>> HELLO, EVERYONE AND WELCOME
TO THIS FIRST OF THE 3 PART
WORKSHOP SERIES SPONSORED BY THE
NATIONAL INSTITUTES OF HEALTH
TALK INITIATIVE.
MY NAME IS VIRGINIA SALO, I AM A
PROGRAM OFFICER AT THE EUNICE
KENNEDY SHRIVERRER NATIONAL
INSTITUTE OF CHILD AND HUMAN
HEALTH DEVELOPMENT AND I AM
THRILLED TO BE MODERATING THIS
SESSION TODAY.
BEFORE WE DIVE INTO IT, I DO
WANT TO TAKE A FEW MINUTES AND
PROVIDE A BRIEF OVERVIEW OF THE
TALK INITIATIVE.
THE GOALS FOR THIS WHOLE
WORKSHOP SERIES AND OUR AGENDA
FOR TODAY.
NEXT SLIDE, PLEASE.
SO TALK WHICH STANDS FOR
TACKLING ACQUISITION OF LANGUAGE
IN KIDS IS A TRANSNIH INITIATIVE
THAT LAUNCHED IN FEBRUARY OF
2023 IN RESPONSE TO A
CONGRESSIONAL MANDATE TO SUPPORT
RESEARCH ON DEVELOPMENTAL DELAYS
AND SPECIFICALLY SPEECH AND
LANGUAGE DELAYS.
SO WITH THAT CALL TO ACTION IN
MIND, THE INTENT OF THE TALK
INITIATIVE IS MULTIPRONGED.
TO ADVANCE OUR UNDERSTANDING OF
WHY CHILDREN WITH VARIOUS
CONDITIONS OR RISK FACTORS ARE
LATE TO TALK, TO DIFFERENTIATE
DEVELOPMENTAL TRAJECTORIES THAT
LEAD TO BETTER OUTCOMES, TO
EVALUATE THE EFFECTIVENESS OF
CLINICAL APPROACHES TO IMPROVE
OUTCOMES AND REALLY THE ULTIMATE
GOAL IS TO PROVIDE PARENTS,
CAREGIVERS, PROFESSIONALS, ALL
OF THOSE WHO ARE WORKING WITH
CHILDREN WHO ARE IDENTIFYING FOR
AT RISK FOR LATE TALKING WITH
THE INFORMATION THEY NEED TO
HELP LATE TALKING CHILDREN GROW
AND THRIVE IN SCHOOL AND LIFE.
NEXT SLIDE, PLEASE.
SO JUST TO GIVE A LITTLE
BACKGROUND ABOUT HOW WE AT THE
TALK INITIATIVE DEFINE LATE
TALKING.
SO LATE TALKING ALSO KNOWN AS
LATE LANGUAGE EMERGENCE IS
DIAGNOSED WITH A CHILD USUALLY
OVER THE AGE OF 18 MONTHS IS NOT
MEETING EXPRESSIVE LANGUAGE
MILESTONES.
APPROXIMATELY 10-20% OF CHILDREN
RECEIVE THIS DIAGNOSIS AND
CHILDREN MAY BE AT HIGHER RISK
FOR LATE TALKING FOR A VARIETY
OF REASONS, INCLUDING BUT
CERTAINLY NOT LIMITED TO
PREMATURE BIRTH, EXPOSURE TO
MALTREATMENT OR TAWMA,
INTELLECTUAL AND DEVELOPMENTAL
DISORDERS AND YET OTHER CHILDREN
PRESENT AS LATE TALKERS FOR NO
KNOWN REASON AND WITH NO OTHER
SYMPTOMS.
OUTCOMES FOR LATE TALKING
CHILDREN ARE VARIABLE AND THE
UNIQUE PREDICTERS AND
DEVELOPMENTAL OUTCOMES ARE YET
REALLY UNKNOWN.
AND ALSO UNDERSTANDING
DEVELOPMENTAL TRAJECTORIES AND
EFFECTIVELY SUPPORTING POSITIVE
OUTCOMES AND EVEN MORE COMPLEX
AND CULTURALLY AND
LINGUISTICALLY DIVERSE CHILDREN
NEXT SLIDE, PLEASE.
SO GIVEN ALL OF THESE UNKNOWNS,
FURTHER RESEARCH IS CLEARLY
NEEDED TO ENHANCE OUR
UNDERSTANDING OF THE FULL RANGE
OF LANGUAGE DEVELOPMENT ACROSS
THE DIVERSE ARRAY OF CHILDREN
WHO EXHIBIT SIGNS OF LATE
TALKING AND THERE'S A REAL
CRITICAL NEED TO BUILD A ROBUST
KNOWLEDGE BASE TO BETTER INFORM
PARENTS AND OTHER CAREGIVERS,
PROFESSIONALS, PUBLIC HEALTH
OFFICIALS AND ALL PARTNERS
REGARDING THE NATURE, EXTENT AND
DEVELOPMENTAL COURSE OF LATE
TALKING CHILDREN AND TO DEVELOP
NEW AND MORE EFFECTIVE WAYS OF
SUPPORTING COMMUNICATION SUCCESS
ACROSS THIS BROAD AND DIVERSE
ARRAY OF CHILDREN.
SO WITH THAT IN MIND, THE
ACTIVITIES OF THE TALK
INITIATIVE HAVE BEEN CENTERED
AROUND 3 COMPLIMENTARY THEMES
FOR REFLECTION AND THESE ARE
REFLECTED FOR THE 3 DIFFERENT
WORKSHOPS IN THIS SERIES.
SO TODAY WE'RE KICKING OFF WITH
THE TOPIC OF LONGITUDINAL DATA
AND THE IDEA HERE IS REALLY TO
SPARK RESEARCHERS TO LEVERAGE
EXISTING LONGITUDINAL DATA AND
NEW DATA COLLECTION EFFORTS TO
ADDRESS BROADER QUESTIONS ABOUT
DEVELOPMENTAL TRAJECTORIES IN
LATE TALKING CHILDREN.
THE SECOND THEME IS AROUND NOVEL
APPROACHES AND THE IDEA HERE IS
THAT CHALLENGE THE RESEARCH
COMMUNITY TO CREATE, ADAPT OR
APPLY NOVEL OR EMERGING
APPROACHES TO THE STUDY OF LATE
TALKERS TO DEVELOP NEW AND MORE
EFFECTIVE WAYS OF UNDERSTANDING
AND SUPPORTING LATE TALKERS IN
RESEARCH AND PRACTICE SETTINGS.
AND THE THIRD THEME IS ABOUT
TRANSLATING RESEARCH INTO
PRACTICE.
THE IDEA HERE IS TO REALLY
GALVANIZE THE RESEARCH COMMUNITY
TO BETTER UNDERSTAND THE
INFORMATION AND PRACTICE NEEDS
OF PARENTS AND PROFESSIONALS AND
TO DETERMINE WHETHER THOSE NEEDS
ARE OR ARE NOT BEING EFFECTIVELY
MET CURRENTLY AND TO USE THIS
AND OTHER INFORMATION TO DEVELOP
AND EVALUATE STATE OF THE
SCIENCE, INFORMATION AND EVIDENT
BASED PRACTICES TO EFFECTIVELY
GUIDE PARENTS, CAREGIVERS, AND
PROFESSIONALS IN SUPPORTING THE
SUCCESS OF LATE TALKING CHILDREN
EMPLOY THE GOALS OF THIS
WORKSHOP ARE 2 FOLD, OR I SHOULD
SAY FOR THE WORKSHOP SERIES,
FIRST IS TO PROVIDE SOME
EXCITING HOT OFF THE PRESS
UPDATES FROM FUNDED PROGECS AND
THE SECOND IS TO DIVE INTO EACH
OF THESE TOPIC AREAS TO DISCUSS
OPPORTUNITIES AND CHALLENGES
THAT THE FIELD FACES AS WE TRY
TO BUILD BETTEDDER UNDERSTANDING
ABOUT LANGUAGE DEVELOPMENT AND
LATE TALKING IN PARTICULAR.
SO WITH THAT IN MIND, LET'S TAKE
A QUICK LOOK AT THE AGENDA FOR
TODAY'S SESSION.
NEXT SLIDE, PLEASE.
PERFECT.
SO IT WILL START OFF WITH 4
FLASH TALKS.
THESE WILL BE BRIEF 5 MINUTE
TALKS, UPDATES AS I SAID FROM
CURRENTLY FUNDED, TALK FUNDED
PROJECTS AND WE WILL AS I SAID
HAVE 4 OF THOSE AND WE WILL SAVE
Q&A F THE END OF THOSE 4 TALKS
AND WE WILL MOVE INTO A PANEL
DISCUSSION REALLY DIVING INTO
THESE CHALLENGES, OPPORTUNITIES,
THE UNIQUE THINGS WE NEED TO BE
CONSIDERING AND THINKING ABOUT
WHEN WE'RE REALLY LOOKING AT
LONGITUDINAL ANALYSIS OF
LANGUAGE DEVELOPMENT AND LAY
TALKERS, A COUPLE OF NOTES FOR
THOSE IN ATTENDANCE TODAY,
PLEASE FEEL FREE TO ENGAGE IN
THIS DIGS CUSHION VIA THE Q&A
BUTTON.
-- DISCUSSION VIA THE Q&A
BUTTON, ENTER THE TOPICS YOU
WOULD LIKE TO SEE THE PANELISTS
SPEAK ABOUT TODAY, ENTER THEM
INTO THE PANEL TODAY AND WE WILL
DO OUR WEST TO INCORPORATE THOSE
THROUGHOUT THE DISCUSSION TODAY.
IF YOU ARE HAVING TECHNICAL
DIFFICULTIES, YOU CAN USE THE
CHAT BUT PLEASE KEEP YOUR
DISCUSSION TOPICS IN THE Q&A
PORTION AND I ENCOURAGE THE
SPEAKERS FROM THE FLASH TALKS
AND PANEL DISCUSSIONS ALSO TO
ENGAGE THROUGHOUT THE DISCUSSION
TODAY EMPLOY THE HOPE IS REALLY
-- TODAY.
THE HOPE IS TO REALLY PUT AS
MANY QUESTIONS OR IDEAS ON TO
THE TABLE SO WE CAN FLESH THEM
OUT TOGETHER WHILE WE HAVE THIS
TIME TOGETHER TODAY.
ALL RIGHT, SO WITH THAT, LET'S
GO AHEAD AND MOVE INTO THE FLASH
TALK PORTION OF OUR SESSION
TODAY AND TO KICK US OFF WE HAVE
DR. BENJAMIN GOLDSTEIN FROM DUKE
UNIVERSITY AND THE WELL BEING OF
YOUNG CHILDREN SCORE AND THE
LATE TALKING DIAGNOSIS.
>> I'M ASSUMING YOU CAN HEAR ME,
SO AGAIN, THANK YOU FOR THE TALK
INITIATIVE, THANK YOU ALL FOR
COMING HERE AND LISTENING TO
THESE WONDERFUL TALKS, THE FOCUS
OF OUR GROUP IS HOW WE USE
ROUTINELY HEALTH COLLECTED
SYSTEM DID THEA TO PARTICULARLY
UNDERSTAND AUTISM AND
NEURODEVELOPMENT CONITION DIDS,
SO WE WILL TALK ABOUT HOW WE DO
WITH LATE TALKING.
MOVE TO THE NEXT SLIDE.
SO MOST STUDIES OF LATE TALKING
HAVE REALLY FOCUSED ON
RELATIVELY SMALL FOCUS COHORTS
OF CHILDREN WHO ARE RECRUITED
INTO STUDIES.
OUR GROUP REALLY TRIES TO LOOK
AT REAL WORLD DATA AND LEVERAGES
HEALTH DATA FROM HEALTH SYSTEMS
TO ALLOW US TO STUDY LARGER AND
IDEALLY MORE DIVERSE GROUPS OF
CHILDREN.
TO IDENTIFY LATE TALKING THE
AMERICAN ACADEMY OF PEDIATRICS
RECOMMENDS MILESTONE
SURVEILLANCE AT EVERY WELL CHILD
VISIT AND THE USE OF
STANDARDIZED SCREENING TOOLS AT
SPECIFIC VISITS.
HOWEVER, THESE ARE NOT ALWAYS
USED AND UNIVERSALLY USED SO
HARD TO UNDERSTAND WHAT THE
IMPACT OF THESE ARE.
THE SURVEY OF WELL BEING OF
YOUNG CHILDREN ARE THE SWYC IS A
BRIEF OPEN ACCESS EHR COMPATIBLE
CAREGIVERS THAT INCLUDES 12 AGE
SPECIFIC FORMS LINKED TO
PEDIATRIC WELL CHILD VISITS FROM
BIRTH TO 5 YEARS.
THE 24 MONTH SWYC, CONSISTS OF
10 QUESTIONS, 7 OF WHICH ARE
SPECIFICALLY RELATED TO LANGUAGE
DEVELOPMENT.
NEXT SLIDE.
SO THE PROJECT GOALS HERE WHICH
I WILL REPORT ON IS TO ASSESS
WHETHER THE 24 MONTH SWYC IS
ASSOCIATED WITH THE FUTURE OR
LATE TALKING DIAGNOSIS AND THEN
TO ASK THE MORE SUBTLE QUESTION
OF USING THE SWYC AIDS
PEDIATRICIANS IN DIAGNOSIS LATE
TALKING.
NEXT SLIDE.
SO FOR OUR STUDY DESIGN WE
IDENTIFY WITH 24 MONTH WELL
CHILD VISIT AND LATE TALKING
WITH 7000 CHILDREN.
WE EXTRACTED WHETHER A CHILD HAD
A SWYC ADMINISTER ANDS THAT WAS
ROUGHLY 50%, AND THEN WE ALSO
ABSTRACTED THEIR ASSOCIATED
SCORE AND THEN WE IDENTIFIED
WHICH CHILDREN LATER RECEIVED A
LATE TALKING DIAGNOSIS WHICH WAS
APPROXIMATELY 12%.
NEXT SLIDE.
SO JUMPING RIGHT INTO THE
RESULTS OF THESE ARE 2
KAPLAN-MIER, AND WE HAVE SWYC
USAGE AND TO TIME TO A LATE
TALKING DIAGNOSIS.
WE OBSERVE THAT THAT GREEN AND
BLUE RED LINE ARE OVERLAPPING
EACH OTHER INDICATING THAT THE
USAGE REALLY RELATED IN NO WAY
TO THE TIMING OF THAT LAY
TALKING DIAGNOSIS, HOWEVER, IN
THE SECOND PANEL WHEN WE LOOK
AMONG THE GROUP OF CHILDREN, WHO
DID RECEIVE A SWYC, WE DO SEE
THAT THE -- THAT 1 SWYC SCORE,
NAMELY THE LOWER SWYC SCORE IS
THE QUICKER A CHILD IS
DIAGNOSED, SO THIS SUGGESTED
THAT THE USAGE OF THE SWYC IS
NOT RELATED TO A MORE TIMELY
DIAGNOSIS BUT THAT SCORE IS
DEFINITELY RELATED TO WHICH
CHILD WILL GET DIAGNOSED.
NEXT SLIDE.
DIGGING INTO THE SWYC
COMPONENTS, SO AS MENTIONED OF
THE 10 QUESTIONS ON THE 24 MONTH
SWYC, WE HIGHLIGHT THE 7 WHICH
ARE REALLY ABOUT LANGUAGE
DEVELOPMENT, SUCH AS BODY PARTS,
COLORS, ET CETERA AND AGAIN WE
SEE VERY CLEARLY, THAT THE --
THAT THE SCORE VALUES, THAT A
CHILD RECEIVES AT THE SURVEY IS
FAIRLY RELATED TO WHETHER THEY
WILL BE DIAGNOSED WITH LAY
TALKING AT THAT ENCOUNTER OR IN
THE FUTURE.
