Effect of congenital heart defects on language development in toddlers with Down syndrome.

BACKGROUND: Down syndrome (DS, OMIM #190685) is the most commonly identified genetic form of intellectual disability with congenital heart defect (CHD) occurring in 50% of cases. With advances in surgical techniques and an increasing lifespan, this has necessitated a greater understanding of the neurodevelopmental consequences of CHDs. Herein, we explore the impact of CHD on language development in children with DS. METHODS: Twenty-nine children with DS were observed systematically in parent-child interactions using the Communication Play Protocol to evaluate their language use; they also completed the Mullen Scales of Early Learning and MacArthur Communication Development Inventory. Mean ages were 31.2 months for children with DS and CHD (DS + CHD, n = 12) and 32.1 months for children with DS and a structurally normal heart (DS - CHD, n = 17). RESULTS: Compared with the DS - CHD controls, the DS + CHD group revealed lower scores in multiple areas, including fine motor skills and expressive and receptive vocabulary. Whereas most differences were not statistically significant, the Communication Development Inventory word count and symbol-infused joint engagement differed significantly (P < 0.01) and marginally (P = 0.09) between groups. CONCLUSIONS: Finding that CHDs may account for part of the variation in language delay allows us to consider the specific mechanisms underlying the impact of CHDs on language acquisition in children with DS. Conclusions from this first study on early language outcomes of children with DS + CHD may be useful for clinicians in providing developmental surveillance and early intervention programmes with specific emphasis on language therapy as part of long-term follow-up for children with DS + CHD.

Research directions in augmentative and alternative communication for preschool children.

PURPOSE: To review issues related to the use of augmentative systems with young children and present a case study of one child and family's experience with the System for Augmenting Language (SAL). METHOD: The case involved a preschool child with severe developmental delays who had little functional speech. Acquisition and use of graphic symbols on a speech-output communication device was studied in home and clinical settings. Language and communication behaviours of the child and his communication partners were observed and language assessment measures were collected. RESULTS: Child engagement state varied across the two settings with a stable profile seen in the therapy setting and a clear increase at home. Child communicative attempts increased following the introduction of the augmented system. Parents reported successful use of the SAL. CONCLUSION: SAL is a viable communication intervention approach for young children.

Communication patterns of youth with mental retardation with and without their speech-output communication devices.

The communication skills of 13 youth with moderate or severe mental retardation were compared while they communicated with a "standard partner" with and without access to their communication devices. When participants employed the communication device, they were able to convey more appropriate information as well as clearer and more specific information to an unfamiliar adult partner than they were able to convey without the device. These findings highlight the distinct contributions the participants' use of an augmented communication device make to the overall communicative interaction.

Social referencing by young chimpanzees (Pan troglodytes).

Social referencing is the seeking of information from another individual and the use of that information to evaluate a situation. It is a well-documented ability in human infants but has not been studied experimentally in nonhuman primates. Seventeen young nursery-reared chimpanzees (14 to 41 months old) were observed in a standard social referencing paradigm in which they received happy and fear messages concerning novel objects from a familiar human caregiver. Each chimpanzee looked referentially at their caregiver, and the emotional messages that they received differentially influenced their gaze behavior and avoidance of the novel objects. It is concluded that chimpanzees can acquire information about their complex social and physical environments through social referencing and can use emotional information to alter their own behavior.

Joint attention in preverbal children: autism and developmental language disorder.

For preverbal children, episodes of joint attention are contexts for communication with responsive adults. This study describes the joint attention of 3- to 5-year-old children, 15 with autistic disorder (AD) and 15 with developmental language disorder (DLD), during play sessions with unfamiliar adults. Adults used fewer conventional than literal bids for joint attention with AD children and vice versa with DLD children. Children with AD were less likely to engage in joint attention than children with DLD. In the allocation of attention, AD children monitored the channel of communication with the adult 37% less often than DLD children. We discuss how perturbations in reciprocal interactions permeate the sharing situation and the implications of this problem for the mastery of cultural conventions.

