Gesture in children with early language delay as a predictor of later language profiles: a follow-up study

Background: A link between gesture and early language development is well-established (Owens, 2005; Iverson & Goldin-Meadow, 2005). O’Neill and Chiat (2012) found a significant correlation between symbolic comprehension and gesture and profiles of language delay in n=22 children aged 2-3 years at time 1 (T1). It is not known whether gesture can be used as a clinical marker to predict later language impairment (LI). Objectives: The current longitudinal study aimed to follow up these children two years later and explore the following questions: Does early gesture use and symbolic skills predict later language profiles? Do specific clinical markers: word/non word repetition and sentence repetition predict persistent language impairment? Does children’s language status and profile change over time? Methods: Participants were 15 children ages 4; 3 – 5; 10 who had been identified as either having mixed receptive and expressive language deficits (RELD) or expressive language deficits (ELD) at T1 by O’Neill and Chiat (2012). The children were assessed using standardised assessments of language, speech, non-word repetition and morphosyntax. Data was analysed using SPSS (v22). Results: The strong correlation between early gesture, symbolic comprehension and language delay at T1 was not evident at T2. Children in the RELD group (n=6) at T1 had persistent language difficulties at T2. Four of these continued to have receptive difficulties. Three presented with co-occurring speech difficulties. Seven children in the ELD group (n=9) at T1 presented with language skills within normal limits at T2 (Wilcoxon Signed Rank test comparing expressive scores from T1 to T2, z= -2,814, p<.05). Despite having an expressive only language impairment at T1, two of these children presented with a receptive only impairment at T2. Seven of these presented with co-occurring speech difficulties. Conclusions: It is well established that there is a need for longitudinal studies following language trajectories and outcomes of children with language delays. This study adds to the literature on the fluid profiles of early language delay and impairment. The children with RELD had persistent difficulties whereas children with ELD showed higher rates of ‘recovery’. These findings are important clinically in terms of prioritisation and intervention to address the varying needs of the children. At T1 there was a strong correlation found between gesture and symbolic comprehension. However, at T2 those relationships no longer prevailed, while it was predicting severity at T1 it did not predict persistence at T2. However, when a partial correlation controlling for age was examined there was a statistically significant relationship between symbolic comprehension T1 and direct language measures T2. Further research is warranted on a larger sample.