NEXT SLIDE.
SO SOME OF THE CONCLUSIONS AND
IMPLICATIONS OF THIS ARE THAT
WHILE ROUTINE PEDIATRIC
SCREENING CAN HELP IDENTIFY
CHILDREN WITH LATE TALKING AT
LEAST IN OUR COHORT THEY WERE
NOT NECESSARY TO IDENTIFY LATE
TALKING CHILDREN SO THIS
HIGHLIGHTS THE NEEDS FOR
IMPROVED SYSTEMATIC METHODS, TO
DETECT LAY TALKING DURING
ROUTINE CLINICAL ENCOUNTERS,
ALSO FOR OUR GROUP IN
PARTICULAR, THIS IS 1 OF OUR
FIRST FORAYS INTO UNDERSTANDING
LATE TALKING.
I THINK IT HIGHLIGHTED
OPPORTUNITIES USING REAL WORLD
DATA TO UNDERSTAND CHILDREN
DIAGNOSED WITH LATE TALKING,
SCREENINGS THAT OCCUR FOR THESE
CHILDREN AND HOW WE CAN
HOPEFULLY UNDERSTAND THEIR
LONGITUDINAL DEVELOPMENTS.
NEXT SLIDE.
FOR FURTHER CONTACT INFORMATION,
YOU CAN REACH OUT TO MYSELF.
FOR QUESTIONS ABOUT THE DATA AND
METHOD LOGICAL APPROACH, OR THE
MPI ON THIS, FOR QUESTIONS ABOUT
THE CLINICAL CONTEXT AND MORE
ABOUT THE IMPLICATIONS AND WE
ALSO HAVE A LINK TO THE DUKE
AUTISM CENTER WHICH IS KIND OF
THE UNDERBELLY OF A LOT OF THIS
WORK AS WELL.
THANK YOU.
>> THANK YOU SO MUCH BEN AND
INCREDIBLE TIMING THERE TO
CONDENSE SO MUCH DATA IN A VERY
SHORT PERIOD OF TIME.
THANK YOU SO MUCH AND I KNOW I
HAVE QUESTIONS THAT HOPEFULLY WE
CAN COME BACK AND VISIT AFTER
THE REST OF THE FLASH TALKS.
SO NOW WE WILL MOVE TO A TALK
FROM RITA KAUSHANSKAYA, ON WORD
LEARNING AND BILING Y'ALL LATE
TALKERS.
>> THANKS, VIRGINIA.
IT IS REALLY A PLEASURE TO BE
HERE, IT'S GOING TO BE A VERY
DIFFERENT TALK FROM THE 1 YOU
HEARD EARLIER, SO THIS IS
PRELIMINARY DATA ON THE GRANT
THAT TRACKS DEVELOPMENT OF
LANGUAGE IN SPANISH-ENGLISH
BILING Y'ALL LATE TALKING
CHILDREN AND THIS IS THE WORK
I'M DOING WITH HALEY VLACH.
NEXT SLIDE, PLEASE.
SO WE ACTUALLY KNOW VERY, VERY
LITTLE ABOUT THE INTERSECTION OF
BILINGUALISM AND LATE TALKING
AND WE DON'T REALLY KNOW WHAT
THE COURSE OF LANGUAGE
DEVELOPMENT MIGHT BE TO CHILDREN
WHO ARE EXPOSED TO MULTIPLE
LANGUAGES.
WHAT WE DO KNOW IS THAT LATE
TALKING CHILDREN HAVE SOME
LEARNING DRVESS AND DIFFICULTIES
WHEN COMPARED TO NONLATE TALKING
CHILDREN AND WE CERTAINLY KNOW
THAT YOUNG CHILDREN WITH
DEVELOPMENTAL DISORDER ARE
HAVING WORDING ENCODING
DIFFICULTIES.
SO 2 SUBGOALS OF THE BROADER
GRANT WERE TO TEST CROSS
SITUATIONAL WORD LEARNING IN 2
YEAR-OLDS SPANISH-ENGLISH
BILINGUAL CHILDREN, LATE TALKING
AND NONLATE TALKING AND TO TEST
DEVELOPMENT TRAJECTORY OF CROSS
SITUATIONAL WORD LEARNING IN
SPANISH-ENGLISH LATE WORD AND
NONLATE WORD TALKING.
SO THE WAY WE TACKLED THIS IS BY
TACKLING THE WORD LEARNING TASK.
IN THIS TASK, PARTICIPANTS ARE
PRESENTED WITH MULTIPLE OBJECTS
AND MULTIPLE LABELS ON EACH
TRIAL WHERE THE MAPPING BETWEEN
THE WORD AND THE LABEL IS
AMBIGUOUS ON ANY SINGLE TRIAL
BUT OVER THE COURSE OF
EXPERIMENT AS LABELS AND OBJECTS
CO OCCUR PARTICIPANTS CAN
TYPICALLY LEARN THE RELIABLE
MAPPING BETWEENLET WORD AND THE
OBLIGATIONS YECT AND IGNORE THE
VARIOUS ASSOCIATIONS.
SO IN OUR EXPERIMENT WE PRESENT
THE CHILDREN WITH 3 SETS OF
NOVEL WORDS.
IN THE ENGLISH ONLY CONDITION,
CHILDREN LEARNED ENGLISH WORDS
FOR NOVEL OBLIGATIONS YECTS.
IN SPANISH ONLY, CHILDREN
LEARNED SPANISH WORDS FOR NOVEL
OBJECTS AND IN THE MIXED
CONDITION, CHILDREN LEARNED BOTH
AN ENGLISH AND SPANISH LABEL FOR
EACH OF THE NOVEL OBJECT AND
CRITICALLY IN THE MIXED
CONDITION, CHILDREN RECEIVED
HALF THE NUMBER OF EXPOSURES TO
ENGLISH AND SPANISH LIKE LABELS
WHEN COMPARED TO THE LANGUAGE
SPECIFIC CONDITIONS.
IN A TEST PHASE CHILDREN WERE
PRESENTED WITH 2 NOVEL OBJECTS
AND HEARD A NOVEL WORD AND WE
INDEX LEARNING THROUGH LIGASE
DATA WHERE RELIABLE LOOKS
TARGETED THAT LEARNING HAS
OCCURRED.
NEXT SLIDE, PLEASE.
SO OUR PROGRESS TO DATE IS THAT
WE ARE STILL VERY MUCH
COLLECTING DATA FOR TIME 1 WHEN
THE CHILDREN ARE 24-30 MONTHS OF
AGE.
WE'RE IN YEAR 2 OF THE THE
GRANT.
OUR LONGITUDE FLAL DATA
COLLECTION WILL BEGIN NEXT YEAR
WHEN CHILDREN TURN 4.
HOWEVER WHAT I WILL PRESENT
TODAY ARE PRELIMINARY DATA WITH
4 YEAR-OLD CHILDREN WITH
DEVELOPMENTAL LANGUAGE DISORDER.
NEXT SLIDE, PLEASE.
SO THIS IS THE FIRST SET OF
PRELIMINARY FINDINGS FOR THE
NEUROTYPICAL 2 YEAR-OLDS, THESE
ARE NONLAY TALKING CHILDREN.
WHAT WE'VE BLOTTED HERE ARE
[INDISCERNIBLE] ON THE TRIALS,
THE WAY TO PRESENT THE TRIALS IS
THAT THE COURSE IS ON THE
AX-AXIS AND THE PRESENTATION TO
TARGETING SYSTEM ARE ON THE
Y-AXIS AND THE SINCE THEY ARE ON
THE SCREEN, THE CHANCE OF SEEING
50%, SO WHEN WE SEE LINES
EXCEEDING 50%, WE KNOW LEARNING
HAS OCCURRED.
OT LEFT WE PLOTTED ENGLISH IN
BLUE AND SPANISH IN RIGHT AND ON
THE RIGHT MIXED LANGUAGE,
ENGLISH IN BLUE, SPANISH IN RED.
SO WHAT YOU ARE SEEING IS ABOVE
RELIABLE LEARNING FOR THE
ENGLISH AND SPANISH NOVEL LIKE
WORDS WHEN THEY WERE TAUGHT THIS
IN THE LANGUAGE LEARNING
CONDITIONS.
YOU SEE THE SINGLE LANGUAGE AND
MIXED LANGUAGE CONDITIONS,
SUGGESTING TO US THAT MIXED
EXPOSURE IS IN FACT DIFFICULT
FOR NEUROTYPICAL 2 YEAR-OLDS TO
EXPERIENCE.
NEXT SLIDE.
THESE ARE LATE TALKING CHILDREN
AND WE ONLY HAVE A HANDFUL OF
CHILDREN IN THIS DATA SET.
YOU SEE A GLIMMER OF LEARNING
FOR THE SPANISH NOVEL WORDS AND
THE SPANISH ONLY CONDITION, BUT
CHILDREN REALLY ARE LEARNING IN
ENGLISH AND IN THE MIXED
LANGUAGE CONDITION, WE BASICALLY
HAVE WIPED OUT LEARNING BECAUSE
WHEN YOU AGGREGATE ALL THESE
LOOKS, IT WILL SUM UP TO 0 SO
WHAT THIS SUGGESTS TO US IS THAT
FIRST LAY TALKING CHILDREN HAVE
DIFFICULTY LEARNING WORDS AND 2
THAT PRESENTING THESE IN A MIXED
LANGUAGE ENVIRONMENT EXACERBATES
THAT DIFFICULTY.
NEXT SLIDE, PLEASE.
THESE ARE 4 YEAR-OLDS WITH DLD,
SO THEY ACTUALLY LEARNED IN BOTH
ENGLISH AND SPANISH IN THE SAME
LANGUAGE CONDITION AND THEY
LEARNED REALLY WELL IN THE MIXED
LANGUAGE CONDITIONS, IN FACT
BETTER THAN SINGLE LANGUAGE
CONDITIONS WITH EXPOSURES, WHICH
SUGGESTS TO US THE MIXING
LANGUAGES MAY BE AN EFFECTIVE
STRATEGY TO SUPPORT LEARNING IN
CHILDREN WITH DLD.
NEXT SLIDE, PLEASE.
YOU CAN CONTACT ME FOR ALL YOUR
QUESTIONS AND THE RESOURCES
LISTED.
WE'LL SEND YOU TO THE LAB
WEBSITE AND USEFUL PUBLICATIONS
THAT'S IT.
>> THANK YOU SO MUCH RITA AND
ONCE AGAIN COMING AWAY WITH SO
MANY QUESTIONS I HOPE WE HAVE
TIME TO DIG INTO.
ALL RIGHT, SO NOW WE'LL MOVE TO
OUR THIRD FLASH TALK FOR TODAY
FROM LISA HUNTER AND SHE WILL BE
TALKING ABOUT EARLY PREDICTION
OF LANGUAGE OUTCOMES USING
NEUROMARKERS IN PREMATURE
INFANTS.
WE'VE HAD A GREAT ARRAY OF
SCIENCE THAT WE'RE HEARING FROM
TODAY, VERY EXCITING.
>> GOOD MORNING EVERYONE.
WE'RE REALLY EXCITED TO BE HERE
AND GRATEFUL FOR THE OPPORTUNITY
TO TALK ABOUT OUR STUDY WHICH IS
CALLED EARLY DEVELOPMENT OF NICU
GRADUATES OR THE EDEN STUDY AND
I'M JOINED TODAY BY MY CO PI
JENNIFER VANNEST WHO WILL
PRESENT SOME OF THE MRI DATA
WE'RE FORTUNATE TO HAVE A REALLY
WONDERFUL VERY MULTIDISCIPLINARY
GROUP OF INVESTIGATORS THAT
INCLUDE OVER ON THE LEFT EXPERTS
IN AUDITORY NEUROSCIENCE AND ON
THE RIGHT IN NEARONATOLOGY,
NEHAL P A RIKH, WHO HAS WORKED
WITH US FROM THE BEGINNING ON
ENROLLING CHILDREN FROM HIS
ORIGINAL STUDIES THAT FOCUSED ON
MOTOR AND COGNITIVE DEVELOPMENT
AND ON THE LOWER LEFT EXPERTS IN
BIOSTATISTICS AND ALSO IN DEEP
LEARNING THAT HAVE BEEN REALLY
IMPORTANT IN HELPING US
UNDERSTAND HOW TO USE PREDICTIVE
FACTORS FROM MRI AND THEN IN THE
LOWER RIGHT, LAUREN PRATHER, WHO
IS AN UPAND COMING LANGUAGE
RESEARCHER, FUBDED ON THE
DIVERSITY SUPPLEMENT FROM THE
PARENT GRANT AS WELL AS TALK
SUPPLEMENT.
AND I CAN GO TO THE NEXT SLIDE.
I DON'T SEE -- I DON'T SEEM TO
HAVE -- APOLOGIES, CONTROL OVER
THE SLIDE.
SMRKS WE'VE GOT CONTROL ON OUR
END SO YOU'RE ON THE BACKGROUND
AND GOALS SLIDE NOW.
>> GREAT.
THANK YOU.
SO FROM THE PARENT GRANT WE
ENROLLED 280 INFAPTS BORN
PREMATURELY AT LESS THAN 32
WEEKS AND ON THE TALK SUPPLEMENT
WE HAVE 40 CHILDREN DIVIDED INTO
40 INFANTS AND 50 CHILDREN BORN
FULL TERM.
WE HAVE AN ARRAY OF PHYSIOLOGIC
MEASURES TO DIG INTO THE RISK
FACTORS WITH BRAIN INJURY AT
BIFGHT AND CONNECTIVITY.
HEARING, SO AUDITORY BRAIN STEM
RESPONSES TO PICK UP REALLY EVEN
SLIGHT DEGREES OF HEARING LOSS
AS WELL AS FACTORS INVOLVED WITH
SPEECH PROCESSING WITH EEG AND
MISS MATCH RESPONSE AT 3 MONTHS
AND THEN JEN WILL TALK MORE
ABOUT THE C SBS THAT WE'RE USING
TO GET MORE SENSITIVE MEASURES
OF SPEECH DEVELOPMENT AT 2 YEARS
OF AGE AS WELL AS MCDI WHICH I
THINK IS MORE WIDELY KNOWN AND
THEN AT 3 YEARS, WE'RE DOING A
TEST OF EARLY LANGUAGE
DEVELOPMENT AND PRELITERACY
MEASURES AND WE ALSO ARE
COLLECTING A WIDE RAINCHL OF
NEURODEVELOPMENTAL AND
ENVIRONMENTAL FACTORS AS WELL AS
SOCIOLOGICAL DEMOGRAPHICS AND
OUR OVERALL PROJECT GOALS ARE TO
REALLY DETERMINE THESE EARLY
FACTORS THAT MAY BE ASSOCIATED
WITH HEARING LOSS AND LANGUAGE
DELAY.
SO WE CAN GO TO THE NEXT SLIDE.
AND GEN WILL TAKE OVER.
>> GREAT.
SO I WILL TALK A LITTLE BIT MORE
ABOUT THE SPECIFICS OF THE
LONGITUDINAL DATA COLLECTION IN
OUR STUDY AND THE PROGRESS THAT
WE'VE MADE SO FAR.
