Understanding A Child's Language Delay


Daniela O'Neill transforms her UW research into an international gold standard for pragmatic language assessment


The first few years in a child's life are full of significant development milestones, from rolling over, to standing and walking, to saying those first few words.

However, not all children progress as they should, and when a parent notes that their toddler's language isn't developing as it should, it could be an early warning sign of a more significant developmental issue.

Daniela O'Neill, a developmental psychologist and University of Waterloo professor, has spent her academic career researching language development and cognition in young children. O'Neill's Language Use Inventory (LUI) has become an international gold standard parent-report measure for assessing pragmatic language development in young children aged 18 to 47 months. Speech-language professionals and researchers globally now use the LUI to evaluate children's early language use, especially among children struggling with social communication, such as children on the autism spectrum.

"When we look at language development in children it is built of essentially three building blocks: vocabulary, grammar, and pragmatics. Pragmatics, which focuses on a child's effective and appropriate use of language in social situations, is where children with autism will struggle," explains O'Neill. "The earlier we can identify the problem, the earlier intervention can begin, so a child can be on a good footing when he or she enters school."

It was a chance conversation with a clinician at a clinic where children are diagnosed for autism that led to the LUI's development, O'Neill explains. "I was on a site visit and one of the clinicians asked when certain kinds of communication come in typically. And I realized that while we knew a lot from research about different types of communication in children, we didn't have the kind of data available to answer that question."

It was a challenge Prof. O'Neill then took back to her research lab, the UW Centre for Child Studies. "As we were dealing with children at a very young age, I knew that a parent-report instrument was the right direction. So I started to think about the kinds of questions I needed to ask of a parent to get at the ways children are using language. That is where the process began."

Over the next few years, funded by the Canadian Institutes of Health Research, O'Neill and her research team at University of Waterloo refined the LUI questionnaire and validated its efficacy in identifying children struggling with language pragmatics. This effort culminated in a Canada-wide study involving 3,500 children, providing O'Neill and her team with the data to develop norms at each month of development, allowing professionals using the LUI to receive a percentile score for a child's pragmatic language use, similar to those used for height and weight comparisons.

The natural next step in a research effort such as this one is typically to work with a publisher to make the assessment tool widely available to the professional community for clinical use. However, University of Waterloo's "inventor-own" IP policy offered Daniela O'Neill another option: commercialize the tool herself.

"The problem with working with a large publishing company to publish the test is that your work is no longer yours. You sign away your rights. And as I talked to other colleagues who went that route, they were quite unhappy. They had no involvement; it didn't belong to them anymore. So the fact I conducted my research here at University of Waterloo was a lucky break. It allowed me to even think about the possibility there was another route I could take."

A meeting with WatCo, University of Waterloo's commercialization office, led to an introduction to the Accelerator Centre (AC), a word-class start-up incubator located in the David Johnston Research + Technology Park: and started Knowledge in Development (KiD) Inc.

"I remember driving down the road from the Accelerator Centre, thinking to myself, 'I guess I can try to publish on my own. If it doesn't work out, I can always go the other route.'"

In 2009, O'Neill and her husband established an eCommerce website to sell the hard copy version of the LUI, and in 2011, joined the AC as an off-site client to build an online version of the tool.

Today, the LUI is in use in 48 US states, all Canadian provinces, the UK, Ireland, Australia and New Zealand. O'Neill is also working with research counterparts in several countries to translate the tool into different languages. It has also been recommended by the National Institute on Deafness and other Communication Disorders (NIDCD) panel of autism experts as a benchmark measure to evaluate pragmatic language functioning in children with autism spectrum disorders.

Apart from the satisfaction that comes from commercializing her research and growing it into a business, Daniela O'Neill revels in the difference she knows her tool is making a difference in the lives of others. "I've had speech-language pathologists search me out to thank me for developing the LUI. They've let me know that because of my tool, they've been able to identify kids earlier and get them the resources they need to be successful. When I get those calls, those are very good days."