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Developmental interventions in infancy during lengthy hospitalizations.

A review of concepts related to infant development, care, and stimulation is presented. A description is provided of the development of an infant with small bowel syndrome during her hospitalization from birth until age 19 months. Interventions which facilitated feeding, sitting, walking, fine motor and language development are described. In addition, interventions are reviewed which focus on enhancing the infant's attachment to her cartakers, object permanence, and object constancy, and helping the normal unfolding of the individuation process. Efforts to "normalize" the hospital environment for the infant are stressed. The implications of the infant's hospitalizations and her future psychological development are discussed.

Anxiety↗

Developmental pathways of children with and without familial risk for dyslexia during the first years of life.

Comparisons of the developmental pathways of the first 5 years of life for children with (N = 107) and without (N = 93) familial risk for dyslexia observed in the Jyväskylä Longitudinal study of Dyslexia are reviewed. The earliest differences between groups were found at the ages of a few days and at 6 months in brain event-related potential responses to speech sounds and in head-turn responses (at 6 months), conditioned to reflect categorical perception of speech stimuli. The development of vocalization and motor behavior, based on parental report of the time of reaching significant milestones, or the growth of vocabulary (using the MacArthur Communicative Development Inventories) failed to reveal differences before age 2. Similarly, no group differences were found in cognitive and language development assessed by the Bayley Scales of Infant Development and the Reynell Developmental Language Scales before age 2.5. The earliest language measure that showed lower scores among the at-risk group was maximum sentence length at age 2. Early gross motor development had higher correlation to later language skills among the at-risk group rather than the control children. The most consistent predictor of differential development between groups was the onset of talking. Children who were identified as late talkers at age 2 were still delayed at the age 3.5 in most features of language-related skills-but only if they belonged to the group at familial risk for dyslexia. Several phonological and naming measures known to correlate with reading from preschool age differentiated the groups consistently from age 3.5. Our findings imply that a marked proportion of children at familial risk for dyslexia follow atypical neurodevelopmental paths. The signs listed previously comprise a pool of candidates for early predictors and precursors of dyslexia, which await validation.

Child↗

Out-of-school settings as a developmental context for children and youth.

