Classification of children with specific language impairment: longitudinal considerations

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.

Communication in Daily Life of Children With Developmental Language Disorder: Parents' and Teachers' Perspectives

PURPOSE

This study explores limitations in communication in daily life of children with developmental language disorder (DLD) from their parents' perspective as well as communicative abilities and social functioning in the classroom from their teacher's perspective. Furthermore, differences between children with mixed receptive-expressive disorder and children with expressive-only disorder in communication in daily life and social functioning are studied.

METHOD

Data were collected through questionnaires completed by parents and teachers of children (5-6 years old) who attended schools for special education for DLD. Language test scores were retrieved from school records. Parents of 60 children answered open-ended questions about situations and circumstances in which their child was most troubled by language difficulties. Teachers of 83 children rated communicative abilities, social competence, and student-teacher relationship.

RESULTS

Parents reported communication with strangers as most troublesome and mentioned the influence of the mental state of their child. Parents considered limitations in expressing oneself and being understood and not being intelligible as core difficulties. Teachers rated the children's communicative abilities in the school context as inadequate, but their scores concerning social competence and the quality of teacher-child relationships fell within the normal range. Children with receptive-expressive disorder experienced limitations in communication in almost all situations, whereas those with expressive disorder faced limitations in specific situations. Children with receptive-expressive disorder were also significantly more limited in their communicative abilities and social competence at school than children with expressive disorder. No differences were found between the two groups in the quality of the teacher-child relationship.

CONCLUSIONS

The results confirm that children with DLD face significant challenges in a variety of communicative situations. We found indications that children with receptive-expressive disorder experience more severe limitations than children with expressive disorder. The involvement of parents and teachers in evaluating a child's communicative ability provides valuable and clinically relevant information.

Selective short-term memory impairment for verbalizable visual objects in children with Developmental Language Disorder

BACKGROUND

Developmental language disorder (DLD) affects the ability to acquire and make use of native language. Possible underlying cognitive mechanisms are related to memory functions.

AIMS

The aim was examination of the relationship between visual short-term memory of objects as well as audiovisual short-term memory, and particular nonverbal and language abilities.

METHODS AND PROCEDURES

The study included 7-9-year-old children with DLD and matched control group. Participants completed the Language Development Test, the Stanford-Binet IQ scale (SB5), and two short-term memory tasks: immediate recall of the visually presented pictograms and immediate recall of audiovisually presented sequences of syllables.

OUTCOMES AND RESULTS

The results revealed diminished levels of short-term visual memory for objects as well as audiovisual memory in children with DLD. However, there were no group differences in the control task of WM.

CONCLUSIONS AND IMPLICATIONS

Results supported the idea of diminished abilities in children with DLD to perform mental operations on verbalizable visual objects. Importantly non-verbal working memory ability, which cannot easily be supported by verbal representations, is at typical levels. This suggests that verbalization ability should be taken into account in the assessment of seemingly non-verbal cognitive functions among children with DLD.

The role of language in mental health during the transition from primary to secondary education

We report a preregistered analysis to test whether children meeting diagnostic criteria for language disorder (LD) have higher self-reported and/or parent-reported mental health symptoms during the transition from primary to secondary education. Data are from a UK-based longitudinal cohort study, The Surrey Communication and Language in Education Study (SCALES). SCALES oversampled children at risk of LD at school entry. Language was measured using a battery of standardised assessments in Year 1 (age 5-6 years, n = 529), and mental health symptoms were measured using self and parent report in Year 6 (age 10-11 years, n = 384) and Year 8 (age 12-13 years, n = 246). Social experiences were also measured using self-report measures in Year 6. Mental health symptoms were stable during the transition from primary to secondary school. Symptom rates did not differ between children with and without LD based on self-report, but children with LD had higher parent-reported mental health symptoms than their peers with typical language. Similarly, early language was negatively associated with parent-reported but not self-reported mental health symptoms. Early language was associated with fewer child-reported positive social experiences in Year 6, but social experiences did not mediate the association between language and mental health. We found poor agreement between parent and self-reported child mental health symptoms across language groups. Future studies should aim to determine sources of disagreement between parent and child report, particularly for children with communication difficulties who may struggle to accurately self-report mental health symptoms.

Cognitive predictors of language abilities in primary school children: A cascaded developmental view

This study investigated the longitudinal relationship between children's domain-general cognitive constraints underlying phonological and sentence processing development in a big sample of typically developing children. 104 children were tested on non-linguistic processing speed, phonological skills (phonological short term memory, phonological knowledge, phonological working memory), and sentence processing abilities (sentence repetition and receptive grammar) in 1^st grade (aged 6 to 6.5) and one year later. A cross-lagged structural equation model showed that non-linguistic processing speed was a concurrent predictor of phonological skills, and that phonology had a powerful effect on the child's sentence processing abilities concurrently and longitudinally, providing clear evidence for the role of domain-general processes in the developmental pathway of language. These findings support a cascaded cognitive view of language development and pose important challenges for evaluation and intervention strategies in childhood.

Nonverbal Switching Ability of Monolingual and Bilingual Children with and without Developmental Language Disorder

Bilingualism is associated with enhanced switching skills, while a developmental language disorder (DLD) may negatively impact switching ability. However, both studies with bilinguals as well as studies including children with DLD have revealed mixed results. Moreover, the interaction of bilingualism and DLD has not been addressed and the origin of the stronger or weaker switching performance is unknown. The current study aimed to fill these gaps. Monolingual and bilingual children with and without DLD (n = 32 in each of the four groups) completed a nonverbal color/shape switching task when they were 7 to 8 years old, and a Continuous Performance Task two years earlier. The latter tapped into their response inhibition and sustained attention skills, which may underlie switching ability. No differences between monolinguals and bilinguals were found on the switching task. Children with DLD had higher mixing costs than peers without DLD, which was driven by differences in sustained attention skills. These results add to the body of research indicating that the cognitive advantages of bilingualism are unstable. Additionally, the results substantiate the hypothesis that attention processes are foundational for complex cognitive skills, such as switching, and suggest cascading effects for children with weaker attention skills, such as children with DLD.

Focus on the Narrative Skills of Teenagers With Developmental Language Disorder and High Functioning Autism

Purpose: Narratives of personal experiences emerge early in language acquisition and are particularly commonly experienced in children’s daily lives. To produce these stories, children need to develop narrative, linguistic, and social-cognitive skills. Research has shown that these skills are impaired in children with developmental language disorder (DLD) and high functioning autism (HFA).

