Caregiving by low income adolescent mothers and the language abilities of their 30-month-old children
A R T I C L E CAREGIVING BY LOW-INCOME ADOLESCENT MOTHERS AND THE LANGUAGE ABILITIES OF THEIR 30-MONTH-OLD CHILDREN TOM LUSTER MARCIA VANDENBELT Department of Family and Child Ecology, Michigan State UniversityABSTRACT: The primary question of interest in this study was: Are the caregiving practices of low-income,teenage mothers during the ﬁrst 2 years of their children’s lives predictive of individual differences inthe language abilities of their 30-month-old children? This question was addressed with a sample of 76teenage mothers and their children who were participating in a family support program. Various measuresof caregiving behavior, assessed when the children were 6, 12, and 24 months old, were signiﬁcantlyrelated to scores on the Preschool Language Scale— 3, the Expressive One Word Picture VocabularyTest, and Receptive One-Word Picture Vocabulary Tests of the children.RESUMEN: La pregunta esencial de interes en este estudio es la de si las practicas de dar cuidado ofrecidas ´ ´por madres adolescentes de bajo recursos economicos, durante los dos primeros anos de vida de sus ninos, ´ ˜ ˜ayudan a predecir las diferencias individuales enlas habilidades de lenguaje de sus ninos de 30 meses de ˜nacidos. Esta pregunta fue respondida con una muestra de 76 madres de la edad antes mencionada, y susninos, quienes participaron en un programa de apoyo familiar. Varias medidas de la conducta de prestar ˜cuidado, evaluadas cuando los ninos tenıan 6, 12 y 24 meses, fueron relacionadas signiﬁcativamente a ˜ ´los resultados en la Escala de Lenguaje Pre-escolar que equivalen a-3, la Prueba de Vocabulario Expresivode la Figura de una Palabra, y las Pruebas de Vocabulario Receptivo de la Figura de una Palabra, porparte de los ninos. ˜ ´ ´RESUME: La principale question etudiee dans ce travail etait la suivante: les pratiques de mode de soin de ´ ´ ´meres adolescentes de milieux defavorises peuvent-elles, durant les deux premieres annees de la vie de ` ´ ´ ` ´leurs enfants, predire les differences individuelles des capacites de langage de leurs enfants de 30 mois? ´ ´ ´Cette question a ete etudiee chez un echantillon de 76 meres adolescentes et leurs enfants qui partiicipaient ´´´ ´ ´ `a un programme de soutien familial. Differentes mesures de comportement de mode de soin, evalue` ´ ´ ´lorsque les enfants avaient 6, 12, et 24 mois, etaient particulierement liees aux scores a l’Echelle de ´ ` ´ `Support for the Family TIES Program and the evaluation of the program was provided by the Mott Children’s HealthCenter in Flint, MI. The authors would like to thank Laura Bates, Brooke Foulds, Sandra Frassetto, Ronda Jackson,Bettie Johnson, Cynthia Jones, Katherine Kenebrew, Jenny Kent-Bryant, Judith Peck Key, Dr. Mary Mittelstaedt,Corine Scheuneman, Kathryn Sims, Robyn Swanson, Marva Williams, and Robin Williams for assisting with the datacollection process. In particular, we acknowledge Mary McCaffery for conducting the language assessments on thechildren for this study. An earlier version of this paper was presented at the Biennial Meeting of the Society forResearch in Child Development, Washington, DC, March, 1997. Address correspondence to: Tom Luster Ph.D.,Department of Family and Child Ecology, 101 Morrill Hall, East Lansing, MI 48824-1030. E-mail: email@example.com.INFANT MENTAL HEALTH JOURNAL, Vol. 20(2), 148– 165 (1999) 1999 Michigan Association for Infant Mental Health CCC 0163-9641/99/020148-18 148
Caregiving by Low-Income Adolescent Mothers ● 149Langage d’Age Prescolaire– 3. Le Test de Vocabulaire Expressif Un Mot Une Image, et aux Tests de ´Vocabulaire Receptif Un Mot Une Image passes par les enfants. ´ ´ZUSAMMENFASSUNG: Die wesentlichste Frage der Studie war: Sind die Betreuungsart von armen, jugen-dlichen Muttern wahrend der ersten zwei Lebensjahre ihrer Kinder bestimmend fur individuelle Differ- ¨ ¨ ¨enzen in der Sprachkenntnis ihrer 30 Monate alten Kinder? Dieser Frage wurde in einer Studiengruppevon 76 jugendlichen Muttern und deren Kinder, die an einem Familienunterstuzungsprogramm teilnah- ¨ ¨men, nachgegangen. Verschiedene Messungen des Betreuungsverhaltens beim 6, 12 und 24 Monate altenKind waren signiﬁkant mit den Ergebnissen der Vorschul— Sprachmessung–3, dem expressiven Ein-Wort— Ein-Bild Vokabeltest und dem rezeptiven Ein-Wort Ein-Bild Vokabeltest der Kinder, verbunden. * * * Although there are large within-group differences, children of adolescent mothers tend toscore lower than peers born to older mothers on measures of cognitive competence, particularlyin the postinfancy period when assessments become more dependent on language skills (Fur-stenberg, Brooks-Gunn, & Chase-Lansdale, 1989; Hayes, 1987; Wadsworth, Taylor, Osborn,& Butler, 1984). By the time they enter school, children of teenage mothers score lower thanpeers on achievement tests, are more likely to be retained in grade, and are eventually at riskfor dropping out of school (Brooks-Gunn & Chase-Lansdale, 1995: Brooks-Gunn, Guo, &Furstenberg, 1993). As Brooks-Gunn and Chase-Lansdale (1995) pointed out, many questions remain aboutthe reasons why children born to teenage mothers fare less well than peers born to oldermothers. It seems likely that a number of factors contribute to the poorer outcomes of thesechildren (e.g., poverty, family structure). One of these factors may be the caregiving theyreceive from their young mothers. Comparisons of the caregiving practices of teenage mothersand more mature mothers show that, on average, teenage mothers: (a) tend to provide lessverbally stimulating environments for their infants; (b) tend to receive lower scores on measuresof the home environment, such as the HOME inventory (Caldwell & Bradley, 1984); and (c)often display more negative affect and less positive affect when interacting with their infants(Barratt & Roach, 1995; Brooks-Gunn & Chase-Lansdale, 1995; Culp, Osofsky, & O’Brien,1996; Luster & Mittelstaedt, 1993). Although several studies have shown differences between teenage and older mothers intheir caregiving practices, and other studies have reported differences in the developmentaloutcomes of children born to younger and older mothers, few studies have examined the relationbetween caregiving practices by teenage mothers and the developmental outcomes of theirchildren (Brooks-Gunn & Chase-Lansdale, 1995; Hubbs-Tait, Osofsky, Hann, & Culp, 1994).The purpose of this study is to examine the relationship between the caregiving practices oflow-income, teenage mothers and the language abilities of their 30-month-old children. Basedon studies of children from other segments of the population, we expected caregiving practicesto be predictive of language development (Baumwell, Tamis-LeMonda, & Bornstein, 1997;
