Prevalence of specific language impairment in kindergarten children

Preschool speech, language skills, and reading at 7, 9, and 10 years: etiology of the relationship

PURPOSE

To examine the etiology of the relationship between preschool speech and language, and later reading skills.

METHOD

One thousand six hundred seventy-two children from the Twins Early Development Study (B. R. Oliver & R. Plomin, 2007) were given a comprehensive speech and language assessment at 4(1/2) years. Reading was assessed at 7, 9, and 10 years. Twin analyses were applied to the data to assess the contributions of genetic and environmental factors to the longitudinal relationships between speech and reading, and language and reading.

RESULTS

Phenotypically, there is a moderate and stable relationship between 4(1/2)-year speech and language scores and reading at 7, 9, and 10 years. Etiologically, at the individual-differences level, both genetic and shared environmental factors contribute to the links between language skills and reading. By contrast, genetic factors account for most of the relationship between early speech and later reading. At the extremes, there appears to be an even stronger role for genetic factors in accounting for the prediction from early speech and language impairments to later reading outcome.

CONCLUSION

Both genetic and environmental factors contribute to the relationship between early language skills and reading, whereas genetic factors play a dominant role in the relationship between early speech and reading.

Mean length of utterance levels in 6-month intervals for children 3 to 9 years with and without language impairments

PURPOSE

The mean length of children's utterances is a valuable estimate of their early language acquisition. The available normative data lack documentation of language and nonverbal intelligence levels of the samples. This study reports age-referenced mean length of utterance (MLU) data from children with specific language impairment (SLI) and children without language impairments.

METHOD

Of the 306 child participants drawn from a data archive, ages 2;6-9;0 (years;months), 170 were in the SLI group and 136 were in the control group. There were 1,564 spontaneous language samples collected, and these were transcribed and analyzed for sample size and MLU in words and morphemes. Means, standard deviations, and effect sizes for group differences are reported for MLUs, along with concurrent language and nonverbal intelligence assessments, per 6-month intervals.

RESULTS

The results document an age progression in MLU words and morphemes and a persistent lower level of performance for children with SLI.

CONCLUSION

The results support the reliability and validity of MLU as an index of normative language acquisition and a marker of language impairment. The findings can be used for clinical benchmarking of deficits and language intervention outcomes as well as for comparisons across research samples.

Identification of clinical markers of specific language impairment in adults

PURPOSE

To investigate the usefulness of 3 tasks known to be effective diagnostic clinical markers of specific language impairment (SLI) in children: (a) nonword repetition, (b) sentence repetition, and (c) grammaticality judgments of finiteness marking.

METHOD

Two groups of young adults, 13 with SLI and 18 with typical language, completed 3 experimental tasks: (a) nonword repetition, (b) sentence repetition, and (c) grammaticality judgments of sentences that were either correct or contained an omitted finiteness marker, an overt agreement error, or an omitted progressive -ing. Analyses included receiver operating characteristic curve analyses and computation of likelihood ratios associated with the use of each task as a clinical marker for SLI, as well as development of a logistic regression model that used multiple tasks as predictors.

RESULTS

Each marker task significantly contributed to classification of adults as affected or unaffected by SLI, with moderate positive and negative likelihood ratios. A combination of the 3 marker tasks was the best predictor of affectedness status with moderate to large likelihood ratios.

CONCLUSIONS

The results suggest that SLI persists into adulthood and that effective clinical markers of this disorder are similar to those used to identify SLI in children. Refinement of these tasks to increase their likelihood ratios will improve their usefulness in diagnosing SLI in adults.

Early vocabulary development in deaf native signers: a British Sign Language adaptation of the communicative development inventories

BACKGROUND

There is a dearth of assessments of sign language development in young deaf children. This study gathered age-related scores from a sample of deaf native signing children using an adapted version of the MacArthur-Bates CDI (Fenson et al., 1994).

METHOD

Parental reports on children's receptive and expressive signing were collected longitudinally on 29 deaf native British Sign Language (BSL) users, aged 8-36 months, yielding 146 datasets.

RESULTS

A smooth upward growth curve was obtained for early vocabulary development and percentile scores were derived. In the main, receptive scores were in advance of expressive scores. No gender bias was observed. Correlational analysis identified factors associated with vocabulary development, including parental education and mothers' training in BSL. Individual children's profiles showed a range of development and some evidence of a growth spurt. Clinical and research issues relating to the measure are discussed.

CONCLUSIONS

The study has developed a valid, reliable measure of vocabulary development in BSL. Further research is needed to investigate the relationship between vocabulary acquisition in native and non-native signers.

Genetics of developmental dyslexia

Developmental dyslexia is a highly heritable disorder with a prevalence of at least 5% in school-aged children. Linkage studies have identified numerous loci throughout the genome that are likely to harbour candidate dyslexia susceptibility genes. Association studies and the refinement of chromosomal translocation break points in individuals with dyslexia have resulted in the discovery of candidate genes at some of these loci. A key function of many of these genes is their involvement in neuronal migration. This complements anatomical abnormalities discovered in dyslexic brains, such as ectopias, that may be the result of irregular neuronal migration.

