Prevalence of specific language impairment in kindergarten children

Primary or "specific" language impairment and children learning a second language

We review empirical findings from children with primary or "specific" language impairment (PLI) and children who learn a single language from birth (L1) and a second language (L2) beginning in childhood. The PLI profile is presented in terms of both language and nonlinguistic features. The discussion of L2 learners emphasizes variable patterns of growth and skill distribution in L1 and L2 which complicate the identification of PLI in linguistically diverse learners. We then introduce our research program, designed to map out common ground and potential fault lines between typically developing children learning one or two languages, as compared to children with PLI.

Speech disruptions in the sentence formulation of school-age children with specific language impairment

BACKGROUND

Many school-age children with specific language impairment produce sentences that appear to conform to the adult grammar. It may be premature to conclude from this, however, that their language formulation ability is age appropriate.

AIMS

To determine whether a more subtle measure of language use, speech disruptions during sentence formulation, might serve to distinguish children with specific language impairment from their typically developing peers at an age when grammatical accuracy was high. We analysed the rate of speech disruptions in simple sentence production in school-age children with specific language impairment and typically developing age-matched peers. We predicted that: (1) the specific language impairment group would exhibit more speech disruptions than the typically developing group as a result of reduced language proficiency even when grammatical accuracy was high; and (2) the specific language impairment group would demonstrate greater reductions in disruption frequency as compared with the typically developing group when given sentences that model the target syntactic structures.

METHODS & PROCEDURES

Twenty-eight children (17 specific language impairment, 11 typically developing, mean = 8;10 years) with no history of stuttering were presented with a series of picture pairs. The examiner described the first picture using a simple sentence and asked the child to repeat the sentence; the child then described the second picture. There were two priming conditions: Matching Syntax condition (paired pictures requiring different syntactic structures) and Different Syntax condition (paired pictures requiring different syntax structures). All testing was audio-recorded and speech disruptions (repetitions, revisions, fillers, long silent pauses) were transcribed and tabulated for each target response. The data were analysed by analysis of variance (ANOVA).

OUTCOMES & RESULTS

The specific language impairment group demonstrated a significantly greater number of speech disruptions when compared with the typically developing group. There was no effect for priming.

CONCLUSIONS & IMPLICATIONS

School-age children with specific language impairment appear to have difficulty with sentence formulation when compared with typically developing peers even when grammatical accuracy is high. We concluded that school-age children with specific language impairment may demonstrate subtle but persistent language formulation difficulties.

Is expressive language disorder an accurate diagnostic category?

PURPOSE

To propose that the diagnostic category of "expressive language disorder" as distinct from a disorder of both expressive and receptive language might not be accurate.

METHOD

Evidence that casts doubt on a pure form of this disorder is reviewed from several sources, including the literature on genetic findings, theories of language impairments, and the outcomes of late talkers with expressive language delays. Areas of language that are problematic in production but not readily amenable to comprehension testing are also discussed.

CONCLUSIONS

The notion of expressive language disorder has been formalized in classification systems and is implicit if not explicit in the organization of many standardized tests. However, a close inspection of the evidence suggests that deficits in language expression are typically accompanied by limitations in language knowledge or difficulties processing language input. For this reason, the diagnostic category of expressive language disorder should be used with considerable caution. This view has implications for both research and clinical practice.

The diagnostic accuracy and construct validity of the structured photographic expressive language test--preschool: second edition

PURPOSE

In order to support evidence-based practice, this study served to evaluate the diagnostic accuracy, convergent validity, and divergent validity of the Structured Photographic Expressive Language Test-Preschool: Second Edition (SPELT-P2; J. Dawson, J. A. Eyer, J. Fonkalsrud, 2005) in order to determine whether it can be used as a valid measure for identifying language impairment in preschoolers.

METHOD

The SPELT-P2 was administered to 54 children with typically developing language and 42 children with specific language impairment.