150 ● T. Luster and M. Vandenbeltde Villiers & de Villiers, 1978; Walker, Greenwood, Hart, & Carta, 1994). However, thecaregiving arrangements for children of teenage mothers are often complex and subject tochange as the roles of the young mothers (e.g., student, employee, full-time caregiver) changeover time. Because of these complex and changing caregiving arrangements, we believe thatit is important to study the extent to which the caregiving practices of the teens are predictiveof the developmental outcomes of their children, rather than assuming that the ﬁndings forlow-income teenage mothers will mirror the ﬁndings for more mature mothers. Early studies of the caregiving practices of teenage mothers showed that many teen mothersprovide less verbal stimulation for their children than other caregivers. For example, Osofskyand Osofsky (1970) observed adolescent mothers before and during a pediatric exam, and ratedthe mothers positively on levels of warmth and physical interaction, but assigned low scoresfor verbal interaction. Epstein (1980) identiﬁed three types of parenting styles by teenagemothers: (a) sharing (sensitive, responsive, and authoritative); (b) directive (commanding, in-trusive, and authoritarian); and (c) a relatively nonverbal style in which only the physical needsof the babies were attended to by the mothers. Epstein found that the nonverbal style was themost characteristic of the 98 teens in her sample. More recent studies conﬁrm these earlyﬁndings that many teenage mothers provide their children with relatively unstimulating lan-guage environments (Brooks-Gunn & Chase-Lansdale, 1995; Culp, Culp, Osofsky, & Osofsky,1991; Culp, Osofsky & O’Brien, 1996). For example, Culp, Osofsky, and O’Brien comparedthe speech of adolescent and older others and found that adolescent mothers spoke fewer words,made fewer utterances while sharing a joint focus of attention with their infants, described andlabeled objects less often, gave more commands, and displayed positive affective speech lessoften than older mothers. Given that teenage mothers were recognized as providing environ-ments for their infants that were low in verbal stimulation as early as 1970, it is surprising tous that there is relatively little research examining the relationship between caregiving practicesby teenage mothers and the language abilities of their children. Wadsworth and her colleagues (1984) studied a birth cohort of children from Great Britainwho were born between April 5 and 11, 1970. Included in the sample of nearly 12,000 childrenwere approximately 1100 children born to mothers under the age of 20. The children weretested with the English Picture Vocabulary Test (EPVT), a measure of receptive vocabulary,when they were 5 years old. Children born to teenage mothers scored lower on the test thantheir peers even when other factors were controlled. However, several variables included in amultivariate analysis were stronger predictors of EPVT scores than maternal age, includingsocioeconomic status, gender (boys scored higher), birth weight, health visitors’ assessmentsof home furnishings, and breast feeding. In this study, separate analyses were not conductedon the subsample of children born to teenage mothers. Studies in the United States have used the National Longitudinal Survey of Youth (NLSY)to examine factors related to individual differences in scores on the Peabody Picture VocabularyTest (PPVT; Dunn & Dunn, 1981) among children born to adolescent mothers (Barratt, 1991;Moore & Snyder, 1991). Moore and Snyder found that early childbearing was associated withlower scores on the PPVT for Caucasian children, but not for African-American or Hispanicchildren. They also examined several potential inﬂuences on children’s receptive vocabulary,conducting separate analyses for each of the ethnic groups. In all three ethnic groups, familieswho received more favorable scores on a shortened version of the HOME inventory had chil-dren with higher scores on the PPVT. Mothers’ scores on the Armed Forces Qualifying Test(AFQT), a measure of intellectual ability, also predicted PPVT scores for Caucasian and Af-rican-American children, but not for Hispanic children. In the Hispanic subsample, childrenperformed better on the PPVT if their mothers had completed high school.
Caregiving by Low-Income Adolescent Mothers ● 151 Thus, large-scale surveys in the United States and Great Britain suggest that the environ-ments that children of teenage mothers experience may contribute to depressed scores onmeasures of receptive vocabulary. However, as is typical of large studies involving nationalsamples, the amount of information available on the caregiving the children received waslimited because of the practical problems involved in collecting such data. One recent study that did collect extensive information on caregiving by teenage mothersand related it to children’s PPVT scores at 44 months was conducted by Hann, Osofsky, andCulp (1996). They found that children who performed better on the PPVT had mothers whodisplayed more positive affect at the 13 and 20-month assessments, and engaged in more verbalreciprocity at 20 months. A cumulative demographic risk index was also associated with lowerPPVT scores when mother – infant interaction measures were controlled. Like the study by Hann and her colleagues (1996), the present study explores the rela-tionship between caregiving and language abilities in children born to teenage mothers with asmall sample of families that was studied more intensively than families in the large-scalesurveys described above. The families in this sample were involved in a family support pro-gram, and data were collected regularly on the caregiving practices of the young mothers aspart of the evaluation of the program. Half of the families in the study received weekly homevisits from a paraprofessional family advocate; more extensive information is available oncaregiving practices of the young mothers in this subsample than the teens who received lessintensive services. The family advocates, who knew the families intimately and were knowl-edgeable sources about the teens’ caregiving practices, provided ratings of parenting (e.g.,warmth, responsiveness) that could be used in this study to address the primary question ofinterest. Other measures of caregiving, such as assessments of the home environment, wereavailable for the young mothers from both treatment groups (i.e., those receiving the Home-Visiting Program and those receiving less intensive services). Thus, a positive feature of thepresent study is that longitudinal data are available on the caregiving practices of the teens,and data on caregiving were collected from diverse sources in more than one setting. Consistent with an infant mental health perspective, we hypothesized that the overall qual-ity of the relationship between an infant and caregiver would be predictive of language devel-opment. This hypothesis is supported by the ﬁndings from a meta-analysis of seven studiesexamining the relation between quality of attachment (secure vs. insecure) and the languageabilities of children (van Ijzendoorn, Dijkstra, & Bus, 1995). Infants who were rated as securelyattached in Ainsworth’s Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978) tendedto perform better on later language assessments. Language acquisition is likely to be facilitatedby caregivers who are sensitive and verbally responsive to their infants, who are highly involvedwith their infants, and who provide labels for objects and actions (Baumwell et al., 1997; Culpet al., 1996). Caregivers also provide playthings for their infants and a great deal of languagestimulation is provided for infants as they interact with caregivers around these objects. Al-though there is value in focusing on speciﬁc aspects of parenting that may inﬂuence languagedevelopment, our view is that it is the overall environment that the child experiences over timethat is most important (i.e., the whole is greater than the sum of its parts). As infant mentalhealth researchers and practitioners have long noted, speciﬁc caregiving practices occur in thecontext of a relationship and in the context of the overall emotional climate in the home. Sothe amount of verbal stimulation that the mother provides is important, but its effect is likelyto depend on whether it is done in the context of a warm relationship that is characterized byinteractional synchrony between the caregiver and infant. The play materials in the home arelikely to be important for cognitive growth, but the extent to which the playthings draw care-giver and infant into joint activities is also important. For these reasons, the primary focus of