Aim: This study aimed to determine whether narrative skills are still impaired in adolescence and to highlight the language similarities and differences between teenagers with DLD and HFA in the production of a narrative of a personal experience.

Method: Ten teenagers with DLD, 10 teenagers with HFA and 10 typically developing (TD) teenagers, matched on chronological age, told a narrative of a personal experience. These stories were analyzed to evaluate narrative skills through coherence (respect of the narrative schema) and cohesion (anaphora and connectors) and social-cognitive skills (affective and cognitive mental states of the characters, and arbitrary vocalizations such as voice noises).

Results: Teenagers with DLD were less compliant with the complication step in the narrative schema than teenagers with HFA or TD. No difference was observed between the three groups of teenagers in terms of cohesion or regarding the positive and negative social-cognitive skills used in narratives.

Conclusion: When producing a narrative of a personal experience, HFA teens do not have difficulties neither with narrative skills and with social-cognitive skills assessed in this paper. In DLD the profile of the teens is not the same: They do not have difficulties with social-cognitive skills and with a part of narrative skills (cohesion), and they have difficulties with the narrative schema.

Executive Function, Working Memory, and Verbal Fluency in Relation to Non-Verbal Intelligence in Greek-Speaking School-Age Children with Developmental Language Disorder

Developmental Language Disorder (DLD) is often associated with impairments in working memory (WM), executive functions (EF), and verbal fluency. Moreover, increasing evidence shows poorer performance of children with DLD on non-verbal intelligence tests relative to their typically developing (TD) peers. Yet, the degree and generality of relevant difficulties remain unclear. The present study aimed at investigating WM capacity, key EFs and verbal fluency in relation to non-verbal intelligence in Greek-speaking school-age children with DLD, compared to TD peers (8–9 years). To our knowledge, the present study is the first to attempt a systematic relevant assessment with Greek-speaking school-age children, complementing previous studies mostly involving English-speaking participants. The results showed that children with DLD scored lower than TD peers on the non-verbal intelligence measure. Groups did not differ in the inhibition measures obtained (tapping resistance to either distractor or proactive interference), but children with DLD were outperformed by TD peers in the WM capacity, updating, monitoring (mixing cost), and verbal fluency (phonological and semantic) measures. The effects showed limited (in the case of backward digit recall) or no dependence on non-verbal intelligence. Findings are discussed in terms of their theoretical and practical implications as well as in relation to future lines of research.

Do Children With Developmental Language Disorder (DLD) Have Difficulties With Interference Control, Visuospatial Working Memory, and Selective Attention? Developmental Patterns and the Role of Severity and Persistence of DLD

Purpose Many children with developmental language disorder (DLD) have weaknesses in executive functioning (EF), specifically in tasks testing interference control and working memory. It is unknown how EF develops in children with DLD, if EF abilities are related to DLD severity and persistence, and if EF weaknesses expand to selective attention. This study aimed to address these gaps. Method Data from 78 children with DLD and 39 typically developing (TD) children were collected at three times with 1-year intervals. At Time 1, the children were 5 or 6 years old. Flanker, Dot Matrix, and Sky Search tasks tested interference control, visuospatial working memory, and selective attention, respectively. DLD severity was based on children's language ability. DLD persistence was based on stability of the DLD diagnosis. Results Performance on all tasks improved in both groups. TD children outperformed children with DLD on interference control. No differences were found for visuospatial working memory and selective attention. An interference control gap between the DLD and TD groups emerged between Time 1 and Time 2. Severity and persistence of DLD were related to interference control and working memory; the impact on working memory was stronger. Selective attention was unrelated to DLD severity and persistence. Conclusions Age and DLD severity and persistence determine whether or not children with DLD show EF weaknesses. Interference control is most clearly impaired in children with DLD who are 6 years and older. Visuospatial working memory is impaired in children with severe and persistent DLD. Selective attention is spared.

Quantitative genome-wide association analyses of receptive language in the Danish High Risk and Resilience Study

BACKGROUND

One of the most basic human traits is language. Linguistic ability, and disability, have been shown to have a strong genetic component in family and twin studies, but molecular genetic studies of language phenotypes are scarce, relative to studies of other cognitive traits and neurodevelopmental phenotypes. Moreover, most genetic studies examining such phenotypes do not incorporate parent-of-origin effects, which could account for some of the heritability of the investigated trait. We performed a genome-wide association study of receptive language, examining both child genetic effects and parent-of-origin effects.

RESULTS

Using a family-based cohort with 400 children with receptive language scores, we found a genome-wide significant paternal parent-of-origin effect with a SNP, rs11787922, on chromosome 9q21.31, whereby the T allele reduced the mean receptive language score by ~ 23, constituting a reduction of more than 1.5 times the population SD (P = 1.04 × 10-8). We further confirmed that this association was not driven by broader neurodevelopmental diagnoses in the child or a family history of psychiatric diagnoses by incorporating covariates for the above and repeating the analysis.

CONCLUSIONS

Our study reports a genome-wide significant association for receptive language skills; to our knowledge, this is the first documented genome-wide significant association for this phenotype. Furthermore, our study illustrates the importance of considering parent-of-origin effects in association studies, particularly in the case of cognitive or neurodevelopmental traits, in which parental genetic data are not always incorporated.

Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

BACKGROUND

Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision.

AIMS

To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification.

METHODS & PROCEDURES

A database of 11,450 children was analysed consisting of data on children, aged 2-7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono- and bilingualism, nature of the language delay, and language profile of the children.

OUTCOMES & RESULTS

Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems.

CONCLUSIONS & IMPLICATIONS

This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children. What this paper adds What is already known on the subject Identifying language disorders before children enter school can foster the initiation of early interventions before these problems interfere with formal education and behavioural adjustment. Information on caseload characteristics is important to plan speech and language therapy service provision. There are only a few studies on the caseload characteristics of children at first referral for language assessment. What this paper adds to existing knowledge This study provides a detailed description of the caseload characteristics of children referred to Dutch speech and hearing centres. The results reveal an age bias in referral: boys were referred earlier than girls, and monolingual children were revealed earlier than bilingual children. On top of that, bilingual children seemed to have more complex problems at referral. What are the potential or actual clinical implications of this work? This study indicates that it is important to be aware of bias in the age of referral of subgroups of children with language disorders. Solutions might be to implement a language screening instrument designed for use by non-speech-language therapists, and training in early recognition of girls and multilingual children with (less complex) language disorders for health professionals in key positions in child healthcare. In addition, it might be worthwhile to assign speech and language therapists with diverse ethnic and language backgrounds and/or with experience with bilingual/cultural children in a regional mentoring function to support referral agents and parents.