RESULTS

A discriminant analysis revealed good sensitivity (90.6%), good specificity (100%), and good positive and negative likelihood ratios, with a standard score cutoff point of 87 used to determine group membership. Analyses of convergent and divergent validity also supported use of the SPELT-P2 for identifying language impairment in preschoolers.

IMPLICATIONS

The empirical evidence supports use of the SPELT-P2 as a valid measure for correctly identifying the presence or absence of language impairment in 4- and 5-year-old preschool children.

Grammatical Morpheme Effects on Sentence Processing by School-Aged Adolescents with Specific Language Impairment

Sixteen-year-olds with specific language impairment (SLI), nonspecific language impairment (NLI), and those showing typical language development (TD) responded to target words in sentences that were either grammatical or contained a grammatical error immediately before the target word. The TD participants showed the expected slower response times (RTs) when errors preceded the target word, regardless of error type. The SLI and NLI groups also showed the expected slowing, except when the error type involved the omission of a tense/agreement inflection. This response pattern mirrored an early developmental period of alternating between using and omitting tense/agreement inflections that is characteristic of SLI and NLI. The findings could not be readily attributed to factors such as insensitivity to omissions in general or insensitivity to the particular phonetic forms used to mark tense/agreement. The observed response pattern may represent continued difficulty with tense/agreement morphology that persists in subtle form into adolescence.

Genes, cognition, and communication: insights from neurodevelopmental disorders

Twin and family studies have demonstrated that most cognitive traits are moderately to highly heritable. Neurodevelopmental disorders such as dyslexia, autism, and specific language impairment (SLI) also show strong genetic influence. Nevertheless, it has proved difficult for researchers to identify genes that would explain substantial amounts of variance in cognitive traits or disorders. Although this observation may seem paradoxical, it fits with a multifactorial model of how complex human traits are influenced by numerous genes that interact with one another, and with the environment, to produce a specific phenotype. Such a model can also explain why genetic influences on cognition have not vanished in the course of human evolution. Recent linkage and association studies of SLI and dyslexia are reviewed to illustrate these points. The role of nonheritable genetic mutations (sporadic copy number variants) in causing autism is also discussed. Finally, research on phenotypic correlates of allelic variation in the genes ASPM and microcephalin is considered; initial interest in these as genes for brain size or intelligence has been dampened by a failure to find phenotypic differences in people with different versions of these genes. There is a current vogue for investigators to include measures of allelic variants in studies of cognition and cognitive disorders. It is important to be aware that the effect sizes associated with these variants are typically small and hard to detect without extremely large sample sizes.

Use of gesture development in profiling children's prelinguistic communication skills

PURPOSE

Comparing children's skills across and within domains of development has become a standard in providing early intervention services. Profiling a child's strengths and challenges can help in making decisions regarding eligibility, diagnosis, and intervention. Profiling is particularly important for children who are not yet talking, due to the variability in production skills and the lack of guidelines as to which children are "at risk" for communication deficits versus those who are "late talkers." One area underutilized in profiling is gesture development, despite the fact that research has indicated that the amount and type of gesture use can help in early identification and is predictive of later language.

METHOD

To guide practicing professionals and researchers in using gesture development to profile children's communication skills, this article provides an overview of the types of gestures and their development, describes assessment methods and tools to document gesture development, pinpoints behaviors and factors important in identifying children with disabilities, and ends with brief examples of using profiling in assessment and intervention planning.

CONCLUSIONS

Gesture use should be an important component in profiling children's communication skills, and this type of profiling can enhance both the assessment and intervention process.

