Acknowledgments

1. LONGITUDINAL ANALYSIS OF RATES OF GESTURES, VOCALIZATIONS, AND WORD USE IN TODDLERS WITH CLEFT PALATE Nancy Scherer, Ph. D., Sarah Boyce, M.S., & Gerri Martin, M.S. Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN Abstract INTRODUCTION. The purpose of this study was to examine the rate of communicative acts, canonical vocalizations and word use during transition from prelinguistic to linguistic development. METHODS. This retrospective study included 15 participants from a previous longitudinal study of nonsyndromic children with cleft lip and/or palate (CLP). The children were evaluated at 18, 24 and 30 months of age, during which time they transitioned from a prelinguistic level of development (10 or less words) to a linguistic level (more than 10 words). Ten-minute samples of clinician-child interaction were viewed and coded for the three variables. Data was recorded on the number of gestural communicative acts (CA), canonical vocalizations (CV) and words the children produced at the 3 time points. RESULTS. The results indicate that children with CLP demonstrated delays when transitioning from prelinguistic to linguistic levels of development. Rates of communicative acts and word use showed significant increases from 18 to 30 months of age and were correlated. While rates of canonical vocalizations showed increases, they were not significant. DISCUSSION. Assessment of gestural communicative acts may provide a measure of development that could be helpful in predicting which children are emerging into word use. • Method • Participants: • Retrospective study of children between 18 and 30 months of age (previous longitudinal study of children with cleft lip and/or palate). • 15 participants (nine females and six males) from northeast Tennessee. • Nine of the participants had cleft lip and palate, while the remaining six participants had cleft palate only. • At 18 months of age, 100% of the participants were in the prelinguistic level (10 or less words reported on the MacArthur Communicative Development Inventory; CDI) . At 24 months of age, 50% of the participants were in the prelinguistic level and the remaining 50% were in the linguistic level (more than10 words on CDI). At 30 months of age, 100% of the participants were in the linguistic level. • Procedures: • The children were evaluated at 18, 24, and 30 months of age. • The researchers independently viewed ten-minute videotaped samples of each child while he/she was actively engaged with the clinician. • Data were recorded on the number of communicative acts, canonical vocalizations, and words the child produced at each age. • A communicative act consisted of the following: two out of three communicative means (eye gaze, gesture, or vocalization), directed towards another person, and displayed a communicative purpose (protoimperativeand protodeclarative) (Calandrella and Wilcox, 2000; Bates, Camaioni, Volterra, 1975). • The data were then converted to a rate per minute ratio. • Reliability for coding was calculated with a second reviewer watching 30 percent of each ten-minute sample. The mean inter-coder reliability was 98.3 percent (87-100%). • ANOVA’s with the test of additivity were conducted to compare the communicative acts, canonical vocalizations and words across ages. Paired t-tests were used to compare adjacent age-point mean levels. Results cont. Correlation at 36 months of age: Communicative acts and words- The rate of word use was positively correlated with the rate of communicative acts (r = 0.544, p = 0.036). Canonical vocalizations and words- The linear correlation coefficient was -0.345 and was not statistically significant (p = 0.208). • Discussion • Age Comparisons: • The children showed delayed rates of communicative acts, canonical vocalizations and word use when compared to norms of noncleft children. • The children progressed more slowly through the transition from prelinguistic to linguistic levels than noncleft norms. • Rates of communicative acts and word use showed significant increases between 18 and 30 months of age and were significantly correlated. • Language Level Comparisons: • The rates of communicative acts exceeded those of noncleft children who were in the prelinguistic and early linguistic stage of development. • Results • Age Comparison: • Figure 1. Number and Mean of Communicative Acts • per minute calculated at 18, 24, 30 months • Figure 2. Number and Mean of Canonical Vocalizations • per minute calculated at 18, 24, 30 months • Age of Children (in months) • Results shown in Figure 1 indicate an increase • in the average rate per minute of communicative • acts across time points. Changes from 18 to 30 • months was slow but statistically significant • (p = 0.04). • Figure 3. Number of Words per minute • calculated at 18, 24, 30 months • `` • Age of Children (in months) • Results shown in Figure 2 indicate an over all increase • in average rates of canonical vocalizations across time points; however there were very different patterns of acquisition when compared to communicative acts or words. Statistical comparisons across ages were not significant . • Age of Children (in months) • Results shown in Figure 3 indicate a significant increase in • the rate per minute of words use between 18 and 30 • months of age (p=0.01) with the greatest change between • 24 and 30 months of age (p=0.02). However, there is • substantial variability in individual performance. Number of Communicative Acts Clinical Implications Assessment of communicative acts between 18 and 30 months of age may assist clinicians by assessing early communicative milestones that are less dependent on vocal production. Introduction Studies of early communicative development have shown a relationship between rates of communicative acts and canonical vocalizations with the acquisition of words for typically developing children (Yoder & Warren, 1999; Calandrella & Wilcox, 2000). Typically developing children are using communicative acts at a rate of 1 act per minute at the prelinguistic level (Wetherby, Cain, Yonclas, & Walker, 1988; Proctor-Williams, Dixon, Brown, Ringley, Barber, & Light-Newell, Submitted). The rate increases to approximately 2 acts per minute when children are using more than 10 words and 5 acts per minute when children reach the multi-word stage (Wetherby, Cain, Yonclas, & Walker, 1988; Proctor-Williams et al., Submitted) . Delays in early speech and language have been reported for children with cleft lip and/or palate (Scherer & D’Antonio, 1997; Chapman, Hardin-Jones, Schulte, & Halter, 2001). However, there has been little examination of nonverbal milestones of early communicative development that supports early word learning n children with cleft lip and/or palate. The purpose of this study was to examine children's rates of communicative acts, canonical vocalizations, and words during the transition from prelinguistic to linguistic level. Acknowledgments This study was funded in part by a grant from the National Institutes of Health-Institute on Deafness and other Communicative Disorders 18 months 24 months 30 months Number of Canonical Vocalizations References Bates, E., Camaioni, L., Volterra, V. (1975). The acquisition of performatives prior to speech. Merrill-Palmer Quarterly, 21, 205-226. Calandrella, A.M., & Wilcox, M.J. (2000). Predicting language outcomes for young prelinguistic children with developmental delay. Journal of Speech, Language, and Hearing Research, 43, 1061-1071. Chapman, K. L., Hardin-Jones, M., Schulte, J., & Halter, K. (2001). Vocal development of 9-month-old babies with cleft palate. Journal of Speech, Language, and Hearing Research, 44, 1268-1283. Proctor-Williams, K., Dixon, W., Brown, J., Ringley, M., Barber, T. & Light-Newell, C. (Submitted). Prelinguistic communication indicators of readiness for first words. American Journal of Speech-Language Pathology. Scherer, N. J., & D'Antonio, L. (1997). Language and play development in toddlers with cleft lip and/or palate. American Journal of Speech-Language Pathology, 6(4), 48-54. Wetherby, A. M., Cain, D. H., Yonclas, D. G., & Walker, V. G. (1988). Analysis of intentional communication of normal children from the prelinguistic to the multiword stage. Journal of Speech and Hearing Research, 31, 240-252. Yoder, P.J., & Warren, S.F. (1999). Facilitating proto-declaratives and proto-imperatives in prelinguistic children with developmental delays. Journal of Early Intervention,22(4), 337-354. 18 months 24 months 30 months Number of Words 18 months 24 months 30 months