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.

Preterm infant contingent communication in the neonatal intensive care unit with mothers versus fathers.

Very few studies have assessed infant capacity for bidirectional, contingent communication at birth, and to our knowledge there are none with preterm infants in the neonatal period. Presence versus absence of such interactive contingency makes a difference for our theories of development. We examined whether preterm infants can contingently coordinate behaviors with mothers and fathers in spontaneous communication in the Neonatal Intensive Care Unit (NICU), and whether mother-infant versus father-infant engagement and contingency differ. Twenty Italian preterm infants (60% girls, born 27-33 weeks, largely middle-class families) lying in a heated cot in the NICU were videotaped at 35 weeks with mothers, and fathers (counterbalanced), in face-to-face communication. Videotapes were coded on a 1-s time-base with parent and infant engagement scales. Multilevel time-series models evaluated self-contingency (auto-correlation) and interactive contingency (lagged cross-correlation). Mothers (vs. fathers) showed higher levels of engagement, interpreted as more arousing. Fathers (vs. mothers) showed more midrange engagement, interpreted as less "demanding" of infant engagement. Infants were more gaze-on-parent's-face and gaze-on-environment with mothers than fathers. Fathers interacted contingently with infants, whereas mothers did not. However, infants interacted contingently with mothers, but not fathers. When infants were in lower engagement levels 1 s prior, fathers stayed in lower engagement levels in the current second, closer to infants than mothers. We suggest that fathers were more coordinated because fathers were more able to join the infant's dampened state. We suggest that infants were more coordinated with mothers because mothers were more socially stimulating, and more familiar. We conclude that preterm infants, shortly after birth, are capable of contingent communication. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Fathers' experiences of supporting their partners during their preterm infant's stay in the neonatal intensive care unit: a multi-method study.

OBJECTIVE: To explore how the fathers experience their role as a support for their partner and the relationship with them during their preterm infant's stay in the NICU. STUDY DESIGN: Multi-method longitudinal study involving ethnographic observation, semi-structured interviews, self-report questionnaires, and clinical information. Twenty fathers of preterm infants hospitalized in a level-III-NICU were included. Data were analyzed using thematic continent analysis. RESULTS: Three main themes were identified: support for mother (subthemes: putting mother's and infant's needs first; hiding worries and negative emotions; counteracting the sense of guilt; fear that the mother would reject the child), mother's care for the infant (subthemes: observing mother engaged in caregiving; mother has "something extra"), and couple relationship (subthemes: collaboration; bond). CONCLUSION: Fathers supporting their partners during the stay in the NICU experience emotional distress and the need for being supported that often are hidden. This demands a great deal of emotional and physical energy.

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.

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.

The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities.

The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.

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.

Interactive sequences between fathers and preterm infants in the neonatal intensive care unit.

AIMS: The first purpose of the study was to examine fathers' spontaneous communicative behavior with their preterm infants in the neonatal intensive care unit, and how father's and infant's behaviors affected each other. The second purpose was to examine any possible association between the fathers' and/or infants' characteristics and the quality of fathers' behaviors with their infants. STUDY DESIGN/SUBJECTS/OUTCOME MEASURES: Father-preterm infant dyads (n=20) were assessed at 34-36 weeks postmenstrual age, during a spontaneous face-to-face communication with the infant placed in a heated cot in the NICU, and coded according to the Parent-Preterm Infant Coding System. RESULTS: The presence of the father's Affiliative Behavior increased the occurrences of infant Gazing at the parent's face. In turn, infant gazing increased the occurrence of paternal Affiliative Behavior. The likelihood of infant's Gazing at the father's face was also significantly elicited by infrequent occurrences of paternal Affectionate Talk, co-occurring with Gazing at infant with Positive Facial Affect (but no Touch). With regard to the predictors of quality in father-infant interactions, we found a significant positive correlation between fathers' level of depressive symptomatology and fathers' Affiliative Behavior. CONCLUSION: Our results show the of bidirectional sequential patterns of communication between fathers and preterm infants at 35 weeks postmenstrual age, and provide important information about the quality and modalities of paternal communication and their influence on infant behavioral states. From a clinical perspective, these results suggest that father-specific interventions designed to improve and sustain fathers' positive engagement with infants in the NICU should be pursued.

Culture-specific development of early mother-infant emotional co-regulation: Italian, Cameroonian, and West African immigrant dyads.

Studies conducted in Western countries document the special role of mother-infant face-to-face exchanges for early emotional development including social smiling. A few cross-cultural studies have shown that the Western pattern of face-to-face communication is absent in traditional rural cultures, without identifying other processes that promote emotional Co-regulation. The present study compared three different samples: Western middle-class families in Italy, rural traditional Nso farmer families in Cameroon, and West African sub-Saharan immigrant families in Italy using biweekly observations of 20 mother-infant dyads from each cultural context from age 4 to 12 weeks. Longitudinal sequential analysis of maternal and infant behaviors showed that from as early as 4 weeks, in Italian dyads maternal affectionate talking is linked with infant active attention to mother in sequences of face-to-face contact; this link fosters the subsequent emergence of infant smiling/cooing, and then sequences of positive feedback between infant and maternal emotional expressions that, by the 3rd month, dynamically stabilize. In contrast, for Cameroonian/Nso dyads over the 2nd and 3rd month, maternal motor stimulation marked by rhythmic vocalizing is linked with infant active attention to surroundings. The relatively few smiling/cooing actions of Nso babies at their mothers were answered mainly with tactile stimulation that did not foster the maintenance of face-to-face visual contact. Finally, West African immigrant dyads showed a combination of both face-to-face and sensorimotor coregulated exchanges observed in their new and native cultures. These findings suggest that emotional Co-regulation in early infancy can occur via multiple, culture-specific pathways that may be substantially different from the western pattern of face-to-face communication. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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.