Screening for the Identification of Oral Language Difficulties in Brazilian Preschoolers: A Validation Study

Purpose This study aimed to develop and validate a screening questionnaire for the early identification of language difficulties in Brazilian Portuguese-speaking preschool children. Method The article is divided into two studies. In the first study, we reported the theoretical principles that guided the development of the Screening for Identification of Oral Language Difficulties by Preschool Teachers (SIOLD) and tested the validity of its structure. The psychometric properties of the SIOLD were tested using a sample of 754 children attending Year 1 of preschool. Thirty-two teachers coming from eight different schools completed individual questionnaires for all their students. Confirmatory factor analysis was used to assess the validity of the SIOLD. In the second study, we investigated the accuracy of the questionnaire for identifying children with oral language difficulties using a different sample of 100 preschool children. Using receiver operating characteristic and precision recall curves, we assessed the sensitivity and specificity of the SIOLD to identify children who showed impaired language performance in a short battery of tests. Results The SIOLD has been shown to be a valid and accurate questionnaire for assessing the form and content of oral language in preschool children. It showed good accuracy, with sensitivity ranging between .750 and .857 and specificity of .946 for the identification of language difficulties. Among the cases positively identified by the SIOLD as having language difficulties, 54.5% were true cases of language disorders, while 45.5% were false alarms. The combination of these findings shows that the SIOLD overpredicts positive cases but identifies most children with true language disorders and passes most children without language disorders, as required of a good screening test. Conclusions The questionnaire provides a useful tool for enabling Brazilian teachers to refer children with language difficulties to the speech-language services. The theoretical and clinical implications are discussed.

A View of the Lexical-Grammatical Link in Young Latinos With Specific Language Impairment Using Language-Specific and Conceptual Measures

Purpose This study investigated the nature of the association of lexical-grammatical abilities within and across languages in Latino dual language learners (DLLs) with specific language impairment (SLI) using language-specific and bilingual measures. Method Seventy-four Spanish/English-speaking preschoolers with SLI from preschools serving low-income households participated in the study. Participants had stronger skills in Spanish (first language [L1]) and were in the initial stages of learning English (second language [L2]). The children's lexical, semantic, and grammar abilities were assessed using normative and researcher-developed tools in English and Spanish. Hierarchical linear regressions of cross-sectional data were conducted using measures of sentence repetition tasks, language-specific vocabulary, and conceptual bilingual lexical and semantic abilities in Spanish and English. Results Results indicate that language-specific vocabulary abilities support the development of grammar in L1 and L2 in this population. L1 vocabulary also contributes to L2 grammar above and beyond the contribution of L2 vocabulary skills. However, the cross-linguistic association between vocabulary in L2 and grammar skills in the stronger or more proficient language (L1) is not observed. In addition, conceptual vocabulary significantly supported grammar in L2, whereas bilingual semantic skills supported L1 grammar. Conclusions Our findings reveal that the same language-specific vocabulary abilities drive grammar development in L1 and L2 in DLLs with SLI. In the early stages of L2 acquisition, vocabulary skills in L1 also seem to contribute to grammar skills in L2 in this population. Thus, it is critical to support vocabulary development in both L1 and L2 in DLLs with SLI, particularly in the beginning stages of L2 acquisition. Clinical and educational implications are discussed.

Behind the Scenes of Developmental Language Disorder: Time to Call Neuropsychology Back on Stage

Although the Developmental Language Disorder (DLD), also known as Specific Language Impairment in children has been the focus of unceasing scientific attention for decades, the nature and mechanisms of this disorder remain unclear. Most importantly, we still cannot reliably identify children requiring urgent intervention among other ‘late talkers’ at an early age and understand the high prevalence of comorbidity with psychiatric phenomena such as Autism Spectrum Disorder. One of the main reasons for this is the traditional ‘diagnosis-by-exclusion,’ resulting in heterogeneity of the DLD population. This paper proposes an alternative approach to the diagnosis, treatment and research of DLD, claiming that it is these children’s multiple deficits in neuropsychological development, which impede the spontaneous acquisition of their first language. Specifically, this review of the state-of-the-art in DLD research demonstrates deep and systematic interconnections between the speech and other higher cognitive functions developing in early childhood, including perception, attention and executive functions. In the proposed framework, speech is, therefore, considered as one of neuropsychological abilities, and the delay in its development is explained by other neuropsychological deficits, resulting in highly individual clinical profiles. By considering DLD as a complex neuropsychological syndrome, whose successful treatment depends on a holistic approach to diagnosis and intervention, we may significantly increase the efficacy of speech therapy, and also better understand the flexibility of the developing brain, its compensatory mechanisms and hence the comorbidity of DLD with psychiatric symptoms. Implications for using this paradigm in future scientific research are discussed.

Reconceptualizing developmental language disorder as a spectrum disorder: issues and evidence

BACKGROUND

There is considerable variability in the presentation of developmental language disorder (DLD). Disagreement amongst professionals about how to characterize and interpret the variability complicates both the research on understanding the nature of DLD and the best clinical framework for diagnosing and treating children with DLD. We describe and statistically examine three primary possible models for characterizing the variability in presentation in DLD: predictable subtypes; individual differences; and continuum/spectrum.

AIMS

To test these three models of DLD in a population-based sample using two distinct types of cluster analyses.

METHODS & PROCEDURES

This study included children with DLD (n = 505) from the US Epidemiological Study of Language Impairment database. All available language and cognitive measures were included. Two cluster methods were used: Ward's method and K-means. Optimal cluster sizes were selected using Bayesian information criteria (BIC). Bootstrapping and permutation methods were used to evaluate randomness of clustering.

OUTCOMES & RESULTS

Both clustering analyses yielded more than 10 clusters, and the clusters did not have spatial distinction: many of these clusters were not clinically interpretable. However, tests of random clustering revealed that the cluster solutions obtained did not arise from random aggregation.

CONCLUSIONS & IMPLICATIONS

Non-random clustering coupled with a large number of non-interpretable subtypes provides empirical support for the continuum/spectrum and individual differences models. Although there was substantial support for the continuum/spectrum model and weaker support for the individual differences model, additional research testing these models should be completed. Based on these results, clinicians working with children with DLD should focus on creating treatment plans that address the severity of functioning rather than seeking to identify and treat distinct subtypes. Additional consideration should be given to reconceptualizing DLD as a spectrum condition.

