ABSTRACT Although most infants acquire language with seemingly little effort, a subset, referred to as late talkers (LT), show early delays in language milestones in the second or third year of life, and are at risk for a later diagnosis of developmental language disorder. To date, research on LT has identified several potential factors that are associated with poorer language at this age including demographic, family history and child neurocognitive variables but there is little research focusing on predictors of LT in the first year of life, before the onset of major language milestones. Studying early predictors is critical for identifying those infants who are in greatest need for pre-emptive interventions that focus on promoting speech and language development. We propose to address this issue in the infants enrolled in our ongoing RO1 NS12908 project, which is a longitudinal study of a large cohort of socioeconomic, racially and ethnically diverse infants recruited from a large urban pediatric primary care facility at Boston Children's Hospital. This parent project provides a unique opportunity to investigate a rich set of predictors of LT collected in the first year of life. In order to address our goals, we plan to identify LT (defined as below the 20th percentile) from the CSBS administered at 12 months, or using the MCDI at 18 or 24 months.. We will add an 18 month visit to administer the MCDI and collect a parent-child play-based interaction. We also plan to expand the language measures collected at 24 months to include the MCDI and parent-child interaction, and add a 30- month outcome visit, at which the same set of enriched language measures will be collected. These additional time points will allow us to investigate development change in language in infants identified as LT into the third year of life. The supplement will address the following specific aims. Aim 1: Using a prospective study design in a racially, ethnically and socioeconomically diverse primary care population, we will identify the EEG features measured during the first year of life at 4, 9 and 12 months that are associated with late talkers (LT) identified at 12, 18 or 24 months; Aim 2: In this same sample of infants, we will identify demographic and environmental factors that are associated with late talkers (LT) identified at 12, 18 or 24 months And Aim 3: We will develop exploratory predictive models of LT, both transient LT (resolved by 30 months) and persistent LT (remaining at lowest 20% at 30 months), using both EEG and behavioral/demographic/ environmental factors collected in the first year of life. In parallel with the parent grant, our goal is to create scalable, practical neurobiologically-based tools combined with demographic, family and health history information that will advance our ability to identify LT in the first year of life across resources settings, reduce disparities in identification, and thereby greatly improve access to early language and communication interventions.

Narrative Little is known about the factors that predict delayed language acquisition in children identified as late talkers. We will investigate demographic, family history, and functional brain markers (using EEG) collected in the first year of life in a large pediatric primary care clinic that disproportionately serves under-represented groups. Our goal is to understand key predictors and outcomes of language trajectories of late talking children.