Language and reading abilities of children with autism spectrum disorders and specific language impairment and their first-degree relatives

Autism spectrum disorder (ASD) and specific language impairment (SLI) are developmental disorders exhibiting language deficits, but it is unclear whether they arise from similar etiologies. Language impairments have been described in family members of children with ASD and SLI, but few studies have quantified them. In this study, we examined IQ, language, and reading abilities of ASD and SLI children and their first-degree relatives to address whether the language difficulties observed in some children with ASD are familial and to better understand the degree of overlap between these disorders and their broader phenotypes. Participants were 52 autistic children, 36 children with SLI, their siblings, and their parents. The ASD group was divided into those with (ALI, n=32) and without (ALN, n=20) language impairment. Relationships between ASD severity and language performance were also examined in the ASD probands. ALI and SLI probands performed similarly on most measures while ALN probands scored higher. ALN and ALI probands' language scores were not related to Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule algorithm scores. SLI relatives scored lowest on all measures, and while scores were not in the impaired range, relatives of ALI children scored lower than relatives of ALN children on some measures, though not those showing highest heritability in SLI. Given that ALI relatives performed better than SLI relatives across the language measures, the hypothesis that ALI and SLI families share similar genetic loading for language is not strongly supported.

Managing referrals for children with receptive language delay

This study investigates relations between language and cognitive scores in children with receptive language (RL) delay and suggests guidelines for referral for cognitive testing. This retrospective review of the test scores of 41 children, ages 17 to 76 months (mean = 37.7 months), focuses on examining associations between RL and cognitive scores. Results show that mean RL scores are positively correlated with mean cognitive scores and that receptive scores are significant predictors of cognitive performance. Children with RL scores of >1 standard deviation below the mean are at risk for concomitant cognitive deficits. Because children with RL delay are at considerable risk for cognitive deficits, the authors recommend considering referral for cognitive testing when RL standard scores fall below 85.

SPEEDY babies: A putative new behavioral syndrome of unbalanced motor-speech development

Even though difficulties in motor development in children with speech and language disorders are widely known, hardly any attention is paid to the association between atypically rapidly occurring unassisted walking and delayed speech development. The four children described here presented with a developmental behavioral triad: 1) atypically speedy motor development, 2) impaired expressive speech, and 3) tongue carriage dysfunction resulting in related misarticulations. Those characteristics might be phenotypically or genetically clustered. These children didn't have impaired cognition, neurological or mental disease, defective sense organs, craniofacial dysmorphology or susceptibility to upper respiratory infections, particularly recurrent otitis media. Attention should be paid on discordant and unbalanced achievement of developmental milestones. Present children are termed SPEEDY babies, where SPEEDY refers to rapid independent walking, SPEE and DY to dyspractic or dysfunctional speech development and lingual dysfunction resulting in linguoalveolar misarticulations. SPEEDY babies require health care that recognizes and respects their motor skills and supports their needs for motor activities and on the other hand include treatment for impaired speech. The parents may need advice and support with these children.

Are working memory measures free of socioeconomic influence?

PURPOSE

This study evaluated the impact of socioeconomic factors on children's performance on tests of working memory and vocabulary.

METHOD

Twenty Brazilian children, aged 6 and 7 years, from low-income families, completed tests of working memory (verbal short-term memory and verbal complex span) and vocabulary (expressive and receptive). A further group of Brazilian children from families of higher socioeconomic status matched for age, gender, and nonverbal ability also participated in the study.

RESULTS

Children from the low socioeconomic group obtained significantly lower scores on measures of expressive and receptive vocabulary than their higher income peers but no significant group differences were found on the working memory measures.

CONCLUSION

Measures of working memory provide assessments of cognitive abilities that appear to be impervious to substantial differences in socioeconomic background. As these measures are highly sensitive to language ability and learning in general, they appear to provide useful methods for diagnosing specific learning difficulties that are independent of environmental opportunity.

Reading achievement growth in children with language impairments

PURPOSE

This study examined the reading achievement growth of children with language impairments (LI) across the school grades. The authors sought to determine whether children with LI demonstrate a delayed, deficit, or cumulative pattern of reading achievement growth when compared with children with typical language (TL).

METHOD

A group of 225 children with LI and a group of 379 children with TL were identified in kindergarten and were administered multiple measures of word recognition and reading comprehension in 2nd, 4th, 8th, and 10th grades.

