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Early Developmental Trajectories of Speech and Language Predict Different Pathways To Later Outcomes in Late-Talking Children

Award Number: R21HD122964
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2028

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Early Developmental Trajectories of Speech and Language Predict Different Pathways To Later Outcomes in Late-Talking Children - Contributing to the NIH TALK initiative, the goal of this research is to improve understanding of early developmental trajectories that drive later outcomes in late-talking children. Late talking is defined by delays in expressive language in the absence of other developmental delays or hearing loss and affects 10-20% of toddlers, of whom 15-25% will continue to exhibit language impairments up to 6 years, with lifelong impact on opportunity and achievement. Late language emergence is typically not diagnosed until 18-24 months, when other developmental disorders first become apparent, so the current definition is not helpful for early screening in the first two years of life, before the age of formal diagnosis, when interventions are likely to be most effective. Our research addresses these issues by contributing new data that will help to understand how late talking emerges from birth via early trajectories of vocal development specific to late talkers that predict later outcomes and differentiate other developmental disorders. The study we propose is based on secondary data analysis of home audio recordings and clinical outcome measures derived from a large-scale prospective longitudinal study of vocal development in infancy, already conducted as part of an NIH Autism Center of Excellence (NIH P50 MH100029). In the original study, digital audio recorders (LENA) were used to make all- day recordings of each child’s natural language environment, every month from 0-36 months, from which we derived a battery of longitudinal acoustic measures characterizing vocal development. We will reanalyze 51,412 hours of data from 4,448 recordings in this data set for 252 infants, including 72 late talkers, to recalculate trajectories of early vocal development for late talkers, and supply new automated language transcripts that will enable us to measure language development. We test the overarching hypothesis that late talking emerges from a cascade of earlier delays in developmental milestones that accumulate beyond the critical window for language. Our first specific aim is to establish how infants who end up as late talkers begin to develop speech and language from birth. We test the hypothesis that late-talking children exhibit delays and deviations in key stages of vocal development that precede the onset of first words. Our second specific aim is to determine how late talkers differ from children with other disorders. We test the hypothesis that late-talking children exhibit patterns of infant vocalization, parental input, and infant-caregiver interaction that discriminate late talkers from ASD or global developmental delays. Our third specific aim is to evaluate the performance of vocal biomarkers for early screening of late talking, sharing our results through a cloud-based platform we developed for autism. Our research will: (a) further understanding of developmental trajectories of late-talking children by leveraging existing data; (b) create shared data resources to identify patterns and predictors of developmental outcomes; and (c) explore potential underlying mechanisms, risk factors, and sequelae. These results will help ensure that all late-talking children are identified early and given the best chance to speak.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $438,266 )
2026	2026	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Child Health and Human Development Extramural Research	001	1	8/25/2026	NEW	$0
2026	2026	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Child Health and Human Development Extramural Research	000	1	8/20/2026	NEW	$438,266
														Subtotal = $438,266

Grand Total All Awards = $438,266

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Early Developmental Trajectories of Speech and Language Predict Different Pathways To Later Outcomes in Late-Talking Children

Award Number: R21HD122964

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2028

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