Individual differences in online spoken word recognition: Implications for SLI

Thirty years of research has uncovered the broad principles that characterize spoken word processing across listeners. However, there have been few systematic investigations of individual differences. Such an investigation could help refine models of word recognition by indicating which processing parameters are likely to vary, and could also have important implications for work on language impairment. The present study begins to fill this gap by relating individual differences in overall language ability to variation in online word recognition processes. Using the visual world paradigm, we evaluated online spoken word recognition in adolescents who varied in both basic language abilities and non-verbal cognitive abilities. Eye movements to target, cohort and rhyme objects were monitored during spoken word recognition, as an index of lexical activation. Adolescents with poor language skills showed fewer looks to the target and more fixations to the cohort and rhyme competitors. These results were compared to a number of variants of the TRACE model (McClelland & Elman, 1986) that were constructed to test a range of theoretical approaches to language impairment: impairments at sensory and phonological levels; vocabulary size, and generalized slowing. None of the existing approaches were strongly supported, and variation in lexical decay offered the best fit. Thus, basic word recognition processes like lexical decay may offer a new way to characterize processing differences in language impairment.

Lexical-semantic organization in children with specific language impairment

PURPOSE

To determine whether children with specific language impairment (SLI) show deficits in lexical-semantic organization and, if so, whether these deficits are commensurate with their delay in vocabulary size and whether the deficits affect all children with SLI.

METHOD

Fourteen children with SLI, 14 age matches (AM), and 14 expressive vocabulary matches (VM) generated 3 associations to each of 48 words. Associations were coded as semantic (e.g., dog-pet), clang (e.g., cow-how), or erroneous (e.g., spoon-Disney).

RESULTS

Relative to the AM children, children with SLI produced fewer semantic responses, more clangs, and more errors. Relative to the VM children, fewer semantic responses and more errors in the children with SLI were found in by-item analyses. Across elicitation trials, semantic responses decreased in the AM and VM children but remained stable in the SLI children. Examination of individual performance in the SLI group revealed that poor semantic performance was associated with a deficit in expressive vocabulary and a gap between receptive and expressive vocabularies.

CONCLUSIONS

Significant variability in lexical-semantic organization skills exists among children with SLI. Deficits in lexical-semantic organization were demonstrated by a subgroup of children with SLI who likely had concomitant word-finding difficulties.

Twenty-year follow-up of children with and without speech-language impairments: family, educational, occupational, and quality of life outcomes

PURPOSE

Parents, professionals, and policy makers need information on the long-term prognosis for children with communication disorders. Our primary purpose in this report was to help fill this gap by profiling the family, educational, occupational, and quality of life outcomes of young adults at 25 years of age (N = 244) from the Ottawa Language Study, a 20-year, prospective, longitudinal study of a community sample of individuals with (n = 112) and without (n = 132) a history of early speech and/or language impairments. A secondary purpose of this report was to use data from earlier phases of the study to predict important, real-life outcomes at age 25.

METHOD

Participants were initially identified at age 5 and subsequently followed at 12, 19, and 25 years of age. Direct assessments were conducted at all 4 time periods in multiple domains (demographic, communicative, cognitive, academic, behavioral, and psychosocial).

RESULTS

At age 25, young adults with a history of language impairments showed poorer outcomes in multiple objective domains (communication, cognitive/academic, educational attainment, and occupational status) than their peers without early communication impairments and those with early speech-only impairments. However, those with language impairments did not differ in subjective perceptions of their quality of life from those in the other 2 groups. Objective outcomes at age 25 were predicted differentially by various combinations of multiple, interrelated risk factors, including poor language and reading skills, low family socioeconomic status, low performance IQ, and child behavior problems. Subjective well-being, however, was primarily associated with strong social networks of family, friends, and others.

CONCLUSION

This information on the natural history of communication disorders may be useful in answering parents' questions, anticipating challenges that children with language disorders might encounter, and planning services to address those issues.

Language and social factors in the use of cell phone technology by adolescents with and without specific language impairment (SLI)

PURPOSE

This study aimed to compare cell phone use (both oral and text-based) by adolescents with and without specific language impairment (SLI) and examine the extent to which language and social factors affect frequency of use.

METHOD

Both interview and diary methods were used to compare oral and text-based communication using cell phones by 17-year-olds: 52 adolescents with SLI and 52 typically developing (TD) peers.

RESULTS

Overall, adolescents with SLI are motivated users of mobile technology, and they engage with both oral uses (phoning) and text-based uses (text messaging). However, adolescents with SLI do not exchange text messages as often as their TD peers. Social rather than language factors are associated with frequency of cell phone use in adolescence.

CONCLUSIONS

These findings indicate that social difficulties restrict text-based uses of cell phones by adolescents with SLI, which can in turn reduce the opportunities that these adolescents have to develop social networks and make arrangements to engage in peer social interaction.

Data Recycling: Using Existing Databases to Increase Research Capacity in Speech-Language Development and Disorders

Purpose

This clinical forum was organized to provide a means for informing the research and clinical communities of one mechanism through which research capacity might be enhanced within the field of speech-language pathology. Specifically, forum authors describe the process of conducting secondary analyses of extant databases to answer questions of relevance to speech and language development and disorders.

Method

This prologue defines the concept of secondary analysis of databases and provides an overview of each of the articles that make up the forum.

Conclusion

Researchers invested in addressing basic and applied problems of relevance to speech and language services in schools can make use of a variety of extant databases to increase research capacity.

The Language and Literacy Development of Head Start Children: A Study Using the Family and Child Experiences Survey Database

Purpose

This article provides information about the Head Start Family and Children Experiences Survey (FACES). It also presents the findings of a study that capitalizes on the strengths of the data from FACES to investigate the impact of child and family characteristics, speech-language impairment, and the home literacy environment on the language and early literacy outcomes of children from low-income families.