Do emotional difficulties and peer problems occur together from childhood to adolescence? The case of children with a history of developmental language disorder (DLD)

Children and adolescents with developmental language disorder (DLD) are, overall, vulnerable to difficulties in emotional adjustment and in peer relations. However, previous research has shown that different subgroups follow different trajectories in respect to the quality of peer relations. Less is known about the trajectories of emotional development. We consider here the possibility that development in these two domains is interrelated: that is, the trajectories of emotional and peer problems will proceed in parallel. We conducted longitudinal joint trajectories analyses of emotional and peer relations in a sample of young people identified as having DLD at the age of 7 years and seen at intervals up to 16 years. Potential influences on joint trajectory group membership were examined. Findings revealed five distinct joint trajectories. Emotional and peer difficulties do occur together from childhood to adolescence for just over half of the sample, but not all. The variables most clearly associated with group membership were pragmatic language ability, prosociality and parental mental health. This is the first study to examine joint longitudinal trajectories of emotional and peer difficulties in individuals with DLD. We demonstrate that development in individuals with DLD is heterogeneous and identify three key variables associated with personal and social adjustment from childhood to adolescence. Theoretical and clinical implications of these findings are discussed.

Discriminating autism and language impairment and specific language impairment through acuity of musical imagery

Deficits in auditory short-term memory have been widely reported in children with Specific Language Impairment (SLI), and recent evidence suggests that children with Autism Spectrum Disorder and co-morbid language impairment (ALI) experience similar difficulties. Music, like language relies on auditory memory and the aim of the study was to extend work investigating the impact of auditory short-term memory impairments to musical perception in children with neurodevelopmental disorders. Groups of children with SLI and ALI were matched on chronological age (CA), receptive vocabulary, non-verbal intelligence and digit span, and compared with CA matched typically developing (TD) controls, on tests of pitch and temporal acuity within a voluntary musical imagery paradigm. The SLI participants performed at significantly lower levels than the ALI and TD groups on both conditions of the task and their musical imagery and digit span scores were positively correlated. In contrast ALI participants performed as well as TD controls on the tempo condition and better than TD controls on the pitch condition of the task. Whilst auditory short-term memory and receptive vocabulary impairments were similar across ALI and SLI groups, these were not associated with a deficit in voluntary musical imagery performance in the ALI group.

Feasibility of event-related potential (ERP) biomarker use to study effects of mother's voice exposure on speech sound differentiation of preterm infants

Atypical maturation of auditory neural processing contributes to preterm-born infants' language delays. Event-related potential (ERP) measurement of speech-sound differentiation might fill a gap in treatment-response biomarkers to auditory interventions. We evaluated whether these markers could measure treatment effects in a quasi-randomized prospective study. Hospitalized preterm infants in passive or active, suck-contingent mother's voice exposure groups were not different at baseline. Post-intervention, the active group had greater increases in/du/-/gu/differentiation in left frontal and temporal regions. Infants with brain injury had lower baseline/ba/-/ga/and/du/-/gu/differentiation than those without. ERP provides valid discriminative, responsive, and predictive biomarkers of infant speech-sound differentiation.

Two Grammatical Tasks for Screening Language Abilities in Spanish-Speaking Children

PURPOSE

This study assessed concurrent validity evidence for 2 grammatical tasks of a new screener, the Tamiz de Problemas de Lenguaje, for identifying monolingual Spanish-speaking children at risk for specific language impairment with grammatical deficits.

METHOD

A total of 770 4- to 6-year-old monolingual, Spanish-speaking children with and without language impairment were sampled from 3 different states in Mexico. Multiple logistic regression and receiver operating characteristic curve analyses were conducted to assess the predictive utility of the model and the classification accuracy of the tasks. The criterion was diagnosis of specific language impairment with grammatical deficits on the basis of a comprehensive language assessment.

RESULTS

Results indicated that sensitivity estimates ranged from .90 to .94 and specificity estimates from .83 to .92. Overall, there was a good balance between sensitivity and specificity estimates with moderate to large positive and negative likelihood ratios.

CONCLUSION

Results suggested that the 2 grammatical tasks are suitable for identifying 4- to 6-year-old monolingual Spanish-speaking children at risk for grammatical deficits.

ASD Is Not DLI: Individuals With Autism and Individuals With Syntactic DLI Show Similar Performance Level in Syntactic Tasks, but Different Error Patterns

Do individuals with autism have a developmental syntactic impairment, DLI (formerly known as SLI)? In this study we directly compared the performance of 18 individuals with Autism Spectrum Disorder (ASD) aged 9;0–18;0 years with that of 93 individuals with Syntactic-Developmental Language Impairment (SyDLI) aged 8;8–14;6 (and with 166 typically-developing children aged 5;2–18;1). We tested them using three syntactic tests assessing the comprehension and production of syntactic structures that are known to be sensitive to syntactic impairment: elicitation of subject and object relative clauses, reading and paraphrasing of object relatives, and repetition of complex syntactic structures including Wh questions, relative clauses, topicalized sentences, sentences with verb movement, sentences with A-movement, and embedded sentences. The results were consistent across the three tasks: the overall rate of correct performance on the syntactic tasks is similar for the children with ASD and those with SyDLI. However, once we look closer, they are very different. The types of errors of the ASD group differ from those of the SyDLI group—the children with ASD provide various types of pragmatically infelicitous responses that are not evinced in the SyDLI or in the age equivalent typically-developing groups. The two groups (ASD and SyDLI) also differ in the pattern of performance—the children with SyDLI show a syntactically-principled pattern of impairment, with selective difficulty in specific sentence types (such as sentences derived by movement of the object across the subject), and normal performance on other structures (such as simple sentences). In contrast, the ASD participants showed generalized low performance on the various sentence structures. Syntactic performance was far from consistent within the ASD group. Whereas all ASD participants had errors that can originate in pragmatic/discourse difficulties, seven of them had completely normal syntax in the structures we tested, and were able to produce, understand, and repeat relative clauses, Wh questions, and topicalized sentences. Only one ASD participant showed a syntactically-principled deficit similar to that of individuals with SyDLI. We conclude that not all individuals with ASD have syntactic difficulties, and that even when they fail in a syntactic task, this does not necessarily originate in a syntactic impairment. This shows that looking only at the total score in a syntactic test may be insufficient, and a fuller picture emerges once the performance on different structures and the types of erroneous responses are analyzed.

Which Preschool Children With Specific Language Impairment Receive Language Intervention?

Purpose

Potential biases in service provision for preschool children with specific language impairment (SLI) were explored.

