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Language outcomes at 7 years: early predictors and co-occurring difficulties

Lookup NU author(s): Professor Cristina McKeanORCiD, Professor Sheena Reilly



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Objective: To examine at 7 years the language abilities of Australian children, the salience of early life factors and language scores as predictors of language outcome, and the co-occurrence of difficulties associated with low language. Methods: Design: Longitudinal cohort study of 1910 infants recruited at age 8-10 months. Exposures: Early life factors - Child gender, prematurity, birth weight/order, twin birth, socioeconomic status, non-English speaking background, family history of speech/language difficulties; Maternal - mental health, vocabulary, education, age; Child language – at ages 2 and 4 years. Outcomes: 7-year standardized language scores; low receptive and/or expressive language (scores ≥ 1.25 SD below the mean), co-occurring difficulties - autism, literacy, social, emotional and behavioural adjustment, and HRQL. Results: 227/1204 (18.9%) children who provided outcome data met criteria for low language. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language at ages 2 and 4 years were added. Together, early life factors moderately discriminated between children with and without low language (area under the curve: 0.68-0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85-0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioural difficulties, and limitations in school and psychosocial functioning. Conclusions: Child language ability at 4 years was a more accurate predictor of low language at 7 than a range of early child, family and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties

Publication metadata

Author(s): McKean C, Reilly S, Bavin E, Bretherton L, Cini E, Conway L, Cook F, Eadie P, Prior M, Wake M, Mensah F

Publication type: Article

Publication status: Published

Journal: Pediatrics

Year: 2017

Volume: 139

Issue: 3

Print publication date: 01/03/2017

Online publication date: 08/02/2017

Acceptance date: 22/11/2016

Date deposited: 24/11/2016

ISSN (print): 0031-4005

ISSN (electronic): 1098-4275

Publisher: American Academy of Pediatrics


DOI: 10.1542/peds.2016-1684


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