Method

Data from the FACES 1997 cohort were used in this study. Variables included in the analysis were child and family characteristics (e.g., age, gender, ethnicity, etc.); parent report of speech-language impairment; frequency of home literacy activities; and children’s scores on vocabulary, letter-word identification, and early reading assessments.

Results

The results revealed that children’s vocabulary abilities in Head Start were affected by maternal education, ethnicity, and the frequency of home literacy activities, and children’s letter-word identification abilities were impacted by maternal education and the child’s gender and age. Additionally, children’s reading abilities in kindergarten were predicted by ethnicity, speech-language impairment, and the home literacy environment, as well as by children’s vocabulary and letter-word identification abilities in Head Start.

Conclusion

The findings demonstrate the unique contributions that the home literacy environment and the presence of speech-language impairment during preschool make in children’s early reading outcomes.

Present conceptualization of early childhood neurodevelopmental disabilities

Neurodevelopmental disabilities are collectively a common problem in child health that frequently prompts neurologic assessment and intervention. They are a group of heterogeneous conditions that share a disturbance in the acquisition of basic developmental skills in a chronologically appropriate manner. Lacking uniform diagnostic means of ascertainment, their recognition depends on fulfilling present consensus opinion regarding the various subtypes now recognized. Distinctive subtypes of neurodevelopmental disabilities can be accurately diagnosed according to present consensus conceptualization. Dual diagnosis of neurodevelopmental disabilities in the same child is possible, given present opinion. It can be expected that these conceptualizations will be dynamic and guide ongoing research efforts that will elucidate basic mechanisms, effective therapeutic interventions, and evaluate outcomes.

Using Language Sample Databases

Purpose

Over the past 50 years, language sample analysis (LSA) has evolved from a powerful research tool that is used to document children’s linguistic development into a powerful clinical tool that is used to identify and describe the language skills of children with language impairment. The The Systematic Analysis of Language Transcripts (SALT; J. F. Miller & A. Iglesias, 2008) Software Project has developed several databases of language samples from more than 6,000 typical speakers. This article presents an overview of the SALT databases and then demonstrates the power of these databases in classifying children with language impairment.

Method

Conversational language samples were elicited from 244 children with language impairment who were between 3 and 13 years of age. Language production measures generated from these transcripts were compared to measures from 244 transcripts in the SALT conversational database. A series of discriminant function analyses were completed to document the sensitivity and specificity of the language sample measures.

Results

The language sample measures were effective in classifying children based on their language status, with correct identification of 78% of the children with language impairment and 85% of the children who were typically developing.

Conclusion

The SALT databases provide a useful tool for the clinical management of children with language impairment.

The EpiSLI Database: A Publicly Available Database on Speech and Language

Purpose

This article describes a database that was created in the process of conducting a large-scale epidemiologic study of specific language impairment (SLI). As such, this database will be referred to as the EpiSLI database. Children with SLI have unexpected and unexplained difficulties learning and using spoken language. Although there is no uniform standard for the diagnosis of SLI, the construct encompasses a language deficit occurring in the presence of grossly normal sensory and nonverbal cognitive abilities (H. Tager-Flusberg & J. Cooper, 1999). Although these language difficulties are most apparent during the preschool and early school years, evidence now exists that these problems are usually present well into adulthood and are probably present throughout a person’s life (see, for instance, C. J. Johnson et al., 1999; S. E. Stothard, M. J. Snowling, D. V. M. Bishop, B. B. Chipchase, & C. A. Kaplan, 1998; J. B. Tomblin, 2008).

Discussion

Much of what we know of these children has come from research on children who have been clinically identified and served. Certainly, by studying those who are being served, our research base is most likely to be relevant to clinical services. However, there is a danger in this research strategy. It is quite possible that not all children with SLI are clinically identified and served within our service delivery systems. In such circumstances, there is the potential for systematic factors to influence which children do or do not find their way to clinical service.

Clinical Implications

If our research questions are concerned with the characteristics of the actual population of children with SLI that exists in our communities and not just those who are being served, then we need to turn to methods of epidemiology to aid our research.

Modeling developmental language difficulties from school entry into adulthood: literacy, mental health, and employment outcomes

PURPOSE

Understanding the long-term outcomes of developmental language difficulties is key to knowing what significance to attach to them. To date, most prognostic studies have tended to be clinical rather than population-based, which necessarily affects the interpretation. This study sought to address this issue using data from a U.K. birth cohort of 17,196 children, following them from school entry to adulthood, examining literacy, mental health, and employment at 34 years of age. The study compared groups with specific language impairment (SLI), nonspecific language impairment (N-SLI), and typically developing language (TL).

METHOD

Secondary data analysis of the imputed 5-year and 34-year data was carried using multivariate logistic regressions.

RESULTS

The results show strong associations for demographic and biological risk for both impairment groups. The associations are consistent for the N-SLI group but rather more mixed for the SLI group.

CONCLUSIONS

The data indicate that both SLI and N-SLI represent significant risk factors for all the outcomes identified. There is a strong case for the identification of these children and the development of appropriate interventions. The results are discussed in terms of the measures used and the implications for practice.

The effects of Fast ForWord Language on the phonemic awareness and reading skills of school-age children with language impairments and poor reading skills

PURPOSE

To examine the efficacy of Fast ForWord Language (FFW-L) and 2 other interventions for improving the phonemic awareness and reading skills of children with specific language impairment with concurrent poor reading skills.

