Early language delay and later language development: a longitudinal study

Background: Many children who are identified with language delay in the early preschool years (age 2-3) will go on to develop age appropriate language skills by age 4-5, however some will continue to present with language impairment varying in nature and severity. It is inefficient to provide speech and language therapy to young children whose problems are likely to resolve (Dale et al, 2003). Identifying reliable predictive measures in the early years to distinguish children whose language will resolve from those who will persist with language impairment will prove valuable to clinicians, allowing for earlier intervention and preventative measures to be put in place. Significant correlations have been found between early gesture and language (Chiat & Roy, 2008). Gesture use and symbolic comprehension were explored in two subgroups of children (n=22) aged 2-3 years (Time 1); expressive language delay only (ELD) and receptive & expressive language delay (RELD). Results indicated differences in both the frequency and type of gesture uses, thus suggesting different underlying skills in each subgroup. Due to the fluidity of language profiles around this developmental period, language profiles from Time 1 are likely to have changed when the children are aged 4-5, with some persisting and others being resolved. Conducting a longitudinal study enables us to investigate whether the early language profiles and early gesture measures from Time 1 are useful in predicting the presence and nature of language impairment 2 years later. Objectives: • To investigate whether early gesture use and symbolic comprehension are reliable indicators of later language profiles. • To investigate whether early language profiles are predictive of persisting language difficulties Methods: 15 children from the original Time 1 cohort, were followed up (age 4-5 years, Time 2) and assessed on measures of receptive and expressive language, speech, phonological and morphosyntactic processing and nonverbal abilities. They were divided into subgroups based on their language diagnoses. Correlations between gesture, symbolic comprehension and language profiles at T1, against language scores and subgroups from T2 were generated. Results: At Time 2, 7/9 of the T1 ELD group had no impairment. 6/6 of the T1 RELD group persisted with language problems with 4/6 of them continuing to present with receptive language impairments. Significant correlations were found between symbolic comprehension and both receptive and expressive language scores at T2 and symbolic comprehension emerged as a strong predictor for later language impairment. Gesture scores were found to be weak predictors of language abilities at T2. Conclusion: Identification of early language profiles proves to be a significant clinical marker for persistent language difficulties where receptive delays in children aged 2-3 are most likely to persist. Early measures of symbolic comprehension might also prove clinically useful in identifying children who are likely to persist with language impairment. Further larger scale, longitudinal studies are warranted to investigate the relationship between gesture and symbolic comprehension and language development in specific subgroups of children to further assess the usefulness of these measures in predicting language outcome.