Variation in communicative skills, defined as gestures, vocabulary comprehension and vocabulary production, was examined as a function of gender, birth order, childcare and socioeconomic status (SES) in 1,019 18-month-old children. The children were recruited at their regular check-up at a number of randomly selected Child Health Care centers in a Swedish county. The participation rate was 88%. The children were assessed by their mothers using a short version of the Swedish Early Communicative Development Inventories. The results demonstrate significant effects of gender and birth order on vocabulary comprehension and vocabulary production. Girls scored higher than boys and first-born children scored higher than later-born children. Type of childcare (family care, care at home and day-care centers) interacted with gender and birth order on vocabulary production and indicated that family care is not as advantageous as care at home or at day-care centers. SES had no effect on children's communicative skills at this age.

The findings support the importance of reading and communication quality to early language development. Knowledge of the relationship between children's vocabulary and book reading in a context of joint attention is both theoretically and practically valuable to speech and language pathologists, pre-school teachers, child health workers and other professionals.

Although the SCS18 has strength, the age of 18 months seems to be too early for identification of severe language disability.

This study evaluates a screening instrument for identification of severe developmental language disability (DLD) in 3-year-old children, which is used as a routine assessment at several child health centres (CHCs) in Sweden. The results are reported in terms of clinical outcome (false- and true-positive rates), kind and extent of DLD, signs of comorbidity and relation between nurses' and parents' observations. More than 60 CHC nurses, all with experience of the screening instrument, assessed in all 2359 3-year-old children (98% of the whole population) by direct observation of their language comprehension, language production and level of co-operation. In addition to the screening parents answered a questionnaire. Children who failed the screening had their hearing assessed and were clinically examined by trained speech and language therapists. Forty-four (34 boys and ten girls) of the 65 referred children were clinically examined. Apart from two false-positive cases most of them were diagnosed as generally and severely language disabled. According to the nurses' observations attention deficit was common among the referred boys, which was later confirmed by the speech therapist in two-thirds of them. Agreement between nurses and parents was poor and only half of the parents were concerned about their child's language development. In the light of this result, continued application of the screening and the use of parent questionnaires is discussed.

Background: A community-representative sample of screened and clinically examined children with language delay at 2.5 years of age was followed up at school age when their language development was again examined and the occurrence of neuropsychiatric/neurodevelopmental disorder (attention deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD)) was documented.