SO ALL OF THE PARTICIPANTS IN
OUR STUDY WITH THE HISTORY OF
PREMATURE BIRTH HAVE AN MRI
COLLECTED DURING NATURAL SLEEP
THAT WE CAN USE TO ASSESS BOTH
FUNCTIONAL AND STRUCTURAL
CONNECTIVITY THAT'S AT TERM
EQUIVALENT AGE.
THEN AT 3 MONTHS THE
PARTICIPANTS COME IN FOR RESTING
STATE AND SPEECH OF ODGE THAT WE
WILL SHARE RESULTS FROM IN A FEW
MINUTES AND THEN, AT AGE 2 AND A
HALF, WE DO THE COMMUNICATION
AND SYMBOLIC BEHAVIOR SCALES
WHICH IS A VIDEO RECORDED
PLAY-BASED ASSESSMENT THAT LOOKS
AT MULTIFACETED COMMUNICATION
SKILLS INCLUDING GUESTERAL,
SOCIAL, AND VERBAL ASPECTS OF
COMMUNICATION.
SO ITUES A SERIES OF
COMMUNICATION IN TEMPTATIONS TO
ILLICIT THIS WIDE RANGE OF
COMMUNICATION FROM THE CHILDREN.
OUR TALK SUPPLEMENT HAS ALLOWED
US TO COLLECT A GROUP OF TERM
CONTROL CHILDREN WITH THE CSBS,
THEN AT AGE 3, WE DO THE
[INDISCERNIBLE] A MORE
STANDARDIZED LANGUAGE ASSESSMENT
ALONG WITH A LANGUAGE SAMPLE AND
SOME TESTS OF PRELITERACY
SKILLS.
AT ALL OF THESE TIME POINTS, THE
CHILDREN'S HEARING IS ALSO
THOROUGHLY CHARACTERIZED.
>> NEXT SLIDE.
>> GREAT.
SO I WANTED TO JUST SHARE A BIT
OF PRELIMINARY DATA FROM OUR
FUNCTIONAL MRI, RELATING THOSE
MEASURES TO LANGUAGE OUTCOMES AT
AGE 2.
IN THIS PRELIMINARY ANALYSIS IN
133 CHILDREN, WE SELECTED A SET
OF REGIONS THAT SUPPORT LANGUAGE
DEVELOPMENT AND LOOKED AT PAIR
WISE FUNCTIONAL CONNECTIVITY AND
SAW A CORRELATION BETWEEN THE
SOCIAL AFFECT OF SUBSCALEOT CSBS
AND CONNECTIVITY BETWEEN LEFT
FRONTAL AND PARIETAL REGIONS.
SO NEXT SLIDE, AND WE WILL GO
BACK TO LISA.
I THINK YOU'RE ON MUTE.
>> I THINK WE WILL STOP THERE.
>> IF YOU WOULD LIKE TO TAKE 1
MORE MINUTE, WE HAVE A LITTLE
BIT OF TIME.
>> OKAY, IN THIS SLIDE, WE'RE
SHOWING THAT OUR FULL TERM
HEALTHY CONTROL CHILDREN HAVE
FAR BETTER HEARING SHOWN IN THE
GREEN COMPARED TO THE PRETERM
CHILDREN.
WE HAD SOME WITH NORMAL HEARING,
BUT QUITE A BIT IN YELLOW SHOWN
WITH TEMPORARY CONDUCTIVE
HEARING LOSS AND ALSO SENSORY
NEURAL HEARING LOSS WHICH IS
CONSIDERED PERMANENT AND OVERALL
CLOSE TO 30% OF CHILDREN DID
HAVE SOME DEGREE OF HEARING
LOSS.
THESE ARE GENERALLY NOT BEING
PICKED UP WITH NEW BORN HEARING
SCREENING PERHAPS DUE TO
INSENSITIVITY OF THAT MEASURE
BUT ALSO THE RISK FOR
PROGRESSIVE AND LATER ONSET
HEARING LOSS AND WE ARE FIND
THANKSGIVING SEEMS TO BE 1 OF
THE IMPORTANT RISK FACTORS FOR
LANGUAGE DELAY AT 2 AND 3 YEARS
OF AGE.
SO WITH THAT I WILL STOP.
THANK YOU.
>> GREAT.
THANK YOU VERY MUCH.
SO MUCH DENSE DATA HERE IN SUCH
A SHORT AMOUNT OF TIME.
SO THANK YOU SO MUCH.
>> ALL RIGHT, WE WILL MOVE TO
OUR FINAL FLASH TALK FOR TODAY
FROM RACHEL BARR AT GEORGETOWN
UNIVERSITY.
WILL TALK TO US ABOUT FAMILY
MEDIA PRACTICES AND LATE TALKER
STATUS IN EARLY CHILDHOOD.
>> THANK YOU.
OUR PROJECT IS -- AND I'M HERE
WITH MY COLLEAGUE Mc CALL
BOOTH AS WELL.
OUR PROJECT WHICH IS RUN THROUGH
THE CAFE CONSORTIUM AND THE DATA
PRACTICES AND [INDISCERNIBLE].
NEXT SLIDE, PLEASE.
AND WE KNOW QUITE A LOT ABOUT
MEDIA PRACTICES AND LANGUAGE
OUTCOMES BUT VERY LITTLE ABOUT
HOW THEY'RE SOCIETIED WITH LATE
TALKER STATUS SPECIFICALLY.
SO WHAT WE KNOW SO FAR IS THAT
IT'S NOT JUST THE AMOUNT OF
EXPOSURE, BUT RATHER THE QUALITY
OF THAT [INDISCERNIBLE] EXPOSURE
WITH LANGUAGE DATA OUTCOMES.
SO POOR QUALITY MEDIA EXPOSURE
IS ASSOCIATED WITH THE POOR
LANGUAGE OUTCOME ACROSS TIME IN
LONGITUDINAL STUDIES AND JOINT
[INDISCERNIBLE] -- I DON'T KNOW
HOW TO FIX THE ECHO.
IT WASN'T HERE BEFORE.
DOES ANYONE HAVE ANY
SUGGESTIONS?
I'LL JUST KEEP GOING.
SO JOINT EXPOSURE IS THE
[INDISCERNIBLE] MEDIA DATA
LANGUAGE OUTCOMES.
SO TECHNOFEAR ENSEL IS ANOTHER
THING THAT IS INVOLVES JUST LIKE
GETTING THE NOTIFICATION, IT'S
WHEN A RELATIONSHIP IS DISRUPTED
BY TECHNOLOGY, SO WHEN PARENTS
ARE USING THEIR OWN MEDIA TO
HAVE PARENT CHILD INTERACTION
AND IT'S LIKELY TO BE ASSOCIATE
WIDE FOREIGN LANGUAGE OUTCOMES
AS WELL, BUT AS I SAID, THERE
HASN'T BEEN ANY WORK CONNECTING
WHETHER OR NOT PROLONGED QUALITY
AND CONTENT AND CONTEXT OF
EXPOSURE AND LATE TALKER STATUS,
AND WHETHER OR NOT HIGH QUALITY
CONTENT AND JME COULD BE
PROTECTIVE.
SO WHAT OUR GOALS ARE IS TO
EXAMINE THE RELATIONSHIP BETWEEN
EXPOSURE AND LATE TALKER STATUS
AND TO EXAMINE TRAJECTORIES OF
EXPRESSIVE LANGUAGE GROWTH IN
LATE TALKERS.
NEXT SLIDE, PLEASE.
SO I'M GOING TO PRESENT SOME
PRELIMINARY DATA ON OUR PROGRESS
TO DATE.
LIKE OTHER DATA STUDIES OUR
COLLECTION IS TILL ONGOING SO I
WILL PRESENT SOME CONCURRENT
FINDINGS AND PRELIMINARY
LONGITUDINAL FINDING.
TWO KEY MEASURES -- LET'S SEE IF
THIS WORKS.
IS THE ECHO NOW GONE?
NNO, THE ECHO IS STILL THERE, I
WOULD SAY KEEP GOING AND TALK
SLOWLY, IT'S NOT SO DISRUPTIVE.
>> OKAY.
SO WE HAVE 2 MEASURES, THE MEDIA
ASSESSMENT QUESTIONNAIRE FROM
THE CAFE CONSORTIUM AND WE USE
THE CDI WHICH TRACKS THE
PROJECTIVE VOCABULARY
ACQUISITION.
SO FOR WE COLLECTED RESPONSES
FROM 752 ENGLISH SPEAKING
CHILDREN, AGE 3 YEARS AND
YOUNGER.
WE HAVE CALCULATED OUR MEDIA
PRACTICE VARIABLES, BUT
DURATION, QUALITY OF CONTENT,
JOINT MEDIA ENGAGEMENT AND
TECHNOFER ENSEL, AND CREATED
INITIAL COMBINED LONGITUDINAL
STATUSES.
NEXT SLIDE, PLEASE.
WE ARE PRESENTING, OUR DATA
WITHIN THE FRAMING OF OUR
PROJECT IS BY THE DREAMER
FRAMEWORK, THIS IS FOR THE
DYNAMIC ECOLOGICAL APPROACH TO
MEDIA EFFECTS RESEARCH.
OKAY, I'M GOING TO TRY MUTING.
>> WE NEED YOUR AUDIO.
WE APPRECIATE YOU WORKING WITH
US.
IT WAS WORKING FINE BEFORE, SO
LONG AS YOU KEEP TALKING AT THE
PACE YOU ARE, NOT IDEAL BUT
YOU'RE DOING GREAT.
>> GREAT.
I DON'T KNOW WHY IT CHANGED.
OKAY, SO THE DREAMER FRAMEWORK
HAD BEEN DEVELOPED BY OUR GROUP
AND WHAT YOU CAN SEE IS AN IMAGE
HERE ON THE RIGHT, WHAT WE'RE
TRYING TO DO IS EXAMINE HOW
STRUCTURAL FACTORS THINGS LIKE
GROWING UP DURING THE PANDEMIC,
AND CHILDHOOD FACTORS SUCH AS
AGE AND DEMOGRAPHIC, ARE
ASSOCIATED WITH THE DAILY
DYNAMIC USE OF MEDIA, SO THINGS
LIKE WHETHER OR NOT THERE'S
TECHNOINTERFERENCE, MOTIVATIONS
THAT PARENTS HAVE FOR USING
MEDIA, THE DURATION AND THE
JOINT MEDIA ENGAGEMENT AND YOU
HAVE THAT DYNAMIC DAILY USE
ASSOCIATED WITH LATE TALKER
STATUS.
SO NOW I WILL PRESENT THE
CONCURRENT FINDINGS, NEXT SLIDE,
PLEASE.
AND WHAT WE CAN SEE HERE ARE
PRELIMINARY CROSS SECTIONAL
FINDINGS.
ON THE TABLE ON THE RIGHT, WHAT
YOU CAN SEE ARE ALL THE
VARIABLES WE HAVE ENTERED SO FAR
AND IN THE FINAL MODEL AND THEN
WE PULL OUT THE 2 KEY FINDINGS
FROM THE FINAL MODEL.
WHAT WE SEE CONCURRENTLY IN
CHILDREN UNDER 3 YEARS, IS THAT
THE TOTAL DURATION OF TELEVISION
AND VIDEO TIME IS ASSOCIATED
WITH LATE TALKER STATUS AND HAS
BEEN FOUND IN PRIOR RESEARCH
ALSO FAMILY EDUCATION AND INCOME
ARE ASSOCIATED WITH LATE TALKER
STATUS, SUCH THAT LEVELS OF
[INDISCERNIBLE] AND FEWER FAMILY
RESOURCES ARE ASSOCIATE WIDE
LATE TALKER DATA.
AND WE CONDUCTED 1 MODEL, IF
WAVE 1 AND 2 ON THE SUBSET OF
DATA, THE DATA WE COLLECTED 1
YEAR PAST AND WHAT WE FIND AND
WHAT WE'RE LOOKING AT IS THE
DURATION OF EXPOSURE, AT
TIMELINE LATE TALKERS BETTER AND
[INDISCERNIBLE] AT EACH TIME
POINT WE FIND THAT TELEVISION
DURATION, BETWEEN TIME 1 AND 1
YEAR LATER, ARE ASSOCIATED LATE
TALKER STATUS, AND LATE TALKER
STATUS ARE ASSOCIATED 1 YEAR
LATER, HOWEVER, WE ALSO FIND
THAT TELEVISION DURATION AT TIME
.1, IS ASSOCIATED WITH LATE
TALKER DATA 1 YEAR LATER AT TIME
.2.
NEXT SLIDE PLEASE.
HERE ARE OUR RESOURCES AND
PLEASE FEEL FREE TO CONTACT US
WITH ANY QUESTIONS YOU MIGHT
HAVE.
>> THANK YOU SO MUCH RACHEL AND
THANKS SO MUCH FOR WORKING
THROUGH THE TECHNICAL
DIFFICULTIES THERE THIS IS JUST
SUCH A BROAD ARRAY OF SCIENCE
FOR PROGECS WHICH IS REALLY
EXCITING TO SEE AND SOME
QUESTIONS CAME IN.
I'M GOING TO START WITH LET'S
SEE, 1 TO LISA BECAUSE THE
SPEAKERS ALREADY STARTING TO
ANSWER SOME OF THESE IN THE CHAT
AND THIS 1 HASN'T BEEN ANSWERED
YET, THE QUESTION IS WHETHER
THERE'S A HEIGHTENED INCIDENCE
OF EAR FLUID OR MIDDLE EAR
EFFUSION FOR THE PREMATURE
INFANTS?
>> YES, THAT'S A GREAT QUESTION.
AND I'M SORRY I GLOSSED OVER
THAT A LITTLE BIT AT THE END BUT
WE ARE FINDING NOT ONLY AT 3
MONTHS OF AGE, BUT CONTINUING TO
AGE 2 AND 3, DEFINITELY
INCREASED AND CHRONIC OTITIS
MEDIA WITH EFFUSION AND WE'RE
INTERESTED IN LOOKING AT THAT
COMPARED TO THE MORE PROMINENT
FORMS OF HEARING LOSS AS A RISK
FACTOR.
>> GREAT.
THANK YOU.
RITA YOU ANSWERED THIS QUESTION
IN THE Q&A BUT I WOULD LOVE FOR
YOU TO MAYBE COME OFF MUTE AND
TALK ABOUT THIS A LITTLE BIT
MORE, YOU KNOW I WILL SAY AND I
THINK YOU WILL PROBABLY
REINFORCE THIS IDEA THAT THESE
ARE PRELIMINARY DATA, YOU DON'T
HAVE A FULL LONGITUDINAL SET,
YOU DON'T HAVE FULL DAILY BASIS
THEA SET BUT CLEAR POTENTIAL
IMPLICATIONS OR ADVICE WE MIGHT
GIVE TO BILINGUAL FAMILIES ABOUT
WHAT TO DO, WITH THEIR KIDS, HOW
TO USE LANGUAGE, SO, I WONDER IF
YOU CAN MAYBE EXPAND ON THAT A
LITTLE BIT.
>> ABSOLUTELY, WOULD BE HAPPY
TO.
SO THE QUESTION WAS 2 FOLD, 1
WAS ABOUT HOW DO WE INTERPRET
THE FINDINGS FOR THE CHILDREN
WITH DEVELOPMENTAL LANGUAGE
DISORDER AND I THINK JAMES BOOTH
HAD A VERY SIMILAR QUESTION AND
WHETHER THIS IS A D.O.D. EFFECT
OR MATURATION EFFECT IS HARD TO
TELL AT THIS POINT BECAUSE WE
DON'T UPON HAVE LONGITUDINAL
DATA YET.