RESULTS

Confirmatory factor analyses indicated that the constructs of word recognition and reading comprehension were invariant across grades and groups of children with LI and TL. Further analyses indicated that a multiple group latent growth curve analysis was appropriate. This analysis showed that children with LI differed significantly from children with TL in initial level (2nd grade) of word recognition and reading comprehension, but they did not differ significantly in the shape of their growth trajectories.

CONCLUSION

These results are consistent with a deficit model of reading growth in children with LI. Findings are discussed in terms of implications for early identification.

A functional genetic link between distinct developmental language disorders

BACKGROUND

Rare mutations affecting the FOXP2 transcription factor cause a monogenic speech and language disorder. We hypothesized that neural pathways downstream of FOXP2 influence more common phenotypes, such as specific language impairment.

METHODS

We performed genomic screening for regions bound by FOXP2 using chromatin immunoprecipitation, which led us to focus on one particular gene that was a strong candidate for involvement in language impairments. We then tested for associations between single-nucleotide polymorphisms (SNPs) in this gene and language deficits in a well-characterized set of 184 families affected with specific language impairment.

RESULTS

We found that FOXP2 binds to and dramatically down-regulates CNTNAP2, a gene that encodes a neurexin and is expressed in the developing human cortex. On analyzing CNTNAP2 polymorphisms in children with typical specific language impairment, we detected significant quantitative associations with nonsense-word repetition, a heritable behavioral marker of this disorder (peak association, P=5.0x10(-5) at SNP rs17236239). Intriguingly, this region coincides with one associated with language delays in children with autism.

CONCLUSIONS

The FOXP2-CNTNAP2 pathway provides a mechanistic link between clinically distinct syndromes involving disrupted language.

Expository discourse in adolescents with language impairments: examining syntactic development

PURPOSE

This study examined syntactic development in a large cohort of adolescents. At kindergarten, each participant had been identified as having specific language impairment (SLI), nonspecific language impairment (NLI), or typical language development (TLD).

METHOD

The participants (n = 444) had a mean age of 13;11 (years;months; range = 12;10-15;5). Language samples were elicited in 2 genres, conversational and expository, and analyzed for mean length of T-unit and subordinate clause production.

RESULTS

Mean length of T-unit and the use of nominal, relative, and adverbial clauses were greater during the expository task than the conversational task for all groups. Thus, even the SLI and NLI groups produced longer sentences containing greater amounts of subordination when speaking in the expository genre than in the conversational genre. No group differences were revealed by the conversational task. However, on the expository task, the TLD group outperformed both the SLI and NLI groups on mean length of T-unit, and the TLD group outperformed the NLI group on relative clause use.

CONCLUSIONS

Speech-language pathologists may wish to employ expository discourse tasks rather than conversational tasks to examine syntactic development in adolescents.

Autistic symptomatology and language ability in autism spectrum disorder and specific language impairment

BACKGROUND

Autism spectrum disorders (ASD) and specific language impairment (SLI) are common developmental disorders characterised by deficits in language and communication. The nature of the relationship between them continues to be a matter of debate. This study investigates whether the co-occurrence of ASD and language impairment is associated with differences in severity or pattern of autistic symptomatology or language profile.

METHODS

Participants (N = 97) were drawn from a total population cohort of 56,946 screened as part of study to ascertain the prevalence of ASD, aged 9 to 14 years. All children received an ICD-10 clinical diagnosis of ASD or No ASD. Children with nonverbal IQ > or =80 were divided into those with a language impairment (language score of 77 or less) and those without, creating three groups: children with ASD and a language impairment (ALI; N = 41), those with ASD and but no language impairment (ANL; N = 31) and those with language impairment but no ASD (SLI; N = 25).

RESULTS

Children with ALI did not show more current autistic symptoms than those with ANL. Children with SLI were well below the threshold for ASD. Their social adaptation was higher than the ASD groups, but still nearly 2 SD below average. In ALI the combination of ASD and language impairment was associated with weaker functional communication and more severe receptive language difficulties than those found in SLI. Receptive and expressive language were equally impaired in ALI, whereas in SLI receptive language was stronger than expressive.

