Sentence Repetition: A Clinical Marker for Developmental Language Disorder in Danish

A processability theory perspective on morphosyntax in school-age children with developmental language disorder

This study examines the production of morphosyntax in Swedish-speaking children diagnosed with Developmental Language Disorder (DLD). Data from a Sentence Repetition Task was used to investigate if there is an implicational order according to Processability Theory (PT) in grammatical structures produced by school-age children with DLD. PT is a cognitive theory of language development that assumes five implicational stages of morphosyntactic development. The analysis was based on a selection of sentences representing the different PT stages. The participants (n = 49; 6;5-11;5 years of age) were recruited from school language units for children with DLD. The results confirm an implicational order: the participants produced structures from a higher stage only if they also produced structures from lower stages. It is suggested that the developmental hierarchy can be used in the intervention of children with DLD by focusing on the next stage. Also, only 26.5% of the participants achieved PT stage 4, and one child (2%) reached the highest PT stage 5. This is discussed in relation to what is known regarding PT stages in typically developing children, as well as associations with language, memory, and non-verbal measures.

Developmental language disorder: similarities and differences between 6-year-old mono- and multilingual children

This study investigated language ability in 6-year-old mono- and multilingual children who, at age 2;6 years, had screened positive for developmental language disorder (DLD). One hundred children (32 girls, 68 boys) were assessed at an average age of 2;9 years (T1) and 85 of them (30 girls, 55 boys) were reassessed at age 6;0 years (T2) using a standardised test battery. Of these, 68 (23 girls, 45 boys) met the criteria for DLD diagnosis; 28 of them were monolingual and 40 multilingual. Language profiles at T2 were analysed, as were the associations between DLD and a mono- or multilingual background as well as other measures collected at T1, including mean length of utterance (MLU), heredity and parental education. As expected, the results showed that the total group (including both mono- and multilingual children) scored below test norms for 6-year-olds on all language tests, except for receptive vocabulary, where the monolingual children scored in line with those norms. The multilingual group performed significantly less well than the monolingual one on language comprehension, receptive vocabulary, recalling sentences, word finding and story retelling; disparities regarding MLU and language comprehension were already evident at T1. Interestingly, MLU at T1 showed a moderate association with language comprehension at T2 in the total group. The monolingual children were more likely than the multilinguals to have heredity for DLD or reading and writing disorders. In conclusion, language difficulties identified through screening and assessment before age 3 years often persist at age 6 years.

The Stability of Linguistic Skills of Arabic-Speaking Children Between Kindergarten and First Grade

PURPOSE

This study aimed to evaluate the stability of phonological awareness (PA) and language achievements between kindergarten and first grade among Arabic-speaking children.

METHOD

A total of 1,158 children were assessed in PA and language skills in both grades and were classified based on distinct and integrated achievements on PA and language following percentiles' cutoff criteria. The classification of distinct achievements constituted high, intermediate, low, and very low achievement-based groups for each domain. The classification of the integrated achievements on both domains constituted four groups: intermediate-high PA and language, very low PA, very low language, and doubly low (very low PA and language). Descriptive statistics and McNemar's tests were used to examine the stability of these groups.

RESULTS

The analyses showed a significant improvement in achievements on most tasks. The distinct classification for PA and language indicated that many more kindergarteners in the extreme distribution with high and very low achievement levels maintained this profile in first grade compared to those with intermediate achievements. For PA, 55.7% of kindergarteners with high, 30% with intermediate, 30.4% with low, and 45.5% with very low achievements maintained their achievements in first grade. For language, 52.5% of kindergarteners with high, 34.5% with intermediate, 38.8% with low, and 59.8% with very low achievements maintained their language achievements. The integrated classification indicated a higher achievement stability rate for kindergarteners with intermediate-high PA and language (91.3%) and for doubly low achievers (84.7%) compared to very low PA (24.1%) or very low language (31.8%) achievers.

CONCLUSIONS

The study indicated a higher variability in the distribution of the intermediate achievements compared to the high and very low achievements, which were more stable across grade. The results emphasize the need for dynamic linguistic assessments and early intervention for children with very low achievements in PA and language who show a poor prognosis.

Sentence Repetition as a Diagnostic Tool for Developmental Language Disorder: A Systematic Review and Meta-Analysis

PURPOSE

This systematic review and multilevel meta-analysis examines the accuracy of sentence repetition (SR) tasks in distinguishing between typically developing (TD) children and children with developmental language disorder (DLD). It explores variation in the way that SR tasks are administered and/or evaluated and examines whether variability in the reported ability of SR to detect DLD is related to these differences.

METHOD

Four databases were searched to identify studies that had used an SR task on groups of monolingual children with DLD and TD children. Searches produced 3,459 articles, of which, after screening, 66 were included in the systematic review. A multilevel meta-analysis was then conducted using 46 of these studies. Multiple preregistered subgroup analyses were conducted in order to explore the sources of heterogeneity.

