Impairment in non-word repetition: a marker for language impairment or reading impairment?

Assessing phonological short-term memory in Greek: Reliability and validity of a non-word repetition test

This study explores the reliability and validity of a NWR task in a large cohort of 387 TD Greek-speaking children aged 7-13 years attending elementary (Grades 2-6) and secondary school (Grade 1), divided into six age groups. Further, the relationship between NWR and reading fluency skills as well as the predictive value of the NWR on reading fluency skills in TD children are examined. To investigate the external reliability of the NWR task, test-retest reliability was performed, and excellent test-retest reliability was found. Internal reliability was explored with Cronbach's alpha coefficient and good reliability was found. To explore convergent validity, correlation analysis between NWR and reading fluency was conducted and significant and strong correlations were found for all age groups excepted 2 (ages 9-10 and 12-13). To examine predictive validity, regression analysis was conducted between these two variables and showed that performance on NWR contributed significantly to reading fluency skills, suggesting that NWR skills are a good predictor of reading skills. Finally, it was explored whether the relevant scores increase as a function of age and found significant differences between groups that differed in 2 years or more, while this difference was no longer significant after 10 years. This finding suggests that phonological STM increases in capacity along with age, but only until the age of 10, where it seems to reach a ceiling. In addition, linear regression analysis showed that age contributed significantly to performance on NWR test. To sum up, the present study provides normative data of a NWR test for a wide age range, which does not exist in the Greek language (particularly for ages over 9 years) and it can be concluded that the present NWR test can be successfully used as a reliable and valid measure of phonological STM in the age range that was examined in this study.

Altered engagement of the speech motor network is associated with reduced phonological working memory in autism

Nonword repetition, a common clinical measure of phonological working memory, involves component processes of speech perception, working memory, and speech production. Autistic children often show behavioral challenges in nonword repetition, as do many individuals with communication disorders. It is unknown which subprocesses of phonological working memory are vulnerable in autistic individuals, and whether the same brain processes underlie the transdiagnostic difficulty with nonword repetition. We used functional magnetic resonance imaging (fMRI) to investigate the brain bases for nonword repetition challenges in autism. We compared activation during nonword repetition in functional brain networks subserving speech perception, working memory, and speech production between neurotypical and autistic children. Autistic children performed worse than neurotypical children on nonword repetition and had reduced activation in response to increasing phonological working memory load in the supplementary motor area. Multivoxel pattern analysis within the speech production network classified shorter vs longer nonword-repetition trials less accurately for autistic than neurotypical children. These speech production motor-specific differences were not observed in a group of children with reading disability who had similarly reduced nonword repetition behavior. These findings suggest that atypical function in speech production brain regions may contribute to nonword repetition difficulties in autism.

Who is Right? A Word-Identification-in-Noise Test for Young Children Using Minimal Pair Distracters

PURPOSE

Many children have difficulties understanding speech. At present, there are few assessments that test for subtle impairments in speech perception with normative data from U.K. children. We present a new test that evaluates children's ability to identify target words in background noise by choosing between minimal pair alternatives that differ by a single articulatory phonetic feature. This task (a) is tailored to testing young children, but also readily applicable to adults; (b) has minimal memory demands; (c) adapts to the child's ability; and (d) does not require reading or verbal output.

METHOD

We tested 155 children and young adults aged from 5 to 25 years on this new test of single word perception.

RESULTS

Speech-in-noise abilities in this particular task develop rapidly through childhood until they reach maturity at around 9 years of age.

CONCLUSIONS

We make this test freely available and provide associated normative data. We hope that it will be useful to researchers and clinicians in the assessment of speech perception abilities in children who are hard of hearing or have developmental language disorder, dyslexia, or auditory processing disorder.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.17155934.

Phonological predictors of nonword repetition performance in bilingual children

INTRODUCTION

Previous research (Gibson et al., 2015; Summers, Bohman, Gillam, Peña & Bedore, 2010) has suggested an advantage in Spanish over English on nonword repetition tasks with Spanish-English bilingual children. However, comparing nonwords of equal syllable lengths across languages may not sufficiently account for phonological differences across languages. We compared Spanish-language nonword sets of different lengths to select a set that would be equivalent with respect to difficulty in English. We considered language-specific phonological structure and level of difficulty in evaluating nonword performance in 126 first- and second-grade, Spanish-English bilingual children. We predicted that adding 5-syllable words to the Spanish nonword set and monosyllabic words to the English set would result in comparable difficulty.