SO ONCE WE DO AND WE HAVE 4
YEAR-OLDS THAT ARE RESOLVED AS
WELL AS 4 YEAR-OLDS WITH DLD,
WHETHER THIS IS DEVELOPMENTAL
LANGUAGE DISORDER OR AGE THAT'S
ACTUALLY ENHANCING CHILDREN'S
LEARNING FROM THE LANGUAGE
INPUT.
I WILL SAY WE'RE NOT THE FIRST
1S TO SHOW BENEFITS TO COLD
SWITCHING IN CHILDREN WITH DLD
SPECIFICALLY BUT IT SEEMS THAT
THE BENEFIT OF DLD THAT INCLUDES
ATTENTION MAY BENEFIT FROM INPUT
THAT HAS MIXED INFORMATION.
SO WHERE INFORMATION IS
INTERWEAVE SO IT MAY BE THIS IS
IN FACT A DLD FINDING.
SO FOR THE PRACTICAL
IMPLICATIONS OF WHAT WE'RE
SEEING WITH LATE TALKING AS WELL
AS CHILDREN WITH DLD, ABSOLUTELY
NEED THE FULL SAMPLE BEFORE I
WILL SAY ANYTHING DIRECTIVE BUT
AGAIN THIS IS NOT THE FIRST TIME
WE SEE THIS IN OUR STUDIES WHERE
IN GENERAL IT SEEMS THAT
CHILDREN LEARN BETTER WHEN INPUT
IS SORT OF TAGGED AND SEGREGATED
BY LANGUAGE.
WE IN THIS PARTICULAR GRANT WE
HAVE OTHER EXPERIMENTS WHERE WE
WILL ALSO TRY AND FIGURE OUT
WHETHER THE 1 LANGUAGE 1 PERSON
APPROACH MAY BE ESPECIALLY
USEFUL TO CHILDREN WITH SORT OF
RISK FACTORS ASSOCIATED WITH
LANGUAGE DEVELOPMENT AND SO THAT
WILL BE I THINK REALLY HELPFUL
AS WELL AS WE THINK ABOUT ADVICE
TO PARENTS AND CLINICIANS.
>> GREAT.
THANK YOU.
I HAVE A QUESTION I WANT TO PASS
TO BEN AND LAUREN AND ASK ABOUT
THAL SORT OF DIFFERENTIAL TIMING
OF THESE VERSUS POSITIVE
NEGATIVE IDEBTIFICATION THROUGH
THE SWYC.
AND MY QUESTION IS SORT OF
MULTIFOLD HERE, YOU KNOW, WHAT
-- I GUESS IT'S REALLY ABOUT
WHAT OTHER FACTORS BEING BROUGHT
TO THE TABLE THAT ARE AIDING IN
THIS DIAGNOSIS AND WHAT'S
IMPACING IT?
ARE THE DATA JUST NOT BEING
LOOKED AT IN A TIMELY MATTER FOR
THIS SWYC OR WHAT ARE THE
FACTORS THAT DEFERENTIATE THESE.
>> NO, THAT'S A GREAT QUESTION.
IT'S SOMETHING WE TRY TO GRAPPLE
WITH THE IMPLICATIONS BECAUSE
YOU WOULD HAVE HYPOTHESIZED THAT
THE USE OF THE SWYC WOULD HAVE
LED TO MORE TIMELY DIAGNOSIS.
I THINK, YOU KNOW I THINK WE ARE
INTERPRETING IT THAT NOT THAT
THE SWYC IS NOT USEFUL BUT THAT
IT'S NOT NECESSARY.
THE SWYC IS DEFINITELY A GOOD
SCREENING TOOL IN THAT IT
CAPTURES CHILDREN WHO ARE LATER
TO BE DIAGNOSED WITH LATE
TALKING BUT IN PEDIATRICIAN IT'S
NOT A NECESSARY TOOL TO AID IN
THAT DIAGNOSIS.
WE WERE SEEING WHICH WE
DEPARTMENT HAVE TIME TO PRESENT
HERE, SOME INTERACTIONS
PARTICULARLY BASED ON SOME
SOCIOECONOMIC STATUS OF THE
CHILD WHERE WE'RE REDUCING SOME
KIND OF MODERATION OF THE EFFECT
THERE, BUT FOR THE MOST PART I
THINK THE IMPLICATION WAS THAT
WHILE THE SWYC IS A USEFUL
DEVELOPMENTAL TOOL HERE, THERE
-- PEDIATRICIANS ARE ABLE TO
RECOGNIZE LATE TALKING IN THEIR
PATIENT WHEN IS THEY'RE COMING
THROUGH WITHOUT IT OR WITH IT.
>> AND WHILE YIER HERE, IT LOOKS
LIKE ANOTHER QUESTION CAME IN, I
DON'T KNOW IF YOU SEE THAT BUT
ASKING TO UNPACK THE SWYC AND AN
ITEM LEVEL, SO, WE LOOKED AT IT,
SO WHEN WE LOOKED AT THE
INDIVIDUAL COMPONENTS, WE SHOWED
THE 7 OF THE 10 METRICS, THEY
WERE ALL PRETTY MUCH HAD THE
SAME KIND OF STEP FUNCTION IF
YOU SCORED A 0, 1, 2, THE 0S
WERE ALMOST -- WE DIDN'T REALLY
LOOK AT SPECIFICALLY 1 ITEM
WHERE IT WAS 1 ITEM WAS MORE
IMPORTANT THAN THE RPGHT,
PSYCHOMETRICALLY WE'RE ACTUALLY
EVEN BY BREAKING THEM DOWN INTO
THESE TALKING SCORES, IT'S NOT
REALLY THE WAY TO USE SWYC, IT'S
DESIGNED AS AN OVERALL TOOL AND
AS A DEVELOPMENTAL TOOL THAT'S
MEANT TO BE LOOKEDDA THE IN A
LONGITUDINAL WAY AND NOT EVEN IN
THE WAY WE'RE LOOKING AT IT AT A
SINGLE TIME POINT BUT IN GENERAL
MOST OF THOSE TALKING LANGUAGE
RELATED MEASURES WERE RELATED TO
A FUTURE LAY TALKING DIAGNOSIS.
>> GREAT, AND THERE'S A QUESTION
IN A DIFFERENT DIRECTION FROM
THESE MORE SPECIFIC PROJECT
RELATED QUESTION ANDS THIS IS TO
EVERYONE AND I THINK I WILL POSE
THIS AS A CAP OFF TO THIS
PORTION OF THE SESSION AS WE
MOVE INTO THE DISCUSSION AFTER
THIS, BUT THE QUESTION IS, ABOUT
CONSENSUS ON THE CRITERIA, FOR A
LATE TALKING DIAGNOSIS.
OR I GUESS FOR THE DIFFERENT
STUDIES BEING CATEGORIZED AS AT
RISK OR OR BEING A LAY TALKER
AND I'M WONDERING, I THINK YOU
EACH TOUCHED ON THIS, IN YOUR --
IN YOUR INDIVIDUAL PRESENTATIONS
BUT MAYBE WE CAN DO A QUICK
ROUND ROBIN FROM THE 4 PROJECTS
JUST TO LAY THAT OUT ON THE
TABLE AND THEN I KNOW THIS IS
DEFINITELY SOMETHING WE'RE GOING
TO GET INTO THE DISCUSSION MORE.
SO, IF EVERYONE CAN JUST COME ON
REALLY QUICK AND SAY, LIKE THIS
IS WHAT WE USED, THIS IS HOW WE
CATEGORIZED, ANY FEELINGS,
POSITIVE, NEGATIVE ABOUT THAT
AND THEN WE'LL -- WE'LL UNPACK
IT SOME MORE AS WE CONTINUE AND
RITA I SEE YOU OFFCAMERA SO GO
FOR IT.
>> WELL, I SHOULDN'T HAVE TURNED
IT ON FIRST.
SO WE JUST USE PERCENTILE CUT
OFFS ON THE CTI AND FOR THE
BILINGUAL CHILDREN WE BASICALLY
USE THE CUT OFF OF 20th
PERCENTILE FOR THE STRONGER
LANGUAGE AS THE DIAGNOSTIC
CRITERIA FOR LATE TALKING.
>> WE ALSO USE SBDI CUT OFF BUT
WE USE THE TENTH PERCENTILE NOW.
>> WE'RE DOING EVERYTHING OFF
DIAGNOSIS CODES SO WE'RE
REQUIRING 2 DIAGNOSIS CODES AT
SEPARATE ENCOUNTERS THAT ARE
INDECAATIVE OF LANGUAGE
DEVELOPMENT.
>> SO I THINK OUR APPROACH IS A
LITTLE BIT DIFFERENT BECAUSE THE
CHILDREN IN OUR STUDY ARE
ENROLLED BECAUSE OF THEIR
HISTORY OF PREMATURE BIRTH, SO,
WE HAVE A LOT OF DATA.
SO WE TYPICALLY LOOK AT THE
LANGUAGE OUTCOMES AS CONTINUOUS
VARIABLES, WE HAVEN'T
NECESSARILY USED CUT OFFS FOR
LATE TALKERS BUT WE HAVE THE
CDI, WE HAVE A LOT OF
INFORMATION FROM THIS CSBS, SO I
THINK WE HAVE THE POSSIBILITY TO
CATEGORIZE THE CHILDREN WITH A
HISTORY OF PREMATURITY IN
DIFFERENT WAYS BUT SO FAR WE'VE
BEEN LOOKING AT THESE LANGUAGE
OUTCOMES AS CONTINUOUS
VARIABLES.
>> GREAT.
THANK YOU.
ALL RIGHT, SO, I'M PUMPED UP,
I'M REALLY EXCITED, ALREADY SO
MANY QUESTIONS COMING UP AND
GREAT SCIENCE BEING TOUCHED ON
SO LET'S GO AHEAD AND MOVE ON TO
THE PANEL DISCUSSION OF TODAY'S
DISCUSSION.
SO AS I TOUCHED ON AT THE START
DEVELOPMENTAL TRAJECTORIES
REALLY VARY WIDELY, RIGHT, NOT
ONLY FOR CHILDREN IDENTIFIED AS
AT RISK OF LATE TALKING BUT
REALLY FOR THE WIDE RANGE OF
WHAT'S CONSIDERED AVERAGE
LANGUAGE DEVELOPMENT MORE
BROADLY AND SO, GIVEN THIS
IMMENSE VARIABILITY, IT'S A REAL
CHALLENGE FOR THE FIELD TO BE
ABLE TO DISTINGUISH PATTERNS OF
DIFFERENT TRAJECTORIES AND TO
ASSOCIATE THOSE 2 TRAJECTORIES
EARLY ON WITH LATER OUTCOMES.
AND AT A HIGH LEVEL THIS BROAD
CHALLENGE IS WHAT WE WILL SPEND
SOMETIME UNPACKING TODAY AND
WHAT WE'VE ALREADY SORT OF
TOUCHED ON A LITTLE BIT AND SO
FOR THE PANEL DISCUSSION, WE
WILL TOUCH ON 3 SOMEWHAT MORE
CONCRETE PIECES OF THIS PUZZLE,
HOW BEST TO CHARACTERIZE EARLY
LANGUAGE TRAJECTORIES, SOMETHING
WE JUST STARTED AND HEAR HOW THE
MEASURES WE USE CAN INFLUENCE
SORT OF THE INTERPRETATIONS THAT
WE'RE ABLE TO MAKE, HELP OR
HINDER US IN THIS WORK AND THEN
GETTING INTO THE NITTY-GRITTY OF
LONGITUDINAL DATA COLLECTION, IN
TERMS OF RECRUITMENT, RETENTION
AND IMPORTANTLY REPRESENTATION
IN DOING THIS KIND OF WORK.
SO, BEFORE WE DIVE INTO OUR
FIRST QUESTION, AND THE FIRST
TOPIC, LET ME INTRODUCE OUR
PANELISTS TODAY, SO PLEASE MAKE
WELCOME DR. ARIELLE BOROVSKY,
FROM PURDUE UNIVERSITY,
DR. KIMBERLY NOBLE AT TEACHER'S
COLLEGE, COLUMBIA UNIVERSITY,
DR. LAURA JUSTICE OHIO STATE
UNIVERSITY AND DR. KELLY VAUGHN
FROM UT HEALTH HOUSTON AND
EVERYONE FEEL FREE TO COME ON
CAMERA, YOU DON'T NEED TO UNMUTE
IF YOU'RE NOT CHATTING YET.
AND ALSO AS A REMIND TORE
EVERYONE IN THE AUDIENCE, PLEASE
CONTINUE TO POST YOUR QUESTIONS
IN THE Q&A.
THANK YOU FOR BRINGING THOSE IN
ALREADY AND TO THE OTHER
SPEAKERS WHO JUST GAVE FLASH
TALKS, PLEASE FEEL FREE ALSO TO
ENGAGE IN THIS DISCUSSION
PORTION OF THE SESSION TODAY.
SO FIRST BEFORE WE GET INTO THE
SORT OF MEASUREMENT SPECIFIC
QUESTIONS,IDE LIKE TO TALK ABOUT
THIS IDEA OF HOW BEST TO
CHARACTERIZE WHO IS OR IS NOT A
LATE TALKER AND ESPECIALLY AS WE
TALK ABOUT THE TRAJECTORIES AND
LONGITUDINAL DATA, IT MAY MAKE
SENSE TO QUESTION WHETHER
NARROWING DOWN THE DEFINITION TO
OBSERVE AT A SINGLE TIME POINT
IS REALLY THE FIRST OPTION
RATHER THAN SORT OF CONSIDERING
TRAJECTORY AS A WHOLE.
SO I WILL PASS THIS OFF TO
ARIELLE, YOU FIRST AND TALK
ABOUT THE POTENTIAL TRADE-OFFS
BETWEEN THIS IDEA OF MEASURING
THINGSA THE A SINGLE TIME POINT
VERSUS CONSIDERING THE WHOLE
TRAJECTORY.
>> YEAH, THANK YOU FOR THAT
QUESTION AND I THINK THAT -- AS
YOU MENTIONED THIS IDEA, OF
MEASURING AT A SINGLE TIME POINT
WAS WRAPPED UP IN THESE IDEAS
THAT THERE ARE THESE CUMULATIVE
CHALLENGES IN LEARNING AND
COMMUNICATION THAT HAVE
ACCUMULATED OVER TIME AND SO
WE'RE USING THIS LABEL TO REALLY
ASWRIEB WHAT'S REALLY LIKE A
VECTOR OR A CURVE IN DEVELOPMENT
BY VERY SPARSE DATA FROM JUST
THAT SINGLE TIME POINT AND SO,
IT'S REALLY COMPLICATED BY THE
FACT THAT CHILDREN DO ACTUALLY
SHOW A LOT OF VARIABILITY
DEPENDING ON WHEN YOU MEASURE.
SO FOR EXAMPLE IN OUR DATA WHAT
WE SEE IS THAT CHILDREN ASSESSED
AT 1 TIME POINT MIGHT NOT FALL
IF YOU TAKE A CATEGORICAL
APPROACH TO LATE TALKING
MEASUREMENT, MIGHT NOT FALL
WITHIN THAT DIAGNOSTIC CATEGORY
BUT AT ANOTHER TIME POINT MIGHT
DO SO AND THEN MIGHT BOUNCE BACK
AND FORTH OVER TIME AND SO,
THESE -- THE STANDARD MEASURES
ARE DOING A GREAT JOB OF GIVING
US A STABLE IDENTIFIER OF WHICH
CHILDREN MIGHT BENEFIT MOST FROM
EXTRA SUPPORT, MIGHT GIVE US
THAT LONG-TERM MEASURE.
