RESUMO
BACKGROUND: Perfluoroalkyl substances (PFAS) are persistent chemicals used in everyday consumer products leading to ubiquitous human exposure. Findings of impaired neurodevelopment after prenatal exposure to PFAS are contradictory and few studies have assessed the impact of postnatal PFAS exposure. Language development is a good early marker of neurodevelopment but only few studies have investigated this outcome separately. We therefore investigated the association between prenatal and early postnatal PFAS exposure and delayed language development in 18 to 36-month-old Danish children. METHODS: The Odense Child Cohort is a large prospective cohort. From 2010 to 2012 all newly pregnant women residing in the Municipality of Odense, Denmark was invited to participate. Concentration of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) were assessed in maternal serum collected in the 1st trimester of pregnancy and in child serum at 18 months. Parents responded to the Danish adaption of the MacArthur-Bates Communicative Development Inventories (MB-CDI) when their child was between 18 and 36 months. Language scores were converted into sex and age specific percentile scores and dichotomized to represent language scores above or below the 15th percentile. We applied Multiple Imputation by Chained Equation and conducted logistic regressions investigating the association between prenatal and early postnatal PFAS exposure and language development adjusting for maternal age, pre-pregnancy BMI, education and respectively fish intake in pregnancy or childhood and duration of breastfeeding in early postnatal PFAS exposure models. RESULTS: We found no significant associations between neither prenatal nor early postnatal PFAS exposure and language development among 999 mother-child pairs. CONCLUSION: In this low-exposed cohort the finding of no association between early postnatal PFAS exposure and language development should be interpreted with caution as we were unable to separate the potential adverse effect of PFAS exposure from the well documented positive effect of breastfeeding on neurodevelopment. We, therefore, recommend assessment of child serum PFAS at an older age as development of the brain proceeds through childhood and even a small impact of PFAS on neurodevelopment would be of public health concern at population level due to the ubiquitous human exposure.
Assuntos
Ácidos Alcanossulfônicos , Poluentes Ambientais , Fluorocarbonos , Efeitos Tardios da Exposição Pré-Natal , Animais , Humanos , Gravidez , Feminino , Criança , Lactente , Pré-Escolar , Estudos Prospectivos , Fluorocarbonos/efeitos adversos , Desenvolvimento da Linguagem , Primeiro Trimestre da Gravidez , Encéfalo , Poluentes Ambientais/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/epidemiologiaRESUMO
Objective: Maternal thyroid autoimmunity and thyroid function in early pregnancy may impact fetal neurodevelopment. We aimed to investigate how thyroid autoimmunity and thyroid function in early pregnancy were associated with language acquisition in offspring at 12-36 months of age. Methods: This study was embedded in the prospective Odense child cohort. Mother-child dyads were excluded in case of maternal intake of thyroid medication during pregnancy. The parents completed MacArthur-Bates Communicative Development Inventories (MB-CDI) every third month to assess their offspring's productive vocabulary. All completed reports for each child were included in the analyses. Logistic growth curve models evaluated associations between MB-CDI scores and levels of maternal thyroid peroxidase antibodies (TPOAb), free thyroxine (FT4), and thyrotropin, respectively, measured in early pregnancy (median gestational week 12). All models were stratified by offspring sex and adjusted for maternal age, education, pre-pregnancy body mass index, parity, breastfeeding, and offspring age. Results: The study included 735 mother-child dyads. Children born to mothers with TPOAb ≥11 kIU/L, opposed to TPOAb <11 kIU/L, had a lower probability of producing words at age 18-36 months for girls (OR = 0.78, P < 0.001) and 33-36 months for boys (OR = 0.83, P < 0.001). The probability of producing words was higher in girls at 30-36 months of age with low-normal maternal FT4 vs high-normal FT4 (OR = 0.60, P < 0.001), and a similar trend was seen in boys. Results were ambiguous for thyrotropin. Conclusion: In women without known thyroid disease, TPOAb positivity in early pregnancy was negatively associated with productive vocabulary acquisition in girls and boys. This association was not mediated by a decreased thyroid function, as low-normal maternal FT4, unexpectedly, indicated better vocabulary acquisition. Our results support that maternal thyroid autoimmunity per se may affect fetal neurodevelopment.