152 ● T. Luster and M. Vandenbeltthis paper is the overall caregiving environment that the young mothers provide for their chil-dren. However, additional information is provided about the relation between more speciﬁccaregiving practices and the language capabilities of the children as well. METHODParticipantsThe sample for this study was 76 children whose language ability was assessed when theywere 30-month-olds, and their mothers who were teenagers when the children were born. Allof the children were ﬁrstborn. The families were involved in Family TIES (Trust, Information,Encouragement, Support), a 5-year family support program provided by the Mott Children’sHealth Center in Flint, Michigan. Family TIES was designed to help teenage mothers copewith early childbearing and to support the development of their children so that the childrenultimately arrived at school prepared to succeed in that setting. To be eligible for the Family TIES program, the teens had to come from low-incomefamilies (150% of poverty or less), be school eligible, and expecting their ﬁrst child. At en-rollment, the teens ranged in age from 13 to 19, with a mean of 16.0 years. At the intakeinterview, the pregnant teens were randomly assigned to one of two treatment groups. Thoseassigned to the more intensive treatment received weekly home visits from a paraprofessionalfamily advocate; they are referred to here as the Home-Visited Group. As the acronym for theprogram suggests, the family advocate attempted to establish a trusting relationship with theteens and their families, provided information about services available in the community andabout child care and parenting, provided emotional and instrumental support (e.g., emergencyfood, diapers, transportation), and encouraged the mothers to pursue the goals of the program(e.g., high school completion). Each of the six advocates in the Home-Visited Group had acaseload of 12 clients when the program began (N 72). In the less intensive treatment group, referred to as the Standard Program Group, onefamily advocate provided services to approximately half of the teens in the program (70 clientsat enrollment). This advocate was housed at the health center and worked with the teensprimarily via phone and mail. The advocate for the Standard Program provided essentially thesame types of services (e.g., information, encouragement) and promoted the same goals (e.g.,high school completion) as the advocates in the more intensive treatment group. However,because of the relatively high case load, this advocate had considerably less contact with eachof her clients and therefore the depth of the relationship between the client and provider differedfor the two groups. Extensive data were collected on the teens at enrollment, and the twogroups did not differ signiﬁcantly on any of the key variables assessed at that time. Additionalinformation about the Family TIES program can be found in earlier publications (Luster, Perl-stadt, McKinney, Sims, & Juang, 1996: Luster, 1998). Thirty-six children from the Home-Visited Group and 40 children from the Standard Pro-gram participated in a language assessment when the children were 30 months old. Childrenfrom the two treatment groups did not differ, on average, on any of the language measures.Therefore, data from the two treatment groups were combined for this study. The racial com-position of the sample reﬂected the community from which the participants were drawn. Mostof the mothers and infants were African-American (63%) or Caucasian (30%). The remainingdyads were Hispanic (3%) or biracial (5%). Fifty-ﬁve percent of the children who were assessedat 30 months were male. Eighty-eight percent of the mothers in the sample were never married,11% were married, and one mother was divorced. Twenty-three percent of the teens were livingwith their mothers at the time of the 30-month assessment.
Caregiving by Low-Income Adolescent Mothers ● 153AttritionData used for this study were collected at ﬁve points in time — at enrollment (prenatal period)and when the children were 6, 12, 24, and 30 months old. Of the 142 teens who enrolled inFamily TIES, the number of clients who participated in subsequent assessments was 124 at 6months, 116 at 12 months, 99 at 24 months, and 85 at 30 months. For various reasons, completedata were not available for all teens and infants who participated in assessments at particularpoints in time. For example, although 116 teens participated in the 12-month assessments, only106 completed the videotaped teaching task at the health center that was used as one indicatorof caregiving. The HOME inventory, which was also assessed at 12 months in the teen’s home,was completed for only 83 of the clients; those who did not complete this part of the assessmenttypically refused to be interviewed at home or repeatedly broke interview appointments, orwhen they were interviewed at home the infant was being cared for elsewhere. Similarly, 85young mothers participated in the 30-month assessments, but language ability was assessed foronly 76 of their children. The research team went to great lengths to maintain contact with theteens and keep them involved in the study, but only 60% of the mothers who enrolled in FamilyTIES and 54% of their ﬁrstborn children participated in the 30-month assessment. An analysis was conducted to determine if those who participated in the 30-month as-sessment differed from those who were not assessed on data collected at enrollment. Partici-pators and nonparticipators did not differ on most key variables assessed at enrollment suchas age, mothers’ level of education, fathers’ level of education, educational aspirations, orexpectations, and locus of control orientation. However, those who did not participate at 30months received more favorable scores on a measure of childrearing beliefs, the Adult – Ado-lescent Parenting Inventory (AAPI; Bavolek, 1984). Signiﬁcant differences in the scores ofparticipators and nonparticipators were found on two of the four subscales of the AAPI, in-appropriate expectations and empathy; for the other two belief subscales, corporal punishmentand role reversal, differences between the two groups approached statistical signiﬁcance(p .10). Although differences were found on the childrearing belief measure assessed atenrollment, those who participated did not differ signiﬁcantly from those who did not partic-ipate in the 30-month assessment on any of measures of caregiving assessed at 6, 12, and 24months.MeasuresMeasures of caregiving. For children in both treatment groups, caregiving was measured whenthey were 12 and 24 months old. Three measures of caregiving were used. The home environ-ment was measured for both groups at 12 and 24 months, and maternal behavior was assessedin a videotaped teaching task at 12 months. Each of these measures is described below. Inaddition, the Home-Visited teens were rated on several dimensions of parenting by their familyadvocates when the children were 6 and 24 months old. The family advocates in the Home-Visited Group were asked to complete these ratings because of their extensive involvementwith, and knowledge about, their families. The family advocate for the Standard Program hadconsiderably less contact with her families and therefore was not asked to complete the par-enting ratings.Home environment. The overall quality of the home environment was assessed when theinfants were 12 months old with the Home Observation for Measurement of the Environment(HOME; Caldwell & Bradley, 1984). The HOME is a widely used measure and earlier studiesdemonstrated that the HOME is predictive of individual differences in the cognitive competence
