Morgan Lindee, Delehanty Abigail, Dillon Julie Cleary, Schatschneider Chris, Wetherby Amy M
Marcus Autism Center, School of Medicine, Department of Pediatrics, Emory University, 1920 Briarcliff Rd., Atlanta, GA 30320.
Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA 15282.
Early Child Res Q. 2020;51:366-378. doi: 10.1016/j.ecresq.2019.12.005. Epub 2020 Jan 17.
Late talkers are a heterogeneous group of toddlers and reliable predictors of persistent language delay have been elusive. The purpose of this study was to determine the extent to which early social communication and vocabulary production predicted variance in language outcomes at 2 and 3 years of age.
Participants were 408 typically developing and late-talking toddlers who completed the Communication and Symbolic Behavior Scales Caregiver Questionnaire and Behavior Sample (CSBS CQ and CSBS BS) at a mean of 20 months, the Language Development Survey (LDS) at a mean of 24 months, and the Mullen Scales of Early Learning (MSEL) at a mean of 25 months. A subgroup of 198 children completed a second MSEL at 3 years of age. Associations among the LDS, CSBS CQ, CSBS BS, and MSEL were examined using correlational and hierarchical linear regression analyses. Logistic regression was used to examine each measure's contribution to predicting language delay at 2 and 3 years.
Moderate to large correlations were observed among all variables. The LDS, CSBS CQ, and CSBS BS added unique contributions to the prediction of 2- and 3-year expressive and receptive language outcomes. Measures of speech and vocabulary production were the strongest predictors of language outcomes at age 2. At age 3, social and symbolic communication played a more significant role in accounting for variance in expressive and receptive language outcome. A similar pattern emerged for the categorical prediction of language delay.
Measures of social communication between 18-21 months added important information to predicting language outcomes at 2 and 3 years, above and beyond parent-reported expressive vocabulary production measured at 24 months, with small effect sizes overall. Implications for identifying younger children who are at risk for continued language delay and recommendations for referral to early intervention programs are discussed.
说话晚的幼儿是一个异质性群体，而持续语言发育迟缓的可靠预测因素一直难以捉摸。本研究的目的是确定早期社交沟通和词汇产出在多大程度上能够预测2岁和3岁时语言发育结果的差异。
研究对象为408名发育正常和说话晚的幼儿，他们平均在20个月时完成了沟通与象征性行为量表照顾者问卷及行为样本（CSBS CQ和CSBS BS），平均在24个月时完成了语言发展调查问卷（LDS），平均在25个月时完成了马伦早期学习量表（MSEL）。198名儿童的亚组在3岁时完成了第二次MSEL测试。使用相关分析和分层线性回归分析检验LDS、CSBS CQ、CSBS BS和MSEL之间的关联。使用逻辑回归分析检验各项指标对预测2岁和3岁时语言发育迟缓的贡献。
所有变量之间均观察到中度至高度相关性。LDS、CSBS CQ和CSBS BS对预测2岁和3岁时的表达性和接受性语言发育结果均有独特贡献。言语和词汇产出指标是2岁时语言发育结果的最强预测因素。在3岁时，社交和象征性沟通在解释表达性和接受性语言发育结果的差异方面发挥了更重要的作用。在语言发育迟缓的分类预测中也出现了类似的模式。
18至21个月时的社交沟通指标为预测2岁和3岁时的语言发育结果增添了重要信息，这超出了24个月时家长报告的表达性词汇产出情况，总体效应量较小。文中讨论了识别有持续语言发育迟缓风险的年幼儿童的意义以及转介至早期干预项目的建议。