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.

Fathers' experiences with their preterm babies admitted to neonatal intensive care unit: A multi-method study.

AIM: The aim of this study was to investigate fathers' emotional experiences of their infant's preterm birth and subsequent stay in neonatal intensive care unit. BACKGROUND: When a baby is born preterm, there is also the premature interruption of the process of preparation for fatherhood. As a result, the impact on fathers of the preterm birth can bring negative consequences for the development of father-infant relationship. DESIGN: A multi-method approach was used which included ethnographic observation, semi-structured interviews with fathers, a self-report questionnaire and clinical information between September 2015-March 2017. METHOD: Data were analysed using a mixed-method: a thematic analysis of data from the interviews and quantitative analyses to detect possible clusters of fathers' emotional experiences and associations between clusters and fathers' and/or infants' characteristics. RESULTS: Two clusters were identified. The "fathers-of-preterm-infants" touched their baby as soon as they were given the opportunity and without fear that they would harm their infant. They were struck by their baby's physical appearance. In contrast, the "preterm fathers" preferred not to touch their baby when first given the chance, for fear of breaking/damaging/infecting her/him. They were struck both by the baby's physical appearance and by the technology/equipment around her/him and were afraid that their infant would die. All the "fathers-of-preterm-infants", but only just over half of the "preterm fathers", were actively engaged in their infant's care. Clusters were associated with the infant's gestational age. CONCLUSION: Fathers of preterm infants should receive personalized support specifically addressed to them and based on the infant's gestational age.

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.

Parental engagement and early interactions with preterm infants during the stay in the neonatal intensive care unit: protocol of a mixed-method and longitudinal study.

INTRODUCTION: The preterm infants' developmental outcomes depend on biological and environmental risk factors. The environmental factors include prolonged parental separation, less exposure to early mother/father-infant interactions and the parents' ability to respond to the trauma of premature birth. In the case of premature birth, the father's ability to take an active part in the care of the infant from the start is essential. The parents' emotional closeness to the preterm infant hospitalised in the neonatal intensive care unit (NICU) may be crucial to the well-being of the newborn, the development of mutual regulation, the establishment of a functioning parent-infant affective relationship and the parents' confidence in their ability to provide care for their baby. METHODS AND ANALYSIS: This is a mixed-method, observational and longitudinal study. The methodological strategy will include: (1) ethnographic observation in a level III NICU located in Italy for a duration of 18 months; (2) 3-minute video recordings of mother-infant and father-infant interaction in the NICU; (3) a semistructured interview with fathers during the infants' hospital stay; (4) 3-minute video recordings of mother-infant and father-infant face-to-face interaction in the laboratory at 4 months of corrected age; (5) self-report questionnaires for parents on depression and quality of the couple relationship at the approximate times of the video recording sessions. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethical Committee for Clinical Trials of the Verona and Rovigo Provinces. Results aim to be published in international peer-reviewed journals, and presented at relevant national and international conferences. This research project will develop research relevant to (1) the quality and modalities of maternal and paternal communication with the preterm infant in the NICU; (2) the influence of maternal/paternal social stimulation on the infant behavioural states; (3) the quality and modalities of paternal support to the partner and possible influences on mother-infant relationship.

Spontaneous Gesture Production and Lexical Abilities in Children With Specific Language Impairment in a Naming Task.

PURPOSE: The purpose of the study was to investigate the role that cospeech gestures play in lexical production in preschool-age children with expressive specific language impairment (E-SLI). METHOD: Fifteen preschoolers with E-SLI and 2 groups of typically developing (TD) children matched for chronological age (n = 15, CATD group) and for language abilities (n = 15, LATD group) completed a picture-naming task. The accuracy of the spoken answers (coded for types of correct and incorrect answers), the modality of expression (spoken and/or gestural), types of gestures, and semantic relationship between gestures and speech produced by children in the different groups were compared. RESULTS: Children with SLI produced higher rates of phonological simplifications and unintelligible answers than CATD children, but lower rates of semantic errors than LATD children. They did not show a significant preference for spoken answers, as TD children did. Similarly to LATD children, they used gestures at higher rates than CATD, both deictic and representational, and both reinforcing the information conveyed in speech and adding correct information to co-occurring speech. CONCLUSIONS: These findings support the hypotheses that children with SLI rely on gestures for scaffolding their speech and do not have a clear preference for the spoken modality, as TD children do, and have implications for educational and clinical practice.

Gesture and speech during shared book reading with preschoolers with specific language impairment.

This study examined (a) the relationship between gesture and speech produced by children with specific language impairment (SLI) and typically developing (TD) children, and their mothers, during shared book-reading, and (b) the potential effectiveness of gestures accompanying maternal speech on the conversational responsiveness of children. Fifteen preschoolers with expressive SLI were compared with fifteen age-matched and fifteen language-matched TD children. Child and maternal utterances were coded for modality, gesture type, gesture-speech informational relationship, and communicative function. Relative to TD peers, children with SLI used more bimodal utterances and gestures adding unique information to co-occurring speech. Some differences were mirrored in maternal communication. Sequential analysis revealed that only in the SLI group maternal reading accompanied by gestures was significantly followed by child's initiatives, and when maternal non-informative repairs were accompanied by gestures, they were more likely to elicit adequate answers from children. These findings support the 'gesture advantage' hypothesis in children with SLI, and have implications for educational and clinical practice.