154 ● T. Luster and M. Vandenbeltof children. In all, there are 45 items on the HOME; some items rely on maternal report andother items are based on observations recorded during the interview, which generally takesabout an hour to complete. Each item is scored yes or no, with yes responses indicating thepresence of positive features of the environment; a total score for the scale is computed bycounting the items that are scored yes. The aspects of the environment assessed by the HOMEare: (a) emotional and verbal responsivity; (b) acceptance of the child’s behavior; (c) organi-zation of the environment; (d) provision of play materials; (e) parental involvement with thechild; and (f) opportunities for variety. The HOME was administered by a child developmentspecialist and a social worker who were trained in the use of the instrument. The HOME wascompleted on 83 of the families participating in Family TIES; of these families, 61 had childrenwhose language capabilities were assessed at 30 months. For children who participated in thelanguage assessment at 30 months, their mothers’ scores on the HOME ranged from 11 to 42with a mean of 31.0 (SD 7.7). When the children were 24 months old, the home environment was assessed with theNCAST HOME (Barnard, 1978), a version of the HOME inventory that can be used in a clinicsetting. At the 24-month assessment, data were collected from 84 families in the program inthe health center during a well-child checkup; 59 of these families had children whose languagewas assessed at 30 months. The NCAST HOME, like the original version, comprises 45 itemsand covers the same content areas. The NCAST HOME includes observation and self-reportitems, but because it is administered in a clinic setting it relies to a greater extent on self-reportthan the original version of the HOME. The NCAST HOME was administered by graduateassistants who conducted the interviews with the mothers and were trained to administer theinstrument. Among those who completed the language assessments at 30 months, the meanscore on this measure was 31.1 (SD 5.5) with a range from 17 to 42.Teaching task. A maternal teaching task was videotaped at the 12-month assessment. Thesevideotapes were used to score the Nursing Child Assessment Teaching Scale (NCATS; Barnard,1978). All of the tapes were scored as part of a doctoral study by a graduate student who hadreceived training on the instrument (Mittelstaedt, 1994). In all, 106 of the mother – infant dyadswere assessed with this measure; 68 of these families had children who also completed thelanguage assessment at 30 months. The 73 items of the NCATS are divided into six subscales,four focusing on maternal behavior and two on infant behavior. Like the HOME, each item isscored yes or no, with the number of items scored yes counted for each subscale score. Scoresfrom the four maternal subscales were summed to produce an overall indicator of the mother’steaching skill. The four subscales are: (a) sensitivity to cues, (b) response to distress, (c) social-emotional growth fostering, and (d) cognitive growth fostering. There are 50 items in thesesubscales. For the 68 dyads who participated in the 30-month assessment, the mean NCATSscore was 32.6 (SD 8.0) with a range from 18 to 45.Advocates’ assessments of caregiving. At the 6- and 24-month assessments, the family ad-vocates for the Home-Visited Group rated the young mothers on ﬁve dimensions of caregiving:(a) the teen’s ability to read the child’s cues; (b) her responsiveness to the child’s cues; (c) thedegree to which she provided an intellectually supportive environment; (d) how much shetalked with the child; and (e) the amount of warmth displayed to the child. The advocate ratedeach dimension on a 5-point scale. Higher ratings were given to the teens who were perceivedby the family advocates as providing relatively supportive care. The ﬁve rating scales weresummed to produce composite measures of caregiving at 6 and 24 months. Cronbach’s alphafor this measure of caregiving was .86 at the 6-month assessment and .94 at the 24-monthassessment. The mean score was 19.0 (SD 4.6) at the 6-month assessment and 18.8 (SD 5.1)
Caregiving by Low-Income Adolescent Mothers ● 155at the 24-month assessment. At the 6-month assessment, scores ranged from 5 to 25; at 36months, scores ranged from 6 to 25. The program supervisor for Family TIES, who was also part of the research team, trainedthe family advocates in the use of the caregiving rating scales. She also worked individuallywith each of the family advocates when they completed the rating scales for their ﬁrst clientsat the 6-month assessment. Advocates completed a rating only if they could make a rating withconﬁdence and ratings were completed only for teens who were still involved in the programat the time the ratings were completed. Ratings were made on 61 teens at the 6-month assess-ment and 46 teens at the 24-month assessment. Thus, caregiving was assessed at three points in time before the language assessments wereconducted — 6 months, 12 months, and 24 months. Caregiving was assessed in the home, inthe health center, and from videotapes of the mother and infant during a teaching task. Care-giving was assessed both by trained interviewers and the family advocates who based theirassessments on weekly home visits over a 2-year period.Language assessments. The children’s receptive vocabulary and expressive language skillswere assessed for this study by a speech and language specialist from the health center whowas blind to treatment group status and scores on the caregiving assessments. Raw scores oneach of the measures were converted to standard scores based on a population mean of 100and a standard deviation of 15. In all, 76 children participated in the language assessment.However, the number of children who completed each of the four language measures variedfrom 62 to 70. Children who did not complete all four language measures typically failed tocomplete the full battery of tests because of their inability to stay focused on the task. Althoughall of the children in the sample would be considered at risk for low achievement based ontheir background characteristics, as is shown below, there was considerable variability in thelanguage capabilities of these children. The Receptive One-Word Picture Vocabulary Test (ROWPVT) was one measure used toassess the child’s receptive vocabulary (Gardner, 1985). In this assessment, the examiner tellsthe child the name of a word and the child has to select the picture that matches the word froma group of four pictures. The items are arranged so that they increase in difﬁculty. Past researchhas demonstrated that the measure is internally consistent; moderate to high correlations werereported between the ROWPVT and other measures of vocabulary (Gardner, 1985). Sixty-sixof the children in this sample completed the ROWPVT assessment. The mean standard scorefor the sample was 81.9 (SD 13.2), with a range from 58 to 118. The child’s expressive language skills were assessed with the Expressive One-Word Pic-ture Vocabulary Test - Revised (EOWPVT; Gardner, 1990). In this assessment, the child isshown a picture and must identify the object that is shown by stating the name of the object.Like the ROWPVT, past research has indicated that the EOWPVT is a reliable and validmeasure of expressive language ability. Seventy children completed the EOWPVT. The meanscore for the sample was 90.3 (SD 9.8), with a range from 72 to 130. The Preschool Language Scale — 3 was also used; it includes an expressive languagesubscale and a receptive language subscale (Zimmerman, Steiner, & Pond, 1992). The recep-tive/auditory subscale for 30-month-old children is designed to determine if the children un-derstand the use of objects (e.g., “Show me what you can ride.”); descriptive concepts (“Whichone is wet?”); part/whole relations (“Show me the door of the car.”); and the use of pronouns(“Show me, they are playing.”). Seventy children were assessed on the PLS-3 receptive subs-cale. Scores on the measure ranged from 65 to 115 with a mean of 86.8 (SD 11.4). The PLS-3 expressive subscale for 30-month-old children assesses their ability to answerwhat, where, and yes/no questions (“Is he sleeping?”); use verbs ing (“The boy is playing.