Mothers' expressed attitudes: associations with maternal depression and children's self-esteem and psychopathology.

OBJECTIVE: Mothers' expressed attitudes about their children were examined to discern whether the associations between maternal depression and children's psychopathology and self-esteem might be modified by the mother's expression of critical attitudes. METHOD: Mother-child dyads with mothers who had a history of at least one episode of unipolar major depression during the child's lifetime (N = 20) were compared to dyads with well parents (N = 19). Children's ages ranged from 8 to 10 years. Mothers' attitudes toward their children were derived from semistructured interviews. The affect expressed in each maternal statement was coded as neutral, positive, descriptive negative, or affectively charged negative. RESULTS: Affectively charged negative statements were found to be associated with mothers with a history of depressive episodes. A tendency was noted for the highest rates of psychopathology to be among children of depressed mothers who used affective-negative statements. Mothers' use of affectively charged negatives was found to modify the association between maternal depression and children's lower global self-worth. CONCLUSIONS: Clinicians attuned to mothers' expression of critical attitudes toward their children might detect children at risk for lowered self-esteem and the development of psychopathology.

Measuring the impostor phenomenon: a comparison of Clance's IP Scale and Harvey's I-P Scale.

Many of the discrepancies reported to date in empirical investigations of the impostor phenomenon (IP) may be due in part to (a) the use of different methods for identifying individuals suffering from this syndrome (impostors), (b) the common use of a median split procedure to classify subjects and (c) the fact that subjects in many studies were drawn from impostor-prone samples. In this study, we compared the scores of independently identified impostors and nonimpostors on two instruments designed to measure the IP: Harvey's I-P Scale and Clance's IP Scale. The results suggest that Clance's scale may be the more sensitive and reliable instrument. Cutoff score suggestions for both instruments are offered.

Symbol vocabulary and the focus of conversations: augmenting language development for youth with mental retardation.

Communication devices designed to augment the language development of individuals with severe cognitive disabilities and little or no functional speech typically contain primarily nouns because they seem easiest to acquire and evaluate. In this study, the effect of a more diverse vocabulary was assessed. Systematic observations of the use of computerized speech-output devices by 12 youth with moderate or severe mental retardation and severe spoken language disability and by their partners were made over a 2-year period. Social-regulative symbols (e.g., "please," "I'm finished") were used as soon as they were introduced, and their availability expanded the focus of conversations both at home and at school. Implications for conceptualizing variation in early language use and for the design of language intervention programs are discussed.

Kung infancy: the social context of object exploration.

The present study consists of new analyses of systematic observations of Kung infants made by Konner during the late 1960s and early 1970s. Our intent was to examine claims about the role of object sharing in development by describing how Kung infants develop interest in objects and how their caregivers act toward them when they are engaged in object-related acts. Results indicated that infants first displayed sustained interest in objects beginning at 4 months of age and that, beginning at about 8 months, they also began to engage in relational play and to give objects to others. Others tended to ignore infants during episodes of object manipulation and play, but moments of object offering were often socially embedded. These findings provide support for claims that there are universal changes in infants' involvement with objects and that their involvement is channeled in a culturally relevant manner by their caregivers.

Coordinating attention to people and objects in mother-infant and peer-infant interaction.

In a longitudinal study, infants 6-18 months of age were observed in their homes playing with their mothers and with peers. Of primary concern was how they coordinated their attention to people and objects. Observations were coded using a state-based scheme that included a state of coordinated joint engagement as well as states of person engagement, object engagement, onlooking, and passive joint engagement. All developmental trends observed were similar regardless of partner: person engagement declined with age, while coordinated joint engagement increased. Passive joint engagement, object engagement, and onlooking did not change with age. However, the absolute amount of some engagement states was affected by partner: both passive and coordinated joint engagement were much more likely when infants played with mothers. We conclude that mothers may indeed support or "scaffold" their infants' early attempts to embed objects in social interaction, but that as attentional capabilities develop even quite unskilled peers may be appropriate partners for the exercise of these capacities.