Method

In Study 1, children with SLI receiving treatment (SLI-T) and those with SLI not receiving treatment (SLI-NT) were compared on demographic characteristics and developmental abilities. Study 2 recruited children with articulation disorders receiving treatment (ARTIC-T) to determine if knowing service provision status influenced the results of Study 1.

Results

In Study 1, the SLI-T group was rated by teachers as having poorer executive functioning than children in the SLIT-NT group, and the SLI-T group also came from families whose mothers had more education. These 2 variables alone predicted SLI-T and SLI-NT group membership with 84% accuracy. In Study 2, the ARTIC-T group were perceived as having comparable executive functioning to the SLI-NT group and better than the SLI-T group, indicating that teachers' knowledge of service provision did not influence their ratings of children's executive functioning.

Discussion

Preschool children with SLI, whose mothers have higher education levels and whose teachers perceive them as having poorer executive functioning, are more likely to receive intervention. Recognizing service delivery biases is critical for improving early provision of intervention for this population.

Retelling stories: Grammatical and lexical measures for identifying monolingual spanish speaking children with specific language impairment (SLI)

Children with Specific Language Impairment (SLI) have grammatical and lexical difficulties when telling stories. The aim of this work was to explore whether language productivity measures, such as mean length of utterance (MLU), percentage of ungrammatical sentences (%UGS), total number of words (TNW), and number of different words (NDW) produced by young children during a story retell task, can be used to accurately differentiate monolingual Spanish-speaking children with SLI from children with typical language development (TLD). Fifty monolingual Spanish-speaking children between 4; 0 and 6; 11 years were assigned to one of two groups: 25 children with SLI and 25 TLD age-matched peers. A scripted picture book was read to each child and the child was subsequently asked to retell the story using pictures. Story retells were analyzed for MLU, %UGS, TNW, and NDW. Results showed significant differences between groups on all four measures. Children with SLI showed significantly lower MLU, TNW and NDW, and significantly higher%UGS when compared with age-matched peers with TLD. Results suggest that measures of language productivity obtained during story retells may be used to accurately detect differences in language performance and differentiate monolingual Spanish-speaking children with SLI from their typical peers. The findings from this study have clinical implications for assessment and identification of monolingual Spanish-speaking children with language impairments.

Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology

BACKGROUND

Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology.

METHODS

The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities.

RESULTS

We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term 'Language Disorder' is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, 'Developmental Language Disorder' (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co-occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability.

CONCLUSIONS

This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.

Identifying the Dimensionality of Oral Language Skills of Children With Typical Development in Preschool Through Fifth Grade

PURPOSE

Language is a multidimensional construct from prior to the beginning of formal schooling to near the end of elementary school. The primary goals of this study were to identify the dimensionality of language and to determine whether this dimensionality was consistent in children with typical language development from preschool through 5th grade.

METHOD

In a large sample of 1,895 children, confirmatory factor analysis was conducted with 19-20 measures of language intended to represent 6 factors, including domains of vocabulary and syntax/grammar across modalities of expressive and receptive language, listening comprehension, and vocabulary depth.

RESULTS

A 2-factor model with separate, highly correlated vocabulary and syntax factors provided the best fit to the data, and this model of language dimensionality was consistent from preschool through 5th grade.

CONCLUSION

This study found that there are fewer dimensions than are often suggested or represented by the myriad subtests in commonly used standardized tests of language. The identified 2-dimensional (vocabulary and syntax) model of language has significant implications for the conceptualization and measurement of the language skills of children in the age range from preschool to 5th grade, including the study of typical and atypical language development, the study of the developmental and educational influences of language, and classification and intervention in clinical practice.

SUPPLEMENTAL MATERIALS

https://doi.org/10.23641/asha.5154220.

Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children With Language Impairments

Purpose

The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment.

Method

This tutorial reviews the framework of the ICF, describes the implications of the ICF for SLPs, distinguishes between students' capacity to perform a skill in a structured context and the actual performance of that skill in naturalistic contexts, and provides a case study of an elementary school child to demonstrate how the principles of the ICF can guide assessment and intervention.

Implications

The Scope of Practice and Preferred Practice documents for the American Speech-Language-Hearing Association identify the ICF as the framework for practice in speech-language pathology. This tutorial will facilitate clinicians' ability to identify personal and environmental factors that influence students' skill capacity and skill performance, assess students' capacity and performance, and develop impairment-based and socially based language goals linked to Common Core State Standards that build students' language capacity and their communicative performance in naturalistic contexts.

Exploring the learnability and usability of a near field communication-based application for semantic enrichment in children with language disorders

Recently, a few software applications (apps) have been developed to enhance vocabulary and conceptual networks to address the needs of children with language impairments (LI), but there is no evidence about their impact and their usability in therapy contexts. Here, we try to fill this gap presenting a system aimed at improving the semantic competence and the structural knowledge of children with LI. The goal of the study is to evaluate learnability, usability, user satisfaction and quality of the interaction between the system and the children. The system consists of a tablet, hosting an app with educational and training purposes, equipped with a Near Field Communication (NFC) reader, used to interact with the user by means of objects. Fourteen preschool children with LI played with the device during one 45-minute speech therapy session. Reactions and feedbacks were recorded and rated. The system proved to be easy to understand and learn, as well as engaging and rewarding. The success of the device probably rests on the integration of smart technology and real, tangible objects. The device can be seen as a valuable aid to support and enhance communication abilities in children with LI as well as typically developing individuals.

Predictors of Language Gains Among School-Age Children With Language Impairment in the Public Schools

PURPOSE

This study aimed to identify child-level characteristics that predict gains in language skills for children with language impairment who were receiving therapy within the public schools. The therapy provided represented business-as-usual speech/language treatment provided by speech-language pathologists in the public schools.

METHOD

The sample included 272 kindergartners and first-graders with language impairment who participated in a larger study titled "Speech-Therapy Experiences in the Public Schools." Multilevel regression analyses were applied to examine the extent to which select child-level characteristics, including age, nonverbal cognition, memory, phonological awareness, vocabulary, behavior problems, and self-regulation, predicted children's language gains over an academic year. Pratt indices were computed to establish the relative importance of the predictors of interest.

RESULTS

Phonological awareness and vocabulary skill related to greater gains in language skills, and together they accounted for nearly 70% of the explained variance, or 10% of total variance at child level. Externalizing behavior, nonverbal cognition, and age were also potentially important predictors of language gains.