156 ● T. Luster and M. VandenbeltTell me about the girl.”); produce basic sentences (“Tell me about your toys.”); and use pos-sessives (“This is the boy’s cat. Whose cat is this?”). Sixty-two children completed the ex-pressive portion of the PLS-3. The mean score for the sample was 94.0 (SD 12.1), with arange from 65 to 121. The available evidence indicates that the PLS-3 is a reliable and validmeasure of language ability in preschool children (Zimmerman et al., 1992). In the presentstudy, correlations among the four language measures ranged from .54 (PLS-3 receptive andEOWPVT) to .74 (PLS-3 receptive and PLS-3 expressive). Two composite measures of language ability were also created. The composite expressivelanguage score is the mean of the PLS-3 expressive subscale standard score and the ExpressiveOWPVT standard score. The composite receptive language score is the mean of the PLS-3receptive subscale standard score and the Receptive OWPVT standard score. For either com-posite measure, if the child only completed one of the language assessments, his or her scoreon that measure was used as the composite score. The correlation between the two compositescores was .77. A recent study has demonstrated that standardized tests of language ability,such as the measures used in this study, are consistently related to contemporaneous assess-ments of language that are based on maternal report and transcripts of the child’s spontaneousspeech while interacting with their mothers (Bornstein & Haynes, 1998). Furthermore, thevarious assessments of language at 20 months were predictive of verbal ability at 48 months. RESULTSThe Relation Between Caregiving Practicesand Language ScoresPearson correlations between the caregiving practices of the teens and the language scores oftheir children are presented in Table 1. Because of attrition and varying rates of participation,the number of cases on which each correlation is based is presented in the Table 1 under thecorrelation coefﬁcient. Scores on the HOME inventory at 12 months and on the NCAST HOME at 24 monthswere signiﬁcant predictors of all four language scales and the two composite measures. Familieswho received more favorable ratings on the measures of home environment had children whoscored higher on the language assessments. Similarly, mothers who received more favorablescores on the teaching task at 12 months had children who performed better on all of thelanguage assessments at 30 months. Ratings of caregiving at the 6-month assessment by the family advocates for the Home-Visited Group were also related to all of the language scores with the exception of theEOWPVT. The correlations between the advocates’ ratings of caregiving at 6 months and theother language scores assessed 2 years later ranged from .35 to .56. Children who receivedhigher scores on the language assessments had mothers who were rated by the advocates asproviding more supportive environments for their children. Similar results were obtained when advocates’ ratings of caregiving at 24 months werecorrelated with the language scores. The correlation between advocates’ ratings of caregivingand the EOWPVT was not statistically signiﬁcant. The correlations between advocates’ ratingsof caregiving at 24 months and the other language measures were statistically signiﬁcant andranged from .46 to .56. As an additional check on the correlations presented in Table 1, partial correlations werecomputed between the caregiving indices that were assessed for families in both treatmentgroups (i.e., HOME, NCAST HOME, and NCATS) and the language assessments controlling
Caregiving by Low-Income Adolescent Mothers ● 157TABLE 1. Correlations Between Caregiving Measures and Language Assessments Expressive Receptive Expressive Receptive Composite Composite Predictor Variable PLS-3 PLS-3 OWPVT OWPVT Expressive ReceptiveCaregiving measures assessed in both treatment groups Home inventory (12 months) .33* .32* .42* .53* .42* .51* (46) (53) (50) (48) (54) (58) NCAST home inventory (24 .29* .33* .38* .51* .39* .45* months) (48) (51) (52) (50) (55) (58) Nursing child teaching as- .36* .43* .38* .33* .40* .42* sessment (subscales 1 (56) (62) (60) (56) (64) (67) through 4; 12 months)Caregiving assessed by family advocates in the home- visited group only Family advocates’ compos- .52* .40* .27 .35* .56* .50* ite caregiving ratings— 6 (28) (32) (29) (27) (32) (35) months Family advocates’ compos- .49* .46* .15 .56* .48* .51* ite caregiving ratings— 24 (25) (28) (24) (23) (27) (31) monthsNote. The number of cases on which the correlation is based is presented in parentheses under the correlation coefﬁcient. One-tailedtests were used to determine if correlation coefﬁcients were statistically signiﬁcant.* p .05.for treatment group. Controlling for treatment group had a negligible effect on the magnitudeof the correlations, and all correlations remained statistically signiﬁcant.The Relation Between Maternal and Demographic Variablesand the Two Composite Language ScoresBecause of the ﬁndings of Hann and her colleagues (1996), we considered the possibility thatbackground characteristics of the teenage mother (i.e., SES of the family of origin, her schoolsuccess) or her current living arrangement may also be predictive of language scores. In oursample, which by design was limited to low income families, we found that the two compositelanguage scores of the children were not related to indicators of the mothers’ school success(i.e., self-reported GPA and having ever repeated a grade in school), or whether or not theyoung mothers were living with their mothers at the time of the language assessments. T-test results showed that children obtained signiﬁcantly higher scores on both compositelanguage measures if their mothers were living with the children’s fathers or a male partner atthe time of the 30-month assessment. On average, children who resided with a father ﬁgurehad scores on the composite receptive language measure that were 7.5 points higher thanchildren who did not reside with a father ﬁgure (t -2.85, p .05). Children who lived withtheir father or the mother’s boyfriend scored 5.5 points higher, on average, on the expressivecomposite measure (t -2.17, p .05). Multiple regression analyses were conducted to determine if the variable “presence of afather or father ﬁgure in the home” added to our ability to predict the composite languagescores of children. The dummy variable, presence or absence of a father ﬁgure, was entered as