METHOD

A total of 103 children (age 6;0 to 8;11 [years;months]) with language impairment and poor reading skills participated. The children received either FFW-L computerized intervention, a computer-assisted language intervention (CALI), an individualized language intervention (ILI), or an attention control (AC) computer program.

RESULTS

The children in the FFW-L, CALI, and ILI conditions made significantly greater gains in blending sounds in words compared with the AC group at immediate posttest. Long-term gains 6 months after treatment were not significant but yielded a medium effect size for blending sounds in words. None of the interventions led to significant changes in reading skills.

CONCLUSION

The improvement in phonemic awareness, but not reading, in the FFW-L, CALI, and ILI interventions limits their use with children who have language impairment and poor reading skills. Similar results across treatment conditions suggest that acoustically modified speech was not a necessary component for improving phonemic awareness.

Direct versus indirect and individual versus group modes of language therapy for children with primary language impairment: principal outcomes from a randomized controlled trial and economic evaluation

BACKGROUND

Many school-age children with language impairments are enrolled in mainstream schools and receive indirect language therapy, but there have been, to the authors' knowledge, no previous controlled studies comparing the outcomes and costs of direct and indirect intervention delivered by qualified therapists and therapy assistants, and each delivery mode offered to children individually or in groups.

AIMS

To investigate the relative effectiveness of indirect and direct intervention therapy modes delivered individually or in groups for children with primary language impairment.

METHODS & PROCEDURES

A multi-centre randomized controlled trial investigated 161 children with primary language impairment aged 6-11 years randomized to a usual-therapy control group or to direct individual, indirect individual, direct group or indirect group therapy modes. Intervention was delivered three times a week for 30-40-min sessions in mainstream schools over 15 weeks. Language performance was assessed at baseline, post-therapy and at 12 months. Cost analysis was based on salary and travel costs for intervention modes and usual therapy.

OUTCOMES & RESULTS

Compared with controls, children receiving project therapy made short-term improvements in expressive (p = 0.031), but not receptive, language immediately following intervention. Children with specific expressive language delay were more likely to show improvement than those with mixed receptive-expressive difficulties. The four project therapy modes did not differ on primary language outcomes (all p-values>0.392) and there were no further improvements evident at follow-up. Indirect group therapy was the least costly mode, with direct individual therapy the most costly.

CONCLUSIONS & IMPLICATIONS

Intervention in this age group can be effective for expressive language and can be delivered equally effectively though speech and language therapy assistants and to children in groups.

Linguistic and auditory temporal processing in children with specific language impairment

BACKGROUND

Several studies suggest the association of specific language impairment (SLI) to deficits in auditory processing. It has been evidenced that children with SLI present deficit in brief stimuli discrimination. Such deficit would lead to difficulties in developing phonological abilities necessary to map phonemes and to effectively and automatically code and decode words and sentences. However, the correlation between temporal processing (TP) and specific deficits in language disorders--such as syntactic comprehension abilities--has received little or no attention.

AIM

To analyze the correlation between: TP (through the Frequency Pattern Test--FPT) and Syntactic Complexity Comprehension (through a Sentence Comprehension Task).

METHOD

Sixteen children with typical language development (8;9 +/- 1;1 years) and seven children with SLI (8;1 +/- 1;2 years) participated on the study.

RESULTS

Accuracy of both groups decreased with the increase on syntactic complexity (both p < 0.01). On the between groups comparison, performance difference on the Test of Syntactic Complexity Comprehension (TSCC) was statistically significant (p = 0.02).As expected, children with SLI presented FPT performance outside reference values. On the SLI group, correlations between TSCC and FPT were positive and higher for high syntactic complexity (r = 0.97) than for low syntactic complexity (r = 0.51).

CONCLUSION

Results suggest that FPT is positively correlated to syntactic complexity comprehension abilities.The low performance on FPT could serve as an additional indicator of deficits in complex linguistic processing. Future studies should consider, besides the increase of the sample, longitudinal studies that investigate the effect of frequency pattern auditory training on performance in high syntactic complexity comprehension tasks.

Sprachstandserhebungsverfahren für Fünf- bis Zehnjährige (SET 5 – 10)

Der Erwerb der Sprache stellt eine der wesentlichen Entwicklungsherausforderungen der ersten Lebensjahre dar und steht in enger Wechselwirkung zu vielfältigen anderen Entwicklungs- und Leistungsbereichen. Epidemiologische Studien zeigen, dass kein anderer Entwicklungsbereich so häufig von Störungen betroffen ist wie der Sprachliche. Sprachstörungen sind oftmals mit gravierenden Folgen sowohl für die kognitive, speziell die schulische, als auch für die sozial-emotionale Entwicklung verbunden. Die Notwendigkeit einer Intervention bei Sprachentwicklungsstörungen ist unstrittig. Eine Indikationsstellung ist jedoch nur mit zuverlässigen diagnostischen Instrumenten möglich. Der SET 5 – 10 dient der aussagekräftigen Diagnostik des Sprachstands bei Fünf- bis Zehnjährigen. Die Konstruktionsstichprobe setzte sich aus 275 Kindern zusammen. Die Aufgabenanalyse ergab eine gute Verteilung der Schwierigkeitsindizes sowie zufriedenstellende Trennschärfe-Koeffizienten.

Epidemiology of speech and language impairment in a nationally representative sample of 4- to 5-year-old children

PURPOSE

To draw on multiple sources of information to determine prevalence of speech and language impairment in young Australian children.