CONCLUSIONS

This study significantly advances our understanding of the characteristics of children that may contribute to their language gains while receiving therapy in the public schools. Researchers can explore how these characteristics may serve to moderate treatment outcomes, whereas clinicians can assess how these characteristics may factor into understanding treatment responses.

The Role of Frequency in Learning Morphophonological Alternations: Implications for Children With Specific Language Impairment

PURPOSE

The aim of this article was to explore how the type of allomorph (e.g., past tense buzz[d] vs. nod[əd]) influences the ability to perceive and produce grammatical morphemes in children with typical development and with specific language impairment (SLI).

METHOD

The participants were monolingual Australian English-speaking children. The SLI group included 13 participants (mean age = 5;7 [years;months]); the control group included 19 children with typical development (mean age = 5;4). Both groups performed a grammaticality judgment and elicited production task with the same set of nonce verbs in third-person singular and past tense forms.

RESULTS

Five-year-old children are still learning to generalize morphophonological patterns to novel verbs, and syllabic /əz/ and /əd/ allomorphs are significantly more challenging to produce, particularly for the SLI group. The greater phonetic content of these syllabic forms did not enhance perception.

CONCLUSIONS

Acquisition of morphophonological patterns involving low-frequency allomorphs is still underway in 5-year-old children with typical development, and it is even more protracted in SLI populations, despite these patterns being highly predictable. Children with SLI will therefore benefit from targeted intervention with low-frequency allomorphs.

Learning to drive in young adults with language impairment

Language impairment (LI) is a common developmental disorder which affects many aspects of young people's functional skills and engagement with society. Little is known of early driving behaviour in those with this disability. This longitudinal study examines early driving experience in a sample of young adults with LI, compared with a sample of typically developing age-matched peers (AMPs). At age 24 years, significantly fewer participants with LI had acquired a driving licence. A crucial hurdle for those with LI appeared to be the Theory part of the (UK) test. Logistic regression analysis indicated that language ability and a measure of independence at age 17 contributed to the prediction of licence possession at age 24. There was no evidence of differences in traffic violations or accident rates between those with and without LI. There is little evidence that young people with LI are at greater risk on the roads than peers without LI, but some individuals with LI might benefit from support in the course of preparation for driving and in the driving test.

Defining language impairments in a subgroup of children with autism spectrum disorder

Autism spectrum disorder (ASD) is diagnosed on the basis of core impairments in pragmatic language skills, which are found across all ages and subtypes. In contrast, there is significant heterogeneity in language phenotypes, ranging from nonverbal to superior linguistic abilities, as defined on standardized tests of vocabulary and grammatical knowledge. The majority of children are verbal but impaired in language, relative to age-matched peers. One hypothesis is that this subgroup has ASD and co-morbid specific language impairment (SLI). An experiment was conducted comparing children with ASD to children with SLI and typically developing controls on aspects of language processing that have been shown to be impaired in children with SLI: repetition of nonsense words. Patterns of performance among the children with ASD and language impairment were similar to those with SLI, and contrasted with the children with ASD and no language impairment and typical controls, providing further evidence for the hypothesis that a subgroup of children with ASD has co-morbid SLI. The findings are discussed in the context of brain imaging studies that have explored the neural bases of language impairment in ASD and SLI, and overlap in the genes associated with elevated risk for these disorders.

Intrafamilial phenotypic variability of Specific Language Impairment

We investigated language functions in 32 members of a four generation family with several members affected by Specific Language Impairment with an extensive language test battery in order to determine the prevalence, overlap, and homogeneity of linguistic deficits within one pedigree. In sum, one fourth of all family members tested fulfilled the criteria of Specific Language Impairment. Despite of some similarities in language abilities, different combinations of language deficits were observed, and individual language profiles varied substantially. Thus, though there is a high prevalence of language deficits in this family which raises the likelihood of a genetic origin of these deficits, and though all affected study participants displayed selective linguistic deficits with normal non-verbal functioning, language testing showed considerable variance in overlap and homogeneity of linguistic deficits. Thus, even in one genetic population, an underlying linguistic disorder manifests itself in different language abilities to a variant degree.

Depression and Anxiety Change from Adolescence to Adulthood in Individuals with and without Language Impairment

This prospective longitudinal study aims to determine patterns and predictors of change in depression and anxiety from adolescence to adulthood in individuals with language impairment (LI). Individuals with LI originally recruited at age 7 years and a comparison group of age-matched peers (AMPs) were followed from adolescence (16 years) to adulthood (24 years). We determine patterns of change in depression and anxiety using the Child Manifest Anxiety Scale-Revised (CMAS-R) and Short Moods and Feelings Questionnaire (SMFQ). In addition to examining associations with gender, verbal and nonverbal skills, we use a time-varying variable to investigate relationships between depression and anxiety symptoms and transitions in educational/employment circumstances. The results show that anxiety was higher in participants with LI than age matched peers and remained so from adolescence to adulthood. Individuals with LI had higher levels of depression symptoms than did AMPs at 16 years. Levels in those with LI decreased post-compulsory schooling but rose again by 24 years of age. Those who left compulsory school provision (regardless of school type) for more choice-driven college but who were not in full-time employment or study by 24 years of age were more likely to show this depression pathway. Verbal and nonverbal skills were not predictive of this pattern of depression over time. The typical female vulnerability for depression and anxiety was observed for AMPs but not for individuals with LI. These findings have implications for service provision, career/employment advice and support for individuals with a history of LI during different transitions from adolescence to adulthood.

Grammatical morphology is not a sensitive marker of language impairment in Icelandic in children aged 4-14 years

PURPOSE

Grammatical morphology continues to be widely regarded as an area of extraordinary difficulty in children with Specific Language Impairment (SLI). A main argument for this view is the purported high diagnostic accuracy of morphological errors for the identification of SLI. However, findings are inconsistent across age groups and across languages. Studies show morphological difficulty to be far less pronounced in more highly inflected languages and the diagnostic accuracy of morphology in such languages is largely unknown. This study examines the morphological use of Icelandic children with and without SLI in a cross-sectional sample of children ranging from preschool age to adolescence and assesses the usefulness of morphology as a clinical marker to identify SLI.

METHODS

Participants were 57 monolingual Icelandic-speaking children age 4-14 years; 31 with SLI and 26 with typical language development (TD). Spontaneous language samples were coded for correct and incorrect use of grammatical morphology. The diversity of use of grammatical morphemes was documented for each group at different age and MLU levels. Individual accuracy scores were plotted against age as well as MLU and diagnostic accuracy was calculated.