Since the 1990s, there has been a growing recognition of the importance of the out-of-school context for children and adolescents. Fueled in part by family demographics that include substantial numbers of employed mothers and single mothers, in part by concerns about poor academic performance and problem behaviors, and in part by intensified efforts to find ways to promote positive youth development, researchers and practitioners have focused their attention on two particular out-of-school settings: after-school programs and structured activities. The research findings pertaining to full-time (i.e., 5 days a week) after-school programs are mixed, which may reflect the substantial heterogeneity of the programs in terms of children being served, the types of activities offered, and the training and background of the staff. The federal funding of the 21st Century CLCs and various state and local initiatives has increased the numbers of low-income and English-learning students participating in after-school programs. A substantial number of programs are becoming more school-like. The available research suggests that (under some conditions) attending after-school programs is linked to improved social and academic outcomes. Children are more likely to show academic and social benefits when staff-child relationships are positive and nonconflictual, when programs offer a variety of age-appropriate activities from which children can select those of interest, and when children attend on a regular basis. The research findings about voluntary structured activities are more straightforward. Participation in these activities has been consistently linked to positive academic and social developmental outcomes in numerous studies. What appears to be key is that the activities are voluntary, are characterized by sustained engagement and effort, and provide opportunities to build or develop skills. Although the available research has begun to inform our understanding of the out-of-school context, further research is sorely needed. First, there is a need for research to identify the social, cognitive, and linguistic processes by which participation in programs and structured activities influences child and youth developmental outcomes. For example, researchers need to consider the competitiveness of sport activities in relation to children's social and emotional functioning. Researchers also might examine after-school experiences as settings in which complex thought processes can develop. Heath (1999) has conducted initial work in the area of language development by obtaining language samples during voluntary structured activities and analyzing their content. In the initial samples, students engaged in few sustained conversations on a topic and they frequently changed topics. After 3-4 weeks at the program, however, Heath noted substantial changes in the students' conversations and language. The use of conditionals (should, would, could) increased. She also noted increases in strategies to obtain clarifications from others and increases in the use of shifted registers and genres. Heath's (1999) linguistic analyses in conjunction with research that considers social and motivational processes underscore the broader point that the out-of-school context is complex and multi-layered and likely to be of substantial importance in the lives of children and youth. Research is needed to identify other important developmental processes in programs and structured activities. A promising procedure for identifying these processes is experience sampling (Csikszentmihalyi & Larson, 1987; Larson, 1989). Experience sampling methodology allows researchers to collect systematic data about an individual's activities, thoughts, and affective states by obtaining reports from participants at multiple randomly sampled points in time. Participants are signaled to provide a report in a variety of ways, such as with beepers or alarm watches. This record of experiences is not usually captured by other data collection methods. For example, program observations provide data on observed activities, interactions, and program climate, but do not offer insights into students' feelings and experiences within the after-school environment. Questionnaire and survey data are retrospective, asking respondents to recall past experiences and feelings regarding their after-school activities. Experience sampling could be used to examine any number of processes in after-school programs and structured activities. A better understanding of the effects of program content also is needed. Whether after-school programs should focus exclusively on enrichment activities or exclusively on academic activities, or include both enrichment and academic components, is the subject of heated debate. Some after-school scholars (Halpern, 1999; Heath, 1999; Eccles, in press) have argued forcefully that a focus on academics undermines the unique strengths and role of programs, and that programs should emphasize extracurricular enrichment activities. Others (Noam, 2004) have supported the move by policy makers and educators to make programs more academic, with an emphasis on homework help, tutoring, and preparation for academic achievement tests. The effects of different approaches to after-school programming have not been evaluated systematically. Research that describes, compares, and then tests effects of different program content models is needed to determine which types of programs are successful in attracting and keeping students (a necessary condition for programs to effect change), and to determine whether different types of programs are differentially associated with improvements in student outcomes such as school attendance, academic achievement, social competencies, and behavioral adjustment. A related question is whether structured activities that are obligatory or required have the same effects as voluntary structured activities do. Researchers also should further examine the impact of different attendance patterns on child developmental outcomes. We do not have solid information about optimal intensity and duration of attendance in terms of outcomes. There are suggestions in the literature that long-term, frequent attendance at programs is associated with positive outcomes for low-income children. Research needs to examine whether these results hold for middle-income children and youth as well. Finally, experimental studies should be conducted in which children and adolescents are randomly assigned to after-school programs and structured activities. All of the research to date on structured activities, and most of the research on after-school programs, has been nonexperimental, so questions about selection bias remain. Experimental studies in which children and adolescents are randomly assigned to participation in programs and activities would be a valuable next step in understanding relations between participation and child and youth outcomes. Such research should not be conducted until we have more information about the components of high-quality programming in terms of program content and developmental processes, however.

Adolescent↗

Verbal imitation by Down syndrome and nonretarded children.

Grammatical aspects of the spontaneous repetitions of maternal speech by Down syndrome and nonretarded children were in investigated. Verbal imitations were found to be very similar in grammatical structure for the two groups of children at comparable levels of language development.

Child↗

Mental and somatic health and social adjustment in ordinary school children during childhood and adolescence related to central nervous functions as expressed by a complex reaction time.