METHOD

Information about 4,983 children (ages 4-5 years) from Growing Up in Australia: The Longitudinal Study of Australian Children (Australian Institute of Family Studies, 2007) was obtained via parent interviews and questionnaires, teacher questionnaires, and direct assessment. Data were statistically weighted to the Australian population of 253,202 children in the target age group.

RESULTS

Parent-reported prevalence: 25.2% had concerns about how their child talked and made speech sounds (11.8% "concerned"; 13.4% "a little concerned"), and 9.5% had concerns about how their child understood language (4.4% "concerned"; 5.1% "a little concerned"). Parents who reported concerns identified "speech not clear to others" as the most frequent area of difficulty (12.0%). Teacher-reported prevalence: 22.3% of children were considered to be less competent than others in their expressive language ability (6.7% "much less competent"; 15.6% "less competent"); 16.9% were considered to be less competent than others in their receptive language ability (4.0% "much less competent"; 12.9% "less competent"). The match between parent and teacher identification was higher for expressive speech and language concern than for receptive language. Direct assessment: 13.0% of children were 1-2 SDs below the mean on the Adapted Peabody Picture Vocabulary Test-III (S. Rothman, 2003), and a further 1.7% were > 2 SDs below the mean. Parent and teacher reports were significantly correlated with scores obtained via direct assessment. Period prevalence: Parents and teachers reported that 14.5% of children had accessed speech-language pathologist (SLP) services. 2.2% indicated that they needed but could not access an SLP.

CONCLUSION

Multiple indicators of speech and language impairment in diverse contexts confirmed the high prevalence of this condition in early childhood and a concomitant need for SLP services.

A nonword repetition task for speakers with misarticulations: the Syllable Repetition Task (SRT)

PURPOSE

Conceptual and methodological confounds occur when non(sense) word repetition tasks are administered to speakers who do not have the target speech sounds in their phonetic inventories or who habitually misarticulate targeted speech sounds. In this article, the authors (a) describe a nonword repetition task, the Syllable Repetiton Task (SRT), that eliminates this confound and (b) report findings from 3 validity studies.

METHOD

Ninety-five preschool children with speech delay and 63 with typical speech completed an assessment battery that included the Nonword Repetition Task (NRT; C. Dollaghan & T. F. Campbell, 1998) and the SRT. SRT stimuli include only 4 of the earliest occurring consonants and 1 early occurring vowel.

RESULTS

Study 1 findings indicated that the SRT eliminated the speech confound in nonword testing with speakers who misarticulate. Study 2 findings indicated that the accuracy of the SRT to identify expressive language impairment was comparable to findings for the NRT. Study 3 findings illustrated the SRT's potential to interrogate speech processing constraints underlying poor nonword repetition accuracy. Results supported both memorial and auditory-perceptual encoding constraints underlying nonword repetition errors in children with speech-language impairment.

CONCLUSION

The SRT appears to be a psychometrically stable and substantively informative nonword repetition task for emerging genetic research and other research with speakers who misarticulate.

PEDS and ASQ developmental screening tests may not identify the same children

OBJECTIVE

In analyzing data from a larger study, we noticed significant disagreement between results of 2 commonly used developmental screening tools (Parents' Evaluation of Developmental Status [PEDS; parent concern questionnaire] and Ages & Stages Questionnaires [ASQ; parent report of developmental skills]) delivered to children at the same visit in primary care. The screens have favorable reported psychometric properties and can be efficient to use in practice; however, there is little comparative information about the relative performance of these tools in primary care. We sought to describe the agreement between the 2 screens in this setting.

METHODS

Parents of 60 children aged 9 to 31 months completed PEDS and ASQ screens at the same visit. Concordance (PEDS and ASQ results agree) and discordance (results differ) for the 2 screens were determined.

RESULTS

The mean age of children was 17.6 months, 77% received Medicaid, and 50% of parents had a high school education or less. Overall, 37% failed the PEDS and 27% failed the ASQ. Thirty-one children passed (52%) both screens; 9 (15%) failed both; and 20 (33%) failed 1 but not the other (13 PEDS and 7 ASQ). Agreement between the 2 screening tests was only fair, statistically no different from agreement by chance.

CONCLUSIONS

There was substantial discordance between PEDS and ASQ developmental screens. Although these are preliminary data, clinicians need to be aware that in implementing revised American Academy of Pediatrics screening guidelines, the choice of screening instrument may affect which children are likely to be identified for additional evaluation.

Assessing the impact of FOXP1 mutations on developmental verbal dyspraxia

Neurodevelopmental disorders that disturb speech and language are highly heritable. Isolation of the underlying genetic risk factors has been hampered by complexity of the phenotype and potentially large number of contributing genes. One exception is the identification of rare heterozygous mutations of the FOXP2 gene in a monogenic syndrome characterised by impaired sequencing of articulatory gestures, disrupting speech (developmental verbal dyspraxia, DVD), as well as multiple deficits in expressive and receptive language. The protein encoded by FOXP2 belongs to a divergent subgroup of forkhead-box transcription factors, with a distinctive DNA-binding domain and motifs that mediate hetero- and homodimerisation. FOXP1, the most closely related member of this subgroup, can directly interact with FOXP2 and is co-expressed in neural structures relevant to speech and language disorders. Moreover, investigations of songbird orthologues indicate that combinatorial actions of the two proteins may play important roles in vocal learning, leading to the suggestion that human FOXP1 should be considered a strong candidate for involvement in DVD. Thus, in this study, we screened the entire coding region of FOXP1 (exons and flanking intronic sequence) for nucleotide changes in a panel of probands used earlier to detect novel mutations in FOXP2. A non-synonymous coding change was identified in a single proband, yielding a proline-to-alanine change (P215A). However, this was also found in a random control sample. Analyses of non-coding SNP changes did not find any correlation with affection status. We conclude that FOXP1 mutations are unlikely to represent a major cause of DVD.

