The Synergistic Effects of Preterm Birth and Parent Gender on the Linguistic and Interactive Features of Parent-Infant Conversations.

PURPOSE: To investigate the language environments experienced by preterm-born infants, this study compared the linguistic and interactive features of parent-infant conversations involving 2-year-old preterm- and term-born infants. The study also explored how mother-infant and father-infant conversations may be differentially affected by preterm/term birth status. METHOD: Twenty-two preterm-born (< 37 weeks' gestation) and 25 term-born (≥ 37 weeks' gestation) 2-year-old infants engaged in dyadic mother/father-infant free-play interactions that were transcribed to quantify the linguistic (parental volubility, speech rate, lexical diversity, and morphosyntactic complexity) and interactive (infant/parent responsiveness, turn-taking, and conversational balance) features of parent-infant conversations. Language, cognitive, socioemotional, and executive function skills were assessed via standardized tools. RESULTS: Compared to the term group, the preterm group was characterized by lower maternal speech rate, parental lexical diversity, and parent-infant turn-taking, as well as greater mother-infant conversational balance. The preterm group presented poorer language and executive function skills when compared to the term group. CONCLUSIONS: Both similarities and differences exist between the language environments of preterm and term groups. Similarities may be due to the partial developmental catch-up of preterm-born infants (cognitive and socioemotional skills) and parental scaffolding. Differences may partly reflect a parental adaptation to the language and executive function difficulties of preterm-born infants. These findings suggest that researchers/clinicians should appraise the language environment with respect to the unique developmental needs of preterm/term-born infants. Future research directions are provided to advance a more holistic characterization of the language environment and a deeper understanding of the developmental significance of preterm-term differences in such environments. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25021931.

Parent-infant conversations are differentially associated with the development of preterm- and term-born infants.

Preterm birth is a risk factor for language difficulties. To better understand the language development of preterm-born infants, the current study investigated the concurrent associations between parent-infant conversations and the development of 22 preterm-born and 25 term-born infants at 2 years of age. Conversations occurring during mother/father-infant free-play interactions were analyzed to characterize features of parental speech (volubility, speech rate, lexical diversity, and morphosyntactic complexity) and parent-infant exchanges (parent responsiveness, turn-taking, and conversational balance). The infants' language development (receptive communication and expressive communication) and non-language development (cognitive, social-emotional, and executive function) was assessed using standardized measures. Parent-infant conversations were associated with both language and non-language development. This suggests that parent-infant conversations may support language development directly and/or through advancing non-language skills that could promote language learning. The associations between parent-infant conversations and development varied as a function of birth status (preterm or term). This finding may signal the operation of different developmental processes within preterm- and term-born groups. Finally, infant development was differentially associated with mother-infant and father-infant conversations. This may point to the distinct contributions made by mothers and fathers to the development of both preterm- and term-born infants. To optimize language outcomes, these findings indicate that families should be guided to tailor parent-infant conversations to the unique developmental needs and processes of preterm-born infants. Families should also be supported to leverage the distinct developmental contributions of mothers and fathers. Future recommendations are made regarding how to investigate the proposed preterm-term differences in language development processes and the differential developmental contribution of mothers and fathers.

Preterm toddlers' joint attention characteristics during dyadic interactions with their mothers and fathers compared to full-term toddlers at age 2 years.

The current study investigates Joint Attention (JA) characteristics (duration, frequency, source of initiation, type of JA, agent of termination, missed and unsuccessful episodes) in preterm and full-term toddlers' interactions with their mothers and fathers, separately. Thirty-one singleton full-term (Mage = 24.07 months, SD = 1.45; 13 boys) and 17 singleton preterm toddlers (Madjustedage = 24.72 months, SD = 3.39; 12 boys) participated in the study with both parents. JA episodes were examined during dyadic five-minute free play sessions, were coded second-by-second, and were analysed using two-way mixed ANOVAs. Although the total amount of time spent in JA was not significantly different between the preterm and the full-term groups, JA episodes were more frequent, specifically supported JA episodes, and were more often terminated by the child during parent-preterm toddler interactions. Moreover, preterm toddlers missed their fathers' attempts for JA more often than their mothers' and more often than full-term toddlers missed their fathers' and mothers' bids for JA. Further, regardless of the birth status, toddlers initiated more JA with mothers than fathers, and fathers redirected their child's attention to initiate JA more than mothers. Findings indicate that preterm toddlers may struggle to respond to JA bids, especially with their fathers, and to sustain their attention on a specific object or event during interactions. Preterm toddlers may need more support to engage in JA relative to their full-term peers, and redirecting attention strategy may not be optimal for them. Also, toddlers' JA interactions may be different with their mothers and fathers. Findings contribute to the literature by demonstrating preterm toddlers' JA characteristics with both parents compared to full-term toddlers at age two.