158 ● T. Luster and M. Vandenbelta predictor variable with one of the three caregiving measures that were available for the entiresample (i.e., 12-month HOME scores, 12-month NCATS teaching scale scores, and 24-monthNCAST HOME scores); the expressive and receptive composite language scores were used asdependent variables. The presence of a male partner was not a signiﬁcant predictor of eitherlanguage outcomes when the 12-month HOME inventory was controlled. In contrast, HOMEcontinued to be a signiﬁcant predictor of language scores when presence of a father ﬁgure wascontrolled. When the 12-month NCATS teaching scale was controlled, the presence of a fatheror father ﬁgure was unrelated to the expressive composite scale, but was signiﬁcantly relatedto the receptive language scale; in both analyses, the NCATS teaching scale was a signiﬁcantpredictor of language scores. In the third set of analyses, the presence of a father or fatherﬁgure was entered with the NCAST HOME, administered at 24 months. The presence of afather ﬁgure was predictive of expressive language scores in this analysis, but fell short ofbeing signiﬁcant when the receptive composite score was used as the outcome. In both analyses,the NCAST HOME was a signiﬁcant predictor of the language outcome. The teens’ parents’ levels of education were used as indicators of SES. The fathers’ levelof education was unrelated to the language assessments; the teens’ mothers’ education wassigniﬁcantly correlated with the receptive composite score (r .35). Multiple regression anal-yses showed that maternal education was not a signiﬁcant predictor of the composite receptivelanguage measure when it was entered with the 12-month HOME inventory, but the HOMEcontinued to be a signiﬁcant predictor of the language outcome. The teen’s mother’s level ofeducation was a signiﬁcant predictor of receptive language scores if either the NCAST HOMEor the NCATS teaching scale was controlled. The education level of the teen’s mother was notrelated to expressive language composite scores when any of the three caregiving measures(HOME, NCAST HOME, or NCATS teaching scale) was controlled.The Relation Between the Two Composite Language Scoresand Speciﬁc Aspects of the Caregiving EnvironmentIt seems likely that children’s language development is inﬂuenced by many aspects of theirexperience and we believe that global measures of the caregiving environment, such as thoseused in this study, are useful as overall indicators of the quality of care that children receiveat home. Nevertheless, some aspects of caregiving may be more strongly associated with lan-guage capabilities than other aspects. To explore this possibility, a post-hoc analysis was con-ducted to examine the relation between various subscales of the caregiving measures and twocomposite language outcomes. These analyses showed that all six subscales of the HOMEinventory assessed at 12 months were signiﬁcantly related to both language composite scores(see Table 2). Correlations ranged from .24 to .44. Three of the four subscales of the NCATSteaching scale were signiﬁcantly related to both composite language scales with correlationsranging from .28 to .46. The response to distress subscale was not signiﬁcantly related to eitherthe expressive or receptive composite language scale. Three of the six subscales of the NCASTHOME, assessed in the health center at 24 months, were signiﬁcantly related to the two lan-guage composite scores: (a) emotional and verbal responsivity; (b) provision of appropriateplay materials; and (c) opportunities for variety in daily stimulation. The statistically signiﬁcantcorrelations ranged from .34 to .43. Similar analyses were conducted with the ratings completed by the family advocates. Therelations between each aspect of the caregiving environment that was rated by the advocates(e.g., how much the mother talked with the child) and the two language composite scores wereexamined. All of the correlations between the advocates’ ratings of caregiving at 6 months andthe two language outcomes were signiﬁcant with two notable exceptions. Ratings of warmth
Caregiving by Low-Income Adolescent Mothers ● 159 TABLE 2. Correlations Between Speciﬁc Aspects of the Caregiving Environment and the Expressive and Receptive Composite Language Scores Expressive Composite Receptive Composite Predictor Variable Language Scores Language Scores HOME inventory subscales (12 months) Emotional and verbal responsivity .37* .44* Acceptance of the child’s behavior .28* .33* Organization of the environment .25* .35* Provision of play materials .32* .33* Maternal involvement .30* .43* Opportunities for variety .24* .27* NCAST home (24 months) Emotional and verbal responsivity .40* .39* Acceptance of the child’s behavior .13 .16 Organization of the environment .00 .01 Provision of play materials .38* .34* Maternal involvement .02 .02 Opportunities for variety .43* .40* NCATS teaching scale (12 months) Sensitivity to cues .28* .36* Response to distress .15 .12 Social-emotional growth fostering .38* .35* Cognitive growth fostering .41* .46* Advocates ratings of caregiving (6 months) Sensitivity to cues .57* .45* Responsiveness to cues .36* .49* Intellectually supportive environment .59* .54* Verbal stimulation .42* .22 Warmth .22 .28* Advocates ratings of caregiving (24 months) Sensitivity to cues .48* .56* Responsiveness to cues .32† .38* Intellectually supportive environment .39* .44* Verbal stimulation .46* .47* Warmth .52* .50* *p .05. †p .05.were not signiﬁcantly correlated with expressive language scores, and the amount that themother talked to her infant was not related to the receptive composite score. The statisticallysigniﬁcant correlations ranged from .28 to .59. All of the advocates’ ratings of caregiving at24 months were predictive of the two composite language measures. In contrast to the ﬁndingsat 6 months, advocates’ ratings of how much the mother talked with the child at 24 monthswere related to the child’s expressive (r . 46) and receptive language composite scores (r.47). Similarly, ratings of warmth at 24 months were predictive of expressive (r .52) andreceptive language scores (.50). Thus, these analyses showed that most of the subscales of the caregiving measures weused and most of the ratings of caregiving by the family advocates were positively and signif-icantly correlated with both language outcomes. All of the correlations were small to moderatein magnitude, with most of the coefﬁcients in the .25 to .50 range.