Sprachentwicklungsstörungen bei Kindern

Wesentliche Voraussetzung für eine ungestörte Kindesentwicklung ist ein regelrechter Spracherwerb. Sprachentwicklungsstörungen (SES) im Kindesalter sind häufig. Für spezifische (isolierte) Sprachentwicklungsstörungen liegt die Prävalenz bei 6 – 8 %; hinzukommen SES, die mit anderen Störungen assoziiert sind. Da flächendeckende Sprachstandserfassungen im Kindergartenalter, die Kinder mit einem SES-Verdacht einer Diagnostik zuführen sollen, auch in Deutschland in den Blickpunkt rücken und eine erhebliche Unsicherheit in der Diagnosestellung von SES und der Verordnungspraxis für Sprachtherapie besteht, sollen die hier in gekürzter Form vorgestellten, überarbeiteten AWMF-Leitlinien der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie ( Neumann et al., 2008 ) zum Verständnis der Pathogenese von SES, ihrer Begriffsbestimmung, Diagnostik und Therapie beitragen.

[Pretend play ability in pre-school children]

Children with specific language impairment (SLI) are confronted with limitations in their language abilities that cannot be attributed to cognition, hearing impairments, or neurological deficits. However, there is evidence that children with SLI also have impairments. These include, for example, an impaired ability to pretend play. The current article aims to present firstly normal development of play behavior in children, followed by the Child-Initiated Pretend Play Assessment (ChIPPA). This test enables an objective and standardized assessment of whether a child's ability to initiate and sustain pretend play is age-appropriate. SLI children with impaired play behavior should receive structured individual therapy.

Fast mapping semantic features: performance of adults with normal language, history of disorders of spoken and written language, and attention deficit hyperactivity disorder on a word-learning task

PURPOSE

This study was designed to test the word learning abilities of adults with typical language abilities, those with a history of disorders of spoken or written language (hDSWL), and hDSWL plus attention deficit hyperactivity disorder (+ADHD).

METHODS

Sixty-eight adults were required to associate a novel object with a novel label, and then recognize semantic features of the object and phonological features of the label. Participants were tested for overt ability (accuracy) and covert processing (reaction time).

RESULTS

The +ADHD group was less accurate at mapping semantic features and slower to respond to lexical labels than both other groups. Different factors correlated with word learning performance for each group.

CONCLUSIONS

Adults with language and attention deficits are more impaired at word learning than adults with language deficits only. Despite behavioral profiles like typical peers, adults with hDSWL may use different processing strategies than their peers.

LEARNING OUTCOMES

Readers will be able to: (1) recognize the influence of a dual disability (hDSWL and ADHD) on word learning outcomes; (2) identify factors that may contribute to word learning in adults in terms of (a) the nature of the words to be learned and (b) the language processing of the learner.

Response time in adults with a history of language difficulties

The purpose of the study was to investigate speed of processing in college students with a history of problems with language. Affected individuals (n=16) were identified through a self-reported history of language and/or reading difficulties, and compared to a group of 16 unaffected individuals. Measures of language ability and a battery of response time tasks were administered. Results showed that the affected group had lower language performance and slower response time than the unaffected group. Better language performance was associated with faster response time, and this relationship was stronger in the affected group. These findings are consistent with the literature showing that language impairment often persists into adulthood. Further investigation of the relation between processing speed and language ability may help describe vulnerabilities for adults with language problems, as well as ways to promote compensation for those vulnerabilities.

LEARNING OUTCOMES

Readers will (1) increase understanding of associations between processing speed and language in children and adults; (2) become familiar with a method for assessing processing speed; and (3) increase understanding of possible vulnerabilities in adults with a history of language and/or reading problems.

Health-related quality of life of adolescents with childhood diagnosis of specific language impairment

OBJECTIVE

To evaluate the health-related quality of life (HRQoL) of adolescents with a diagnosis of specific language impairment (SLI).

METHODS

A clinical sample of 67 subjects with a childhood diagnosis of SLI, now aged 12-16, were asked to fill out the generic 16D HRQoL questionnaire. The comparison group comprised 235 typically developing peers. Another questionnaire gathered information about school and rehabilitation.

RESULTS

Of the surveyed 73% answered; 77% were male. Total HRQoL score between subjects and controls did not differ. The group profiles had some differences. The SLI group experienced more problems in the dimension of mental functioning (p=0.001), whereas the control group was worse off on the dimension vitality (p=0.003). In the SLI group, low vitality was related to low verbal IQ in childhood, and own perception of literacy problems. Long-term speech therapy was associated with problems in the dimension of speech.

CONCLUSIONS

The overall HRQoL of adolescents with SLI was at age-level, but language-related problems seemed to lead to increased problems in mental functioning. Low vitality was more of a problem for the controls, but also for those SLI children who had inferior language performance. Adolescents' own perceptions of their life quality are of clinical importance, and 16D seems a usable tool to capture them.

Identifying language impairment in children: combining language test scores with parental report

BACKGROUND

Children who meet language test criteria for specific language impairment (SLI) are not necessarily the same as those who are referred to a speech and language therapist.

AIMS

To consider how far this discrepancy reflects insensitivity of traditional language tests to clinically important features of language impairment.