Assuntos
Autoimunidade , Humanos , Feminino , Gravidez , Masculino , Lactente , Pré-Escolar , Estudos Prospectivos , Adulto , Iodeto Peroxidase/imunologia , Autoanticorpos/sangue , Autoanticorpos/imunologia , Desenvolvimento da Linguagem , Tiroxina/sangue , Tireotropina/sangue , Efeitos Tardios da Exposição Pré-Natal/imunologia , Glândula Tireoide/imunologia , Complicações na Gravidez/imunologia , Complicações na Gravidez/sangueRESUMO
Introduction: Previous studies have focused on understanding parental attempts to record language development in children, across many typologically different languages. However, many of these studies restricted their assessment to children up to the age of 3 years. The aim of this paper was to move this boundary by examining language development in typically language developed children older than 3 years. Methods: Using the Croatian version of the Communicative Development Inventories III (CDI-III-HR), we investigated the contribution of parental reports of a child's lexical, grammatical, and metalinguistic awareness abilities to general language abilities assessed by clinicians. Participants included the parents of 151 children between the ages of 30 to 48 months, who completed the CDI-III-HR and reported on their child's language abilities. Results: Our results show that age is significantly associated with the lexical, grammatical, and metalinguistic awareness abilities of a child's language development. These findings confirm that all three abilities increase with age and that parents can perceive changes in a child's language development. The subsections of CDI-III-HR were moderately to strongly associated with each other, with the strongest association being between lexicon and grammar, suggesting that they remain closely related after the age of 30 months. Parental assessments of a child's language development are a better predictor of language production than language comprehension, with grammar making the most consistent and significant contribution. Discussion: This study confirms that the development of grammatical abilities is the most prominent skill between the ages of 30 to 48 months and that parents can observe the transition in the child's language development through their usage of grammar in words to grammar in sentences. Based on the selected sample of children, we discovered different patterns of parental success in assessing the child's language ability. These findings indicate that parents can act as valuable sources of information regarding the child's language abilities, but clinical assessments of early language development should consider many other formal sources of information in addition to parental reports.
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This longitudinal study aims to describe the trajectory of language development in children with CHD aged 12-24 months assessed through an early monitoring and individualized intervention program. We also sought to determine whether early language performances, at 12 months of age, predict 24-month language abilities. We conducted developmental assessments of 49 children with CHD using the Bayley Scales of Infant and Toddler Developmental, third edition (Bayley-III) at 12 and 24 months, and the MacArthur-Bates Communicative Development Inventories (MBCDI) at 12, 18 and 24 months. Compared to normative populations, CHD patients showed significantly lower mean scores in both receptive and expressive language scales of the Bayley-III and the MBCDI at 12 months, whereas at 18 and 24 months only expressive language scores were reduced. No differences were found in the cognitive scale. Communicative gestures at 12 months were significantly predictive of language skills at 24 months of age. Our findings indicate specific vulnerability of language outcome, especially in expressive skills, rather than a global cognitive impairment in our patients with CHD. We recommend using communicative gestures as an early marker of language development to improve our ability to detect language delays in this population.
