Late Talkers (LTs) are at risk for persistent developmental language disorders and show a slowdown in the acquisition of both language and communication skills. The Dynamic Communication Evaluation (DCE) is an event-based coding scheme for the analysis of intentional communicative acts produced via parental interaction, including categories of socio-communicative pragmatics and structural linguistic complexity. This cross-sectional observational study compares the communicative-linguistic competencies detected through the DCE of LTs with those of typical development children. The participants included 19 LT children (24-38 months old) with a vocabulary size lower than the 5th percentile on the Italian version of the MacArthur-Bates CDI, and the findings were compared to the performance of 19 typically developing (TD) children (25-37 months old). The groups were matched for chronological age. Correlations between communicative and linguistic labels and age were found in the LT group in greater numbers than in the TD group. A comparison between the two groups revealed lower abilities in LT than TD children in communicative-pragmatic indices - such as joint attention, responsiveness, and request of information - and in linguistic indices. Socio-communicative pragmatic, lexical, morphosyntactic, and phonological skills influenced each other during development in children with slow language emergence. The findings have clinical implications regarding early identification. Systematic observations appear to have clinical value because they support quantitative and qualitative data collection and guide intervention.
Background: Communication, language, and speech disorders are highly prevalent in children with cerebral palsy (CP) and substantially impact social, educational, and community participation. However, few studies have systematically characterized communicative and linguistic profiles using standardized assessments. This paper outlines the work of the ‘Italian CP & Language Network’ over the last two years, focusing on identifying research priorities, developing specialized assessment protocols, and proposing a shared classification system for speech and language disorders in children with CP. Methods: A survey was sent to 11 specialized centers to investigate clinical practices and assessment tools. Based on the results and an extensive literature review, the group developed three age- and complexity-based diagnostic protocols and a shared classification system. Results: The survey highlighted high variability in test selection, especially for speech and pragmatic assessment, and a significant need for ad hoc tools for augmentative and alternative communication (AAC). Three standardized protocols were defined: (1) early language (<48 months), (2) school-age language and pragmatics (4–12 years), and (3) minimally verbal children (6–12 years). A multi-level classification system for language and speech disorders was proposed to improve diagnostic consistency. Conclusions: Standardizing assessment is a critical step toward early identification of communicative vulnerabilities to guide tailored interventions and promote participation and quality of life across developmental stages. The group provides a framework for prospective multicenter data collection to correlate linguistic and speech phenotypes with neuroradiological features and motor outcomes.
Background: Individuals with complex communication needs (CCNs) require comprehensive communication profiles to guide effective interventions, yet the clinical literature offers limited tools to support this process. To address this gap, the “Italian CP & Language Network”—a multidisciplinary group of speech–language pathologists, psychologists, and child neuropsychiatrists—developed a novel, comprehensive clinical instrument specifically designed to evaluate the communication skills of children and adolescents with CCNs. Methods: The development process was informed by an initial preliminary survey conducted across participating clinical centres to map out the observation tools routinely used in daily practice. Results: Based on these insights, the network designed a structured clinical interview named the Italian IVCAA (Intervista sulla Valutazione delle Competenze e delle Abilità Comunicative). The instrument was structured to systematically assess four core areas: core communication abilities, communicative behaviours, communicative functions, and communicative modalities (vocal, gestural, graphic/symbolic, and written). The Italian IVCAA provides a structured framework that successfully describes an individual’s unique communication profile. It maps out specific strengths and weaknesses across diverse modalities, establishing a standardized baseline for clinical use. Conclusions: The Italian IVCAA serves as a valuable clinical tool for identifying communication profiles in individuals with CCNs. It offers a practical starting point for setting tailored goals in augmentative and alternative communication (AAC) interventions and establishes a reliable framework for monitoring changes in communicative competence over time.
This study collected cross-sectional data on the social, communicative, pragmatic, and linguistic abilities of typically developing 12- to 37-month-old children. A preliminary literature review indicated that no observational tool with robust psychometric properties is currently available to assess communication and language in this age range. To address this gap, a coding scheme was employed on data from 91 typically developing Italian children (all with expressive vocabulary above the 10th percentile), who were divided into 3 groups (G1:12–17 months; G2:18–23 months; G3:24–37 months). Videotaped parent–child play interactions were analyzed to assess communicative frequency, gaze-related communicative prerequisites, communicative roles, communicative functions, and language complexity. Significant group differences and correlations with age and vocabulary were identified, including a reduction in assertiveness and requesting functions and an increase in responsiveness and declarative functions. The developmental progression of linguistic complexity is consistent with the previous literature, supporting the validity of the study and offering implications for both clinical practice and research.