160 ● T. Luster and M. Vandenbelt TABLE 3. Correlations Among the Caregiving Measures Variable 1 2 3 4 5 (1) Home inventory 12 months 1.0 (2) NCAST home 24 months .69* 1.0 (3) NCATS 12 months .53* .43* 1.0 (4) Advocates’ ratings of caregiving— 6 months .27* .47* .46* 1.0 (5) Advocates’ ratings of caregiving— 24 months .57* .48* .34* .51* 1.0 Note. A one-tailed test of signiﬁcance was used. The analyses were limited to families whose children participated in the language assessment at 30 months. * p .05.Relations Among the Caregiving MeasuresAs the ﬁnal step in the analyses, the Pearson correlations among the various indicators ofcaregiving quality were computed. These correlations were computed to determine the con-sistency with which the caregiving practices of the teens were viewed across observers andacross time. These analyses included only families who had children who were assessed on atleast one of the language measures. The results of these analyses are presented in Table 3. Moderate correlations were found among the various caregiving measures. The correlationbetween the two versions of the HOME inventory (administered in the home and the healthcenter) that were assessed 12 months apart was .69. The correlation between the advocates’ratings of caregiving at 6 months and the advocates’ ratings of caregiving 18 months later was.51. DISCUSSIONThe central question addressed in this study was: Are the caregiving practices of low-income,teenage mothers predictive of individual differences in the language abilities of their 30-month-old children? Clearly, caregiving practices of the young mothers were predictive of the chil-dren’s language abilities. Assessments of caregiving made at different points in time (i.e., whenthe child was 6, 12, and 24 months), in different settings (the home, the health center), and bydifferent observers (interviewers, family advocates, scores from videotapes) were related tochildren’s scores on the language assessments. Because the ﬁndings are based on correlational analyses, no conclusions can be drawnabout causal processes. However, one plausible interpretation of the ﬁndings is that differencesin the caregiving practices of teenage mothers do contribute in signiﬁcant ways to individualdifferences in the capabilities of their children. Several studies have demonstrated that thereare large within-in group differences in the caregiving practices of teenage mothers, and thisstudy provided additional support for this conclusion. For example, scores on the 45-itemHOME inventory ranged from 11 to 42 for this sample at the 12-month assessment. Moreover,in our informal conversations with the family advocates, the caregiving practices of some oftheir clients have been described in very positive terms while the caregiving practices of otherswere judged to be inadequate, sometimes bordering on neglectful or abusive. Caregiving dif-ferences of this magnitude could contribute to individual differences in the capabilities of thechildren. Studies of monozygotic and dizygotic twins support the view that environmentalfactors contribute to individual differences in the expressive and receptive language capabilitiesof young children (Reznick, Corley, & Robinson, 1997). However, as Rice (1989) has pointed out, it is difﬁcult to determine the effect of caregiving
Caregiving by Low-Income Adolescent Mothers ● 161practices on language development, in part, because the child may play a signiﬁcant role ineliciting responses from the caregiver. In other words, when mothers interact with their chil-dren, each member of the pair is inﬂuencing the behavior of the other. Moreover, the child isan active learner of language who must process the language he or she hears in order tocomprehend the meaning of words and the rules for expressing those words in meaningfulways. Therefore, children are producers of their own development to some extent and anyrelation between caregiving and children’s language probably does not reﬂect an unidirectionalprocess (Lerner & Busch-Rossnagel, 1981). On the other hand, it would be difﬁcult for us toconclude that the lack of verbal stimulation in many homes resulted from the child’s behavior(e.g., not eliciting involvement from the mother). The family advocates noted that many chil-dren who received little language stimulation from their mothers were eager to have booksread to them by the family advocates, or to engage in dialogue with the advocates while playingwith their toys. Although the caregiving practices of teenage mothers may be important for their children’sdevelopment, they are not likely to be the only inﬂuences on language development. Pastresearch suggests that individual differences in children’s language abilities may be inﬂuencedby genetic differences among children (Moore & Snyder, 1991; Plomin, 1990; Resnick et al.,1997), and by other aspects of the environment. Many teenage mothers are still in school orworking at least part of the day, so the children are exposed to other caregivers, sometimesmany other caregivers, as child-care arrangements can be complex. The father of the baby, themothers’ current partner if not the father, and the teens’ mothers may spend signiﬁcant amountsof time with the child. Little information was available on the practices of other caregivers inthis study, and this is an area that should be examined in future studies. However, given thecomplexity of their child-care arrangements, collecting data on the practices of all caregiversis likely be a daunting task for those who study children of adolescent mothers. In this article, we have focused on the possible inﬂuence of caregiving on children’slanguage development. However, caregiving occurs in a broader context, and factors that in-ﬂuence caregiving may indirectly inﬂuence children’s development. The quality of care theteen provides for her children is likely to be inﬂuenced not only by characteristics of the teensand characteristics of their children, but also the context in which the relationship is evolving(Belsky, 1984; Schellenbach, Whitman, & Borkowski, 1992). Teens who are providing rela-tively low quality care in a stressful context may be able to provide more supportive care undermore favorable circumstances. In an earlier study with this sample, we found that the youngmothers tended to receive higher scores on the HOME inventory when they lived in saferneighborhoods and when the fathers of the babies helped to care for the baby and providedﬁnancial support for the mothers (Luster et al., 1996). Presumably these factors decrease themother’s level of stress and increase her capacity to focus on the needs of her child. Therefore,in considering possible inﬂuences on language development, one should not lose sight of moredistal factors that may inﬂuence the experiences of the child and, ultimately, the child’s com-petencies (Bronfenbrenner, 1979). By examining the relation between caregiving and children’s language abilities, this studyadds information to an area that has received insufﬁcient attention by those who study adoles-cent parenting. Researchers have noted for some time that teenage mothers tend to provide lessverbal stimulation for their children than older mothers. Other researchers have shown that thechildren of teenage mothers tend to score lower than their peers on cognitive assessments,especially when the assessments are language-based rather than focusing on sensorimotor skills.Although it seems reasonable that the lack of verbal stimulation provided by some teenagemothers may be related to the low language scores of their children, surprisingly few studieshave investigated this possibility (for a notable exception see Hann, Osofsky, & Culp, 1996).