CONCLUSIONS

Co-occurrence of ASD and language impairment is not associated with increased current autistic symptomatology but appears to be associated with greater impairment in receptive language and functional communication.

The case against routine electroencephalography in specific language impairment

BACKGROUND

Specific language impairment is a primary developmental language disorder in which language is impaired disproportionately to other developmental domains. Electroencephalography is often conducted in the medical investigation of a child with specific language impairment; however, at present, there is uncertainty regarding necessary testing using electroencephalography.

METHODS

The cases of 111 children with the diagnosis of specific language impairment over a 10-year interval, who also underwent electroencephalography, were systematically reviewed in a retrospective manner. Children with a history of previous afebrile seizures, acquired language delay, or documented language regression, developmental delay, hearing loss, coexisting autistic features, and known central nervous system disorders were excluded.

RESULTS

The majority (76%) of the children were boys. Thirty-five (31.5%) children had abnormal electroencephalography results, including 7 (6.3%) children with epileptiform activity. This is higher than the prevalence rate of epileptiform activity in a historical cohort of 3726 (3.54%) children but not statistically significant. The epileptiform activity was deemed active in only 3 of 7 patients and was not related to the specific type of language delay observed. CONCLUSIONS. Although abnormal electroencephalographic activity is seen frequently in children with specific language impairment, epileptiform activity is rare and without apparent impact on clinical care. Awake electroencephalography does not seem to be useful in the routine diagnostic evaluation of young children with specific language impairment, although further investigations of both wake and sleep electroencephalography in this homogenous population must be conducted before definitive recommendations can be made.

Toward validation of a minimal competence phonetic core for african american children

PURPOSE

This study aimed to show (a) whether the minimal competence core (MCC) of consonants used by African American preschoolers in I. Stockman (2006) can be observed in a larger group of children using shorter and more controlled speech samples and (b) whether the MCC pass/fail outcomes are differentially related to performance on selected criterion measures of typical and atypical speech.

METHOD

Word-initial single and clustered consonants were sampled in the conversational speech of 120 Head Start students who were distributed in a northern (Lansing, Michigan) and a southern (Baton Rouge, Louisiana) regional location.

RESULTS

The data generally corroborated the earlier preliminary report, which was based on just 7 children. More than 80% of the children met criteria for passing the core set of phonetic competencies, which included word-initial consonant clusters and 13 consonant singletons. Pass/fail outcomes were significantly related to suspected clinical delay and the overall Percentage of Consonants Correct-Revised (PCC-R).

CONCLUSION

The initial consonant core identified in this study is potentially useful for identifying speech delay among young African American children. Clinical and research issues related to its use for diagnostic screening are discussed.

Speech and language development and disorders in children

Language disorders are identified when a person has difficulty with expressive language, receptive language, or pragmatic language. Speech disorders are identified when a person's voice, fluency, or articulation call attention to the speaker because his or her speech is sufficiently different from the norm. Speech and language development should be consistent with a child's overall development and can be tracked using typical milestone markers. Differential diagnosis is critical to designing appropriate intervention, which should be tailored to the parents' goals along with the child's clinical and educational needs. Early identification and intervention assist in educational planning and are often associated with better long-term outcomes. Any speech-language therapy plan should be designed with measurable goals and consistent monitoring of progress toward those goals.

Role of working memory in typically developing children's complex sentence comprehension

The influence of three mechanisms of working memory (phonological short-term memory (PSTM capacity), attentional resource control/allocation, and processing speed) on children's complex (and simple) sentence comprehension was investigated. Fifty two children (6-12 years) completed a nonword repetition task (indexing PSTM), concurrent verbal processing-storage task (indexing resource control/allocation), auditory-visual reaction time (RT) task (indexing processing speed), and a sentence comprehension task that included complex and simple sentences. Correlation and regression analyses were run to determine the association between the memory variables and sentence comprehension accuracy. Results revealed: (1) none of the memory variables correlated with simple sentence comprehension, (2) resource control/allocation and processing speed correlated significantly with complex sentence comprehension, even after covarying for age, and (3) attentional functioning and processing speed predicted complex sentence comprehension (after accounting for age). Results were interpreted to suggest that working memory is significantly involved in school age children's comprehension of familiar complex sentence structures.