Talk outside the box: Parents' decontextualized language during preschool years relates to child numeracy and literacy skills in middle childhood.

Children's literacy and numeracy skills are fundamental for early academic performance and later academic success, mental health, and employment prospects in adulthood. Given that parents play a key role in promoting child development, identifying early parenting behaviors that predict literacy and numeracy skills is a research imperative. Emerging evidence suggests that parental use of decontextualized language (DL)-talk that requires cognitive abstraction and transcends the here and now-predicts children's literacy skills. However, its relation to numeracy remains underexplored. Accordingly, the current study examined how DL during interaction with children in infancy (T1) and preschool years (T2) relates to child literacy and numeracy in middle childhood (T3). Participants were 26 Irish mother-father-child triads (16 female children). At T1 and T2, participants engaged in 5-min interactions that were coded for DL. At T3, child literacy and numeracy were assessed using the Wechsler Intelligence Scale for Children-Fourth Edition and teacher report of child scores on national standardized tests. Controlling for child age and contextualized utterances, child reading in middle childhood was negatively related to maternal and child DL in infancy but was positively related to DL during preschool years, suggesting that the benefits of DL may become apparent later in development. Mothers', fathers', and children's DL during preschool years was also positively linked with child numeracy in middle childhood. Thus, embedding DL in conversation with children may have positive domain-specific and cross-domain effects on children's literacy and numeracy performance. Findings provide incentive for future research to examine relations between DL and children's school performance across a wider range of developmental domains.

Domain-specific and cross-domain effects of the home literacy and numeracy environment at 3 years on children's academic competencies at 5 and 9 years.

This study examined whether children's formal and informal home literacy (HLE) and home numeracy (HNE) environments at 3 years old demonstrated domain-specific, and cross-domain effects on children's academic performance at 5 and 9 years old. Participants were 7,110 children (49.4% male; 84.4% Irish), recruited between 2007 and 2008 in Ireland. Structural equation modeling revealed that only the informal HLE and HNE demonstrated both domain-specific and cross-domain positive effects on children's language and numeracy outcomes but not on socioemotional outcomes, at 5 and 9 years old. Effect sizes ranged from small (ß = 0.020) to moderate (ß = 0.209). These results suggest that even casual cognitively stimulating activities that do not directly focus on active teaching may benefit children's educational outcomes. Findings bear implications for cost-effective interventions with far-reaching, and enduring, effects across multiple child outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Parent-child interaction and developmental outcomes in children with typical and elevated likelihood of autism.

BACKGROUND: Early parent-child interactions have a critical impact on the developmental outcomes of the child. It has been reported that infants with a family history of autism and their parents may engage in different patterns of behaviours during interaction compared to those without a family history of autism. This study investigated the association of parent-child interactions with child developmental outcomes of those with typical and elevated likelihood of autism. METHOD: This longitudinal study investigated the relationship between global attributes of parent-child interaction and the developmental outcomes of infant siblings with elevated likelihood (EL: n = 29) or typical likelihood (TL: n = 39) of developing autism. Parent-child interactions were recorded during a session of free-play when the infants were six months of age. Developmental assessments were carried out when the children were 12 and 24 months of age. RESULTS: The intensity of mutuality was significantly higher in the TL group than in the EL group, and developmental outcomes were poorer in the EL group when compared to the TL group. Positive associations between parent-child interaction scores at six months and developmental outcomes at 12 months were observed only in the TL group. However, in the EL group, higher levels of infant positive affect and attentiveness paid to the caregiver is associated with lower autism symptoms. Due to the sample size and design of the study, the findings must be viewed as indicative. CONCLUSION: This preliminary investigation demonstrated differences in the association between parent-child interaction quality and developmental outcomes for children with typical and elevated likelihood for autism. Future studies should combine micro-analytic and macro-analytic approaches to parent-child interaction to further examine the nature of this relationship.