SO IT SUGGESTS THAT WE MIGHT
NEED BETTER MEASURES, BUT THE
TRADE-OFFS HERE ARE BIG, THE
MORE WE MEASURE, THE MORE THE
BURDEN REPLACING ON CAREGIVERS
ON FAMILIES, ON CHILDREN, ON
SCREENING RESOURCES.
IF WE'RE PRESSURING TOO SPARSELY
WE'RE ALSO KIND OF WASTING THE
EFFORT IN THE SENSE THAT WE
MIGHT NOT BE USING, ESPECIALLY
IF WE'RE NOT USING MEASURES THAT
ARE HIGHLY PREDICTIVE OF LEADER
OUTCOMES.
AND SO BALANCING THOSE 2 NEEDS
SEEMS TO BE 1 FACTOR AND SO BUT
TRYING TO FIND THE SWEET SPOT
FOR LONGITUDINAL SAMPLING IS
HARD.
WE NEED BETTER DATA TO REALLY
ANSWER THIS, WE NEED BIGGER DATA
TO ANSWER THIS, AND WE WANT TO
PROBE DEVELOPMENTABLY FOCUS ON
EFFORTS THAT FACILITATE SAMPLING
THAT ARE LOW EFFORT FOR
CAREGIVERS AND LOW COST FOR
PROVIDERS IN TERMS OF TIME TO
DELIVER AND TIME TO INTERPRET
AND SCORE.
AND SO I DON'T REALLY HAVE --
THIS IS THE ANSWERS HERE, I'M
HOPING THAT OTHERS ON THE TEAM
AS WELL WILL BE ABLE TO
BRAINSTORM TOGETHER AS WELL AS
FROM THE AUDIENCE.
BUT I THINK THAT ULTIMATELY,
BALANCING PRIORITIZING REALLY
THE WHAT AND WHEN TO MEASURE
WITH THOSE REAL WORLD CONCERNS
OF OUR RESOURCES WILL HELP US
MOVE THE NEEDLE IN THE RIGHT
DIRECTION.
THAT'S GOING TO PROBABLE BE THE
MOST VALUABLE.
>> SO YEAH, BUILDING OFF THAT
AND ANYONE CAN FEEL FREE TO JUMP
INTO THIS, YOU KNOW, I THINK YOU
HIT THE NAIL ON THE HEAD RIGHT,
WHERE WE HAVE TO FIND THIS
BALANCE BETWEEN IDEALLY WE HAVE
ALL THE DAT ON EVERY KID, RIGHT,
AND THAT WOULD BE ABLE, WE WOULD
BE ABLE TO DIVE INTO ALL OF THAT
BUT THE BURDEN IS OUTSIDE, IT'S
POTENTIALLY FOR THE BENEFIT THAT
WE WOULD BE GETTING THERE AND SO
THINKING ABOUT MOVING US IN A
DIRECTION WHERE WE CAN BOTH HAVE
DENSE DATA, BUT EFFICIENT DATA
COLLECTION, RIGHT?
WHAT ARE SORT OF THE KEY
QUESTIONS THAT WE MIGHT NEED TO
HAVE ANSWERED, SO I CAN, YOU
KNOW BRAINSTORM ON SOME, LIKE,
IS IT IDENTIFICATION OF TIMING
OR APPEARANCE OF A VOCABULARY
SPUR THAT WOULD BE MOST
INFORMATIVE FROM A TRAJECTORY OR
THERE MAY BE OTHER THINGS MAY BE
MORE NUANCED, I THINK RITA
TALKED TO THE IDEA OF LANGUAGE
LEARNING AS REALLY A MARKER OF
POTENTIAL OUTCOMES AS OPPOSED TO
NECESSARILY THIS IS SPECIFICALLY
ON EXPRESSIVE LANGUAGE SO YOU
KNOW AS WE THINK ABOUT WANTING
TO FIND THAT BALANCE BETWEEN
COLLECTING A CLOT OF DATA AND
COLLECTING THE RIGHT DATA AND
SOME OF THE QUESTIONS THAT WE
HAVE ABOUT WHAT THAT TYPE OF
DATA WOULD LOOK LIKE?
>> LAURA, GO FOR IT.
>> I WILL JUST JUMP IN HERE TO
GET THE CONVERSATION GOING.
YOU KNOW WE'RE ALL REALLY GOOD
AT MEASURING KIDS LANGUAGE USING
A LOT OF DIFFERENT TOOLS THAT
ARE OUT THERE AND NUMBER THAT
WE'VE USED FOR A LONG TIME AND
EVEN GOING BACK TO THE SWYC
PRESENTATION, WE'RE NOT REALLY
GOOD AT USING THESE MEASURES, WE
HAVE A TON OF FALSE-POSITIVES, A
TON OF FALSE-NEGATIVES AND I
JUST WANT TO PUSH THE IDEA THAT
I DON'T THINK WE GET AT ENOUGH
IN THE LATE TALK OR LITERATURE
THAT THESE KIDS DEVELOPING
LANGUAGE SKILLS ARE INTERACTING
WITH THE ENVIRONMENT IN WHICH
THEY'RE BEING REARED AND THERE'S
GOT TO BE SOME DIFFERENTIAL
SUTION SEPTORSIBILITY FACTORS
THAT THIS, THE RESEARCHER WHO
STUDIES LATE TALKERS ARE REALLY
NOT ATTENDING THE CONTEXT EXCEPT
AT THE MOST SUPERFICIAL WAY AND
SO I THINK WE REALLY, YOU KNOW
-- I MEAN WE CAN KEEP PUSHING
FOR BETTER MEASURES OR ADD MORE
TO THE CDI, BUT YOU KNOW WHAT IS
IT IN THE CHILD'S ENVIRONMENT
THAT IS INTRODUCING RISK AND
RESILIENCE BECAUSE SO MANY OF
THESE LATE TALKERS ARE GOING TO
END UP HAVING QUASI NORMAL
LANGUAGE BUT THERE'S SO MUCH
WITHIN THE ENVIRONMENT THAT
DRIVES LANGUAGE QUEPMENT AND
WE'VE REALLY GOT TO LOOK AT
THESE INTERACTIONS AND I THINK
DR. BARR'S PRESENTATION REALLY
PUSHED THE ENVELOPE THAT OH,
OKAY, RESOURCES IN THE HOME SEEM
TO DIFFERENTIATE BETWEEN TALKERS
AND NONLATE TALKERS.
SO WHAT IS IT THAT HAPPENING IN
THE MEMORY CLONE ENVIRONMENT
THAT MAY BE LEADING SOME KIDS TO
HAVE YOU KNOW A MORE SUSTAINED
ISSUE WITH LANGUAGE THAN NOT.
>> YEAH AND I THINK TO BUILD OFF
THAT ALSO, THIS IDEA OF -- AND
YOU TOUCHED ON THIS DIFFERENTIAL
SUSCEPTIBILITY, RIGHT?
IT'S NOT JUST THE CHILD, IT'S
NOT JUST THE ENVIRONMENT BUT THE
INTERACTION THEREOF AND CERTAIN
KIDS WILL BE ABLE TO LEVERAGE
CERTAIN THINGS IN THEIR
ENVIRONMENT IN DIFFERENT WAYS,
SORE BE AT RISK TO CERTAIN
THINGS IN THEIR ENVIRONMENT TO
DIFFERENT EXTENTS COMPARED TO
SOME OF THEIR PEERS DEPENDING ON
WHAT THEY'RE SORT OF BRINGING TO
THE TABLE AND WHAT THEY'RE
EXPOSED TO, WHAT THEY'RE
HABITUATED TO HEARING IN THEIR
ENVIRONMENT, ET CETERA, ET
CETERA.
UNLESS SOMEONE HAS SOMETHING
THEY'RE DYING TO STAY AND KEEP
ADDING ON TO THAT, I WANT TO
BRING IN A QUESTION FROM THE
AUDIENCE HERE.
THIS WAS ABOUT WE KEEP SAYING WE
WANT ALL THE DATA, WE WANT LOTS
OF DATA, WE WANT LOTS OF KIDS TO
BE ABLE TO DO THIS DEEP DIVE
INTO DIFFERENTIAL TRAJECTORIES,
AND THE QUESTION IS HOW BIG IS
BIG IN TERPS OF SAMPLE SIZE WHEN
YOU'RE THINKING ABOUT YOU KNOW
DIFFERENT LEVELS OF ANALYSIS
THAT YOU WANT TO DO, THERE ARE
STATIST CALAWAYS TO THINK ABOUT
THIS BUT ALSO THINK BEING
REPRESENTATION AND THE DATA.
SO IF YOU ALL CAN SPEAK TO THIS,
HOW YOU'RE THINK BEING THIS IN
YOUR OWN WORK, ARIELLE?
>> ALL RIGHT, JUST TRYING TO GET
MY HAND TO LOWER, BUT SO I'M NOT
SURE I HAVE A SPECIFIC ANSWER, I
DIDN'T SAY THIS IS THE NUMBER WE
NEED FOR THE BIG DATA OR THE
NUMBER OF DATA POINTS THAT WE
NEED, BUT I THINK 1 APPROACH
WE'RE TAKING IN OUR OWN WORK IS
TRYING TO REALLY OVERSAMPLE AT
THE END OF THE DISTRIBUTION WE
FIND MOST INTERESTING AND
PARTICULARLY IN LATE TALKERS.
SO IN A LOT OF OUR DATA WE'RE
TRYING TO TAKE A CONTINUOUS
APPROACH BECAUSE OF THESE
QUESTIONS THAT CAME UP EARLIER
ABOUT WHAT'S THE CONSENSUS
AROUND LATE TALKER
CLASSIFICATION, BUT IF WE COULD
PRIORITIZE, CREATING SAMPLES
THAT, YOU KNOW IF 10-20% OF
CHILDREN ARE EXPERIENCING LATE
TALKING, OUR SAMPLE SHOULDN'T BE
10-20% LATE TALKING, THEY SHOULD
BE 50% IF WE CAN'T, RIGHT?
AND THAT'S HARDER, BUT PROBABLY
WHAT WE NEED TO DO.
>> ANYONE ELSE OR ANY OF THE
PREVIOUS SPEAKERS WANT TO -- BEN
AND LAUREN YOU TAKE A DIFFERENT
APPROACH TO THE DATA YOU ARE
LOOKING AT AND YOU CERTAINLY
HAVE BIG DATA HEADING ON LARGER
NUMBERS BUT LESS POTENTIAL DEPTH
TO THE DATA ITSELF, RIGHT?
ALTHOUGH, NOT NECESSAR LEE.
SO MAYBE YOU CAN TALK ABOUT HOW
YOUR TEAM THINKS ABOUT
TRANSLATIONAL RESEARCH TRADE OFF
OF THE BIGGER END.
NYEAH, IT'S DEFINITELY IN THE
WORLD, MY BACKGROUND IS IN
INFORMATICS AND BIOSTATTIST
INCREASE IN BODYS SO A LOT OF
WHAT WE THINK ABOUT IS THE FIT
FOR PURPOSE OF DATA AND HOW
USEFUL IS IT FOR ANSWERING A
PARTICULAR QUESTION AND FOR US 1
OF THE VALUES OF USING THESE
LARGER COHORTS OF HEALTH SYSTEM
RELATED DAILY BASIS THEA IS THAT
WE DEFINITELY DO GET A MUCH MORE
DIVERSE POPULATION IN OUR HEALTH
SYSTEM, IT SERVES A
MAIORITY-MINORITY POPULATION AND
WE GET TO SEE THINGS WITHIN A
REAL WORLD CONTEXT.
THE TRADE-OFF OF THAT OBVIOUSLY
IS THAT WE'RE VERY LIMITED IN
THE WAYS THAT WE CAN IDENTIFY
CHILDREN, RIGHT?
SO I THINK YOU NEED TO HAVE THIS
BALANCE BETWEEN VERY DEEP
PHENOTYPING OF COHORT TO COLLECT
THE INFORMATION YOU NEED TO AND
THEN YOU NEED A LARGER, BROADER
POPULATION AS WELL, WHICH CAN
PROVIDE MORE OF A BIRD A EYE
VIEW, 1 THING WE'RE LOOKING AT
IS THE POTENTIAL BIASES AND
DIAGNOSIS AND CAN WE FIND
INDICATIONS IN THE WAY OF THE
CLINICAL NARRATIVE AND NOTES TO
FIGURE OUT THAT KIDS WHO LOOK
LIKE THEIR PEDIATRICIANS ARE
SAYING THEY'RE LATE TALKING BUT
AREN'T ROUGH ATOM VIEDING A
DIAGNOSIS CODE FOR THAT AND WE
ARE SEEING SOME DEMOGRAPHIC
DISPARITIES IN THE WAY THAT'S
BEING DOCUMENTED WITHIN THE
CHARTS, WHICH KIND OF HIGHLIGHTS
YOU KNOW THE CHALLENGES AND THIS
ADMINISTRATIVE DATA IS THAT IT'S
NOT GOING TO BE A GOLD STANDARD
VERSION BUT CAN GIVE A BROADER
PERSPECTIVE OF WHAT THIS LOOKS
LIKE IN A POPULATION.
>> I THINK THAT'S A REALLY
IMPORTANT POINT TO SORT OF EPPED
THIS PIECE ON, RIGHT, IS THE FIT
BETWEEN.
IT'S NOT JUST ABOUT THE SAMPLE
SIZE, IT'S NOT JUST ABOUT THE
MEASURES ISSUES IT'S ABOUT THE
FIT BETWEEN THE DATA AND THE
QUESTIONS THAT YOU'RE BOTH
TRYING TO ASK AND BEING MINDFUL
ABOUT THE QUESTIONS THAT YOU CAN
ANSWER THROUGH THE DATA THAT YOU
HAVE AVAILABLE AND MAKING SURE
IT'S FIT THERE AND YOU'RE NOT
OVERINTERPRETTING OR
UNDERINREPRESENTATION RETINAL
LOCATIONING OR
MISINREPRESENTATION RETINAL
LOCATIONING BASED ON A LACK OF
DATA AND SCIENTIFIC QUESTIONS.
DIVING BACK INTO THE CONTEXT
PIECE WE TOUCHED ON A BIT
EARLIER, RACHEL BARR, YOU WANT
TO ADD SOMETHING THERE ABOUT THE
CONTEXT IS THINKING ABOUT THE
HOME ENVIRONMENT?
>> CAN YOU HEAR ME NOW, THIS
TIME?
>> YES.
>> NICE AND CLEAR.
>> SO THIS BRINGS ME TO THE -- I
JUST WANTED TO REITERATE HOW
THINGS LIKE TECHNOFER ENSEL AND
THE MEDIA IN THE HOME COULD BE
PROVIDING THE SUPPORT FOR THE
CHILD OR COULD BE PROVIDING THIS
INTERFERENCE, SO I WAS SIMPLY
TRYING TO DO THE TALK AND THEN
THERE WAS NOTIFICATIONS COMING,
I WAS ECHOING, SO IT WAS TO
HEAR, IT WAS INTERACTING WITH
THE RESEARCH THAT WAS TRYING TO
CONVEY AND I THINK, THAT WAS
PERHAPS THE BEST DEMONSTRATION
OF HOW MEDIA COULD POTENTIALLY
INTERFERE WITH AND MAKE IT MUCH
MORE DIFFICULT FOR WHO ARE
DIFFERENTIALLY SUSCEPTIBLE WHO
HAVE LANGUAGE DIFFICULTY TO
PROCESS THIS INCOMING
INFORMATION, SO IF YOU HAVE
SIGHT, HEARING LOSS OR SLOWER
PROCESSING SPEED, THIS CONTEXT
OF THE MEDIA ENVIRONMENT IS
GOING TO BE VERY DIFFERENT THAN
CHILDREN WHO HAVE TYPICAL
PROCESSING AND HEARING.