RESULTS

The systematic review found a great deal of methodological variation, with studies spanning 19 languages, 39 SR tasks, and four main methods of production scoring. There was also variation in study design, with different sampling (clinical and population sampling) and matching (age and language matching) methods. The overall meta-analysis found that, on average, TD children outperformed children with DLD on the SR tasks by 2.08 SDs. Subgroup analyses found that effect size only varied as a function of the matching method and language of the task.

CONCLUSIONS

Our results indicate that SR tasks can distinguish children with DLD from both age- and language-matched samples of TD children. The usefulness of SR appears robust to most kinds of task and study variation.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25864405.

Testing the Continuum/Spectrum Model in Russian-Speaking Children With and Without Developmental Language Disorder

PURPOSE

Previously, Lancaster and Camarata (2019) showed that the continuum/spectrum model of the developmental language disorder (DLD) best explained the high heterogeneity of symptoms in children with DLD. We hypothesize that the continuum/spectrum approach can include not only children with DLD but also typically developing (TD) children with different timelines and patterns of language acquisition. This model can explain individual language profiles and deficits in children.

METHOD

We assessed language abilities in a group of Russian-speaking children with DLD aged 4-7 years (n = 53) and their age- and gender-matched peers without speech and language diagnoses (n = 53, TD). We evaluated the children's performance at four language levels in production and comprehension domains, using 11 subtests of the standardized language assessment for Russian: Russian Child Language Assessment Battery (RuCLAB). Using the k-means cluster method and RuCLAB scores, we obtained two clusters of children and analyzed their language performance in individual subtests.

RESULTS

The analysis revealed that the two clusters of children both included DLD and TD participants: Group 1, with higher test scores (TD = 45, DLD = 24 children), and Group 2, with lower scores (TD = 8, DLD = 29). Children from Group 1 mostly had lower scores at one of the language levels, whereas those from Group 2 struggled at several language levels. Furthermore, children with DLD from both groups tended to be more sensitive to linguistic features such as word length, noun case, and sentence reversibility compared to TD children.

CONCLUSIONS

The presence of two mixed groups shows that children with diagnosed DLD could perform on par with TD children, whereas some younger TD children could perform similarly to children with DLD. Our findings support the continuum/spectrum model: Linguistic skills in preschool children are a continuum, varying from high to poor skills at all language levels in comprehension and production. To describe a child's language profile, the tasks assessing all language levels should be used.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25521400.

Morphosyntactic skills in Arabic-speaking children with autism spectrum disorder: Evidence from error patterns in the sentence repetition task

Background and aims

Although autism spectrum disorder (ASD) has not traditionally been associated with morphosyntactic impairments, some children with ASD manifest significant difficulties in this domain. Sentence Repetition (SRep) tasks are highly reliable tools for detecting morphosyntactic impairment in different languages and across various populations, including children with ASD. This study is among the first to evaluate morphosyntactic abilities of Palestinian-Arabic (PA) speaking children using a PA SRep task.

Methods

A total of 142 PA-speaking children, aged 5-11, participated in the study: 75 children with typical language development (TLD) and 67 children with ASD. The PA SRep task targeted morphosyntactic structures of varying complexity (simple subject-verb-object [SVO] sentences, biclausal sentences, wh-questions, relative clauses). Children's accuracy scores were assessed across these structures and error patterns encompassing morphosyntactic and pragmatic aspects were analyzed.

Results

Two subgroups of ASD emerged: 43% showed age-appropriate language skills (ASD  +  NL) pairing up with TLD peers, while 57% showed signs of morphosyntactic impairment (ASD  +  LI). Children in both groups exhibited a higher frequency of morphosyntactic errors than pragmatic ones. Children with ASD  +  LI showed difficulties with producing complex morphosyntactic structures, such as relative clauses and object wh-questions. Error analysis revealed that children in the ASD  +  LI group produced sentence fragments and simplified constructions when complex structures were targeted.

Conclusions

The current study extends the cross-linguistic evidence of the heterogeneity of morphosyntactic profiles in children with ASD to Arabic-speaking children. Error analysis indicates that poor morphosyntax, rather than pragmatics, challenges children's performance on the SRep task.

Implications

Our results emphasize the importance of comprehensive language assessment in children with ASD and underscore the need for tailored intervention plans targeting impaired morphosyntactic structures in some children with ASD.

Identifying Developmental Language Disorder in Deaf Children with Cochlear Implants: A Case Study of Three Children

(1) Background: While spoken language learning delays are assumed for deaf and hard of hearing (DHH) children after cochlear implant (CI), many catch up with their hearing peers. Some DHH children with CIs, however, show persistent delays in language, despite protective factors being in place. This suggests a developmental language disorder (DLD). However, at present there is little consensus on how to diagnose DLD in DHH children. (2) Methods: Given the lack of consensus in this area, a set of case studies provides an appropriate first step. The goal of this paper is to show the plausibility of a DLD diagnosis, following careful analysis of protective and risk factors. A retrospective case study review was conducted for three children. Their long-term language outcomes up to four years after CI were considered in the context of access to sound, speech sound discrimination, social skills and non-verbal cognition. (3) Results: It was possible to posit DLD in one child who had experienced good access to sound, alongside good speech discrimination abilities and social development, and normal non-verbal cognition, but who presented with severe language learning difficulties. (4) Conclusions: Finding markers for DLD in DHH children is important for diagnosis and intervention. The implications for clinical practice are discussed.