Quality improvements in radiation oncology clinical trials.

Clinical trials have become the primary mechanism to validate process improvements in oncology clinical practice. Over the past two decades there have been considerable process improvements in the practice of radiation oncology within the structure of a modern department using advanced technology for patient care. Treatment planning is accomplished with volume definition including fusion of multiple series of diagnostic images into volumetric planning studies to optimize the definition of tumor and define the relationship of tumor to normal tissue. Daily treatment is validated by multiple tools of image guidance. Computer planning has been optimized and supported by the increasing use of artificial intelligence in treatment planning. Informatics technology has improved, and departments have become geographically transparent integrated through informatics bridges creating an economy of scale for the planning and execution of advanced technology radiation therapy. This serves to provide consistency in department habits and improve quality of patient care. Improvements in normal tissue sparing have further improved tolerance of treatment and allowed radiation oncologists to increase both daily and total dose to target. Radiation oncologists need to define a priori dose volume constraints to normal tissue as well as define how image guidance will be applied to each radiation treatment. These process improvements have enhanced the utility of radiation therapy in patient care and have made radiation therapy an attractive option for care in multiple primary disease settings. In this chapter we review how these changes have been applied to clinical practice and incorporated into clinical trials. We will discuss how the changes in clinical practice have improved the quality of clinical trials in radiation therapy. We will also identify what gaps remain and need to be addressed to offer further improvements in radiation oncology clinical trials and patient care.

Joint attention episodes during interactions with fathers but not mothers at age 2 years is associated with expressive language at 3 years.

Joint Attention (JA) in parent-infant interaction has been demonstrated to contribute to infants' language outcomes. A limited number of studies have investigated the characteristics of JA episodes during parent-toddler interaction in relation to toddlers' language development. The majority of these studies were conducted with mothers, whereas JA with fathers remains understudied. The current study investigated JA episodes during interactions with mothers and fathers separately as well as longitudinal associations with child language outcomes. A total of 31 toddlers (18 girls) and their mothers and fathers participated in the study at ages 2 years (M = 24.07 months, SD = 1.45) and 3 years (M = 37.44 months, SD = 1.72). JA episodes were observed during free play interactions at age 2 and were coded microanalytically; receptive and expressive language skills were assessed by Bayley Scales of Infant and Toddler Development-Third Edition at ages 2 and 3. No significant differences in JA episodes were found between mother-toddler and father-toddler dyads. Whereas JA characteristics with mothers were not found to be significantly associated with toddlers' language outcomes, multiple linear regression analyses showed that paternal education and parent-followed JA episodes during father-toddler interaction at age 2 explained a significant amount of variance in toddlers' expressive language skills at age 3. Findings suggest that JA episodes during interactions with fathers might benefit toddlers' expressive language development.

Antenatal depression and maternal infant directed speech during the first postnatal year.

BACKGROUND: Antenatal depression is emerging as a potential risk factor for lower maternal sensitivity during postnatal mother-infant interactions. The present study investigated the relationship between both antenatal and postnatal depression and features of infant directed speech, a key indicator of maternal sensitivity during the first postnatal year. METHODS: Pregnant women with either a clinical diagnosis of Major Depressive disorder (MDD; n = 20) or a history of MDD (n = 26) and a control group (n = 34) were recruited to the study and followed up at two, six and twelve months postpartum. A free-play mother-infant interaction was recorded at each time-point and the lexical and syntactic complexity of the mothers' speech was measured from the transcript. RESULTS: No significant group differences were observed at either two, six or twelve months. However, mediation analyses indicated that antenatal depression was indirectly associated with maternal syntactic complexity at two and twelve months through concurrent maternal depression scores. LIMITATIONS: The findings of this study are limited by its small sample size. The sample also comprised predominantly well-resourced women which limits the generalisability of the findings to wider or less advantaged populations. CONCLUSIONS: This study contributes to the emerging evidence base concerning the impact of antenatal depression and postnatal depression on early mother-infant interactive behaviour, specifically infant-directed speech. These findings further highlight the importance of identifying women with antenatal depression in order to support them to engage in therapeutic interventions at the earliest possible opportunity.

