Gesture screening in young infants with the UK-CDI: Highly sensitive to risk factors for communication delay.

Alcock, K. J., Rowland, C. F., Meints, K., Christopher, A. E., Just, J., Brelsford, V., & Summers, J. (2017). Gesture screening in young infants with the UK-CDI: Highly sensitive to risk factors for communication delay. Paper presented at the Society for Research in Child Development, Austin, TX.


Most methods of screening for early signs of communication delay in young infants include spoken language, receptive language, and gesture measures. Clinicians and researchers often rely just on early spoken and comprehended words to identify children at risk of communication delay.  At young ages (8-18 months) few children have many spoken words so often comprehension alone is measured. Gesture scales can be an afterthought; for example the Communicative Development Inventory (CDI) Gesture scale in English has never been validated. Yet gestures are used frequently by young children and can be an important source of information. We report data from the UK-CDI Words & Gestures (W&G) scale, investigating validity and sensitivity to risk factors of the UK-CDI Gesture scale. Data from 1212 families, socio-economically representative of the UK, were included in our normative sample. Children were aged 8-18 months and balanced by month of age and gender as far as possible. Parents also completed the Family Questionnaire assessing biological and social risk factors. An additional 30 families of infants aged 16-18 months completed the UK-CDI W&G and their infants completed an experimental gesture challenge task. This first validation of the Gesture scale of an English language CDI showed a significant correlation between gesture challenge scores and CDI Gesture scores. Cronbach’s Alpha for gesture and vocabulary subscales were both over 0.9. Gesture scores correlated significantly with more biological and social risk factors than verbal comprehension or production scores. Gesture correlated with gender, birthweight, prematurity, firstborn status, and childcare hours while comprehension only correlated with firstborn status and childcare hours, and production with birthweight, prematurity, firstborn status and childcare hours but not gender. This held even when we controlled for age. Gesture (but not verbal production or comprehension) was significantly poorer in boys than girls, in babies born before 33 weeks gestation, and in children who spent fewer hours in non-parental care. Gesture and verbal production were both poorer in children with birthweights below 2.2 kg. Gesture, verbal comprehension and verbal production were poorer in children with a reported family history of spoken language impairment. Verbal comprehension alone was poorer in non-first-borns and in children with some levels of parental education. Both verbal comprehension and production were poorer in children of mothers of some age groups. We conclude that gesture has powerful sensitivity to detect children at risk of future communication difficulties, and that our parental report gesture scale is valid and internally consistent. We also find that gesture scores may be influenced less by social desirability. For both parental education and maternal age, children of the youngest mothers and the least well educated families were reported to have higher vocabularies, while no gesture differences were reported. Families may over-report vocabulary but give a more realistic estimate of gesture. Parent report of early communicative gesture is an extremely sensitive measure, discriminating between children at risk through social and biological circumstances, and has the potential to be at least as valid as, if not more valid than, comprehension or production of verbal vocabulary.