A cohort of ordinary Swedish children were followed up from school entry through childhood and adolescence and checked retrospectively from birth to the age of 6 years regarding psychiatric and physical health and contact with the social welfare authorities. The children were allocated to different risk groups at age 7 on the basis of their psycho-physical development expressed as complex reaction time (CRT). It was previously shown that many of the slow CRT children have problems in psychomotor and language development at school, and that many leave compulsory school with poor achievements in Swedish and gymnastics as continuing signs of their developmental delay. This study shows that slow CRT children have an increased prevalence of child psychiatric problems. At an early age there were symptoms of aggression, hyperactivity and withdrawal in conjunction with developmental delay. During adolescence, depression, maladjustment and psycho-somatic disorders were prominent features, often in association with developmental delay, dyslexia and poor motoric skill. These children could have a disadvantage at school and in society and they felt themselves "handicapped" and were stressed by feelings of limited future possibilities. In adolescence, many of them were in need of help, especially financial aid from the social welfare services. The findings stress that a slow cognitive processing ability seen as a slow CRT must be considered a handicap of importance and a risk-factor in the society of today, with primary or secondary psychic and social manifestations often in a multifactorial setting of biological co-morbidity and family problems. In contrast, an advanced CNS development with a fast CRT may be seen as a protective factor.

Adolescent↗

[Child development examinations in well-child clinics for infants and young children].

The health centres for infants and toddlers have recently been supplied with new forms for examination and registration of psychomotor development. These forms, which were especially designed for use in this setting are largely based on the work of Gesell. His sub-division in 5 fields of development is followed and items are chosen from his work. The forms are completed by adding a number of neurological items directed at the detection of pathology (Touwen) and some items concerning speech and language development (Schaerlaekens). The method is based on observations of developmental characteristics at the ages at which 90% of normal children in child health centres display these items. Reference-values are derived from a longitudinal study which was carried out in child health centres and comprised 550 children (Schlesinger-Was). These children provided per item the data for a cumulative percentile curve in which the age of the 90th percentile could be read. It is expected that by directing the assessment at the age of P90 an early detection of developmental disorders will result, while the number of false referrals will stay relatively small. Since the forms were incorporated in the new social-medical record for youth health care which has recently been introduced for nation-wide use, they are available on a large scale. Pediatricians therefore may be increasingly confronted with referrals based on this method of examination.

Adaptation, Psychological↗

[The dynamics of the spoken language and parental guidance].

The aim of parental guidance of deaf children is to allow the parents to understand and adapt to the unusual language development of their child. The authors propose a system of explanation of the control of language which will lead to the development of confidence, relaxation and spontaneity--the three determining factors--as well as to enlightenment; it will act as a point of reference during their introduction to the physiology of language, and as a guideline for the attitude of rehabilitation which needs to be adopted.

Child, Preschool↗

Outcome of very preterm small for gestational age infants: the first nine years of life.

OBJECTIVE: To determine the influence of intrauterine growth retardation of preterm infants on mortality and cognitive development. DESIGN: A nationwide study cohort of very preterm and/or small for gestational age infants (< 32 weeks and/or < 1500 g) born alive in 1983 in the Netherlands. Assessment on neuromotor and cognitive development at five years, and a parental questionnaire on school performance at nine years. Cognitive outcome is defined as handicap for mental and speech-language development, and need for special education. SAMPLE: 134 small for gestational age infants (< 10th centile) and 410 appropriate for gestational age infants (between 25th and 75th centile) of all infants between 25 and 32 weeks of gestational age were identified; infants with congenital malformations and not of caucasian race were excluded. MAIN OUTCOME MEASURES: Neonatal mortality, in-hospital and five years mortality; Cognitive outcome at five years; School performance at nine years. RESULTS: The mortality risk for small for gestational age compared with appropriate for gestational age infants was significantly higher, after adjustment for gestational age, sex, multiple pregnancy and mode of delivery (OR 2.56, 95% CI 1.26-5.26). Small for gestational age infants showed more often gross motor and minor neurological dysfunction, but less cerebral palsy than appropriate for gestational age infants. Cognitive outcome at five years in small for gestational age infants was significantly worse than appropriate for gestational age infants stratified for mode of delivery OR 2.44 (95% CI 1.05-5.55). At nine years of age significantly more small for gestational age infants (16.4%) needed special education than appropriate for gestational age infants (11.9%). CONCLUSION: Intrauterine growth retardation increases the risk of mortality and of cognitive disorders.

