title: Infant communication and subsequent language development in children from low-income families:  the role of early cognitive stimulation.
abstract: OBJECTIVE
  To explore the relationship between early cognitive stimulation in the home, 6-month infant communication, and 24-month toddler language in a low-socioeconomic status sample.
  
  
  METHODS
  Longitudinal analyses of mother-child dyads participating in larger study of early child development were performed. Dyads enrolled postpartum in an urban public hospital. Cognitive stimulation in the home at 6 months was assessed using StimQ-lnfant, including provision of toys, shared reading, teaching, and verbal responsivity. Early infant communication was assessed at 6 months including the following: (1) Emotion and eye gaze (Communication and Symbolic Behavior Scale DP-CSBS DP), (2) Communicative bids (CSBS DP), and (3) Expression of emotion (Short Temperament Scale for Infants). Toddler language was assessed at 24 months using the Preschool Language Scale-4, including the following: (1) expressive language and (2) auditory comprehension.
  
  
  RESULTS
  Three hundred twenty families were assessed. In structural equation models, cognitive stimulation in the home was strongly associated with early infant communication (β = 0.63, p <.0001) and was predictive of 24-month language (β = 0.20, p <.05). The effect of early cognitive stimulation on 24-month language was mediated through early impacts on infant communication (Indirect β = 0.28, p =.001). Reading, teaching, availability of learning materials, and other reciprocal verbal interactions were all related directly to infant communication and indirectly to language outcomes.
  
  
  CONCLUSIONS
  The impact of early cognitive stimulation on toddler language is manifested through early associations with infant communication. Pediatric primary care providers should promote cognitive stimulation beginning in early infancy and support the expansion and dissemination of intervention programs such as Reach Out and Read and the Video Interaction Project.
authors.affiliation: Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY 10016, USA. Carolyn.brockmeyer@nyumc.org
authors.forename: Carolyn Brockmeyer
authors.initials: CB
authors.lastname: Cates
authors.forename: Benard P
authors.initials: BP
authors.lastname: Dreyer
authors.forename: Samantha B
authors.initials: SB
authors.lastname: Berkule
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: White
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Arevalo
authors.forename: Alan L
authors.initials: AL
authors.lastname: Mendelsohn
mesh_terms: D000328:Adult; D002668:Child Rearing / Q000523:psychology*; D002675:Child, Preschool; D003142:Communication; D005260:Female; D006801:Humans; D007223:Infant; D007804:Language Development; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D009483:Neuropsychological Tests; D011203:Poverty / Q000191:economics / Q000523:psychology*; D014505:Urban Population