanings) and semantically related words were compared with control conditions within and across languages and grades. Study 1 tested the performance of school-age children with balanced versus unbalanced knowledge of first-language (L1) Italian and second-language (L2) German. Study 2 compared unbalanced bilingual children with L1 Italian and L2 French or German to investigate the effect of lexical similarity in the children's languages. Children were found to activate both languages on receiving an auditory stimulus; performance in each language was affected by proficiency in the other language, degree of between-language similarity, and length of experience with each language. The BLINCS (Bilingual Language Interactive Network for Comprehension of Speech) model was invoked as a plausible framework for conceptualizing the nature of bilingual phonolexical representation and its effect on word recognition.

Communication dynamics between mothers and their children with cochlear implants: Effects of maternal support for language production.

This study examined (a) the functions and modalities of maternal and child communication during interaction between mothers and children with cochlear implants (CIs), comparing them with mothers and normally hearing (NH) children, and (b) the effectiveness of maternal support strategies in eliciting adequate answers in children with CI. Twenty preschoolers with CIs (M = 40 months) and 40 NH children - 20 matched by chronological age (CANH, M = 40 months) and 20 matched by hearing age (HANH, M = 25 months) - were videotaped during shared book reading and toy play with their mothers. Child and maternal utterances were coded for communicative functions and modalities (vocal, gestural, bimodal), including gesture types; maternal repairs were examined for type of support provided, and child answers for adequacy. Mothers in the CI group and in the CANH group displayed higher proportions of Informative Repairs than mothers of HANH children. However, unlike the mothers of NH children, mothers of children with CIs used bimodal utterances significantly more than vocal utterances. Sequential analysis revealed that maternal Informative Repairs elicited the production of Adequate Answers in both children with CIs and CANH. Interestingly, in the CI group this association was found only when Informative Repairs were accompanied by gestures. These findings offer suggestions for intervention programs focused on parent-child conversation.

Socio-emotional adjustment of adolescents with cochlear implants: Loneliness, emotional autonomy, self-concept, and emotional experience at the hospital.

Recent studies have reported contrasting results in the socio-emotional adjustment of Italian adolescents with cochlear implants (CIs). The aim of the present study is to explore the relationship between the socio-emotional adjustment of adolescents with CIs, the quality of their hospital stay, and their age at CI activation. The participants were 29 adolescents with CIs (CI group) and 29 typically developing adolescents (TD group). The Emotional Autonomy Scale, the Loneliness and Aloneness Scale for Children and Adolescents, and the Multidimensional Self-Concept Scale were administered to each participant. The emotional experience reported during the hospital stay was considered for each participant in the CI group. The adolescents with CIs displayed significantly higher levels of loneliness and lower levels of aversion toward aloneness than the TD group participants. Adolescents who had received the CI in preschool displayed a higher level of physical self-concept than adolescents who had received it later. The adolescents' emotional experiences at the hospital were reported to be quite complex and related to their relationships with parents. In summary, the findings point to a specific type of fragility in socio-emotional adjustment-focused on loneliness/aloneness-rather than a general one.

Spontaneous language production of Italian children with cochlear implants and their mothers in two interactive contexts.

BACKGROUND: In recent years many studies have shown that the use of cochlear implants (CIs) improves children's skills in processing the auditory signal and, consequently, the development of both language comprehension and production. Nevertheless, many authors have also reported that the development of language skills in children with CIs is variable and influenced by individual factors (e.g., age at CI activation) and contextual aspects (e.g., maternal linguistic input). AIMS: To assess the characteristics of the spontaneous language production of Italian children with CIs, their mothers' input and the relationship between the two during shared book reading and semi-structured play. METHODS & PROCEDURES: Twenty preschool children with CIs and 40 typically developing children, 20 matched for chronological age (CATD group) and 20 matched for hearing age (HATD group), were observed during shared book reading and semi-structured play with their mothers. Samples of spontaneous language were transcribed and analysed for each participant. The numbers of types, tokens, mean length of utterance (MLU) and grammatical categories were considered, and the familiarity of each mother's word was calculated. OUTCOMES & RESULTS: The children with CIs produced shorter utterances than the children in the CATD group. Their mothers produced language with lower levels of lexical variability and grammatical complexity, and higher proportions of verbs with higher familiarity than did the mothers in the other groups during shared book reading. The children's language was more strongly related to that of their mothers in the CI group than in the other groups, and it was associated with the age at CI activation. CONCLUSIONS & IMPLICATIONS: The findings suggest that the language of children with CIs is related both to their mothers' input and to age at CI activation. They might prompt suggestions for intervention programs focused on shared-book reading.

The role of geminates in infants' early word production and word-form recognition.

Infants learning languages with long consonants, or geminates, have been found to 'overselect' and 'overproduce' these consonants in early words and also to commonly omit the word-initial consonant. A production study with thirty Italian children recorded at 1;3 and 1;9 strongly confirmed both of these tendencies. To test the hypothesis that it is the salience of the medial geminate that detracts attention from the initial consonant we conducted three experiments with 11-month-old Italian infants. We first established baseline word-form recognition for untrained familiar trochaic disyllables and then tested for word-form recognition, separately for words with geminates and singletons, after changing the initial consonant to create nonwords from both familiar and rare forms. Familiar words with geminates were recognized despite the change, words with singletons were not. The findings indicate that a feature occurring later in the word affects initial consonant production and perception, which supports the whole-word phonology model.