Child↗

Language delay in infants associated with middle ear disease and mild, fluctuating hearing impairment.

We report on a study of the relationship between early persistent middle ear disease and early language learning for 35 infants. Three independent measurements were used to evaluate hearing sensitivity and the status of the middle ear. Language development was assessed using two standardized measurements for both comprehension and expression. The otitis-prone group had a 71.5% incidence of language delay with 42.9% delayed greater than 6 months. For the normal group 21.4% had language delay, with one child having delay greater than 6 months. The feasibility of including language screening for at-risk infants is discussed.

Acoustic Impedance Tests↗

Longitudinal predictors of developmental status and social interaction in premature and full-term infants at age two.

This investigation involved the longitudinal assessment of 30 mother-preterm and 40 mother-full-term dyads from birth to 2 years of age. Measures of maternal attitudes, maternal perception of the infant, and parental functioning were obtained at 1 and 8 months of infant age. Mother-infant interactions were observed at 4, 8, 12, and 24 months. Infant cognitive, motor, and language development was assessed at 4, 12, and 24 months. Results indicated that by age 2 years, no group differences were apparent on any child development, mother-child interaction, or maternal attitudinal measures; the lone exception was that preterms were significantly poorer in motor skills. This similarity in functioning at age 2 years was in marked contrast to earlier findings of major group differences at 12 months. Correlational and regression analyses indicated that the developmental and social interaction outcomes were predicted by different factors in the two groups; moreover, whereas 40%-60% of the variance in preterm infants' social and cognitive outcomes could be accounted for, only 15%-30% was accounted for in the full-term group. These results are discussed in terms of compensatory mechanisms that may characterize the parenting of high-risk infants, and of the applicability of transactional models of development.

Attitude↗

Acquisition of Pig Latin: a case study.

A boy's acquisition of Pig Latin was monitored throughout the year preceding first grade. Abilities underlying this game include the identification of words, deletion of the first syllabic onset (i.e. prevocalic consonants) of each word, blending of this onset and the suffix [ei] onto the word's end, and short-term memory for speech units. Performance improved over time as the underlying abilities developed. Meanwhile, various informative errors were made. Throughout most of the study, onsets that were correctly removed from a word's beginning were often added to its end incorrectly; unstressed function words were repeated intact and not transformed; and the first syllabic onset was overlooked when the syllable was unstressed. Because speech games like this one depend upon basic language skills, they can clarify aspects of ordinary language development.

Child, Preschool↗

Pittsburgh Registry of Infant Multiplets (PRIM).

This paper describes the Pittsburgh Registry of Infant Multiplets (PRIM; Pittsburgh, Pennsylvania), the results of pilot research conducted in this registry, and the plans for future studies. The main focus of the registry is on psychological development and the risk for behavioral disorders. Particularly, characteristics associated with antisociality and the risk for substance use disorders (e.g., aggressivity, hyperactivity/impulsivity), as well as language development and other traits (e.g., dental health) are among the research targets.

Child Behavior Disorders↗

Early N400 development and later language acquisition.

Recent developmental research on word processing has shown that mechanisms of lexical priming are already present in 12-month-olds whereas mechanisms of semantic integration indexed by the N400 mature a few months later. In a longitudinal setting we investigated whether the occurrence of an N400 at 19 months is associated with the children's language skills later on. To this end children were retrospectively grouped according to their verbal performance in a language test at 30 months. Children with later age-adequate expressive language skills already displayed an N400 at 19 months. In contrast, children with later poor expressive language skills who have an enhanced risk for the development of specific language impairment (SLI) did not show an early N400. The results imply that children who have deficits in their expressive language at the age of 30 months are already impaired in their semantic development about one year earlier.

Data Interpretation, Statistical↗

A comparison of the transition from first words to grammar in English and Italian.

