BACKGROUND During the first 3-years of life, as the brain undergoes dramatic growth, children begin to develop speech and language. Hallmarks of this progression are seen when children reach developmental milestones, forming the foundation of language. Expressive language milestones, such as the production of a child's first word, are delayed in 5-8% of children. While for some children delays in reaching these milestones are harbingers of developmental disorders, for others expressive language delays appear to resolve. Regardless of whether or not early language skills appear resolved, difficulty with later comprehension is a likely outcome. Whether this heightened risk for poor comprehension differs based on text features, individual characteristics, or receipt of intervention remains unknown. Moreover, this relationship between expressive language development and comprehension is not yet linked to neurobiology, though the inferior longitudinal fasciculus (ILF) is a potential neurobiological correlate. Therefore, we investigated the impact of, and interactions between, expressive language development, early intervention, and the ILF on comprehension. METHODS Longitudinal recurrent survival analyses predicted the risk of answering a comprehension question incorrectly. Predictors of comprehension included expressive language development, passage features, participant characteristics, fractional anisotropy, receipt of early intervention, and later diagnosis of speech or language disorders. RESULTS Children with later expressive language milestones had poorer comprehension. When comprehension text features were examined, children with later milestones had poorer listening and reading comprehension, and poorer narrative and expository comprehension. The left ILF acted as a neurodevelopmental correlate, one that moderated the relationship between expressive language milestones and comprehension. Specifically, the left ILF exacerbated the relationship for those who did not receive early intervention and buffered the relationship for those who received intervention services. Early intervention decreased the risk of poor comprehension by 39% for children later diagnosed with a speech or language disorder. CONCLUSIONS Early intervention should be provided for children with delayed expressive language milestones, particularly those who are at risk for speech or language disorders. The ILF plays a critical role in the relationship between expressive language development and comprehension, which may be that of a protective factor for children with the most severe early issues with speech and language.

中文翻译：

---

表达性语言发展和左下纵筋膜对听和读理解的影响。

背景技术在生命的头3年中，随着大脑的急剧发展，儿童开始发展言语和语言。当儿童达到发展里程碑并形成语言基础时，就可以看到这种进步的标志。富有表现力的语言里程碑（例如，生成孩子的第一个单词）在5-8％的孩子中被延迟。对于某些儿童而言，延迟到达这些里程碑是发展障碍的预兆，而对于另一些儿童，表达性语言延迟似乎可以解决。不管早期的语言能力是否得到解决，后期理解的困难都是可能的结果。这种理解力差的高风险是否会因文字特征，个人特征或接受干预而有所不同仍然未知。而且，尽管下纵筋膜（ILF）是潜在的神经生物学相关因素，但表达语言发展与理解之间的这种关系尚未与神经生物学联系起来。因此，我们调查了表达性语言发展，早期干预和ILF对理解的影响以及它们之间的相互作用。方法纵向复发生存分析预测错误回答理解问题的风险。理解力的预测因素包括表达语言的发展，通过特征，参与者特征，分数各向异性，接受早期干预以及后来对言语或语言障碍的诊断。结果具有较晚表达语言里程碑的孩子的理解力较差。在检查了理解文字功能后，具有里程碑意义的孩子的听和读理解能力较差，叙述和说明的理解力也较差。左ILF充当神经发育相关因子，可调节表达性语言里程碑与理解之间的关系。具体来说，左翼ILF加剧了那些没有接受早期干预的人的关系，并缓冲了那些接受干预服务的人的关系。对于后来被诊断患有言语或语言障碍的孩子，早期干预可以将他们理解能力差的风险降低39％。结论应为表现语言障碍较迟的儿童，特别是那些有言语或语言障碍风险的儿童提供早期干预。