Background. Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children. Methods. We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies. Results. Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy. Conclusions. Monitoring risk situations and employing caregivers’ reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.

Among children in the third year of life, late talkers comprise from 9% to 20%. This range seems to increase when addressing preterm children. This study examined video-recorded child spontaneous speech during parent–child book sharing as well as linguistic skills reported through the MacArthur Bates Communicative Development Inventories (MB-CDI) Short Form in 61 late talkers aged 30 months old (26 low-risk preterm, 8 females; 35 full-term, 12 females). Differences between low-risk preterm and full-term late talkers in child language measures and parental speech input were tested, as were the roles of child and parent factors on child language. Low-risk preterm and full-term late talkers showed similar speech and language skills. Similarly, no differences were found in measures of parental speech between groups. Child cognitive score, chronological age, and low-risk preterm status were positively associated with lexical diversity, rate, and composition of child speech production, whereas family history for language and/or learning disorders as well as parent measures of lexical diversity, rate, and grammatical complexity were negatively associated with the above child variables. In addition, child cognitive score and low-risk preterm status were positively associated with the MB-CDI measures of word and sentence production. Findings are discussed in terms of the need of good practices when following up on low-risk preterm children and of interventions targeting parents’ input to preterm and full-term late talkers.

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Infants with an older sibling with an Autism Spectrum Disorder diagnosis (Sibs ASD) are at high risk for language delay (LD) as well as infants born preterm, especially those with an extremely low gestational age (ELGA, GA ≤ 28 weeks). Gestures play a crucial role in language development and delays in gesture production may have negative cascading effects on it. The present exploratory study examined gesture production in 18-month-old infants with different underlying risks for LD. Seventy monolingual United States infants (41 Sibs ASD with no eventual ASD diagnosis and 29 infants with a typically developing older sibling -Sibs TD) and 40 monolingual Italian infants (20 ELGA without major cerebral damages, congenital malformations or sensory impairments and 20 full-term - FT infants, GA ≥ 37 weeks) were included. Both groups were followed longitudinally from 18 to 24, 30, and 36 months (corrected for ELGA infants). A 30-minute mother-infant play session with age-appropriate toys was video recorded at 18 months of age. Deictic (requesting, pointing, showing and giving), conventional, and representational gestures spontaneously produced by infants were coded; rate per 10 min was calculated. LD was defined as a score ≤10th percentile on the American English or Italian version of the MacArthur-Bates CDI on at least two time points between 18 and 36 months. Fifteen Sibs ASD and 9 ELGA infants were identified as infants with LD. Sibs ASD-LD and Sibs ASD-no LD produced fewer pointing gestures compared to Sibs TD (p = 0.038; p = 0.004); ELGA-LD infants produced significantly fewer pointing gestures than ELGA-no LD (p = 0.024) and FT (p = 0.006) infants. Low rates of pointing at 18 months are a marker of LD in Sibs ASD and ELGA infants. The potential implications of reduced pointing production and characteristics of different populations at risk for LD should be considered for understanding the emergence of LD.

Parent-implemented language interventions have been used for children with expressive language delays, but no study has yet been carried out using this intervention for low-risk preterm children. The current study examined the effect of a parent-implemented dialogic book reading intervention, determining also whether the intervention differently impacted low-risk preterm and full-term children. Fifty 31-month-old late talkers with their parents participated; 27 late talkers constituted the intervention group, and 23 constituted the control group. The overall results indicated that more children in the intervention group showed partial or full recovery of their lexical expressive delay and acquired the ability to produce complete sentences relative to the control group. Concerning full-term late talkers, those in the intervention group showed a higher daily growth rate of total words, nouns, function words, and complete sentences, and more children began to produce complete sentences relative to those in the control group. Concerning low-risk preterm late talkers, children in the intervention group increased their ability to produce complete sentences more than those in the control group. We conclude that a parent-focused intervention may be an effective, ecological, and cost-effective program for improving expressive lexical and syntactic skills of full-term and low-risk preterm late talkers, calling for further studies in late talkers with biological vulnerabilities.