Social knowledge in children with language impairments: examination of strategies, predicted consequences, and goals in peer conflict situations

This study investigated social knowledge in school-age children, aged 8-12 years, with and without language impairment (LI and TD groups). A hypothetical peer conflict task was administered to examine the relationship among prosocial responses and parent/teacher ratings of children's social behaviours. Stimuli included 12 hypothetical peer conflict vignettes presented in an open-ended and forced choice condition. The LI group generated (open-ended) and selected (forced choice) fewer prosocial strategies. When asked to predict a friend's reaction to a selected conflict resolution strategy, the LI group predicted fewer positive consequences; however, the proportion of prosocial strategies followed by prediction of a positive peer consequence was similar across groups. Both groups identified more self-interest than relationship goals as the rationale for selected strategies. In the LI group, teacher ratings of children's social skills and problems in peer provocation situations were associated with selection of prosocial strategies. Implications for clinical service providers are discussed.

Neurological and magnetic resonance imaging findings in children with developmental language impairment

Neurologic and radiologic findings in children with well-defined developmental language impairment have rarely been systematically assessed. Children aged 7 to 13 years with developmental language impairment or normal language (controls) underwent language, nonverbal cognitive, motor and neurological assessments, standardized assessment for subtle neurological signs, and magnetic resonance imaging. Nine children with developmental language impairment and 12 controls participated. No focal abnormalities were identified on standard neurological examination. Age and developmental language impairment were independent predictors of neurological subtle signs scores (r(2) = 0.52). Imaging abnormalities were identified in two boys with developmental language impairment and no controls (P = .17). Lesions identified were predicted neither by history nor by neurological examination. Previously unsuspected lesions were identified in almost 25% of children with developmental language impairment. Constraints regarding cooperation and sedation requirements may limit the clinical application of imaging modalities in this population.

Sensitivity of a system of care in recognizing communication disorders in children with serious emotional disorders

This study evaluated the sensitivity and specificity of a system of care (SOC) in identifying communication disorders in children with serious emotional disorders (SED). Speech/language screenings were completed on 39 children. Children showing possible communication disorders received comprehensive speech-language evaluations. Records were reviewed for communication disorders suspected and identified by the SOC and for services provided. Results showed that the SOC was poor in identifying communication disorders in children with SED. This study underscores the importance of SOCs addressing the needs for appropriate identification and treatment of communication disorders in children with SED.

Self-esteem, shyness, and sociability in adolescents with specific language impairment (SLI)

PURPOSE

To determine if lower global self-esteem, shyness, and low sociability are outcomes associated with SLI in adolescence. Possible concurrent predictive relationships and gender differences were also examined.

METHOD

Fifty-four adolescents with SLI, aged between 16 and 17 years, were compared with a group of 54 adolescents with typical language abilities on the Rosenberg Self-Esteem scale (Rosenberg, 1965) and the Cheek and Buss Shyness and Sociability scales (Cheek & Buss, 1981).

RESULTS

The SLI group had significantly lower global self-esteem scores than the group with typical language abilities. The adolescents with SLI were more shy than their peers, but the groups did not differ in their sociability ratings. Regression analysis found that language ability was not concurrently predictive of self-esteem but shyness was. Mediation analysis suggested that shyness could be a partial but significant mediator in the relationship between language ability and global self-esteem.

CONCLUSIONS

Older adolescents with SLI are at risk of lower global self-esteem and experience shyness, although they want to interact socially. The relationship between language ability and self-esteem at this point in adolescence is complex, with shyness potentially playing an important mediating role.