SO IT'S ABOUT A CONTEXT
INTERACTION, I WANTED TO SORT OF
FOLLOW UP AND HOW ACTUALLY THAT
MY PRESENTATION ALTHOUGH
DISTORTED WAS PERHAPS THE
PERFECT EXAMPLE OF HOW THAT
CONTEXT COULD INTERFERE WITH
CHILD DEVELOPMENT BUT ALSO TO
SAY, WHEN WE'RE THINKING ABOUT
CONTEXTURAL FACTORS HOW IT MIGHT
PROTECT JOINT ENGAGEMENT IN
PLAY, MEDIA, ANY DAILY
ACTIVITIES WITH THE CHILD,
CLEARLY ENHANCES THE LANGUAGE
INPUT AND MAY BE PARTICULARLY
IMPORTANT FOR CHILDREN WHO MAY
BE MORE SUSCEPTIBLE FOR LATE
TALKERS.
>> GREAT POINTS AND YES, THANK
YOU FOR BRINGING, YOU KNOW
SCIENCE TO LIFE FOR US ALL.
SO I WANT TO -- THIS IS ANOTHER
QUESTION FROM THE AUDIENCE,
REALLY THINKING ABOUT -- I THINK
GETTING IT AND DIFFERENTIATING
TRAJECTORIES.
THE QUESTION IS ABOUT HOW WE
THINK ABOUT THE DISTINCTIVENESS
VERSUS THE OVERLAP FOR THE LATE
TALKER PHENOTYPE VERSUS
DEVELOPMENTAL LANGUAGE DELAY
PHENOTYPE AND I THINK THIS IS A
REALLY OPEN QUESTION IN A LOT OF
WAYS, RIGHT, AS WE THINK ABOUT
DIFFERENTIATING TRAJECTORIES.
SO IF ANYONE HAS ANYTHING TO ADD
OR TO EXPAND UPON IN TERMS OF
THAT QUESTION.
AND THIS IS OPEN TO OUR PANEL OR
PREVIOUS SPEAKERS FROM TODAY AS
WELL.
>> I COULD ADD MAYBE A BRIEF
THING BUT IF OTHER PEOPLE WANT
TO JUMP IN, I AM TOTALLY HAPPY
TO HEAR THEIR THOUGHTS AS WELL,
BUT MOSTLY TO SAY THAT THAT'S AN
EXCELLENT QUESTION AND THAT IT'S
ASSUMED AND THERE ARE SOME DATA
TO SUGGEST THAT CHILDREN WHO ARE
LATE TALKING ARE AT ENHANCED
RISK FOR DLD BUT THAT'S NOT
UNIVERSALLY SEEN ACROSS ALL
STUDIES AND THERE ARE EVEN CASES
THAT WE SEE IN OUR OWN DATA FOR
CHILDREN WHO EARLY ON SEEM TO BE
SHOWING TYPICAL DEVELOPMENT
TRAJECTORIES AND THEN LATER
FALLING INTO A MORE LANGUAGE
DELAYED STATUS, SO RIGHT, IT'S A
HUGE QUESTION AND WHERE TO WHERE
IT SEEMS TO SOME EXTENT THERE'S
A REAP BUT IT'S NOT CLEARLY A 1
TO 1 RELATIONSHIP AT ALL.
.
>> YOU KNOW I TAKE A STANCE OF
GETTING EXCITED ABOUT SCIENTIFIC
QUESTIONS FOR WHICH THERE ARE
MORE OPEN QUESTIONS THAN
ANSWERS, RIGHT AND THIS IS
CERTAINLY 1 OF THEM AND A BIG
REASON WHY WE'RE ALL HERE TODAY
AND OVER THE NEXT COUPLE OF
WEEKS TO TALK ABOUT THESE THING
SYSTEM THAT THERE IS AS OF YET
SO MUCH UNKNOWN IN TERMS OF WHAT
ARE THE EARLY MARKERS THAT ARE
GOING TO DISTINGUISH THESE 2
GROUPS OF KIDS AND ALSO FROM
THOSE WHO ARE GOING TO GO ON TO
RECOVER OR SHOW SORT OF MORE
AVERAGE LANGUAGE TRAJECTORIES
LATER ON IN LIFE, SO PROBABLY
MORE OPEN QUESTIONS OF ANSWERS
TO THIS AS OF YET.
SO I THINK A LOT OF QUESTIONS
THAT ARE COMING IN AND A LOT OF
WHAT WE'RE WE'RE SORT OF
TOUCHING ON IN THIS DISCUSSION
AS WELL GET US MORE INTO THE
NITTY-GRITTY OF NOT JUST
THINKING ABOUT THESE
TRAJECTORIES, BUT HOW WE'RE
MEASURING THEM.
WHAT ARE THE ACTUAL TOOLS THAT
WE'RE USING AND THERE ARE SO
MANY -- SO MANY QUESTIONS AND
IDEAS AND THOUGHTS COMING IN
ABOUT THIS, BUT SOMETHING THAT
WE HAVE TOUCHED ON ONLY A LITTLE
BIT HERE THAT I WOULD REALLY
LOVE TO EXPAND UPON A LITTLE BIT
IS THIS IDEA OF MEASUREMENT AS A
REPRESENTATION ISSUE.
SO RITA, YOU PRESENTED DATA WITH
BILINGUAL KIDS OR KIDS BEING
EXPOSE OFFICE OF DIVERSITY 2
DIFFERENT LANGUAGES AND 1 WAY OF
MEASURING THEM WAS TO USE, YOU
KNOW THEIR STRONGEST LANGUAGE
BUT THERE ARE SORT OF A SLEW OF
DIFFERENT WAYS WE CAN MEASURE
LANGUAGE DEVELOPMENT IN KIDS WHO
ARE LEARNING MULTIPLE OR EXPOSED
TO MULTIPLE LANGUAGES AND
THERE'S NOT REALLY CLEAR
GUIDANCE OR STANDARDIZED
ASSESSMENTS HERE.
SO I KNOW KELLY YOU DO A LOT OF
WORK IN THIS AREA AND I'M HOPING
YOU CAN EXPAND ON THE CHALLENGES
YOU SEE AND THE OPPORTUNITIES
YOU SEE AND THE WAYS YOU ARE
APPROACHES THIS.
>> YEAH, SO I THINK PROBABLY
HISTORICALLY, THE SOLUTION WAS
WE JUST EXCLUDE KIDS WHO ARE
NONENGLISH SPEAKING BECAUSE WE
ONLY HAVE ENGLISH SPEAKING
ASSESSMENTS FOR LANGUAGE, FOR
EARLY LANGUAGE DEVELOPMENT AND I
THINK THAT CAN'T BE THE SOLUTION
FOREVER.
WE HAVE TO MAKE OUR RESEARCH
MORE ENCLUESIVE AND MAKE SURE
THAT KIDS WHO SPEAK OTHER
LANGUAGES OR SPEAK MULTIPLE
LANGUAGES WE ARE UNDERSTANDING
THEIR LANGUAGE DEVELOPMENT AS
WELL.
SO I THINK THERE ARE A COUPLE OF
KEY ISSUES, THE FIRST BEING THAT
WE DON'T HAVE ARK ASSESSESMENTS
THAT ARE STANDARDIZED AND NORMED
ACROSS EVERY POSSIBLE LANGUAGE.
SO FOR EXAMPLE WHEN YOU HAVE
BILINGUAL KIDS AND YOU'RE
ASSESSING USING THE CDI, MANY
KIDS WILL HAVE SPANISH ENGLISH
FAMILIES, COMPLETE BOTH THE
ENGLISH CDI AND SPANISH CDI AND
DO A COMPOSITE MEASURE TO
COMBINE THE 2 BUT WE STILL DON'T
ALWAYS HAVE A GREAT SENSE OF
WHAT'S TYPICAL, WHAT NORMS DO WE
USE FOR THESE COMPOSITE SCORES
AND SO I THINK THERE'S STILL A
LOT OF WORK TO BE DONE IN THAT
AREA.
ANOTHER OPTION THAT WE'RE USING
IN MY RESEARCH IS THAT MOST
RECENT VERSION OF THE PRESCHOOL
LANGUAGE SKILLS WHICH IS AN
ENGLISH VERSION AND SPANISH
VERSION WHICH HAS BEEN NORMED
FOR BILINGUAL KIDS AND FOR THAT
ASSESSMENT YOU WOULD ADMINISTER
ITEMS IN SPANISH AND THEN IF THE
CHILD MISSES THE ITEM YOU COULD
TRY AGAIN IN ENGLISH TO SEE IF
THEY CAN RESPOND CORRECTLY IN
ENGLISH, SO I THINK THERE ARE
SOME OPTIONS OUT THERE, BUT THEY
ONLY -- THEY'RE LIMITED IN THE
LANGUAGES THAT THEY COVER.
THEY DON'T COVER EVERY TYPE OF
MULTILINGUAL THAT YOU MIGHT
ENCOUNTENER YOUR RESEARCH.
OF COURSE ALONG WITH NOT HAVING
ACCESS TO LOTS OF ARK
ASSESSESMENTS, YOUR STAFF, YOUR
RESEARCH STAFF ALSO NEEDS TO BE
PROFICIENT IN THE LANGUAGE THAT
YOU'RE ASSESSING, SO, I'M
INTERESTED IN KIND OF DISCUSSING
WITH YOU ALL SOME AMTERNATIVE
OPTIONS.
SO IS THERE A WAY TO USE AN
ENGLISH ONLY ARK ASSESSESMENT
PAIRED WITH SOME KIND OF
EXTENSIVE LANGUAGE BACKGROUND
QUESTIONNAIRE TO KIND OF WEIGHT
THE ENGLISH ASSESSMENT OR ARE
THERE OTHER OPTIONS SUCH AS MORE
NATURALISTIC INTERACTIONS OR
RECORDINGS OF THE HOME LANGUAGE
ENVIRONMENT, LIKE
[INDISCERNIBLE] RECORDINGS THAT
COULD BE APPLIED RELATING TO THE
LANGUAGE, WE COULD TRANSCRIBE,
USING SOME KIND OF AUTOMATIC
TRANSCRIPTION THAT DOESN'T
REQUIRE OUR STAFF TO HAVE ALL
THE KNOWLEDGE OF THE BACKGROUND
LANGUAGE AND USE THAT TO GET
CHILD UTTERANCES, AND ADULT
UTTERANCES AS AN ALTERNATIVE
APPROACH TO MEASURING LANGUAGE
IN THE HOME.
SO I THINK, YEAH, THAT'S WHEREI
WANT TO START, WHAT ARE THE
ALTERNATIVES IF YOU DON'T SPEAK
THE LANGUAGES THAT YOUR
PARTICIPANTS SPEAK.
>> AND JUST TO FOLLOW UP ON
THAT, I WOULD AGREE WITH
EVERYTHING KELLY JUST SAID, YOU
KNOW IT'S SO IMPORTANT I THINK
NOT TO MEASURE BILING Y'ALL
CHILDREN USING ONLY ENGLISH ONLY
STANDARDIZED ASSESSMENTS BECAUSE
THEN WE KNOW WE WILL BE
UNDERSCORING THEM AND EVEN WITH
THE APPROACH OF USING THE NCBI
IN BOTH VERSIONS THEY WEREN'T CO
NORMED ON THE SAME EXAMPLES SO
THE PERCENTILES AREN'T
EQUIVALENT WHICH MAKE ITS
CHALLENGING TO COME UP WITH THE
COMPOSITES.
I KNOW KATHLEEN [INDISCERNIBLE]
GROUP DEVELOPED, THE DUAL
LEARNERS ENGLISH-SPANISH TO
OVERCOME THOSE ISSUES.
I THINK THIS IDEA OF DAY LONG
[INDISCERNIBLE] IS POTENTIALLY
VERY INTERESTING, YOU KNOW
IDEALLY WE WOULD BE ABLE TO
DEVELOP SOME KINDS OF NORMS OR
AT A MINIMUM AS KELLY SUGGESTED
PAIRING WITH SOME KIND OF CODING
SCHEME TO MEASURE TYPES AND
TOKENS WITH BOTH LANGUAGES AND
SIMILAR METRICS.
>> I THINK THE Y-THING THAT
KELLY HAD WAS PERHAPS A VERY --
COULD BE A VERY USEFUL 1 IF WE
HAVE EXISTING DATA SETS BECAUSE
OFTEN IF WE HAVE THESE
LONGITUDINAL DATA SETS WE CAN
SEE HOW WE CAN MAXIMIZE WHAT
WE'VE ALREADY COLLECTED
ESPECIALLY WITH THOUGHTS OF
COLLECTING DATA AT LATER TIME
POINTS.
I WAS WONDERING, YOU WOULD WANT
TO HAVE THAT FROM DETAILED
EXPOSURE, OF COURSE, HOW WOULD
YOU GO ABOUT DOING THAT EXACTLY?
WHAT WOULD BE THE STRATEGY?
>> YEAH, I DON'T HAVE A LOT OF
IDEAS IN THIS AREA, IT WAS JUST
SOMETHING THEY HEARD SOMEONE
PROPOSE RECENTLY THEY THOUGHT IS
KIND OF WORTH EXPLORING A LITTLE
BIT MORE IF YOU HAD SOME VERY
RELIABLE AND TRUSTWORTHY
ASSESSMENT OF THE PERSON THAT
THEY WERE EXPOSED TO ENGLISH
VERSIONUS OTHER LANGUAGES, MAYBE
YOU COULD ASSIGN A WEIGHT TO THE
ENGLISH VOCABULARY MEASURE THAT
YOU USED AND THEN ASSUME THAT
THEIR OTHER LANGUAGE MAKES UP
THE REST OF THE PERCENTAGE.
>> I MEAN I ASK BECAUSE
[INDISCERNIBLE] -- KIDS AND THE
PATTERNS, THE MODELS LOOK QUITE
DIFFERENT FOR THE CHILDREN
[AUDIO CUTS OUT ]
>> SORRY RACHEL YOUR AUDIO WAS
CUTTING OFF TOWARDS THE END
THERE.
>> VIRGINIA CAN I MAKE A QUICK
COMMENT?
>> PLEASE.
>> WHICH IS THAT I THINK THIS
CONVERSATION IS REALLY ENLIGHT
EVENING IN TERMS OF THE GAP
BETWEEN WHAT WE KNOW IS WHAT WE
NEED TO KNOW IN THIS AREA.