Cross-linguistic similarities and differences in early lexical and grammatical development are reported for 1001 English-speaking children and 386 Italian-speaking children between 1;6 and 2;6. Parents completed the English or Italian versions of the MacArthur Communicative Development Inventory: Words and Sentences, a parent report instrument that provides information about vocabulary size, vocabulary composition and grammatical complexity across this age range. The onset and subsequent growth of nouns, predicates, function words and social terms proved to be quite similar in both languages. No support was found for the prediction that verbs would emerge earlier in Italian, although Italians did produce a higher proportion of social terms, and there were small but intriguing differences in the shape of the growth curve for grammatical function words. A strikingly similar nonlinear relationship between grammatical complexity and vocabulary size was observed in both languages, and examination of the order in which function words are acquired also yielded more similarities than differences. However, a comparison of the longest sentences reported for a subset of children demonstrates large cross-linguistic differences in the amount of morphology that has been acquired in children matched for vocabulary size. Discussion revolves around the interplay between language-specific variations in the input to young children, and universal cognitive and social constraints on language development.

Child Language↗

Acquisition of conversational response skills by young Down syndrome and nonretarded young children.

The acquisition of conversational response skills by young retarded and nonretarded children matched for chronological age (CA) and expressive linguistic ability was compared. Retarded children showed delayed response performance in comparison with CA-matched nonretarded peers. When matched for language level, however, retarded children demonstrated significantly greater response abilities than did nonretarded children. These findings indicate that the language development process of retarded children is developmentally delayed and different with respect to the synchrony of syntactic development and communicative competence. The findings further suggest that the acquisition of conversational response rules is not determined by the child's expressive language ability as measured by a mean length of utterance score, but is directly influenced by social-experiential factors as measured by the child's age.

Child, Preschool↗

A front-end automation tool supporting design, verification and reuse of SOC.

This paper describes an in-house developed language tool called VPerl used in developing a 250 MHz 32-bit high-performance low power embedded CPU core. The authors showed that use of this tool can compress the Verilog code by more than a factor of 5, increase the efficiency of the front-end design, reduce the bug rate significantly. This tool can be used to enhance the reusability of an intellectual property model, and facilitate porting design for different platforms.

Algorithms↗

Communication options for children with hearing loss.

This article examines the communication options that are available for use within families of infants and young children who are hard-of-hearing or deaf. The need for language development, regardless of the specific communication mode, is stressed. The demands of the current environment of early identification and intervention often put families in a position of needing to decide among communication methods before they are fully knowledgeable and/or emotionally ready. Specific communication options are delineated and considered within a continuum of spoken and visual language. Available research related to early acquisition of language by infants and young children who are hard-of-hearing and deaf is reviewed; outcomes, when available, are presented for specific methods from reports of older children. Factors that influence families' decisions regarding the selection of a communication option are highlighted in the context of the existing literature. An ongoing evaluative process that respects the choices of families is advocated; a context in which change(s) in communication mode through childhood is viewed as a positive circumstance. The ultimate goal in the selection of any communication approach is to ensure that infants and young children who are hard of hearing or deaf and their families are language proficient and fluent communicators.

Child↗

Teenage motherhood: its relationship to undetected learning problems.

This study describes characteristics of a group of 64 adolescent mothers and their infants who participated in a program for teenage mothers run by a local health department. A majority of the girls for whom California Achievement Test (CAT) scores were available scored one or more years below grade level in reading and in language skills. Relative delays in infant development (language and social domains) were also documented. High levels of self-esteem as well as general social acceptance (by adults and peers) of early out-of-wedlock parenting suggest that early motherhood may represent an alternative avenue to experiencing success for girls who are having academic difficulties. These findings, which suggest the likelihood of a high incidence of undetected learning problems in this population, indicate that these difficulties may have a significant relationship to the high rate of school dropout associated with adolescent motherhood. The findings bring into question the notion of "unintended pregnancies" and the wisdom of current federal policies for preventing adolescent parenthood that rely on the promotion of abstinence.

Adolescent↗