METHOD

Participants repeated nonwords of increasing lengths in English of 1, 2, 3, and 4 syllables and in Spanish of 2, 3, 4, and 5 syllables. Percent phonemes correct was calculated for total sounds. A repeated measures ANOVA was used to compare accuracy across word lengths.

RESULTS

Results indicated significant differences in overall means between languages when nonwords of equal word lengths were compared, but no significant differences in overall means when lengths of 1 - 4 syllables in English and 2 - 5 syllables in Spanish were used. Differences between languages varied at individual levels of complexity.

CONCLUSIONS

The finding that level of word length affects performance may have implications for understanding the factors in clinical test development for bilingual children. Further research may benefit from assessing additional language variables and additional language combinations to extend findings.

Promoting Reading Achievement in Children With Developmental Language Disorders: What Can We Learn From Research on Specific Language Impairment and Dyslexia?

Purpose Specific language impairment (SLI; see also developmental language disorder) and dyslexia are separate, yet frequently co-occurring disorders that confer risks to reading comprehension and academic achievement. Until recently, most studies of one disorder had little consideration of the other, and each disorder was addressed by different practitioners. However, understanding how the two disorders relate to each other is important for advancing theories about each disorder and improving reading comprehension and academic achievement. The purpose of this clinical focus article is to integrate research on SLI and dyslexia as well as advocate for the consideration of comorbidities in future research and clinical practice. Method The first section reviews definitions as well as inclusionary and exclusionary criteria for SLI and dyslexia. The second section reviews research demonstrating that SLI and dyslexia are different disorders that often co-occur. Studies examining language, working memory, and academic achievement in children with separate versus co-occurring SLI and dyslexia are reviewed. The final section compares and contrasts school identification frameworks for children with SLI and dyslexia and considers the potential benefits of incorporating broad language skills into response to intervention (RTI) assessment frameworks. Conclusions Children with weak language skills are at a high risk of experiencing reading problems, but language difficulties are often hidden from view. Directly addressing language skills within school RTI frameworks can help improve the identification and treatment of children with SLI and dyslexia as well as support improved reading comprehension and academic achievement for all students. Presentation Video https://doi.org/10.23641/asha.13063793.

Language disorders

Developmental language disorders (DLD) are prevalent and persistent among school-age children but are often underrecognized. This chapter discusses the ways in which the various components of communication are impacted by these disorders and outlines the differences in expression seen in different languages. Research on biological and psychologic roots of the syndrome is also reviewed. As yet, no single definitive cause has been identified; the disorders are likely to result from a constellation of genetic, biological, and cognitive weaknesses that are influenced by environmental experiences. Basic methods of assessment and differential diagnosis are presented and the principles guiding the development of intervention programs are discussed.

Comorbidity of Auditory Processing, Attention, and Memory in Children With Word Reading Difficulties

OBJECTIVES

To document the auditory processing, visual attention, digit memory, phonological processing, and receptive language abilities of individual children with identified word reading difficulties.

DESIGN

Twenty-five children with word reading difficulties and 28 control children with good word reading skills participated. All children were aged between 8 and 11 years, with normal hearing sensitivity and typical non-verbal intelligence. Both groups of children completed a test battery designed to assess their auditory processing, visual attention, digit memory, phonological processing, and receptive language.

RESULTS

When compared to children who were good readers, children with word reading difficulties obtained significantly lower average scores on tests of auditory processing, including the frequency pattern test, gaps in noise, frequency discrimination, Dichotic Digit difference Test, and Listening in Spatialized Noise. The two groups did not differ on the discrimination measures of sinusoidal amplitude modulation or iterated rippled noise. The results from children with word reading difficulties showed that 5 children (20%) had comorbid deficits in auditory processing, visual attention, and backward digit memory; whereas 12 children (48%) had comorbid auditory processing and visual attention deficits only, and 2 children (8%) had comorbid deficits in auditory processing and digit memory; the remaining children had only auditory processing, visual attention, or digit memory deficits.

CONCLUSION

The current study highlights the general co-existence of auditory processing, memory, and visual attention deficits in children with word reading difficulties. It is also noteworthy, however, that only one fifth of the current cohort had deficits across all measured tasks. Hence, our results also show the significant individual variability inherent in children with word reading difficulties.