AND I THINK WHEN WE LOOK AT THE
ROLE OF NIH IN FOSTERING
SCIENTIFIC INQUIRY THAT THIS
CONVERSATION IN ABOUT 7-8 YEARS
FROM NOW WILL BE FUNDAMENTALLY
DIFFERENT BECAUSE OF YOUR TALK
INITIATIVE AND I DON'T KNOW -- I
KEEP SAYING SOME SENATOR OUT
THERE HAS A LATE TALKER, LIKE
SOMEBODY OUT THERE HAS TAKEN
THIS ON, I DON'T KNOW WHO THEY
ARE, I'M VERY GRATEFUL BUT THIS
INITIATIVE, YOU KNOW IF I LOOK
AT THE RO-1 INVITATION THAT YOU
HAVE OUT THERE, YOU'RE INVITING
THE BEST AND MOST INNOVATIVE
MIND OUT THERE TO PUT THEIR BEST
IDEAS FORWARD AND TAKE SOME OF
THESE IDEAS TO FRUITION, SO I'M
REALLY EXCITED WHAT NIH HAS DONE
IS WHAT GOVERNMENT FUNDING
ENTITIES OUGHT TO DO WHICH IS TO
STIMULATE RESEARCH WHERE IT'S
NEEDED.
SO MY POINT IS 7 OR 8 YEARS FROM
NOW, WE WILL NO SO MANY MORE
THINGS ABOUT THIS ISSUE OF EARLY
LANGUAGE ASSESSMENT AND WHAT
MIGHT BE POSSIBLE.
>> WELL I LOVE THOSE KIND WORDS
AND I LOVE YOUR OPTIMISM AND I
CERTAINLY HOPE, YOU KNOW THAT'S
THE GOAL WE'RE ALL HERE TO
ACCOMPLISH TODAY.
I HOPE I LED APPROPRIATELY WITH
THE SENSE THAT I DON'T EXPECT US
TO COME AWAY FROM TODAY OR THE
OTHER, YOU KNOW SESSIONS OF THIS
WORKSHOP SERIES WITH ANSWERS,
RIGHT, BUT MOSTLY WITH
QUESTIONS, WHAT ARE THE
UNANSWERED QUESTIONS AND WHERE
DO WE REALLY NEED TO BE PUTTING
OUR RESOURCES ACROSS THESE BEST
MINDS THAT WE HAVE GATHERED
TOGETHER.
SO SORT OF BUILDING OFF THAT,
SOME OF THE BEST MAY OR MAY NOT
BE ON THE CALL TODAY, HAVE
REFERENCED SOME EXISTING WORK ON
ESPECIALLY USING THE CDI, AND
BILINGUAL POPULATIONS AND THE --
THIS IS SORT OF A QUESTION BUT A
BIT OF A COMMENT BUT PREVIOUS
WORK SUGGESTED ADMINISTERING THE
CDI IN BOTH LANGUAGES AND THEN
CALCULATING THE TOTAL SCORE
RATHER THAN A CONCEPTUAL CORE
AND I KNOW THIS IS SORT OF A
REALLY CURRENT TOPIC IS THIS
IDEA OF MEASURING BILINGUAL
VOCABULARY IN TERMS OF
INDIVIDUAL LANGUAGE, TOTAL LIKE
AND OF ACTUAL WORDS VERSUS SORT
OF COMBINED CONCEPTUAL
VOCABULARY AND THERE ARE
TRADE-OFFS I THINK TO EITHER,
AGAIN THAT WOULD FIT THE DATA
AND QUESTION YOU'RE TRYING TO
ASK, AND SO, WONDERING IF THERE
ARE THOUGHTS ON WHEN EITHER OF
THESE APPROACHES MIGHT BE MOST
APPROPRIATE.
NI THINK THAT'S A GREAT QUESTION
AND I DON'T THINK THAT WE HAVE A
CLEAR ANSWER.
I FEEL LIKE IN MANY OF OUR
STUDIES, WE KIND OF CALCULATE
BOTH AND TRY TO FIGURE OUT WHICH
BETTER REFLECTS OR WHICH BETTER
MATCHES OUR MONOLINGUAL SAMPLE
BUT I THINK IT'S DEFINITELY
SOMETHING WE NEED TO COME TO
CONSENSUS ON ESPECIALLY IN THESE
EARLY YEARS.
>> HELLO, COULD I HOP IN, THIS
IS LISA HUNTER AGAIN, I'M ON
VIDEO.
THERE WAS A REALLY INTERESTING
QUESTION BY BRIAN Mc LENOIRY
IN LINE WITH THAT LAURA WAS
SAYING ABOUT CATCHING UP FOR
LATE TALKERS THAT A MAJOR GOAL
MIGHT BE TO REALLY FOCUS ON
RECOVERY.
THAT'S SOMETHING WE'VE BEEN
THINKING A LOT IN OUR DATA
BECAUSE WE HAVE A RELATIVELY
SMALL SAMPLE COMPARED TO THESE
LARGER EPIDEMIOLOGIC STUDIES BUT
DENSE DATA COLLECTION WHICH IS
SOMETHING THAT HE MENTIONED
ESPECIALENTIALLY DEMOGRAPHIC
INFORMATION.
I'D LIE LOAF TO HEAR WHAT PANEL
-- I'D LOVE TO HEAR WHAT
PANELISTS THINK ABOUT THIS,
RECOVERY RESIL WRENS, CHILDREN
WHO SLEEP APNEA AND OBESITYEM TO
CATCH UP AND COME BACK, AND WE
COME UP TO MOTHER'S EDUCATIONAL
LEVEL, WHICH SEEMS TO BE A
MAGICAL BULLET OR PILL OR AND
WE'RE SEEING THAT IN THE
PREMATURE DATA AND EVEN IN THE
CHILDREN WITH HEARING LOSS,
MOTHER'S EDUCATION, THERE'S
SOMETHING VERY IMPORTANT THERE
HAPPENING IN THE ENVIRONMENT SO
JUST CURIOUS ABOUT WHAT THE
PANELISTS THINK ABOUT MEASURING
THOSE FACTORS.
>> YEAH, VIRGINIA DO YOU MIND?
>> GO FOR IT.
NTHIS
N--
>> THIS IS WHAT OUR CURRENT RO-1
AND SUPPLEMENT IS TALK FOR,
WHICH IS LINKING SOC QUO
ECONOMIC STATUS TO LANGUAGE OR
TRAJECTORIES RISKS FOR LATE
TALKERS, THEY'RE JUST USING
THESE PROXY VARIABLES FOR LIKE
[INDISCERNIBLE].
AND SO WHAT WE'VE BEEN TRYING TO
DO IS UNPACK WHAT IS IT ABOUT
LIVING IN A HOME EXPERIENCING
ECONOMIC HARDSHIP LEADS TO
DISRUPTION IN LANGUAGE
DEVELOPMENT.
LIKE WHAT IS THE ACTUAL
MECHANISM THROUGH WHICH ECONOMIC
HARDSHIP WOULD LEAD TO ISSUES
WITH LANGUAGE ACQUISITION.
AND SO WE'RE USING THE FAMILY
STRESS MODEL WHICH PROPOSES
THERE'S 4 OR 5 DIFFERENT
DIMENSIONS OF THE FAMILY CONTEXT
THAT MIGHT BE MECHANISMS THROUH
WHICH LANGUAGE IS DISRUPTED AND
YOU KNOW I MEAN BASICALLY ALL
PATHS LEAD TO LARGELY A
DISRUPTION AND CAREGIVER CHILD
INTERACTION BUT IT IS WHAT IS
BRINGING ABOUT THAT DISRUPTION
AND YOU KNOW A LOT OF IT IS
TOXIC STRESS IN THE ENVIRONMENT
THAT NONE OF US AS MIDDLE CLASS
RESEARCHERS CAN TRULY COMPREHEND
REALLY BUT YOU HAVE THIS STRESS,
STRIFE, INTENTION, CONFLICT IN
THE HOUSEHOLD ENVIRONMENT
BROUGHT ABOUT BY ECONOMIC
HARDSHIP THAT THEN IS DISRUPTING
PARENTING WHICH THEN SEEMS TO BE
IMPACTING WHAT'S GOING ON IN THE
CHILD'S BRAIN.
I THINK KIM NOBLE'S WORK HAS
DONE A TERRIFIC JOB TRYING TO
LOOK AT WHAT IS IT ABOUT SES
THAT SEEMS TO BE IMPRINTING
ITSELF ON THE LANGUAGE
SUBSTRATES OF OUR NEUROBIOLOGY.
AND MAYBE YOU WANT TO COMMENT
ABOUT SOME OF THAT.
NYES, THANK YOU LAURA FOR THE
KIND WORDS AND I TOTALLY AGREE
WITH YOU THAT CERTAINLY THESE
DISTAL FACTORS ARE CERTAINLY
MULTIFACTORIAL PATHWAYS TO THE
OUTCOMES WE CARE ABOUT EMPLOY I
WOULD BE INTERESTED IN HEARING
ABOUT WHAT YOU THOUGHT ABOUT
STRESS TO THE HOME LANGUAGE
ENVIRONMENT, WE LIKELY THOUGHT
THAT WAS 1 PATHWAY TO LANGUAGE
OUTCOMES AND 3 DIFFERENT
INDEPENDENT SAMPLES, WE CONSIST
EPTLY FOUND NO ASSOCIATIONS
BETWEEN MOMS REPORTED STRESS,
MOM'S PHYSIOLOGICAL STRESS,
MOM'S EXPERIENCES WITH STRESS
AGAIN, SELF-REPORT AND VARIOUS
LENA OUTCOMES, WE CAN TALK ABOUT
WHAT THAT MIGHT BE AND I DON'T
FINISH WE HAVE TIME TO GO INTO
YOUR DATA IF YOU WANT TO BUT I
WOULD BE CURIOUS TO HEAR IF YOU
ARE SEEING SOMETHING DIFFERENT.
>> WELL, THE ONLY THING I WILL
GOING SOPHISTICATED SAY IS WE
HAVE TO BE SO CAUTIOUS ABOUT
TALKING ABOUT LOW INCOME
FAMILIES MONOLITHICALLY BECAUSE
LIKE ON PAPER, WE HAVE A LARGE
SAMPLE OF ABOUT 350 MOMS WHO HAD
BABIES AND THEY WERE LIVING IN
REALLY POOR HOMES AND WE LOOK AT
MOMS WHO'S HOMES SITUATION LOOKS
DIRE AND THEN WE LOOK AT THE
REPORTS ON STRESS AND THEY'RE
LIKE, WE'RE HAPPY.
WE'RE NOT STRESSED AT ALL.
SO THERE'S SOMETHING WEIRD ABOUT
STRESS, WELL, LIKE ALL OF US IN
OUR LIVES SOME OF US MANIFEST
STRESS DIFFERENTLY THAN OTHERS.
NI LOVE THAT POINT AND LOOKING
AT THE TIME, I WANT TO MAKE SURE
WE SPEND A LITTLE BIT OF TIME ON
OUR LAST SORT OF TOPIC FOR THIS
DISCUSSION WHICH IS ABOUT YOU
KNOW THE NITTY-GRITTY
RECRUITMENT, RETENTION BUT
REALLY ABOUT REPRESENTATION AND
THESE LONGITUDINAL SAMPLES AND
NOT THINKING ABOUT ANY GROUP
WE'RE LOOKING AT AS A MONOLITHIC
GROUP LOOKING AT INDIVIDUAL
DIFFERENCES AND I THINK A COUPLE
OF DIFFERENT WAYS HAVE BEEN
RAISED BOTH IN TERMS OF OUR
DISCUSSION OF BILINGUAL
POPULATION, SOMEONE IN THE Q&A
RAISED THAT WE TALKED ABOUT
BILINGUALISM FROM A MONOLITHIC
PERSPECTIVE WHICH IS I THINK IS
PROBABLY PRETTY TRUE AND
CERTAINLY REPRESENTATIVE OF THE
MEASURES WE HAVE AVAILABLE TO US
CURRENTLY.
BUT ALSO IN TERMS OF YOU KNOW
JUST THE DIFFERENT -- THE
DIFFERENT SOCIOLOGICAL
DEMOGRAPHIC CULTURAL BACKGROUNDS
THAT OUR FAMILIES ARE BRINGING
TO THE TABLE AND SO I KNOW KIM,
MAYBE YOU WANT TO BUILD ON THIS
CONVERSATION A LITTLE BIT.
>> YEAH, HAPPY TO, THANK YOU
VIRGINIA FOR RAISING THIS
IMPORTANT POINT.
SO I DO HAVE A FEW THOUGHTS AND
I THINK THERE ARE IMPORTANT
THINGS WE NEED TO TAKE INTO
ACCOUNT FROM THE VERY START OF
DESIGNING STUDIES, OF HIRING UP
OUR RESEARCH STAFF, AND RESEARCH
TEAMS.
YOU KNOW, OVER THE YEARS THEY
BECOME MORE AND MORE CONVINCED
IT'S REALLY JUST FUNDAMENTALLY
CRITICAL TO HIRE FAMILY BASING
RESEARCH STAFF WHO ARE VERY
SIMILAR IN TERMS OF THE RACIAL
ETHNIC TOOL OF OF OUR
BACKGROUNDS OF OUR PARTICIPANTS
IDEALLY RECRUITED FROM OUR
PARTICIPANTS COMMUNITIES, I
THINK IT'S ALSO REALLY IMPORTANT
TO INCLUDE THAT RESEARCH STAFF
AND OTHER COMMUNITY MEMBERS AND
FOCUS GROUPS AND OTHER
CONVERSATIONS ABOUT RESEARCH
PLANS TO REALLY GAUGE AND INSURE
THE CULTURAL APPROPRIATENESS OF
OUR RESEARCH DESIGN AS A WHITE
PROFESSOR LIVING IN NEW YORK
CITY, THERE'S ONLY SO MUCH I CAN
DO WITH THE BEST OF
INTENTIONINGS ON MY OWN AND WITH
MY COLLABORATORS, RIGHT?
SO IT'S REALLY JUST CRITICAL TO
REALLY GET THE VOICES OF PEOPLE
IN THE COMMUNITY TO HELP US
UNDERSTAND HOW THEY WOULD
PERCEIVE, WHAT WE MIGHT THINK IS
A GREAT IDEA AND WHAT THEY MIGHT
THINK IS MAYBE NOT SUCH A GOOD
IDEA.
ALSO, YOU KNOW I THINK IT'S
REALLY IMPORTANT IN TERPS OF
RECRUITMENT AND RETENTION TO
BUILDING TRUST WITH OUR FAMILIES
THAT, YOU KNOW, WE ARE NOT UP TO
-- WE DON'T HAVE NEFARIOUS
INTENTIONS AND WE'VE FOUND THAT
WHEN FAMILIES REALLY FORM A BOND
WITH RESEARCH STAFF THEY'RE MUCH
MORE LIKELY TO ENGAGE
LONGITUDINALLY AND THEN THERE'S
OTHER CONSIDERATIONS IN TERMS OF
REALLY TRYING TO WORK HARD TO
MAKE RESEARCH STUDIES ESPECIALLY
LONGITUDINAL STUDIES AND
PROVIDING PAID TRANSPORTATION TO
THE LAB, NOT JUST REIMBURSEMENT
BUT SENDING A CAR TO THE HOME
FOR THE FAMILY FOR YOUNGER
CHILDREN, PROVIDING A MEAL,
PROVIDING HELP FOR SIBLINGS, AND
THERE ARE SOME PEOPLE WHO MIGHT
NOT BE COMFATTERRABLE TO A LAB
BASED SETTING AND ALSO MIGHT NOT
BE COMFORTABLE COMING INTO THEIR
HOME SO HAVING A THIRD OPTION OR
SOMETHING SIMILAR, SORT OF A
NEUTRAL PLACE WHERE WE CAN MEET
IN A QUIET ENVIRONMENT WHERE WE
CAN FEASIBLY CONDUCT MOST OF OUR
ASSESSMENTS, BUT, HAVING IT IN
SOME NEUTRAL TERRITORY, SO THOSE
ARE SOME OF THE WAYS WE TRY TO
REALLY THINK ABOUT REDUCING
BARRIERS FOR PARTICIPATION IN
OUR RESEARCH.