Perinatal depression and children's developmental outcomes at 2 years postpartum.

BACKGROUND: Perinatal depression has been associated with a range of adverse outcomes for children's neurodevelopment. AIMS: This study sought to examine the impact of maternal perinatal depression on 2-year-olds' social-emotional, cognitive, language, and adaptive behavioural development, using data collected at the fifth timepoint of a prospective longitudinal study, which followed participants from pregnancy through to toddlerhood. PARTICIPANTS: 61 women and their children (M age = 26 months, SD = 1.83; 35 boys and 26 girls), of the original cohort of 98, who had been recruited during pregnancy, and stratified into three participant groups: 1. Depressed (those with a clinical diagnosis of Major Depressive Disorder [MDD]); 2. History (currently euthymic with a previous MDD episode); 3. Control (no history of psychiatric disorder). OUTCOME MEASURES: Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D), and children's developmental outcomes were measured using the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III). RESULTS: No direct associations between mothers' depression and children's social-emotional, cognitive or language development were observed. However, an unexpected positive association between maternal depression and children's social adaptive behaviour was found, which conferred an advantage on children whose mothers had suffered from depression. CONCLUSIONS: The current findings contribute to the literature examining the impact of perinatal depression on early childhood outcomes. The unexpected positive association found between maternal depression and children's adaptive behaviour should prompt further research examining the adaptive resilience of young children exposed to maternal depression. This is discussed in the context of differential-susceptibility theory.

Communicative functions of parents' child-directed speech across dyadic and triadic contexts.

This study examined the roles of parental gender and context in the communicative functions of parents' child-directed speech. Seventy three families with toddlers participated in the study. Dyadic and triadic parent-toddler interactions were videotaped during structured play activities. Results indicated context-dependent variability in parents' facilitative speech and gentle guidance. Parental gender effects were observed in parents' directive speech but no gender or contextual effects were observed in parents' referential speech. Results suggest the need for a closer examination of parental gender and contextual factors related to parents' speech functions.

How to use the Bayley Scales of Infant and Toddler Development.

The Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) is a gold standard series of behavioural assessments used by clinicians and researchers to assess the developmental functioning of young children. The rigorous psychometric properties of the tool are attributed to the carefully standardised normative sample and quantitative scoring system. It is a common end-point assessment used in neonatal trials and is routinely used in a clinical setting to assess the development of children at risk of delay. Incidence of developmental delay is higher in clinical populations such as those born preterm or with complications such as neonatal encephalopathy. Early identification of delay is critical as early intervention is most effective in minimising impairment; therefore, routine assessment of developmental outcomes is recommended, particularly among high-risk populations.

Parental toy play and toddlers' socio-emotional development: The moderating role of coparenting dynamics.

This study examined the moderating role of coparenting supportiveness in the association between parental toy play and toddlers' socio-emotional development. Seventy-seven triads (mother, father, toddler) participated in the study. Coparenting dynamics and parental toy play were observed during family interaction and toddlers' socio-emotional development was reported by mothers. Results indicated that maternal toy play was positively associated with toddlers' socio-emotional development but only when this interaction occurred within a supportive coparenting context. No significant associations were observed between fathers' toy play and toddlers' socio-emotional development. This study highlights the critical role played by family dynamics in parent-child play interaction.

Infant language predicts fathers' vocabulary in infant-directed speech.

Research on sources of individual difference in parental Infant-Directed Speech (IDS) is limited and there is a particular lack of research on fathers' compared to mothers' speech. This study examined the predictive relations between infant characteristics and variability in paternal lexical diversity (LD) in dyadic free play with two-year-olds (M = 24.1 months, SD = 1.39, 35 girls). Ten minutes of interaction for sixty-four father-infant dyads were transcribed and multiple regression analyses were performed to examine the effects of a set of distal and proximal sources of infant influence on paternal LD. Fathers' LD was predicted only by infant language, both standardised language scores and dynamic language measures, and was not predicted by infant age, gender, executive function, or temperament. Findings are discussed in the light of the complex interplay of factors contributing to variability in IDS and the infant's linguistic environment.

Fathers' but not Mothers' Repetition of Children's Utterances at Age Two is Associated with Child Vocabulary at Age Four.