RESULTS

MLU and morphological accuracy increased with age for both children with SLI and TD, with the two groups gradually approaching each other. Morphological diversity and sequence of acquisition was similar across TD and SLI groups compared based on age or MLU. Morphological accuracy was overall high, but was somewhat lower in the SLI group, in particular at ages below 12 years and MLU levels below 6.0. However, overlap between the groups was important in all age groups, involving a greater tendency for errors in both groups at young ages and scores close to or at ceiling at older ages. Sensitivity rates as well as likelihood ratios for each morpheme were all below the range considered acceptable for clinical application, whereas better specificity rates in some age groups for some morphemes indicated that very low scores are indicative of SLI whereas high scores are uninformative. Age effects were evident in that the morphemes varied in the age at which they separate the groups most accurately.

CONCLUSIONS

The findings of this study show that Icelandic children with SLI are somewhat more prone to making morphological errors than their TD counterparts. However, great overlap exists between the groups. The findings call into question the view that grammatical morphology is a central area of deficit in SLI.

Emotional health, support, and self-efficacy in young adults with a history of language impairment

Children and adolescents with language impairment (LI) are at risk of emotional health difficulties. However, less is known about whether these difficulties continue into adulthood for this group, or about the potential role of environmental resources (e.g., social support) or internal resources (e.g., self‐efficacy). This study investigates emotional health in 81 adults with a history of developmental LI (aged 24) compared with 87 age‐matched peers (AMPs) using Beck Inventories. Social support and self‐efficacy measures were examined as predictors. The results were fourfold: (1) adults with LI had higher levels of emotional health problems; (2) whilst the availability of social support was similar across groups, people with LI received more help from others compared to peers; (3) social support was not significantly related to emotional health in those with LI – in contrast, for AMPs, uptake of support indicated poorer emotional health; (4) self‐efficacy was the strongest predictor of emotional health in both groups and fully mediated the relationship between language and emotional health (no moderation by group). This cross‐sectional study has implications for concurrent factors that might affect emotional health outcomes for children and young people with and without LI.

Theory of mind and specific language impairment in school-age children

Research on the relationship between aspects of language development and Theory of Mind (ToM) in children with language impairments suggests that children with language impairment show a delay in ToM development. This study aimed to examine the relationships of the syntactic, semantic, and pragmatic skills with ToM in school-age children. Twenty children with Specific Language Impairment (SLI) aged 9-12 years and two control groups, one matched for chronological age (CA) and one for language ability (LA) (aged 8-10 years) were compared on a set of language tasks tapping syntactic, semantic, and pragmatic skills and on an advanced test of ToM. Results showed that children with SLI performed poorly on the ToM task compared to the CA matches. Also, analysis showed that language skills and ToM are related and that syntactic and pragmatic abilities contributed significantly to the prediction of ToM performance in the SLI group. It is concluded that the syntax/pragmatic aspects of the language impact on ToM understanding in children with SLI.

The Production of Complement Clauses in Children With Language Impairment

PURPOSE

The purpose of this research was to provide a comprehensive description of complement-clause production in children with language impairment. Complement clauses were examined with respect to types of complement structure produced, verb use, and both semantic and syntactic accuracy.

METHOD

A group of 17 children with language impairment (mean age = 6;10 [years; months]) was compared with a group of 17 younger children with typical language development (mean age = 4;6). Examples of both nonfinite complements with different subjects and sentential complements involving a range of complement-taking verbs were collected using specially designed elicitation tasks.

RESULTS

The children with language impairment were able to construct both types of complement clauses, had access to a range of verbs that are utilized within these constructions, and had knowledge of the grammatical constraints imposed by these verbs. However, they were more restricted in their production of sentential complements and produced significantly fewer semantically accurate complements (both finite and nonfinite) than the children with typical language development.

CONCLUSION

Children with language impairment evidenced deviant rather than merely delayed development in the area of complement-clause production. Complex sentences such as complement clauses need to be targeted in language intervention programs.

Visual Speech Perception in Children With Language Learning Impairments

PURPOSE

The purpose of the study was to assess the ability of children with developmental language learning impairments (LLIs) to use visual speech cues from the talking face.

METHOD

In this cross-sectional study, 41 typically developing children (mean age: 8 years 0 months, range: 4 years 5 months to 11 years 10 months) and 27 children with diagnosed LLI (mean age: 8 years 10 months, range: 5 years 2 months to 11 years 6 months) completed a silent speechreading task and a speech-in-noise task with and without visual support from the talking face. The speech-in-noise task involved the identification of a target word in a carrier sentence with a single competing speaker as a masker.

RESULTS

Children in the LLI group showed a deficit in speechreading when compared with their typically developing peers. Beyond the single-word level, this deficit became more apparent in older children. On the speech-in-noise task, a substantial benefit of visual cues was found regardless of age or group membership, although the LLI group showed an overall developmental delay in speech perception.

CONCLUSION

Although children with LLI were less accurate than their peers on the speechreading and speech-in noise-tasks, both groups were able to make equivalent use of visual cues to boost performance accuracy when listening in noise.

Stability of Language and Literacy Profiles of Children With Language Impairment in the Public Schools

PURPOSE

The present study focused on the identification and stability of language and literacy profiles of primary school children receiving school-based language therapy over the course of one academic year.

METHOD

Participants included 272 early elementary school-age children (144 boys, 128 girls) who had been clinically identified as having a language impairment. A latent profile analysis was used to identify distinct profiles on the basis of a battery of language and literacy assessments in the fall and spring of the academic year.

RESULTS

Four profiles were identified in both fall and spring that could be best described as representing high, average, and low overall abilities. Two average groups were identified that differentiated according to phonological awareness abilities. Children's profile membership was variable from fall to spring with nearly 60% of children shifting into a higher profile. The results of t tests comparing children who shifted into higher profiles from those who remained stable in profile membership revealed group differences regarding language severity, socio-economic status, and proportion of therapy sessions received in the classroom.

CONCLUSION

These results provide further evidence regarding the heterogeneity of children with language impairment served in the public schools, indicating that differences may be best conceptualized along a continuum of severity.

Auditory Processing in Specific Language Impairment (SLI): Relations With the Perception of Lexical and Phrasal Stress

PURPOSE

We investigated whether impaired acoustic processing is a factor in developmental language disorders. The amplitude envelope of the speech signal is known to be important in language processing. We examined whether impaired perception of amplitude envelope rise time is related to impaired perception of lexical and phrasal stress in children with specific language impairment (SLI).