>> I'M WONDERING, KIM IF YOU ON
THE PANEL OR ANY OF THE OTHER
SPEAKERS CAN SPEAK TO SUCCESS
STORIES.
YOUA -- YOU RAISED A LOT OF
GREAT THINGS AND YOU'RE TRYING
TO INCORPORATE, AND I'M
WONDERING IF YOU HAVE A SENSE OF
FEEDBACK FROM THE PARTICIPANTS
IN YOUR STUDIES OF WHAT HAS
REALLY RESONATED IF ARE THEM AND
1 THING THAT YOU RAISE THAT I
WOULD LOVE TO EXPAND UPON A
LITTLE BIT, TOO, IS THIS IDEA OF
ARE THE QUESTIONS THAT WE'RE
ASKING 1S THAT ARE RESONATING
WITH THEM, RIGHT?
>> I'M HAPPY TO SHARE MAYBE NOT
SUCH A SUCCESS STORY BY LESSONS
LEARNED IS WHAT I'M HOPING IS A
BETTER SUCCESS STORY.
SO IN 1 OF OUR STUDIES, THE
MULTISITE NATIONAL STUDY,
INVOLVING UNCONDITIONAL CASH
TRANSFERS GIVEN OUT TO LOW
INCOME FAMILIES, AND 1 OF THE
THINGS WE WANTED TO MEASURE WAS
PHYSIOLOGICAL STRESS AND WE
THOUGHT, WELL IT WOULD BE SO
MUCH EASIER TO COLLECT CORTISOL
SAMPLES THROUGH HAIR THAN
SALIVA, BECAUSE YOU CAN GET 1
AND DONE MEASURE OF HAIR, IT'S A
SMALL SAMPLE, YOU TAKE IT FROM
THE BACK OF THE HEAD, NO 1 WILL
NOTICE IT, YOU DON'T HAVE TO
WORRY ABOUT VARIATIONS OR
MULTIPLE MEASUREMENTS OVER TIME,
WE HAVE DONE IT BEFORE IN OUR
LAB WITHOUT MUCH DIFFICULTY, AND
WHAT WE REALLY ARE ASHAMED TO
SAY, WE DIDN'T TAKE INTO ACCOUNT
ARE DIFFERENT CULTURAL
CONSIDERATIONS AROUND HAIR
COLLECTION, SO YOU KNOW SOMEONE
WANTS TO TAKE A SAMPLE OF MY
HAIR, MY KIDS HAIR, YOU KNOW AS
LONG AS YOU'RE NOT GOING TO
NOTICE IT, I DON'T HOLD A
PARTICULAR -- THERE'S NO
PARTICULAR CULTURAL STRENGTH TO
TAKING A LITTLE BIT OF MY HAIR
AND WE HAD PREVIOUSLY COLLECTED
HAIR FROM LATINO FAMILIES OF A
NUMBER OF DIFFERENT ORIGINS IN
MY LAB AND AGAIN, IT WAS PRETTY
MUCH -- WE WERE DOING IT PRETTY
SUCCESSFULLY AND WHAT WE HAD
TOOK A REAL BLIND SPOT ABOUT,
NOT REALIZING WAS THAT IN MANY
BLACK OPPORTUNITIES, HAIR IS A
CULTURAL TOUCH STONE AND I DON'T
-- WELL, SO, SO I THINK ASKING A
FAMILY TO TAKE A HAIR SAMPLE WAS
A MUCH MORE PERSONAL AND
INVASIVE REQUEST THAT IS THAN WE
HAD REALIZED WE WERE DOING AND
SO WE WERE GETTING MUCH LOW ARE
BUY-IN THIS OUR NEW ORLEANS SEA
WHICH WAS PREDOMINANTLY
COMPRISED OF PLAQUE FAMILIES AND
-- BLACK FAMILIES AND WE HAD
HIRED MOSTLY BLACK RESEARCH
ASSISTANTS WHO WERE IN THE
COMMUNITY AND SO WE THOUGHT WE
HAD DONE A GOOD JOB THERE, BUT
WE'RE HEARING FROM THEM THEIR
DISCOMFORT IN ASKING THESE
QUESTIONS.
SO I THINK HAD WE DONE A BETTER
JOB AT THE OUTSET, YOU KNOW
REALLY SOLICITING FROM OUR STAFF
HOW THIS ENTIRE PROTOCOL IS A
SOLUTION, SO WE ENDED UP
DROPPING THAT MEASURE IN THE
COLLECTION NOW, A COUPLE YEARS
LATER, WE'RE COLLECTING NAIL
SAMPLES FROM THE CHILDREN.
SO, NAILS, YOU KNOW PEOPLE ARE
MUCH MORE OPEN TO HAVING US CLIP
THEIR NAILS, THEY ACTUALLY ASK
THE MOM TO CLIP THE CHILD'S
NAILS, SOMETHING FOR THE MOST
PART THEY DO AT HOME ANYWAY AND
WE'RE GERONTOLOGYSTSING A
SIMILAR MEASURE, A LITTLE BIT
LESS RESEARCH BASE BEHIND IT BUT
WE'RE IMETTING A VERY SIMILAR
MEASURE OF PHYSIOLOGICAL STRESS
THAT IS MUCH LESS CULTURALLY
FRAUGHT.
SO SEE WHAT OUR ULTIMATE
RESPONSE RATES ARE BUT IT'S
CERTAINLY A LESSON LEARNED FROM
THE FIELD.
>> THANKS FOR SHARING THAT.
IT'S A GREAT CONCRETE EXAMPLE OF
NEEDING TO HAVE AND THIS IS A
MOVE THAT NIH HAS TAKEN BROADLY
BUT I THINK ALSO THE SCIENTIFIC
FIELD IS -- SHOULD BE APPLAUDED
FOR THE MOVES THAT WE'RE ALL
MAKING COLLECTIVELY TO INSURE
REPRESENTATION OF THE RESEARCH
TEAMS AND ENGAGEMENT WITH THE
COMMUNITIES THROUGHOUT ALL
PHASES, RIGHT?
YOU'RE SAYING, WE DID OKAY IN 1
PHASE OF THIS, BUT WE SHOULD
HAVE BEEN DOING THIS MUCH
EARLIER ON AT THE PHASE OF
CONCEPTION WHEN WE THINK ABOUT
THE QUESTIONS WE'RE ASKING AND
THE MEASURES WE'RE BRINGING.
JENNIFER I SAW YOU COME ON
CAMERA, DID YOU HAVE SOMETHING
YOU WANTED TO ADD?
>> YEAH, I WANTED TO MENTION A
LITTLE BIT SOME SOURCES OF BOTH
DATA AND SOME OF THESE
STRATEGIES, TO MAYBE, I DON'T
KNOW HOW MUCH PEOPLE HAVE LOOKED
AT THE ONGOING HEALTHY BRAIN AND
CHILD DEVELOPMENT STUDY THAT'S
GOING ON, I THINK THERE'S
PROBABLY OVERLAP ON SOME OF THE
FOLKS HERE, IT'S 1 OF THE OTHER
STUDIES I WORK ON WHERE WE'RE --
SO THERE ARE 25 SITES
NATIONWIDE, 300 MOMS ENROLLED AT
EACH SITE AND LOOKING AT SPEECH
AND LANGUAGE IS A SMALL PART OF
THAT, I CAN TALK ABOUT WHAT THAT
IS, BUT COMING BACK TO THE
RECRUITMENT AND RETENTION,
STRATEGIES, IN OF THE THINGS
THAT ARE BEING DONE AS PART OF
THE HBCB STUDY ARE REQUIRING
EVERY SITE TO HAVE I COMMUNITY
ADVISORY BOARD AND THAT'S BEEN
REALLY, REALLY HELPFUL FEEDBACK
TO US.
FOR EXAMPLE, 1 OF THE THINGS
THAT CAME FROM OUR COMMUNITY
ADVISORY BOARD, SOME OF THE
THINGS THEY WERE MOST EXCITED
ABOUT WAS JUST GETTING RETURN OF
RESULTS FROM THE STUDY AND
GETTING FEEDBACK ABOUT HOW THEIR
CHILD WAS DOING BUT WE'RE ABLE
TO SHARE THEN ACROSS THE SITES,
DIFFERENT SUGGESTIONS THAT COME
FROM THE COMMUNITY ADVISORY
BOARDS AND CONSTANTLY ASSESSING
WHAT FAMILIES EXPERIENCE IS LIKE
IN THIS STUDY.
SO I WANTED TO MENTION THAT AS A
POSSIBLE SOURCE FOR YOU KNOW
SOME STRATEGIES FOR RECRUITMENT
AND RETENTION BECAUSE WE'RE
REALLY THINKING HARD ABOUT THAT
BECAUSE THE HOPE IS TO RETAIN
THE FAMILIES FOR UP TO 10 YEARS
AND ALSO WE'RE COLLECTING A LOT
OF THESE VARIABLES WE'RE
DISCUSSING ENCLOUDING THE CDI AS
PART OF THE HBCD STUDY SO I JUST
WANTED TO MAKE SURE THAT WAS ON
THE TABLE AS A RESOURCE THAT
PEOPLE KNOW ABOUT BECAUSE THE
DATA WILL ALL BE PUBLICLY
AVAILABLE.
>> WONDERFUL THANKS FOR SHARING
THAT.
AND I'M LOOKING AT THE TIME NOW
AND WE HAVE SO MANY MORE
QUESTIONS COMING IN FROM THE
AUDIENCE AND I JUST DON'T THINK
WE'RE GOING TO -- I KNOW WE'RE
NOT GOING TO ABE ABLE TO GET TO
BUT TO MY POINT OF BEING MORE
QUESTIONS THAT THAN ANSWERS IN
THE AREA OF SCIENTIFIC INQUIRY.
SO A LOT OF WORK TO BE DONE.
IF I CAN TAKE A STAB AT
SUMMARIZING A LOT OF WHAT WE
TOUCHED ON THROUGHOUT TODAY IT
WOULD COME DOWN TO THIS IDEA OF
REPRESENTATION, YOU KNOW ALL THE
WAY FROM MAKING SURE THAT THE
QUALITIES OF THE DATA REPRESENT
THE QUESTIONS THAT WE'RE TRYING
TO ASK, RIGHT?
WE TALK ABOUT THIS FIT BETWEEN
DATA AND QUESTION,
REPRESENTATION AND OUR RESEARCH
TEAMS, REPRESENTATION IN THE
MAKEUP OF THE KIDS THAT WE'RE
STUDYING, RIGHT?
MAKING SURE WE'RE OVERSAMPLING
FOR CERTAIN ASPECTS OR CERTAIN
QUALITIES IN KIDS TO MAKE SURE
WE'RE REALLY GETTING THE DEPTH
OF DATA WE WANT FROM DIFFERENT
COMMUNITIES AND DIFFERENT
DEVELOPMENTAL PROFILES OF KIDS.
THAT'S MY POOR SUMMARY, I KNOW
WE WILL BE ABLE TO LOOK BACK ON
THIS TALK AND THE RECORDING AND
HAVE A LOT OF GREAT TIDBITS TO
COME FROM THE DISCUSSION TODAY
SO I WANT TO THANK EVERYONE FOR
YOUR ENGAGEMENT BUT BEFORE I LET
YOU GO, I DO WANT TO DO A LITTLE
BIT OF WRAP UP ABOUT THE TALK
INITIATIVE.
SO LAURA, THANK YOU FOR PLUGGING
THIS ALREADY, THERE ARE A COUPLE
OF REALLY EXCITING FUNDING
OPPORTUNITIES THAT WE HAVE ON
THE STREET THAT WE HOPE THOSE IN
ATTENDANCE TODAY AND INTERESTED
IN ENGAGING IN THIS KIND OF WORK
WILL TAKE ADVANTAGE OF SO, IN
TERMS OF BUILDING ON THE THEMES
THAT WE HAVE ALREADY IN ACTION
FOR THE TALK INITIATIVE, WE HAVE
A
A PARFOR LEVERAGING DATA SETS,
SO IF YOU HAVE ACCESS TO
PARTICULARLY LONGITUDINAL DATA
SETS THAT INCLUDE OR ARE
RELEVANT TO THE DEVELOPMENT OF
LANGUAGE DEVELOPMENT AND LAY
TALKERS AND HAVE SOME UNIQUE
WHYEDS ABOUT HOW TO BOTH SHARE
AND LEVERAGE THAT DATA, PLEASE
CONSIDER THAT FIRST 1.
WE HAVE A TOPIC COMING UP IN A
COUPLE OF WEEKS, ANOTHER 1 OF
THESE WORKSHOP SERIES ON
INFORMATION AND TRANSLATION TO
PRACTICE.
BUT ALSO THIS IS A QUALITATIVE
METHOD, HEAVY EMPHASIS ON THIS
FUNDING OPPORTUNITY FOR REALLY
GETTING A BETTER UNDERSTANDING
OF WHAT ARE THE INFORMATION AND
PRACTICE NEEDS FOR PARENTS AND
CLINICIANS IN THOSE LATE TALKING
CHILDREN.
A BROAD CALL FOR TALK RELEVANT,
LATE TALKING RELEVANT RO-1 LEVEL
RESEARCH PROJECTS.
AND THEN A TALK RELATED BUT NOT
NECESSARILY SPECIFIC TO LATE
TALKERS, FUNDING OPPORTUNITY TO
REALLY ADVANCE BOTH THE
PRACTICAL TOOLS AND THE WAY THAT
WE CONCEPTUALIZE LANGUAGE
DEVELOPMENT AND THE LANGUAGE
ENVIRONMENT OR OTHER PREDICTERS
OF LANGUAGE.
SO ALL REALLY GREAT
OPPORTUNITIES AND IF YOU HAVE
QUESTIONS ABOUT ANY OF THEM,
PLEASE FEEL FREE TO REACH OUT TO
OUR RELEVANT PROGRAM OFFICER
FROM THE TALK GROUP, OUR WEBSITE
THERE FOR THE TALK INITIATIVE IS
RIGHT THERE AND THEN ON THE NEXT
SLIDE, WE HAVE A QR CODE THAT
WILLING YOU TO THE TALK
INITIATIVE, IF YOU GO TO THE
NEXT SLIDE, JUST WANT TO TAKE 1
LAST SECOND TO PLUG THE NEXT 2
SESSIONS IN THIS SERIES, SO NEXT
WEDNESDAY, WILL BE FOCUSING ON
NOVEL APPROACHES TO THE STUDY OF
LATE TALKERS AND THEN THE
FOLLOWING WEDNESDAY, WE WILL BE
TALKING ABOUT THIS ISSUE OF
TRANSLATING RESEARCH INTO
PRACTICE SO, PLEASE FEEL FREE TO
TAKE A SHOT OF THAT QR CODE AND
GO TO THE TALK INITIATIVE
WEBSITE IF YOU WANT ANYMORE
INFORMATION AND CONTACT
INFORMATION FROM ALL OF US ON
THE NIH SITE.
SO WITH THAT, THANK YOU ALL SO
MUCH FOR JOINING US TODAY, IT'S
BEEN A GREAT DISCUSSION, VERY
EXCITING AND WE LOOK FORWARD TO
SEEING YOU