Language and Literacy Connections for Children Who are African American

Focusing on the links between language and literacy, this paper discusses possible reasons for the persistent reading skill gap between African American and White children. Three theories that describe the mechanisms through which the use of African American English (AAE) might affect literacy learning include (a) teacher bias against AAE, (b) the mismatch between the phonological and morphosyntactic structure of AAE and Standard or Mainstream American English (SAE), and (c) the linguistic flexibility theory, which suggests that it is not the mismatch per se that interferes with literacy learning, but rather students' limited linguistic flexibility. Thus, children who have strong linguistic flexibility are able to switch between the phonological and morphosyntactic structures of AAE and text SAE facilely, but children with weaker linguistic flexibility do not. Plus, a disproportionate number of African American children live in poverty. Thus, they tend to have weaker language and vocabulary skills (and, hence, less linguistic flexibility) when compared to their more affluent peers. By promoting teachers' understanding and sensitivity to students' AAE use and encouraging the use of more effective instructional strategies that are responsive to students' skills and areas of weakness, SLPs can work with teachers to help them understand ways to support African American children's language and literacy learning.

Speech disruptions in the narratives of English-speaking children with specific language impairment

PURPOSE

This study examined the types, frequencies, and distribution of speech disruptions in the spoken narratives of children with specific language impairment (SLI) and their age-matched (CA) and language-matched (LA) peers.

METHOD

Twenty 4th-grade children with SLI, 20 typically developing CA children, and 20 younger typically developing LA children were included in this study. Speech disruptions (i.e., silent pauses and vocal hesitations) occurring in the narratives of these children were analyzed.

RESULTS

Children with SLI exhibited speech disruption rates that were higher than those of their age-matched peers but not higher than those of their language-matched peers. The difference in disruption rates between the SLI and CA groups was restricted to silent pauses of 500-1000 ms. Moreover, children with SLI produced more speech disruptions than their peers before phrases but not before sentences, clauses, or words.

CONCLUSIONS

These findings suggest that there is a relationship between language ability and speech disruptions. Higher disruption rates at phrase boundaries in children with SLI than in their age-matched peers reflect lexical and syntactic deficits in children with SLI.

Characterizing the growth trajectories of language-impaired children between 7 and 11 years of age

BACKGROUND

A number of different systems have been suggested for classifying language impairment in children but, to date, no one system has been widely accepted.

METHOD

This paper outlines an alternative system looking for distinct patterns of change in receptive language skills across time, involving a secondary analysis of children identified as having specific language impairment. Participants The participants were 184 children age-assessed at 3 time points--7, 8, and 11 years of age.

RESULTS

The pattern of receptive language development is highly predictable. The dominant pattern of growth is consistent with declining rates of growth over time for all children. The primary way in which the children differ is with respect to their initial severity. The testing of the 2 classification systems revealed some statistically significant differences among the subtypes with regard to the shape of the growth rates, but the effect sizes associated with these differences were very small. Thus, it is possible to conclude that beyond the dominant pattern of growth, some subtypes of language impairment at 7 years of age showed only subtle differences in receptive language change across time. The results are discussed in terms of the sample selection and the age of the children who were studied.

Oral and written language development of children adopted from china

PURPOSE

The sharp increase in the number of international adoptions in the United States has prompted a heightened interest in the language development of internationally adopted children. Although recent studies have investigated the early language development of adoptees, little is known about the school-age language and literacy skills of internationally adopted children. The focus of this study was the oral and written language skills of school-age adoptees from China.

METHOD

The participants were 24 children between the ages of 7;0 (years;months) and 8;8. Oral and written language skills were assessed using standardized measures and a narrative retell task.

RESULTS

As a group, the majority of children exhibited scores in the average to above average range for all oral and written standardized language measures. Narrative analysis indicated that an increase in the number of grammatical errors was moderately correlated with lower reading comprehension scores. Age at adoption was negatively correlated with several measures, including a narrative measure of grammatical errors per T-unit.