METHODS & PROCEDURES

A total of 245 twin children, 52 of whom had been referred to a speech and language therapist for assessment or intervention, were studied. They were given a battery of language tests and their parents completed the Children's Communication Checklist - 2 (CCC-2).

RESULTS

Language tests that stressed verbal short-term memory were best at distinguishing clinically referred from other cases; narrative and vocabulary tasks were less effective. A discriminant function analysis identified a combination of language test and parental report measures as giving the best discrimination between referred and non-referred cases. Nevertheless, of 82 children classified as language impaired by the discriminant function, 44 had never been referred to a speech and language therapist. These did not appear to be false-positives; they scored at least as poorly as referred cases on literacy tests. They had significantly lower socio-economic backgrounds than referred cases.

CONCLUSIONS & IMPLICATIONS

Language test scores provide important information about which children are at risk of academic failure, though this varies from test to test. Reliance on language tests alone, however, is insufficient; a parental report provides important complementary information in the diagnostic process. Children of low socio-economic status with language problems are particularly likely to have no contact with speech and language therapist services.

Convergent genetic linkage and associations to language, speech and reading measures in families of probands with Specific Language Impairment

We analyzed genetic linkage and association of measures of language, speech and reading phenotypes to candidate regions in a single set of families ascertained for SLI. Sib-pair and family-based analyses were carried out for candidate gene loci for Reading Disability (RD) on chromosomes 1p36, 3p12-q13, 6p22, and 15q21, and the speech-language candidate region on 7q31 in a sample of 322 participants ascertained for Specific Language Impairment (SLI). Replication or suggestive replication of linkage was obtained in all of these regions, but the evidence suggests that the genetic influences may not be identical for the three domains. In particular, linkage analysis replicated the influence of genes on chromosome 6p for all three domains, but association analysis indicated that only one of the candidate genes for reading disability, KIAA0319, had a strong effect on language phenotypes. The findings are consistent with a multiple gene model of the comorbidity between language impairments and reading disability and have implications for neurocognitive developmental models and maturational processes.

Estimulación de narraciones infantiles

OBJETIVO: proveer evidencia sobre la contribución de estimular los guiones para el desarrollo narrativo en un grupo de niños con Trastorno Específico de Lenguaje y déficit narrativo. MÉTODOS: seis niños con Trastorno Específico del Lenguaje constituyeron el grupo experimental al que se le aplicó el programa y seis niños con Trastorno Específico del lenguaje conformaron el grupo control. Todos presentaban déficit narrativo y tenían un promedio de edad de 4 años, 5 meses. El programa se aplicó individualmente durante 18 sesiones. Se comparó el desempeño narrativo antes y después de la intervención en ambos grupos de niños. RESULTADOS: todos los niños del grupo experimental incrementaron significativamente su desarrollo narrativo. Incluso, el 50% de ellos logró niveles narrativos correspondientes a su edad cronológica. En el grupo control no se observó un aumento significativo. CONCLUSIONES: el programa basado en los guiones es una estrategia eficaz para estimular las habilidades narrativas tempranas en niños con Trastorno Específico del Lenguaje y déficit narrativo.

N400 responses of children with primary language disorder: intervention effects

Event-related brain potentials were examined in 6 to 8-year-old children with primary language disorder before and after a 5-week narrative-based language intervention. Participants listened to sentences ending with semantically congruous or incongruous words. By comparison with typical controls, the children with primary language disorder exhibited no pretreatment differences in their N400 responses to congruous and incongruous sentence-final words. After intervention, the typical incongruous-congruous difference was observable owing to a dramatic reduction in the amplitude of the N400 response to congruous words. These characteristic changes in brain responses may reflect a positive effect of the language intervention on the lexical-semantic processing skills in children with language impairment.

Evaluation of a deductive procedure to teach grammatical inflections to children with language impairment

PURPOSE

To evaluate the learning effects of a deductive language-teaching procedure when teaching a novel gender agreement verb inflection to children with language impairment.

METHOD

Thirty-two 6-8-year-old children with language impairment were randomly assigned to either a deductive (N = 16) or an inductive (N = 16) treatment group. In the deductive treatment, the examiner presented a rule guiding the novel inflection to be learned as well as models of the inflection. In the inductive treatment, only models of the verb inflection were presented. Learning was assessed in 3 different production contexts during each of 4 treatment sessions.

RESULTS

Significantly more participants in the deductive group than the inductive group acquired the novel morpheme based on a teaching probe (10 vs. 3), generalization probe (10 vs. 3), and maintenance probe (7 vs. 2). Task performance was not significantly influenced by language ability or nonverbal intelligence.

CONCLUSIONS

The deductive teaching procedure was found to be efficacious when teaching a novel grammatical inflection. However, this effect was limited because treatment gains varied across participants, testing contexts, and sessions. Future studies should continue to examine the efficacy of deductive procedures when integrated into traditional implicit approaches for children with language impairment.

Syntactic development in adolescents with a history of language impairments: a follow-up investigation

PURPOSE

Syntactic development in adolescents was examined using a spoken discourse task and standardized testing. The primary goal was to determine whether adolescents with a history of language impairments would differ from those with a history of typical language development (TLD). This is a companion study to one that examined these same adolescents 2 years earlier (M. A. Nippold, T. C. Mansfield, J. L. Billow, & J. B. Tomblin, 2008).