Auditory memory span in Mandarin-speaking preschoolers with congenital hearing loss: Impact of task structure

Objective: The current research was conducted to test the prediction that children who have hearing loss and are developing spoken language can perform at the same level as hearing children in an auditory memory span task if actual production of speech is excluded from task requirement.Method: A listen-and-point digit span task and two sub-tests of Wechsler Intelligence Scale for Children-IV (Verbal Digit Span and Matrix Reasoning) were administered to thirty hearing children and thirty-three children with hearing loss. A language assessment instrument for Mandarin-speaking preschool children was also administered to the participants with hearing loss.Results: The listen-and-point task not only correlated with the Verbal Digit Span sub-test, but also correlated with the comprehension sub-test of the language assessment instrument. The size of auditory memory span was similar in both groups of participants in the listen-and-point task. Moreover, the memory span estimated in the listen-and-point task was smaller than that estimated in the Verbal Digit Span task. The correlation coefficients between chronological age and the listen-and-point task were also similar in both groups of children.Conclusions: When speech processes are not required in an auditory working memory task, demand for the phonological loop is reduced and the children with hearing loss are able to perform as well as the hearing children. Moreover, the auditory memory span develops at the same rate for the children with hearing loss as for the hearing children.

Understanding Dyslexia in the Context of Developmental Language Disorders

Purpose

The purpose of this tutorial is to discuss the language basis of dyslexia in the context of developmental language disorders (DLDs). Whereas most studies have focused on the phonological skills of children with dyslexia, we bring attention to broader language skills.

Method

We conducted a focused literature review on the language basis of dyslexia from historical and theoretical perspectives with a special emphasis on the relation between dyslexia and DLD and on the development of broader language skills (e.g., vocabulary, syntax, and discourse) before and after the identification of dyslexia.

Results

We present clinically relevant information on the history of dyslexia as a language-based disorder, the operational definitions used to diagnose dyslexia in research and practice, the relation between dyslexia and DLD, and the language abilities of children with dyslexia.

Conclusions

We discuss 3 clinical implications for working with children with dyslexia in school settings: (a) Children with dyslexia—with and without comorbid DLDs—often have language deficits outside the phonological domain; (b) intervention should target a child's strengths and weaknesses relative to reading outcomes, regardless of diagnostic labels; and (c) those who have dyslexia, regardless of language abilities at the time of diagnosis, may be at risk for slower language acquisition across their lifetime. Longitudinal studies are needed to assess multiple language skills early, at the time of the diagnosis of dyslexia, and years later to better understand the complex development of language and reading in children with dyslexia.

School-age outcomes of late-talking toddlers: Long-term effects of an early lexical deficit

BACKGROUND

Early intervention for children identified as late talkers (LTs) at the age of 24 months is still a controversial issue in research and clinical routine. Previous studies have shown inconsistent results regarding predictors of early lexical deficits on school-age outcomes of late-talking toddlers.

METHODS

In a five-wave follow-up study, we investigated various aspects of language and literacy abilities in 39 German-speaking third-graders who had been identified as LTs at the age of 24 months, compared to 39 typically developing children (TDC) also attending the third grade. The duration of auditory sensory memory was examined at the age of 4 years using mismatch negativity (MMN) of tones - an event-related potential not confounded by any language skill. In addition, the predictive value of memory performance was examined in a longitudinal perspective.

RESULTS

Overall, LTs scored within normal range in language and literacy assessments. However, LTs differed from TDC in vocabulary size, verbalization of semantic relations, non-word repetition, and spelling. The findings can be explained by phonological working memory. The duration of auditory sensory memory and spatial working memory did not account for any variance.

CONCLUSIONS

LTs sustain persistent phonological processing limitations even though their native language and literacy performance lay within the normal range at school age. Further research on second language acquisition, academic achievements, and the efficacy of early intervention in late-talking toddlers is recommended.

Understanding Word Reading Difficulties in Children With SLI

Children with specific language impairment (SLI) often show considerable reading difficulties. Research has revealed two primary reading profiles among children with SLI: (a) one of poor word reading and decoding skills and associated reading comprehension difficulties, and (b) one involving relatively strong word reading skills but poor comprehension. This article reviews studies characterizing these two subtypes of SLI, discusses their current clinical implications, and suggests important directions for future study.

Phonological processing in children with specific language impairment with and without reading difficulties

BACKGROUND

Specific language impairment (SLI) is heterogeneous and identifying subgroups within it may help explain the aetiology of the condition. Phonological processing abilities distinguish between children with SLI who do and do not have reading decoding impairments (RDIs).

AIMS

To probe different levels of phonological processing in children with SLI with and without RDI to investigate the cognitive basis of these differences.