Assuntos
Cardiopatias Congênitas/complicações , Transtornos do Desenvolvimento da Linguagem/epidemiologia , Transtornos do Desenvolvimento da Linguagem/etiologia , Desenvolvimento da Linguagem , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Longitudinais , MasculinoRESUMO
Resumen Se examinaron datos provenientes de la evaluación del lenguaje de 104 niños con edades entre 16 y 30 meses residentes en Lima con una versión preliminar de la adaptación de la Forma II de los reportes parentales MacArthur-Bates Communicative Development Inventories (CDI) al español del Perú. Se analizó el léxico productivo a partir de la lista de palabras del reporte y se realizaron análisis de regresión para evaluar si el nivel de vocabulario contribuía a predecir el desarrollo gramatical de los niños, empleando como variables de control la edad del niño y el nivel de escolarización materna (como indicador del nivel socioeconómico) y como variables dependientes la longitud media de los tres enunciados más largos (LME3) y la complejidad morfosintáctica (CM), obtenidas con el CDI. Los sustantivos fueron la clase de palabras más frecuente y que más aumentó con la edad, como en el italiano (Caselli et al., 1995; D'Odorico y Fasolo, 2007) y el español mexicano (Jackson-Maldonado et al., 1993). Además, el nivel de vocabulario predijo el nivel de desarrollo gramatical, como en el español peninsular (Mariscal y Gallego, 2012) y en el mexicano (Thal, Jackson-Maldonado y Acosta, 2000): una vez controlados los efectos de la edad y la escolarización materna, el vocabulario explicó el 20 % de la variabilidad de la LME3 y el 37 % de la variabilidad de la CM. Este estudio ofrece información sobre el desarrollo temprano del vocabulario y la gramática en el español del Perú, una etapa escasamente estudiada en esta variedad.
Abstract We present results from the analysis of data from 104 children with ages ranging from 16 to 30 months, living in Lima, Peru. The data was collected using a preliminary version of the MacArthur-Bates Communicative Development Inventories (CDI), Form II, adapted to Peruvian Spanish. The CDIs are parental reports that assess language through the presentation of a series of items to the parents, mainly in the form of a checklist. We aimed to (1) describe the composition of Peruvian children's productive lexicon at this age, (2) identify whether nouns were the most frequent class in their vocabulary, and also the class which increased the most with age, as is the case in Italian (Caselli et al., 1995; D'Odorico y Fasolo, 2007) and Mexican Spanish (Jackson-Maldonado et al., 1993); and (3) assess whether vocabulary size explained the level of grammatical development as in Peninsular and Mexican Spanish (Mariscal & Gallego, 2012; Thal, Jackson-Maldonado & Acosta, 2000). In order to do so, we analyzed the following data: age; maternal education level (as an indicator of socioeconomic status); vocabulary (represented by a list of more than 500 words that parents recognized as produced or not by their children); the mean length of the three longest utterances produced by the child as reported by parents; and sentence complexity, a measure of the level of structures produced by the child based on the parent's report. To achieve the first and second goals, words in the vocabulary list were classified according to grammatical class. Then, the percentage of production of each class of words was calculated, as well as the correlation between this percentage and age. Children's vocabulary was composed mainly of nouns, which represented 57 % of the production, followed by predicates (verbs and adjectives) and function words (pronouns, determiners, prepositions, conjunctions and connectives). Noun was the class of words that increased the most with age, showing the highest correlation with such variable (r = .72). Correlations between other types of words and age varied: it was also high for adjectives; but moderate for some classes and low for others. This showed that each type of word increased at different rates. Regarding the third goal, to assess the relationship between vocabulary size and level of grammatical development, two regression analyses were conducted to predict the variables mean-length-of-the-three-longest-utterances and sentence-complexity. For both analyses, age and maternal education level were entered in the first step, in order to control for their effect; and vocabulary was entered in the second step. Both models accounted for substantial amounts of variance and showed an important effect on vocabulary. The model with the mean-length-of-the-three-longest-utterances as the dependent variable accounted for 56 % of the variance. The first step explained 37 % of the variance (due to the contribution of both age and maternal education level), and the second step explained an additional 20 %. The model with sentence-complexity accounted for a higher percentage of the variance, 75 %. The first step explained 38 % of the variance, exclusively due to age; while the second step explained an additional 37 %. These results suggest a strong relationship between vocabulary and grammar. Further research is needed to confirm these results with direct measures of child production and more representative samples of children acquiring Peruvian Spanish, including speakers of dialects of other parts of the country. However, these results, preliminary as they are, shed light on the composition of vocabulary and its relationship with grammar in a variety of Spanish scarcely studied during early stages of development.