Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy.
Department of Brain and Behavioral Sciences, University of Pavia, Italy.
J Speech Lang Hear Res. 2024 Oct 8;67(10):3714-3732. doi: 10.1044/2024_JSLHR-23-00815. Epub 2024 Sep 18.
Prediction of developmental language disorder in children under 3 years of age is challenging. Among early risk factors, research has focused on having a positive familial history (FH+) for language or literacy problems and on late language emergence, that is, late-talker (LT) status. The interaction between these two risk factors and their cumulative effect is still debated. Here, we (a) investigate the effect of FH+ on 24-month language development, (b) test for cumulative effects of FH+ status and early language delay on 36-month language outcomes, and (c) disentangle the direct and indirect effects of familial history (FH) on the language outcome.
One hundred eighty-five Italian children were followed up longitudinally between 24 and 36 months of age (64 FH+ and 121 FH-) through parental questionnaires and direct child assessment.
At the age of 24 months, the FH+ group showed worse expressive vocabulary and higher prevalence of LT. At the age of 36 months, main effects of LT and FH were identified on lexical and phonological performances, respectively. Interestingly, significant interaction effects were identified on expressive vocabulary and phonological processing. Path analysis highlights that FH had a direct effect on later measures of phonology, whereas its effect on 36-month lexical abilities was indirect, via measures of expressive vocabulary at 24 months.
The study suggests specific predictive roles of FH and LT status on language development. Interestingly, FH+ seems to represent an additive risk for LT children. The use of cumulative risk measures is confirmed as a powerful approach to identify those children with the highest probability of developing persistent language difficulties.
预测 3 岁以下儿童的发育性语言障碍具有挑战性。在早期风险因素中，研究集中在具有语言或读写问题的阳性家族史（FH+）和语言延迟出现，即晚说话者（LT）状态。这两个风险因素之间的相互作用及其累积效应仍存在争议。在这里，我们（a）研究 FH+对 24 个月语言发展的影响，（b）测试 FH+状态和早期语言延迟对 36 个月语言结果的累积效应，以及（c）区分家族史（FH）对语言结果的直接和间接影响。
185 名意大利儿童在 24 至 36 个月之间通过父母问卷和直接儿童评估进行纵向随访（64 名 FH+和 121 名 FH-）。
在 24 个月时，FH+组表现出较差的表达性词汇量和较高的 LT 患病率。在 36 个月时，LT 和 FH 都有主要作用分别对词汇和语音表现有影响。有趣的是，在表达性词汇和语音处理方面发现了显著的交互作用效应。路径分析突出表明，FH 对后期语音测量有直接影响，而对 36 个月词汇能力的影响是间接的，通过 24 个月的表达性词汇测量来间接影响。
该研究表明 FH 和 LT 状态对语言发展有特定的预测作用。有趣的是，FH+似乎对 LT 儿童构成了额外的风险。累积风险措施的使用被证实是一种强有力的方法，可以识别出那些最有可能发展为持续语言困难的儿童。
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