{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:18:34Z","timestamp":1792790314896,"version":"4.5.0"},"posted":{"date-parts":[[2026,9,22]]},"group-title":"Pediatrics","reference-count":62,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Institutes of Health (NIH) National Institute on Deafness and Other Communication Disorders","award":["K23DC07983"],"award-info":[{"award-number":["K23DC07983"]}],"id":[{"id":"https:\/\/ror.org\/04mhx6838","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Institutes of Health (NIH) National Institute on Deafness and Other Communication Disorders","award":["T32DC000038"],"award-info":[{"award-number":["T32DC000038"]}],"id":[{"id":"https:\/\/ror.org\/04mhx6838","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/0550wc655","id-type":"ROR","asserted-by":"publisher"}]},{"name":"The Rosamund Stone Zander Translational Neuroscience Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>This study examined whether word-based and non-word natural language sampling (NLS) measures complement standardized language scores in characterizing expressive communication among preschool children with autism with language impairment (AUT-LI), Down syndrome (DS), and fragile X syndrome (FXS).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>\n                    Participants included 82 preschool children with AUT-LI (\n                    <jats:italic>n<\/jats:italic>\n                    = 32), DS (\n                    <jats:italic>n<\/jats:italic>\n                    = 34), or FXS (\n                    <jats:italic>n<\/jats:italic>\n                    = 16). Expressive communication was characterized using the Preschool Language Scales and 10-minute natural language samples collected during a standardized play-based protocol. NLS measures included traditional word-based metrics, such as lexical diversity, intelligibility, and word approximations, as well as tiered non-word vocalization measures, including non-speech, single-phoneme, and multi-phoneme vocalizations. Analyses examined age associations, diagnostic group differences, between group differences in variability, and exploratory communication profiles derived using principal component analysis and partitioning around medoids clustering.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Diagnostic groups did not significantly differ on standardized expressive language scores. Children with FXS showed higher performance than the AUT-LI and DS groups on several word-based NLS measures, whereas non-word vocalization measures primarily revealed differences in within-group variability. Word-based NLS measures were consistently associated with standardized expressive language skills, while associations for non-word vocalizations varied by vocalizations type. Cluster-validity indices factored a two-cluster solution. A hypothesis-informed three cluster solution that included non-word vocalizations suggested Higher Language, Lower Output, and High Output-Low Structure profiles.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Standardized and NLS measures provide complementary descriptions of expressive communication in children with neurodevelopmental disorders. Non-word vocalization coding may be especially useful for describing clinical meaningful variation among children with limited expressive language.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.21.26363560","type":"posted-content","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T23:25:13Z","timestamp":1790119513000},"source":"Crossref","is-referenced-by-count":0,"title":["Beyond Words: Natural Language Sampling of Lexical and Non-Word Vocalizations in Preschool Children with Autism, Down Syndrome, and Fragile X Syndrome"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1655-9661","authenticated-orcid":false,"given":"Anna","family":"Adekogbe","sequence":"first","affiliation":[{"name":"Department of Speech, Hearing, Bioscience and Technology, Division of Medical Sciences, Harvard University, Boston, MA, United States"},{"name":"Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antuan","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Speech, Hearing, Bioscience and Technology, Division of Medical Sciences, Harvard University, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Speech, Hearing, Bioscience and Technology, Division of Medical Sciences, Harvard University, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Norberg","sequence":"additional","affiliation":[{"name":"Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, United States"},{"name":"Down Syndrome Program, Division of Developmental Medicine, Boston Children\u2019s Hospital, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Monk","sequence":"additional","affiliation":[{"name":"Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanisha","family":"Chanda","sequence":"additional","affiliation":[{"name":"Department of Speech, Hearing, Bioscience and Technology, Division of Medical Sciences, Harvard University, Boston, MA, United States"},{"name":"Georgia Institute of Technology, Atlanta, GA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinran","family":"Hou","sequence":"additional","affiliation":[{"name":"Tufts University, Medford, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Palowski","sequence":"additional","affiliation":[{"name":"Down Syndrome Program, Division of Developmental Medicine, Boston Children\u2019s Hospital, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Baumer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado Anschutz Medical Center, Aurora, CO, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina T.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Northeastern University, Boston, MA, United States"},{"name":"Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Department of Speech, Hearing, Bioscience and Technology, Division of Medical Sciences, Harvard University, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026092500550710000_2026.09.21.26363560v1.1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2014.00355"},{"key":"2026092500550710000_2026.09.21.26363560v1.2","doi-asserted-by":"publisher","DOI":"10.1044\/2020_jslhr-20-00343"},{"key":"2026092500550710000_2026.09.21.26363560v1.3","doi-asserted-by":"publisher","DOI":"10.1002\/aur.2380"},{"key":"2026092500550710000_2026.09.21.26363560v1.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-018-3628-4"},{"key":"2026092500550710000_2026.09.21.26363560v1.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-017-3033-4"},{"key":"2026092500550710000_2026.09.21.26363560v1.6","doi-asserted-by":"publisher","DOI":"10.1352\/1944-7558-121.2.121"},{"key":"2026092500550710000_2026.09.21.26363560v1.7","doi-asserted-by":"publisher","DOI":"10.1186\/s11689-021-09386-x"},{"key":"2026092500550710000_2026.09.21.26363560v1.8","unstructured":"CDC. 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