What our hands tell us: A two-year follow-up investigating outcomes in subgroups of children with language delay

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.