METHODS & PROCEDURES

A total of 64 children aged 5-17 years were classified using the results of standardized language and single-word reading tests into those with no SLI and no RDI (No SLI/No RDI) (N = 18), no SLI but with RDI (No SLI/RDI) (N = 4, not included in analyses because of the small number), SLI/No RDI (N = 20), and SLI/RDI (N = 22). The groups were compared on a range of tasks engaging different levels of phonological processing (input and output processing and phonological awareness).

OUTCOMES & RESULTS

The SLI/RDI group was distinguished from the SLI/No RDI and No SLI/No RDI groups by more errors in the longer items in non-word repetition and by poorer phonological awareness. Non-word discrimination scores indicated a gradient of performance across groups that was not associated with a qualitatively different pattern of performance.

CONCLUSIONS & IMPLICATIONS

This is the first study contrasting input and output processes associated with phonological processing. The results suggest that deficits in SLI plus RDI may be associated with impairment in actively maintaining phonological representations for phonological processing, which is not present in those without RDI and which leads to reading decoding difficulties.

Identifying phonological processing deficits in Northern Sotho-speaking children: The use of non-word repetition as a language assessment tool in the South African context

Diagnostic testing of speech/language skills in the African languages spoken in South Africa is a challenging task, as standardised language tests in the official languages of South Africa barely exist. Commercially available language tests are in English, and have been standardised in other parts of the world. Such tests are often translated into African languages, a practice that speech language therapists deem linguistically and culturally inappropriate. In response to the need for developing clinical language assessment instruments that could be used in South Africa, this article reports on data collected with a Northern Sotho non-word repetition task (NRT). Non-word repetition measures various aspects of phonological processing, including phonological working memory (PWM), and is used widely by speech language therapists, linguists, and educational psychologists in the Western world. The design of a novel Northern Sotho NRT is described, and it is argued that the task could be used successfully in the South African context to discriminate between children with weak and strong Northern Sotho phonological processing ability, regardless of the language of learning and teaching. The NRT was piloted with 120 third graders, and showed moderate to strong correlations with other measures of PWM, such as digit span and English non-word repetition. Furthermore, the task was positively associated with both word and fluent reading in Northern Sotho, and it reliably predicted reading outcomes in the tested population. Suggestions are made for improving the current version of the Northern Sotho NRT, whereafter it should be suitable to test learners from various age groups.

The unique role of lexical accessibility in predicting kindergarten emergent literacy

The goal of this longitudinal study was to examine how lexical quality predicts the emergence of literacy abilities in 169 Dutch kindergarten children before formal reading instruction has started. At the beginning of the school year, a battery of precursor measures associated with lexical quality was related to the emergence of letter knowledge and word decoding. Confirmatory factor analysis evidenced five domains related to lexical quality, i.e., vocabulary, phonological coding, phonological awareness, lexical retrieval and phonological working memory. Structural equation modeling showed that the development of letter knowledge during the year could be predicted from children's phonological awareness and lexical retrieval, and the emergence of word decoding from their phonological awareness and letter knowledge. It is concluded that it is primarily the accessibility of phonological representations in the mental lexicon that predicts the emergence of literacy in kindergarten.

Rapid Naming and Phonemic Awareness in Children With Reading Disabilities and/or Specific Language Impairment: Differentiating Processes?

PURPOSE

The objective of this study was to assess and compare the predictive values of group membership for rapid automatized naming (RAN) and phonemic awareness (PA) in Dutch school children with and without reading disabilities (RD) or specific language impairment (SLI).

METHOD

A composite word reading index and a formal SLI diagnosis were used to classify a total of 1,267 children aged 8 to 13 years old either as RD-only (n = 126), SLI-only (n = 21), comorbid (RD+SLI; n = 30), or typically developing (n = 1,090). RAN and PA were assessed with 4 standardized subtests. The clinical subgroups were compared to each other and contrasted with the control group.

RESULTS

For each subgroup, results indicate substantial effect sizes of RAN and PA. However, the RD-only group seems to be more affected by poor RAN than the SLI-only group, whereas the 2 groups perform equally poorly on PA. The comorbid group was revealed as most severely impaired on all measurements.

CONCLUSIONS

In studying RD and SLI, this research indicates that it is important to distinguish between RD-only, SLI-only, and comorbid groups. The comorbid group shows additive effects of both disorders.