METHOD

Twenty-two children aged between 8 and 12 years participated in this study. Twelve had SLI; 10 were typically developing controls. All children completed psychoacoustic tasks measuring rise time, intensity, frequency, and duration discrimination. They also completed 2 linguistic stress tasks measuring lexical and phrasal stress perception.

RESULTS

The SLI group scored significantly below the typically developing controls on both stress perception tasks. Performance on stress tasks correlated with individual differences in auditory sensitivity. Rise time and frequency thresholds accounted for the most unique variance. Digit Span also contributed to task success for the SLI group.

CONCLUSIONS

The SLI group had difficulties with both acoustic and stress perception tasks. Our data suggest that poor sensitivity to amplitude rise time and sound frequency significantly contributes to the stress perception skills of children with SLI. Other cognitive factors such as phonological memory are also implicated.

Phonological and morphophonological effects on grammatical development in children with specific language impairment

BACKGROUND

Five-year-olds with specific language impairment (SLI) often struggle with mastering grammatical morphemes. It has been proposed that verbal morphology is particularly problematic in this respect. Previous research has also shown that in young typically developing children grammatical markers appear later in more phonologically challenging contexts.

AIMS

The main aim was to explore whether grammatical deficits in children with SLI are morphosyntactic in nature, or whether phonological factors also explain some of the variability in morpheme production. The analysis considered the effects of the same phonological factors on the production of three different morphemes: two verbal (past tense -ed; third-person singular -s) and one nominal morpheme (possessive -s).

METHODS & PROCEDURES

The participants were 30 children with SLI (21 boys) aged 4;6-5;11 years (mean = 5;1). The data were collected during grammar test sessions, which consisted of question/answer elicitations of target forms involving picture props. A total of 2301 items were analysed using binary logistic regression; the predictors included: (1) utterance position of the target word, (2) phonological complexity of its coda, (3) voicing of the final stem consonant, (4) syllabicity (allomorph type) and (5) participant accounting for the individual differences in the responses.

OUTCOMES & RESULTS

The results showed a robust effect of syllabicity on the correct morpheme production. Specifically, syllabic allomorphs (e.g., She dresses) were significantly more challenging than the segmental ones (e.g., He runs) for all three morphemes. The effects of other factors were observed only for a single morpheme: coda complexity and voicing helped explain variability in past tense production, and utterance position significantly affected children's performance with the possessive. The participant factor also had a significant effect, indicating high within-group variability--often observed in SLI population.

CONCLUSIONS & IMPLICATIONS

The systematic effect of syllabicity across both verbal and nominal morphemes suggests morphophonological influences in the grammatical development of children with SLI that cannot be fully explained by syntactic deficits. Poorer performance in producing syllabic allomorphs can be accounted for by much lower overall frequency of these forms, and by the 'tongue-twisting' effect of producing similar segments in succession, as in added [aedəd], washes [wɒʃəz]. Interestingly, the greater acoustic salience of the syllabic allomorphs (an extra syllable) does not enhance children's abilities to produce them. These findings suggest that the interconnections between different levels of language have a stronger effect on the grammatical development of children with SLI than might be expected. Allomorphy should, therefore, be taken into account when designing language assessments and speech therapy, ensuring that children receive sufficient practice with the entire set of allomorphic variants.

Association between AVPR1A, DRD2, and ASPM and endophenotypes of communication disorders

OBJECTIVES

Speech sound disorder (SSD) is one of the most common communication disorders, with a prevalence rate of 16% at 3 years of age, and an estimated 3.8% of children still presenting speech difficulties at 6 years of age. Several studies have identified promising associations between communication disorders and genes in brain and neuronal pathways; however, there have been few studies focusing on SSD and its associated endophenotypes. On the basis of the hypothesis that neuronal genes may influence endophenotypes common to communication disorders, we focused on three genes related to brain and central nervous system functioning: the dopamine D2 receptor (DRD2) gene, the arginine-vasopressin receptor 1a (AVPR1A) gene, and the microcephaly-associated protein gene (ASPM).

METHODS

We examined the association of these genes with key endophenotypes of SSD - phonological memory measured through multisyllabic and nonword repetition, vocabulary measured using the Expressive One Word Picture Vocabulary Test and Peabody Picture Vocabulary Test, and reading decoding measured using the Woodcock Reading Mastery Tests Revised - as well as with the clinical phenotype of SSD. We genotyped tag single nucleotide polymorphisms in these genes and examined 498 individuals from 180 families.

RESULTS

These data show that several single nucleotide polymorphisms in all three genes were associated with phonological memory, vocabulary, and reading decoding, with P less than 0.05. Notably, associations in AVPR1A (rs11832266) were significant after multiple testing correction. Gene-level tests showed that DRD2 was associated with vocabulary, ASPM with vocabulary and reading decoding, and AVPR1A with all three endophenotypes.

CONCLUSION

Endophenotypes common to SSD, language impairment, and reading disability are all associated with these neuronal pathway genes.

Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category

Social (pragmatic) communication disorder (SCD) is a new diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The purpose of this review is to describe and synthesize the relevant literature from language and autism spectrum disorder (ASD) research relating to pragmatic language impairment and other previously used terms that relate to SCD. The long-standing debate regarding how social communication/pragmatic impairments overlap and/or differ from language impairments, ASD, and other neurodevelopmental disorders is examined. The possible impact of the addition of SCD diagnostic category and directions for future research are also discussed.

Do the symptoms of language disorder align with treatment goals? An exploratory study of primary-grade students' IEPs

Individual Education Plans (IEPs) are legal documents that guide the treatment of students with language disorder (LD). This exploratory study investigated the extent to which students' symptoms of LD align with goals on their IEPs. A total of 99 kindergarten and first-grade students receiving treatment for LD in the public schools participated. IEPs were collected and coded for each student and norm-referenced measures were used to assess students' grammar, vocabulary, listening comprehension, and literacy skills in the fall of the academic year. Results showed there to be alignment between students' symptoms and IEP goals only in the area of vocabulary, such that students who had an IEP goal for vocabulary had lower scores on a vocabulary assessment than those without a goal. In general, there is limited alignment between observed symptoms of LD and treated symptoms as identified on students' IEPs. The limited alignment found in this study suggests more investigation is needed to understand the extent to which IEP goals, as potential indicators of treatment foci, should map on to students' symptoms.

LEARNING OUTCOMES

Readers will be able to: (1) explain the theoretical and practical relevance of treatment goals aligning to symptoms for children with language impairment; (2) identify three analytic methods used to investigate alignment between treatment goals and symptoms; and (3) describe the extent to which IEP goals align to children's symptoms in a sample of children receiving services in the public schools.