METHOD

The participants were 15-year-old adolescents with a history of specific language impairment (SLI; n = 102), nonspecific language impairment (NLI; n = 77), or TLD (n = 247). A sample of spoken discourse was elicited using a Peer Conflict Resolution (PCR) task and analyzed for mean length of T-unit, clausal density, and subordinate clause use. In addition, 2 subtests from the Clinical Evaluation of Language Fundamentals, Third Edition (E. Semel, E. H. Wiig, & W. A. Secord, 1995), Concepts and Directions and Recalling Sentences, were administered.

RESULTS

On the PCR task, the TLD group outperformed the SLI and NLI groups on mean length of T-unit, clausal density, and nominal clause use, and the TLD group outperformed the NLI group on relative clause use. On the standardized testing, the TLD group outperformed the SLI and NLI groups, and the SLI group outperformed the NLI group. Correlation coefficients calculated between the nonstandardized and standardized measures of syntax were statistically significant and positive.

CONCLUSIONS

Speech-language pathologists may wish to employ the PCR task to examine syntactic development in adolescents as a supplement to standardized testing.

Identification of children with language impairment: investigating the classification accuracy of the MacArthur-Bates Communicative Development Inventories, Level III

PURPOSE

This study tested the accuracy with which the MacArthur-Bates Communicative Development Inventories, Level III (CDI-III), a parent report measure of language ability, discriminated children with language impairment from those developing language typically.

METHOD

Parents of 58 children, 49 with typically developing language (age 30 to 42 months) and 9 with language impairment (age 31 to 45 months) completed the CDI-III, a 2-page questionnaire that includes 100 vocabulary items, 12 sentence pairs, and 12 questions regarding linguistic concepts.

RESULTS

A discriminant analysis indicated that the CDI-III total score together with age classified children into language status groups with 96.6% accuracy overall. The corresponding likelihood ratios supported this strong level of accuracy, although precision may not be as high as indicated by broad confidence intervals.

CONCLUSIONS

Results of this study contribute to the accumulating evidence on the types of valid inferences that may be made from the CDI-III, specifically its classification accuracy. Further research should continue to investigate classification accuracy in larger samples with broader maternal education levels and with different types of language impairments. Additional research should also investigate the classification accuracy when the CDI-III is used in combination with other tests.

Relation of three mechanisms of working memory to children’s complex span performance

There is a paucity of research examining the relative contribution of the different mechanisms of working memory (short-term storage [STM], processing speed) to children’s complex memory span. This study served to replicate and extend the few extant studies that have examined the issue. In this study, the relative contribution of three mechanisms of working memory — STM storage, processing speed, attentional resource allocation — to children’s complex span was examined. Children (6—12) completed a digit span task, an auditory-visual reaction time task, a task of attentional allocation, and a complex (listening) span task. Correlation analyses revealed that, after controlling for age, storage, processing speed, and attentional allocation significantly correlated with complex span. Regression analyses showed that, after partialling out age, storage accounted for 12.1% of unique variance in complex span and processing speed accounted for another 6.6% of unique variance; allocation contributed no unique variance. Consistent with the developmental literature, storage and general processing speed play critical roles in children’s complex span performance.

Overlap between autism and specific language impairment: comparison of Autism Diagnostic Interview and Autism Diagnostic Observation Schedule scores

Autism and specific language impairment (SLI) are developmental disorders that, although distinct by definition, have in common some features of both language and social behavior. The goal of this study was to further explore the extent to which specific clinical features of autism are seen in SLI. The children with the two disorders, matched for non-verbal IQ, were compared on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). In the SLI group, 41% met autism or autism spectrum cut-offs for social or communication domains either on the ADI or ADOS or both. No relationship was found between the language deficits exhibited by the children with SLI and their scores on the ADI and ADOS. These findings contribute to evidence that there is some overlap in social and communicative deficits between autism and SLI, supporting the view that autism and SLI share etiologic factors. This continuum of pathology between SLI and autism appears to range from structural language abnormalities as seen in individuals with SLI to individuals with SLI with both structural and social abnormalities to individuals with autism with pragmatic impairment and language abnormalities.

Qualitative aspects of developmental language impairment relate to language and literacy outcome in adulthood

BACKGROUND

Developmental language disorder is a heterogeneous diagnostic category. Little research has compared the long-term outcomes of children with different subtypes of language impairment.

AIMS

To determine whether the pattern of language impairment in childhood related to language and literacy outcomes in adulthood.

METHODS & PROCEDURES

Adults who took part in previous studies as children were traced. There were four groups of participants, each with a different childhood diagnosis: specific language impairment (SLI; n = 19, mean age at follow-up = 24;8), pragmatic language impairment (PLI; n = 7, mean age at follow-up = 22;3), autism spectrum disorder (ASD; n = 11; mean age at follow-up = 21;9), and no childhood diagnosis (typical; n = 12; mean age at follow-up = 21;6). Participants were administered a battery of language and literacy tests.

OUTCOMES & RESULTS

Adults with a history of SLI had persisting language impairment as well as considerable literacy difficulties. Pragmatic deficits also appeared to develop over time in these individuals. The PLI group had enduring difficulties with language use, but presented with relatively intact language and literacy skills. Although there were some similarities in the language profile of the PLI and ASD groups, the ASD group was found to have more severe pragmatic deficits and parent-reported linguistic difficulties in conversational speech.

CONCLUSIONS & IMPLICATIONS

The pattern of deficits observed in different subtypes of developmental language disorder persists into adulthood. The findings highlight the importance of a wide-ranging clinical assessment in childhood, which may provide an indication of outcome in adulthood.