162 ● T. Luster and M. VandenbeltFor this reason, we thought it was important to carefully examine the relation between parentingby teenage mothers and the language abilities of their children when we began our longitudinalstudy of the Family TIES program. Although this study addresses an important issue in the teenage parenthood literature, thedata for this study have certain limitations that also should be noted. First, the sample size issmall and many of the teens who originally enrolled in the Family TIES program did notparticipate in the 30-month assessment or other earlier assessments. Although we provided freetransportation for appointments and incentives for participation, we have found it challengingto maintain a sample of low-teenage mothers in a longitudinal study. Participation in researchthat involves repeated assessments is not likely to be a priority for most teenagers, let aloneteenage parents who have many demands on their time. The small sample size also precludedus from conducting separate analyses for families from different ethnic groups. It would bevaluable to explore these relations in future studies. A second limitation is that the sample does not include teenage mothers from more ad-vantaged circumstances and therefore the results may not be generalizable to all adolescentmothers; only young mothers from low-income families were eligible for this program. Onemust keep this in mind when interpreting the results of the analyses, particularly the averagescores of the children on the measures. Moreover, a restricted range on some variables mayhave attenuated the correlations in some analyses. For example, with a more diverse sample,we may have found a stronger relation between our indicator of SES (the teens’ parents’ levelof education) and the language outcomes. Several studies have shown that SES is related tothe language experiences of children in the home (see Hoff-Ginsberg & Tardiff, 1995 for areview). On the positive side, limiting the study to low-income teens reduces the likelihoodthat caregiving and income are confounded in this study. A third limitation is that advocates’ ratings of caregiving were not available for the teenswho were in the Standard Program Group. The family advocate for teens in the StandardProgram (the less intensive treatment group) worked with the teens primarily via phone andmail from her ofﬁce in the health center and therefore knew less about the caregiving practicesof the teens than the advocates who made weekly home visits had. The small sample size,inconsistent participation in the research assessments, and the fact that data were available ononly half the sample for certain variables also limited the kinds of analyses that could beconducted with this data set. For example, it would have been valuable to conduct a multipleregression analysis to determine if caregiving measures assessed at 6 and 12 months werepredictive of language scores when measures of caregiving at 24 months were controlled. Some may also question our decision to include ratings of caregiving by paraprofessionalfamily advocates in the analyses. However, over the course of the project we have come toview the family advocates as knowledgeable and insightful sources of information. We believethat their ratings based on weekly home visits over a 2-year period are likely to be as valid asother assessments of parenting typically used in research that are based on an hour or two ofobservations by someone who is stranger to the family. The fact that their ratings (even thosemade when the children were only 6 months olds) were predictive of the children’s languagecapabilities and were related to other indicators of caregiving supports the view that the ad-vocates provided valuable information about their clients. Despite the limitations of this study, the data do provide a clear answer to the primaryquestion of interest. The caregiving practices of low-income teenage mothers are predictive ofthe language abilities of their children at 30 months. Based on the results of this study, wewould encourage additional research in this area, especially with adolescent mothers fromdifferent ethnic and income groups. Finally, as we noted earlier, the children in the two treatment groups did not differ, on
Caregiving by Low-Income Adolescent Mothers ● 163average, on the language assessments. These results were disappointing and have caused us torethink our approach to the intervention. If we were starting over, we would consider makingat least two signiﬁcant changes. First, we would expand the component of the home-visitingprogram that focused directly on caregiving. Our intervention focused primarily on providingsocial support for the young mothers and linking them to needed services in the community.Some interventions that focused more on mother – infant interaction, such as the Missouri NewParents As Teachers program, have had success in enhancing children’s language capabilities(White, 1988). Second, we realize now that some of the young mothers in the program, becauseof their problematic developmental histories and current circumstances, needed services (e.g.,mental health services) that go beyond the expertise of paraprofessional family advocates. Thesigniﬁcant needs of the adolescents from multiproblem families have led us to believe that ourmore intensive level of service was not intensive enough for some of families being served bythe program, and that additional services from mental health professionals and others must beprovided in some cases. REFERENCESAinsworth, M.D.S., Blehar, M.C., Waters, E., & Wall, S. (1978). Patterns of attachment. Hillsdale, NJ: Erlbaum.Barnard, K. (1978). Nursing Child Assessment Training: Instructor’s learning resource manual. Seattle, WA: NCAST Publications.Barratt, M.S. (1991). School-age offspring of adolescent mothers: Environments and outcomes. Family Relations, 40, 442– 447.Barratt, M.S., & Roach, M.A. (1995). Early interactive processes: Parenting by adolescent and adult single mothers. Infant Behavior and Development, 19, 97–109.Baumwell, L., Tamis-Lemonda, C.S., & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20, 247–258.Bavolek, S.J. (1984). The Adult-Adolescent Parenting Inventory. Schaumburg, IL: Family Development Resources.Belsky, J. (1984). Determinants of parenting: A process model. Child Development, 55, 83–96.Bornstein, M.H., & Haynes, O.M. (1998). Vocabulary competence in early childhood: Measurement, latent construct, and predictive validity. Child Development, 69, 654–671.Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.Brooks-Gunn, J., & Chase-Lansdale, P.L. (1995). Adolescent parenthood. In M. Bornstein (Ed.), Hand- book on parenting (Vol. 3): Who is the parent? (pp. 113–149). Mahwah, NJ: Erlbaum.Brooks-Gunn, J., Guo, G., & Furstenberg, F.F., Jr. (1993). Who drops out and who continues beyond high school? A 20-year follow-up of black urban youth. Journal of Research on Adolescence, 3, 271– 294.Caldwell, B., & Bradley, R. (1984). Home observation for measurement of the environment. Little Rock, AK: University of Little Rock at Arkansas.Culp, R.E., Culp, A.M., Osofsky, J.D., & Osofsky, H. (1991). Adolescent and older mothers’ interaction patterns with their six-month-old infants. Journal of Adolescence, 14, 195–200.Culp, A.M., Osofsky, J.D., & O’Brien, M. (1996). Language patterns of adolescent and older mothers and their one-year old children: A comparative study. First Language, 16, 61–75.de Villiers, J.G., & de Villiers, P.A. (1978). Language acquisition. Cambridge, MA: Harvard University Press.
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