Sentence Repetition as a Clinical Marker of Developmental Language Disorder: Evidence From Arabic

PURPOSE

Research on the typical and impaired grammatical acquisition of Arabic is limited. This study systematically examined the morphosyntactic abilities of Arabic-speaking children with and without developmental language disorder (DLD) using a novel sentence repetition task. The usefulness of the task as an indicator of DLD in Arabic was determined.

METHOD

A LITMUS (Language Impairment Testing in Multilingual Settings) sentence repetition task was developed in Palestinian Arabic (LITMUS-SR-PA-72) and administered to 30 children with DLD (M = 61.50 months, SD = 11.27) and 60 age-matched typically developing (TD) children (M = 63.85 months, SD = 10.16). The task targeted grammatical structures known to be problematic for Arabic-speaking children with DLD (language specific) and children with DLD across languages (language independent). Responses were scored using binary, error, and structural scoring methods.

RESULTS

Children with DLD scored below TD children on the LITMUS-SR-PA-72, in general, and in the repetition of language-specific and language-independent structures. The frequency of morphosyntactic errors was higher in the DLD group relative to the TD group. Despite the large similarity of the type of morphosyntactic errors between the two groups, some atypical errors were exclusively produced by the DLD group. The three scoring methods showed good diagnostic power in the discrimination between children with DLD and children without DLD.

CONCLUSIONS

Sentence repetition was an area of difficulty for Palestinian Arabic-speaking children with DLD. The DLD group demonstrated difficulties with language-specific and language-independent structures, particularly complex sentences with noncanonical word order. Most grammatical errors made by the DLD group resembled those of the TD group and were mostly omissions or substitutions of grammatical affixes or omissions of function words. SR appears to hold promise as a good indicator for the presence or absence of DLD in Arabic. Further validation of these findings using population-based studies is warranted. Supplemental Material https://doi.org/10.23641/asha.16968043.

Sentence Repetition Tasks to Detect and Prevent Language Difficulties: A Scoping Review

Sentence repetition tasks (SRTs) have been widely used in language development research for decades. In recent years, there has been increasing interest in studying performance in SRTs as a clinical marker for language impairment. What are the characteristics of SRTs? For what purposes have SRTs been used? To what extent have they been used with young children, in different languages, and with different clinical populations? In order to answer these and other questions, we conducted a scoping review. Peer reviewed studies published in indexed scientific journals (2010-2021) were analyzed. A search in different databases yielded 258 studies. Research published in languages other than English or Spanish, adult samples, dissertations, case studies, artificial models, and theoretical publications were excluded. After this exclusion, 203 studies were analyzed. Our results show that most research using SRT were conducted with English monolingual speakers older than 5 years of age; studies with bilingual participants have mostly been published since 2016; and SRTs have been used with several non-typical populations. Research suggests that they are a reliable tool for identifying language difficulties and are specifically suitable for detecting developmental language disorder.

Contextual influences on sentence repetition as a tool for the identification of language impairment in Grade 3 Sepedi-English bilinguals: A case against bilingual norms

BACKGROUND

Specific language impairment (SLI) is difficult to identify because it is a subtle linguistic difficulty, and there are a few measures available to differentiate between typical and atypical language development in bilinguals. Sentence repetition (SR) has strong theoretical foundations and research evidence as a valid tool for the identification of SLI in bilinguals.

OBJECTIVE

This study assessed the value of SR using peer group comparisons to identify Sepedi-English bilingual children at the risk of SLI.

METHOD

One hundred and two Grade 3 learners in three different contexts of education were assessed on equivalent English and Sepedi SR measures.

RESULTS

Eleven participants who scored between 1 and 2 standard deviations (SD) below the peer group means on both the English and Sepedi SR tests were identified with possible SLI. Learners in the English language of learning and teaching (LoLT) - Sepedi additional language (SAL) context obtained similar scores in both languages, a higher score in English than the English LoLT group and a higher score in Sepedi than the Sepedi LoLT - EAL group. The English LoLT group obtained a significantly higher score in English than in Sepedi and a significantly lower score than the other two groups in Sepedi. The Sepedi LoLT group obtained a significantly higher score in Sepedi than in English, their additional language, in which they obtained a significantly lower score than the other two groups.

CONCLUSION

Sentence repetition tasks are valid screening tools to identify bilingual children with SLI by comparing them to peer groups. The SR tests were sensitive to language practices in different educational contexts. It was observed that a bilingual approach that uses both English and the home language as academic languages leads to better language outcomes.