Morphosyntax in Poor Comprehenders

Children described as poor comprehenders (PCs) have reading comprehension difficulties in spite of adequate word reading abilities. PCs are known to display weakness with semantics and higher-level aspects of oral language, but less is known about their grammatical skills, especially with regard to morphosyntax. The purpose of this study was to examine morphosyntax in fourth grade PCs and typically developing readers (TDs), using three experimental tasks involving finiteness marking. Participants also completed standardized, norm-referenced assessments of phonological memory, vocabulary, and broader language skills. PCs displayed weakness relative to TDs on all three morphosyntax tasks and on every other assessment of oral language except phonological memory, as indexed by nonword repetition. These findings help to clarify the linguistic profile of PCs, suggesting that their language weaknesses include grammatical weaknesses that cannot be fully explained by semantic factors. Because finiteness markers are usually mastered prior to formal schooling in typical development, we call for future studies to examine whether assessments of morphosyntax could be used for the early identification of children at risk for future reading comprehension difficulty.

Early identification of reading disabilities within an RTI framework

Early and accurate identification of children at risk for reading disabilities (RD) is critical for the prevention of RD within a response to intervention framework. In this study, we investigated the use of universal screening and progress monitoring for the early identification of RD in kindergarten children. A total of 366 children were administered a battery of screening measures at the beginning of kindergarten and progress-monitoring probes across the school year. A subset of children who showed initial risk for RD also received a 26-week Tier 2 intervention. Participants' achievement in word reading accuracy and/or fluency was assessed at the end of first grade. Results indicated that a screening battery containing measures of letter naming fluency, phonological awareness, rapid naming, or nonword repetition accurately identified good and poor readers at the end of first grade. Findings also showed that children's response to supplemental and/or classroom instruction measured in terms of growth in letter naming fluency added significantly to the prediction of reading outcomes.

Spelling Processes of Children with Nonsyndromic Cleft Lip and/or Palate: A Preliminary Study

Objective

To compare the cognitive-linguistic processes underlying spelling performance of children with cleft lip and/or palate with those of typically developing children.

Design

An assessment battery including tests of hearing, articulation, verbal short-term and working memory, and phonological awareness, as well as word and nonword spelling, was administered to both groups.

Participants

A total of 15 children with nonsyndromic cleft lip and/or palate were case-matched by age and sex to 15 typically developing children. The children were aged between 6 and 8 years and were bilingual, with English the dominant language.

Results

Wilcoxon signed-rank tests revealed that the performance of children with cleft lip and/or palate was significantly poorer on phoneme deletion and nonword spelling ( P < .05) compared with typically developing children. Spearman correlation analyses revealed different relationships between the cognitive-linguistic and spelling measures for the cleft lip and/or palate and typically developing groups.

Conclusions

Children with cleft lip and/or palate underachieve in phonological awareness and spelling skills. To facilitate early intervention for literacy problems, speech-language pathologists should routinely assess the cognitive-linguistic processing of children with cleft lip and/or palate, especially phonological awareness, as part of their case management protocols.

Stability of language performance at 4 and 5 years: measurement and participant variability

BACKGROUND

Language impairment (LI) in the preschool years is known to vary over time. Stability in the diagnosis of LI may be influenced by children’s individual variability, the measurement error of commonly used assessment instruments and the cut-points used to define impairment.

AIMS

To investigate the agreement between two different age-based versions of a language assessment instrument and the stability of the classification of LI using the two measures over a 12-month period.

METHODS & PROCEDURES

A total of 945 participants completed the Clinical Evaluation of Language Fundamentals(CELF—Preschool 2 or 4th Edn) at 4 and 5 years of age. Agreement and stability were analysed using Bland–Altman plots, correlation and odds ratios. Sensitivity and specificity were calculated for two thresholds of the CELF-P2 using the diagnostic category on the child’s subsequent CELF-4.

OUTCOMES & RESULTS

For all CELF scores, mean differences for the cohort between 4 and 5 years were within 1.5 scale score units. In contrast, at the individual level variability was found across the range of scores and was of a greater magnitude than previously reported. Stability in LI classification was low, with 36% of 5-year-olds with LI (defined as a standard score below –1.25) classified as typical at 4 years, even though odds ratios calculated from classifications at the two time points suggested that 4-year-olds with LI had 23 times greater odds than their typical peers to receive a diagnosis of LI at 5 years. The CELF-P2 did not demonstrate adequate levels of diagnostic accuracy for LI at 5 years: sensitivity of 64% and specificity of 92.9%.

CONCLUSIONS

Substantial variability across the entire range of possible CELF scores was observed in this community cohort between the ages of 4 and 5 years. The stability of LI classification was lower than that reported in previous research conducted primarily on smaller clinical cohorts. The current study’s results suggest that the variability observed in developmental language pathways is the result of a combination of limitations in measurement instruments, individual children’s abilities and the arbitrary nature of the boundaries defining LI.

