Reliability of parental assessment of auditory skills in young children: a cross-sectional study in Italian language.

OBJECTIVE: Hearing impairments (HIs) that progress or have later onset may have specific effects on language and cognitive development, but are difficult to suspect during routine primary care visits. Family concern regarding hearing is thought to represent an important risk factor requiring audiological examination. Yet it is not clear how successful parents are in recognising the consequences or specific suspect elements of HI in young children. The aim of this study is to verify whether parents of at-risk children recognise the presence of HI through a parental questionnaire that draws attention to auditory skills development and compares them with language and communication skills. DESIGN: Observational study. SETTING: From 2013 to 2019, parents were administered the Questionnaire on Hearing and Communication Abilities before audiological evaluation of their children at a secondary care institute. PARTICIPANTS: 309 Italian children (1-36 months old) at risk of HI. PRIMARY AND SECONDARY OUTCOME MEASURES: Questionnaire sensitivity in predicting the presence and type of HI. RESULTS: Parents report a decrease in auditory skills for children with sensorineural HI (Χ2(2)=14.4, p=0.003), with an increased concern expressed in 59% compared with 24% in normally hearing children. Both auditory (r=-0.18, p=0.002) and comprehension (r=-0.13, p=0.057) skills weakly but negatively correlated with a diagnosis of HI. On discriminant analysis, the positive predictive value of the questionnaire was 0.78, but with low sensitivity (0.39). CONCLUSIONS: Parents of children with a verified risk of HI have some capacity to recognise non-typical auditory behaviour. Thus, it is important to assess parental concerns during primary care health visits, and a targeted questionnaire on auditory abilities can complement existing screening procedures. However, given the low sensitivity of the questionnaire, we conclude that for a reliable detection of HIs that progress or have later onset an objective screening tool is always required.

Communicative and linguistic development in preterm children: a longitudinal study from 12 to 24 months.

BACKGROUND: Research conducted on preterm children's linguistic skills has provided varying pictures, and the question of whether and to what extent preterm children are delayed in early language acquisition remains largely unresolved. AIMS: To examine communicative and linguistic development during the second year in a group of Italian children born prematurely using the 'Primo Vocabolario del Bambino' (PVB), the Italian version of the MacArthur-Bates Communicative Development Inventory. The primary goal was to compare action/gesture production, word comprehension, and word production, and the relationship between these three domains in preterm children and to normative data obtained from a large sample of Italian children born at term. A second aim was to address the longstanding debate regarding the use of chronological versus corrected gestational age in the assessment of preterm children's abilities. METHODS & PROCEDURES: Parents of twelve preterm children completed the PVB questionnaire at five age points during the children's second year, and scores were compared with those from a normative sample of full-term children and those of 59 full-term children selected as a control group from the normative sample for the PVB. OUTCOMES & RESULTS: Preterm children exhibited a delay in all three aspects of communication and language. In particular, communicative-linguistic age tended to lag approximately 3 months behind chronological age when children were between the ages of 12 and 24 months. When chronological age was used, preterm children's percentile scores for all three components of communication and language fell within the lower limits of the normal range, while scores calculated using corrected age either fell at or above the 50th percentile. CONCLUSIONS & IMPLICATIONS: Findings suggest that despite the significant biological risk engendered by premature birth, early communicative and linguistic development appears to proceed in a relatively robust fashion among preterm children, with tight relations across communicative domains as in full-term children. Employing both chronological and corrected gestational age criteria in the evaluation of preterm children's abilities may provide important information about their progress in language acquisition. This may be especially important during the initial stages of communicative and linguistic development, inasmuch as comparisons of the two sets of scores may provide clinicians with a way to distinguish children who may be at risk for language problems from those who may be expected to progress normally.

Assertive and responsive conversational skills of Italian-speaking late talkers.

BACKGROUND: Previous research on the pragmatic abilities of late talkers at 24 months of age indicates that they have difficulties initiating conversational interactions, but possess intact responsiveness skills. This study uses a parent-administered questionnaire for evaluating the conversational skills of late talkers and suggesting pragmatic intervention goals. AIM: To examine the conversational assertiveness and responsiveness of late talkers at 2 years of age. METHODS & PROCEDURES: A parent report measure, The Social Conversational Skills Rating Scale-Italian version, was administered to 30 parents of late talkers, 30 parents of typically developing children matched for age, and 30 parents of younger, typically developing children matched for vocabulary size. OUTCOMES & RESULTS: The late talkers received significantly lower ratings for both assertiveness and responsiveness in comparison with their age-matched peers. They did not differ significantly from the younger, vocabulary-matched group. Assertiveness and responsiveness mean ratings were positively correlated with vocabulary size for the age-matched group, but not for either of the other two groups. CONCLUSIONS: This study confirms a delay in the development of late talkers' social-conversational skills. An investigation of individual profiles suggests that some late talkers may require goals for vocabulary development as well as independent goals for developing pragmatic skills.

[INTERACT: a model of evaluation and intervention for children who are "late talkers"]. / INTERACT: un modello di valutazione e intervento per bambini "parlatori tardivi".

According to criteria applied in literature toddlers were identified as late talkers if they had less than 50-word expressive vocabulary and no word combinations at 24 months of age. The intervention programmes that use the parents as the primary agents of intervention and use child-centred techniques maximise the quality of parental communication during the emerging language period of the child. INTERACT is an early highly individualised parent and child-centered clinical intervention based on the social-pragmatic theorical approach. It is developed for 24-30 months old children with emerging language. The aims of this study are: to evaluate the gains of the child's expressive language skills and the use of multiword utterances and the changes of the maternal/parental communicative style. Six male children described as late talkers and their mothers participated for six months to INTERACT program. At initial intervention children's average age was 27 months and the average of number words producted was 26. All the mothers show high levels of directiveness. At the end of intervention the expressive vocabulary of late talkers increase in number of different words reaching an average of 407 words and an average linguistic age of 31 months, the gain is fourteen months in six months. The mothers show significant changes in their communicative style, the directiveness and the asynchronous/devaluing behaviours decrease.

Mother-child interactions in Canada and Italy: linguistic responsiveness to late-talking toddlers.

The aim was to examine cross-cultural variation in linguistic responsiveness to young children in 10 English-speaking mother-child dyads and 10 Italian-speaking mother-child dyads. All 20 children were late talkers who possessed delays in expressive vocabulary development but age-appropriate cognitive and receptive language skills. Dyads were filmed in 15-minute free play contexts, which were transcribed and coded for measures of maternal linguistic input (e.g. rate, MLU, labels, expansions) and child language productivity (e.g. utterances, different words used). The results revealed that the Italian mothers used more utterances, spoke more quickly and used a more diverse vocabulary than the Canadian mothers. The Italian children mirrored their mothers and also used more utterances and a more diverse vocabulary than the Canadian children. Mothers in both groups used similar percentages of responsive labels and expansions. However, Italian mothers responded to fewer of their children's vocalizations, using a smaller percentage of imitations and interpretations than the Canadian mothers. Correlations between maternal input and children's language productivity revealed that contingent language measures (e.g. imitations, interpretations, expansions) were related to high levels of productivity in children in both cultural groups. The results support the use of language interventions based on increasing maternal responsiveness for these children at the one-word stage of language development. They also point to differences that may be culturally based. For example, Italian mothers use faster rates of interaction and appear to have higher expectations for their children's verbal participation in interaction. This is reflected in higher rates of language production from their children, even though children in both cultural groups have similar vocabulary sizes.