This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractPurpose: The aim of this study was to investigate whether children with receptive-expressive and expressive-only language delay differ in their use of gesture; to examine relationships between their use of gesture, symbolic comprehension and language; and to consider implications for the nature of problems underlying different profiles of early language delay and for assessment.Method: Twelve children with expressive language delay (ELD) and 10 children with receptive-expressive language delay (R/ELD), aged 2-3 years, were assessed on measures of gesture use and symbolic comprehension.Results: Performance of the R/ELD group was significantly poorer than performance of the ELD group on measures of gesture and symbolic comprehension. Gesture use and symbolic comprehension were significantly associated with receptive language, but associations with expressive language were not significant. Conclusion:Findings of this study support previous research pointing to links between gesture and language development, and more specifically, between delays in gesture, symbolic understanding, and receptive rather than expressive language. Given potentially important implications for the nature of problems underlying ELD and R/ELD, and for assessment of children with language delay, this preliminary study invites further investigation comparing the use of different gesture types in samples of children matched on age and nonverbal IQ.

Purpose This study followed up children identified with expressive language delay (ELD) or receptive/expressive language delay (R/ELD) at 2 years of age, Time 1 (T1), in order to identify their language profiles at 4–5 years, Time 2 (T2), and explore relationships to T1 language, gesture use, and symbolic comprehension. Method Nineteen of 22 children were seen at follow-up (9 of 10 from R/ELD group, 10 of 12 from ELD group). T1 measures assessed receptive and expressive language, gesture use, and symbolic comprehension. At T2, we assessed receptive and expressive language, sentence repetition, and expressive phonology. Results Outcomes for the R/ELD group were significantly poorer, with all children continuing to have delay in receptive and/or expressive language compared to just 20% of the ELD group. Expressive phonology delay was common in both groups. T1 receptive language showed the most pervasive correlations with T2 language measures, but categorical performance on all three T1 measures correctly predicted language outcomes in 16–17 of the 19 children. Conclusion Findings add to evidence that receptive language is a strong predictor of outcomes. Gesture use and symbolic comprehension are also strong predictors and clinically valuable as part of play-based assessments with implications for theoretical understanding and intervention planning.

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