Repetition in child-directed speech has been shown to benefit child language development, yet fathers remain largely understudied in this context because research is primarily dominated by a focus on mothers. Accordingly, the current study, using a comparative approach, examined concurrent and longitudinal associations between parental repetition of children's utterances and child language ability. A period of 10 min of triadic structured play interaction for 21 families was analyzed using bivariate and partial correlations. No associations were found between parents' repetition and children's standardized measures of language ability; however, both mothers and fathers of 2-year-olds (M = 23.82 months, SD = 1.32; 11 girls) engaged in more repetition when their children used less diverse vocabularies in interaction, tentatively suggesting synergies between parental language input and concurrent child vocabulary. Furthermore, although maternal repetition at 2 years of age showed no significant relationship with children's language abilities at 4 years, fathers' repetition of 2-year-olds' utterances showed positive associations with children's vocabulary diversity at 4 years of age even after controlling for maternal repetition and children's language abilities at 2 years. Although these results are inconclusive, it is possible that paternal repetition of children's utterances may contribute to vocabulary development.

Decomposing the social gradient in children's vocabulary skills at 3 years of age: A mediation analysis using data from a large representative cohort study.

Disparities in children's expressive language by socio-economic status are evident early in childhood and impact children's development and educational attainment. This study investigated the processes by which maternal education, as a powerful indicator for socio-economic status, affects early expressive language. A nationally representative cohort study of 8,062 children resident in the Republic of Ireland were assessed on the British Ability Scales (BAS) Naming Vocabulary Test at 36 months. A significant difference of almost six points was found between the mean vocabulary test scores of children whose mothers had completed the minimum level of educational attainment compared with children whose mothers had a degree-level qualification. Mediation analysis revealed that 78% of the difference was explained by mediating variables, with differences in household income, parental practice, and material resources accounting for most of the variation. The findings support interventions which redress gaps in maternal education, income, and caregiving.

Exploring the association of infant receptive language and pitch variability in fathers' infant-directed speech.

The objective of this study was to examine the links between prosodic features of paternal Infant-Directed Speech (IDS) and child characteristics. Pitch variability measures were extracted from the speech samples of 50 fathers during unstructured play with their two-year-old children. Evidence for a link between child receptive language ability (measured by the Bayley Scales of Infant Development III) and fathers' pitch variability was obtained from Multiple Hierarchical Regression. Findings support the hypothesis that fathers tailor their speech to their children. This is one of the few studies to examine the relationship between fathers' IDS and child language ability.

'I'm not complaining because I'm alive': barriers to the emergence of a discourse of cancer-related fatigue.

OBJECTIVE: Cancer-related fatigue (CRF) is a potentially chronic condition that is inadequately discussed, diagnosed and treated. This study examined the factors that contribute to the absence of a discourse of CRF. METHOD: A thematic discourse analysis was carried out on the 'additional comments' left by 73 fatigued cancer patients and survivors as part of a questionnaire study on CRF. RESULTS: The findings indicated that conflict between patients' own conceptualisations of CRF and those of family/friends and/or medical professionals hampers social and medical dialogue of CRF. Fatigue forms a part of patients' ongoing cancer identity even after cancer treatment has been completed; however, because of the dominance of wider social discourses on recovery from illness and cancer survivorship, others fail to recognise individual narratives of CRF when these deviate from or oppose such established discourses. Furthermore, the development of a discourse of CRF is actively obstructed because the enormity of cancer invalidates and overshadows patients' postcancer experiences. CONCLUSION: 'Additional comments' are a rich source of data that can give insight into issues facing patients. Beyond the lack of recognition, support and interventions available for CRF, broader discourses of health, illness and cancer hamper communication regarding this side effect.

Assessing recollection and familiarity in low functioning autism.

Methods to assess recollection and familiarity separately in autism spectrum disorder were recently developed and piloted (Bigham et al. in J Autism Dev Disord 40:878-889, 2010). The preliminary data obtained via these methods showed that whereas recollection was mildly impaired in high functioning autism, familiarity was spared. The current study set out to replicate the methods of assessment for recollection and familiarity devised by Bigham and her colleagues with individuals diagnosed with low functioning autism (LFA). Three critical modifications to the original paradigms were made within the current study. The modifications and implications of the findings for individuals with LFA will be discussed.