AIM: To investigate the possibility of identifying children at risk for language impairment based on a new screening instrument to assess communication and language skills at 18 mo of age.

METHODS: At 18 mo, 58 children were assessed with a screening instrument for communication and language consisting of a professional assessment and a parents' questionnaire. Students of speech and language pathology, well trained in child language assessment, carried out the professional assessment, which was based on observations of play behaviour, interaction and expressive and receptive language skills. Of the 58 children, 43 attended a follow-up assessment of language skills at 54 mo of age.

RESULTS: Nine children were considered to be at risk for language impairment at 18 mo and 10 children were evaluated as being at risk at 54 mo. A significant positive correlation was found between the professional evaluations at 18 mo and the language tests at 54 mo. Verbal comprehension and pretend play correlated significantly with the results on the language tests.

CONCLUSION: A professional screening of communication and language at 18 mo of age is worthwhile for predicting problems in language development. The results further show that language comprehension and pretend play rather than expressive skills should be emphasized.

Communication skills during social interaction at 18 months' age, such as comprehension of instructions and play behaviour, have been shown to predict the results on language tests three years later. Accordingly, children with weak communication skills are at risk for persistent problems of language and communication. Problems of communication in social interaction are also common in children with neuropsychiatric disorders, such as ADHD (attention deficit hyperactivity disorder) and ASD (autism spectrum disorder). For different reasons, it is important to identify children who are at risk for language impairment and neuropsychiatric disorders at as an early age as possible. First, early identification allows early intervention, which may increase the chances of a positive outcome for the child. Second, early identification may decrease the risk of secondary problems with behaviour, and social and emotional wellbeing, which are frequently occurring in children with neuropsychiatric disorders. This paper is an overview of the literature focusing on the importance of early communication skills, i.e. language use in a social interaction context. Conclusion: Early communication skills in social interaction are a possible predictor of language impairment and neuropsychiatric disorders, and should therefore be included in early screening procedures. Furthermore, social interaction enhances language development, and can therefore be regarded as a tool in language intervention.

The present study examined assertiveness and responsiveness in two different conversational contexts: children with specific language impairment (SLI) interactiong with an age-matched peer with typical language development (TLD) and children with SLI interacting with a language-matched peer with TLD. The dialogues where the 10 participating children with SLI interactd with an age peer were characterized by a higher degree of responsiveness and coherence. The age peers tended to dominate the interaction with the children with SLI. The dialogues where children with SLI interacted with a language peer were characterized by less responsivenss and less coherence and the child with SLI was likely to be more dominant in the interaction. Thus children with SLI take different roles in verbal interaction depending on how much support the conversational partner can offer.

This paper explores language intervention for children with specific language impairment in Sweden. The elicitation strategies, style of interaction and language production used by speech and language pathologists (SLPs) were analyzed in two conditions, free conversation and training of grammar. In training, the grammatical targets were used significantly more often by the SLPs, but not by the children. In the free conversations the children talked more and had significantly higher mean length of utterance in words and the SLPs linked significantly more to the child's focus. The two conditions represent different, but complementary approaches to language intervention.