Background and aims Young children with language delays or other factors that heighten risk for autism spectrum disorder often show reduced gesture use. In particular, deictic gestures such as pointing and showing are reported to be deficient in young children with autism spectrum disorder, and their use has been found to predict expressive vocabulary development. The first aim of this study was to examine the production of two types of gestures (deictic and conventional) for two communicative functions (behavior regulation and joint attention) across two observational contexts in a sample of 18-month-old toddlers with significant language delays compared to typical controls. The second aim was to examine if and how gesture use (type and communicative function) at 18 months is associated with later receptive and expressive language. Methods Toddlers with significant language delays (n = 30) or typical development (n = 62) were drawn from longitudinal studies of early language delay as a risk factor for autism spectrum disorder. Toddlers identified with early language delay were classified based on a diagnosis of autism spectrum disorder (n = 12) or non-autism spectrum disorder (n = 18) after an evaluation at 36 months. Gestures were coded from video recordings of the Communication and Symbolic Behavior Scales Developmental Profile–Behavior Sample and a naturalistic parent–child interaction obtained at 18 months. Language outcomes included receptive and expressive age equivalents from the Mullen Scales of Early Learning and the number of words produced on the MacArthur–Bates Communicative Development Inventories. Results At 18 months, toddlers with language delay showed reduced deictic and conventional gesture use in both the Communication and Symbolic Behavior Scales Developmental Profile–Behavior Sample and parent–child interaction compared to toddlers with typical development. Within the language delay group, toddlers with an autism spectrum disorder diagnosis at outcome also produced significantly fewer deictic gestures than those without an autism spectrum disorder diagnosis across both communicative functions and observational contexts. While all groups of toddlers gestured more in the Communication and Symbolic Behavior Scales Developmental Profile–Behavior Sample, the mean difference in gesture use between the Communication and Symbolic Behavior Scales Developmental Profile–Behavior Sample and parent–child interaction was significantly larger in toddlers with typical development than language delay for deictic gestures, as compared to the difference between the two contexts for conventional gestures. In the combined sample, a significant association was found between deictic gestures used in the Communication and Symbolic Behavior Scales Developmental Profile–Behavior Sample and change in the number of words produced from 18 to 36 months, accounting for significant demographic and developmental confounders. Conclusions Findings show that early language delay is associated with reduced deictic and conventional gestures across observational contexts. Importantly, deictic gesture use, but not conventional, was associated with the development of expressive language in toddlers with and without language delays. Implications Deictic gestures play an important role in the development of expressive language in toddlers, including those with language delays. Assessment of young children with language delays should include evaluation of types of gestures used and communicative function of gestures, with assessments utilizing communicative temptations yielding higher rates of gesture production. Directly targeting both gesture type and function in early intervention may be important in facilitating the development of language.

中文翻译：

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带有或不带有语言延迟的幼儿中手势语言随时间的关联

背景和目标患有语言障碍或其他增加自闭症谱系障碍风险的因素的幼儿通常显示出减少的手势使用。特别是，自闭症谱系障碍的幼儿中，指向和显示等手势姿势不足，据报道它们的使用可预测表达性词汇的发展。这项研究的第一个目标是，在一个18个月大的语言严重蹒跚学步的样本中，研究在两种观察情况下两种交际功能（行为调节和共同注意）的两种手势（惯性手势和常规手势）的产生与典型对照相比。第二个目的是研究18个月时的手势使用（类型和沟通功能）是否与以后的接受和表达语言相关联以及如何与之相关。方法：从早期语言延迟的纵向研究中，将具有严重语言延迟（n = 30）或典型发展（n = 62）的幼儿作为自闭症谱系障碍的危险因素。在36个月的评估后，根据对自闭症谱系障碍（n = 12）或非自闭症谱系障碍（n = 18）的诊断，对识别为早期语言延迟的幼儿进行分类。手势是根据“沟通和象征行为量表发展概况-行为样本”以及18个月时获得的自然亲子互动的视频记录进行编码的。语言结果包括从穆伦早期学习量表中接受和表达的年龄，以及麦克阿瑟·贝茨交流发展量表上产生的单词数。结果在18个月时，与具有典型发育能力的幼儿相比，具有语言延迟的幼儿在交流和象征行为量表中的行为和行为量表以及亲子互动方面都减少了对惯性手势和常规手势的使用。在语言延迟组中，具有自闭症谱系障碍诊断结果的幼儿在交流功能和观察环境中，其做出的手势也比没有自闭症谱系障碍诊断者明显少。在“沟通和象征行为量表发展概况-行为样本”中，所有幼儿组都做出了更多手势时，与传统手势的两种语境之间的差异相比，交流和符号行为量表的发展概况-行为样本与父母-儿童互动之间手势使用的平均差异与典型手势的两种语境差异相比，在典型发育阶段的幼儿明显大于语言延迟。 。在合并的样本中，在沟通和象征行为量表发展概况-行为样本中使用的姿势手势与18到36个月内产生的单词数量变化之间存在显着关联，这是造成人口统计学和发展方面混杂因素的主要原因。结论研究结果表明，在观察环境中，早期语言延迟与减少手势和传统手势有关。重要的是，使用专用手势，而不是常规手势，与有或没有语言延迟的幼儿发展表达语言有关。启示偏手势在幼儿（包括语言延迟的幼儿）的表达语言发展中起着重要作用。对有语言障碍的幼儿的评估应包括评估所用手势的类型和手势的交流功能，并利用交流的诱惑进行评估，以提高手势的产生率。在早期干预中直接针对手势类型和功能可能对促进语言发展很重要。包括语言延迟的人。对有语言障碍的幼儿的评估应包括评估所用手势的类型和手势的交流功能，并利用交流的诱惑进行评估，以提高手势的产生率。在早期干预中直接针对手势类型和功能可能对促进语言发展很重要。包括语言延迟的人。对有语言障碍的幼儿的评估应包括评估所用手势的类型和手势的交流功能，并利用交流的诱惑进行评估，以提高手势的产生率。在早期干预中直接针对手势类型和功能可能对促进语言发展很重要。