Memory and language in middle childhood in individuals with a history of specific language impairment

This study reports on the sensitivity of sentence repetition as a marker of specific language impairment (SLI) in different subgroups of children in middle childhood and examines the role of memory and grammatical knowledge in the performance of children with and without language difficulties on this task. Eleven year old children, 197 with a history of SLI and 75 typically developing (TD) peers were administered sentence repetition, phonological short term memory (PSTM) and grammatical morphology tasks. Children with a history of SLI were divided into four subgroups: specific language impairment, non-specific language impairment, low cognition with resolved language and resolved. Performance on the sentence repetition task was significantly impaired in all four subgroups of children with a history of SLI when compared to their age peers. Regression analyses revealed grammatical knowledge was predictive of performance for TD children and children with a history of SLI. However, memory abilities were significantly predictive of sentence repetition task performance for children with a history of SLI only. Processes involved in sentence repetition are more taxing of PSTM for individuals with a history of SLI in middle childhood in a way that does not appear to be the case for TD children.

The impacts of language background and language-related disorders in auditory processing assessment

PURPOSE

To examine the impact of language background and language-related disorders (LRDs--dyslexia and/or language impairment) on performance in English speech and nonspeech tests of auditory processing (AP) commonly used in the clinic.

METHOD

A clinical database concerning 133 multilingual children (mostly with English as an additional language) and 71 monolingual children (7- to 12-year-old native English speakers) with listening concerns was analyzed retrospectively.

RESULTS

Language background had no significant effect on the 3 nonspeech AP tests, but the multilingual group performed worse in most of the speech tests. Children with LRDs generally performed more poorly than those without, except for the masking level difference.

CONCLUSIONS

Although language background affects performance in AP tasks that use speech, the effect of LRDs appears to be more wide-ranging insofar as the majority of the AP tests--speech and nonspeech--were significantly affected by their presence. The effects of language background are probably mediated directly through the effects of language expertise, whereas those associated with LRDs appear to arise from associated deficits in memory and attention. The vast majority of so-called AP tests tap abilities far beyond those typically thought of as specifically auditory; thus, they are poor measures of an AP disorder.

Non-word repetition in adolescents with specific language impairment (SLI)

BACKGROUND

Non-word repetition (NWR) difficulties are common, but not universal, among children with specific language impairment (SLI). However, older children and adolescents with SLI have rarely been studied. Studies disagree on the relationship between NWR difficulties and difficulties with other areas of language and literacy. There is also no consensus about the underlying reason for the difficulties (some) children with SLI have with NWR. Some scholars argue that difficulties with phonological short-term memory or storage cause NWR and other language difficulties, whereas others argue that difficulties with NWR may be due more to difficulties with phonological representations.

AIMS

To investigate NWR abilities and their relationship to other language and literacy abilities in a group of older children with SLI and typically developing controls. To investigate the relative effects of increasing phonological complexity and the number of syllables on the ability of the participants to repeat non-words.

METHODS & PROCEDURES

An NWR test (The Test of Phonological Structure; TOPhS), which systematically varies phonological complexity, was administered to 15 participants with SLI (aged 11-15 years), 30 language and 15 age controls. Standardized language and literacy tests and a specific test of verb agreement and tense marking (Verb Agreement and Tense Test; VATT) were also administered.

OUTCOMES & RESULTS

The participants with SLI showed a bimodal distribution: half achieved age-appropriate NWR, while half scored significantly below language and age controls (d > 7). The two groups of participants with SLI (high versus low scorers) only differed in NWR (d > 5) and agreement (d > 3) and tense marking (d > 2.5), not on the standardized language and literacy measures administered. NWR was also highly correlated with verb agreement (r= 0.97) and tense marking (r= 0.89) among participants with SLI, but not among controls (r= 0.16 and 0.30 respectively). Phonological complexity was related to NWR accuracy, particularly among participants with SLI. The number of syllables had no independent effect on NWR performance for any group.

CONCLUSIONS & IMPLICATIONS

Some children with SLI (who have good NWR) have language difficulties unrelated to any of the factors underlying NWR. Others have a (probably additional) deficit which affects NWR and also leads to greater difficulties with verb agreement and tense marking. The results indicate that difficulties with this particular NWR test are more likely to be due to a deficit with phonology per se, rather than with phonological short-term memory or storage.