Maternal Child-Directed Speech Toward Children With Infantile Spasm or West Syndrome

Maternal child-directed speech (MCDS) plays a critical role in early language and communicative development, yet little is known about how it adapts to neurodevelopmental conditions such as Infantile Spasms/West Syndrome (WS), particularly when co-occurring with intellectual disability (WID) or autism spectrum disorder (WASD).

This study investigated how mothers adapt their speech when interacting with children with WS, including those with WID and WASD, compared to age-matched typically developing (TD) children.

Forty-four mother-child dyads participated in standardized free play sessions. MCDS was transcribed and analysed using the Child Language Data Exchange System (CHILDES), focusing on lexical diversity, noun, verb, adjective and pragmatic features (e.g., exclamations, directiveness, questions, attention-directing expressions, mental state references).

Lexical diversity did not differ significantly between groups. However, clear group differences were found in pragmatic use: mothers of children with WS produced more exclamations, attention-directing expressions, and mental state references, suggesting adaptive strategies to sustain engagement. In the WS and TD groups, MCDS features were significantly associated with children's developmental quotients (DQ), a pattern not observed in the WID or WASD subgroups.

Findings suggest that mothers flexibly adjust their communicative input to children's developmental and interactional needs, with unique adaptations evident in WS. These results underscore the importance of tailoring parent-mediated interventions to support communication in children with complex neurodevelopmental contexts.

What is already known on this subject Maternal child-directed speech (MCDS) varies across neurodevelopmental conditions. Prior research has documented this variability in children with language delay and developmental language disorder (DLD), including those with co-occurring autism spectrum disorder (ASD). What this paper adds to the existing knowledge To date, no studies have examined MCDS in the context of early-onset epilepsy during infancy, such as Infantile Spasms or West Syndrome (WS), leaving a critical gap in the literature. This study demonstrates that MCDS is shaped by (i) the neurological impact of WS, including alterations in social responsiveness that may occur independently of intellectual disability or ASD; (ii) the child's developmental abilities; and (iii) communicative features associated with ASD. These findings broaden our understanding of how maternal speech adapts to diverse, early-emerging neurodevelopmental disorders. What are the potential or actual clinical implications of this work? This study highlights the complexity of mother-child communication in the context of WS and co-occurring conditions. The findings underscores the need for tailored clinical interventions that consider both caregiver input and the child's communicative and developmental profile. MCDS may potentially serve both as a sensitive indicator of developmental status and as a modifiable element of early intervention. Personalized approaches that build on the child's communicative strengths while addressing specific challenges may support improved language outcomes and broader cognitive development.