Analyzing caregiver linguistic input during a remote dialogic book-sharing interventions for toddlers with clefts.
openNIDCD - National Institute on Deafness and Other Communication Disorders
PROJECT SUMMARY
Cleft palate with or without cleft lip (CP±L) is among the most common congenital conditions, affecting
approximately 1 in 450 infants worldwide and 1 in 1050 infants in the United States. While most
children undergo early surgical repair, many continue to experience significant speech and language
delays that impact social and academic development. Recent research has highlighted the potential of
parent/caregiver-focused interventions in supporting language development in children with CP±L, but
the specific mechanisms underlying these interventions are not yet fully understood.
This goal of this study is to examine the mechanistic role of parent/caregiver's speech inputs in
supporting language development in toddlers with CP±L. This study fills critical gaps by transcribing,
coding, and analyzing observational data from a remote dialogic book-sharing (DBS) intervention for
toddlers with CP±L (randomized controlled trial or RCT of the intervention, Book Sharing for Toddlers
with Clefts – BOOST; NCT06338319). Unlike prior work relying on audio-only data, this research
uniquely includes gestural communication, such as deictic gestures, which may act as compensatory
strategies in children with impaired speech and are linked to vocabulary development.
Through language sample analysis of video-recorded parent-child book-sharing interactions collected at
five timepoints, we will examine how parent/caregiver language quantity (e.g., utterance frequency,
speech rate, pause time) and responsiveness (e.g., contingent responses, conversational turns, deictic
gestures, personalization, categorization, and temporal responses) change over the course of the
intervention. We will also evaluate how these changes relate to expressive and receptive language
improvements in children with CP±L.
Clinically, this work will clarify caregiver-mediated mechanisms to enhance targeted interventions for
children with CP±L and other language delays, improving long-term developmental outcomes. In line
with the R15's dual goals, the project will build research infrastructure by training undergraduate and
graduate students in developmental research methods, including transcription, coding, and data analysis.
This training will provide hands-on interdisciplinary experience, strengthen research capacity at a
primarily undergraduate institution, and foster a collaborative environment that integrates clinical and
developmental science.
By moving beyond traditional speech metrics to incorporate gesture and multidimensional
responsiveness, this study advances understanding of parent input's role in language development for
children with CP±L and lays a foundation for future research to refine and expand parent-mediated
interventions.
Chong R15
Up to $530K
health research