CONCLUSION

These findings provide an encouraging outlook on the oral and written language outcomes of internationally adopted children from China through the early elementary grades. Moreover, these findings support earlier research that speaks to the resiliency and robustness of language acquisition abilities in children.

Working memory and learning in children with developmental coordination disorder and specific language impairment

The authors compared 6- to 11-year-olds with developmental coordination disorder (DCD) and those with specific language impairment (SLI) on measures of memory (verbal and visuospatial short-term and working memory) and learning (reading and mathematics). Children with DCD with typical language skills were impaired in all four areas of memory function for their age level, and this pattern was also found to be characteristic of a larger DCD group with varied language abilities. SLI-group deficits in standard scores were observed for the verbal versions of the short-term and working memory tasks only. There were also differential links between memory and attainment between the two groups, with visuospatial working memory strongly related to numeracy in the SLI group and all of the memory measures correlated with at least one attainment measure in the DCD group. Reasons for why working memory contributes to learning in these two developmental groups are discussed.

Grammaticality judgements in adolescents with and without language impairment

BACKGROUND

Existing evidence suggests that young children with specific language impairment have unusual difficulty in detecting omissions of obligatory tense-marking morphemes, but little is known about adolescents' sensitivity to such violations.

AIMS

The study investigated whether limitations in receptive morphosyntax (as measured by grammaticality judgements) were present at age 16 years, and, if so, whether participants' profiles showed less sensitivity to omissions of tense and agreement morphemes than to (1) inappropriate uses (intrusions) of these same morphemes, and (2) omissions of morphemes that do not encode tense and agreement. The study also compared adolescents with language impairment and non-verbal IQ more than 1 standard deviation (SD) below the mean (nonspecific language impairment) to adolescents with specific language impairment.

METHODS & PROCEDURES

Adolescents with specific language impairment (n = 48), adolescents with non-specific language impairment (n = 25), and adolescents with normal language development (n = 108) performed speeded grammaticality judgements of sentences presented over headphones. Half the sentences were ungrammatical. They included omissions of non-tense morphemes (-ing and possessive -s), omissions of tense morphemes (-ed and third-person singular present -s), and intrusions of the same tense morphemes. The A' statistic was used as the dependent variable for comparisons across groups and item types.

OUTCOMES & RESULTS

Overall, the normal language development group was more sensitive to grammatical violations than the specific language impairment and non-specific language impairment groups, and there was no significant interaction of group and item type. Post-hoc analyses showed that the specific language impairment group was less sensitive to violations than the normal language development group on each item type, and the specific language impairment and non-specific language impairment groups did not differ. Across groups, performance on omission of past tense -ed was lowest, and properties of the items that may have contributed to this difference were explored.

CONCLUSIONS

The adolescents with language impairment in this study showed evidence of reduced sensitivity to morphological errors, including both tense-marking and non-tense-marking morphemes, but no evidence of any extraordinary difficulty in detecting the omission of tense-marking morphemes, in contrast to results from other research on younger children with specific language impairment. Participants whose non-verbal IQ score was too low to meet the criteria for specific language impairment performed similarly to their peers with specific language impairment. Grammatical competence is compromised in these adolescents with specific language impairment and non-specific language impairment. Neither researchers nor clinicians can assume that adolescents with language impairment have fully mastered grammatical morphology.

Emotional health in adolescents with and without a history of specific language impairment (SLI)

OBJECTIVE

This study examined the emotional health of adolescents with and without specific language impairment (SLI).

METHOD

One hundred and thirty-nine adolescents with a history of SLI (15;10 years) and a peer group of 124 adolescents with normal language development (NLD) (15;11 years) participated, who were in their final year of compulsory schooling. The risk of emotional difficulties was assessed using the Moods and Feelings Questionnaire (MFQ) and the Child Manifest Anxiety Scale-R (CMAS-R). Comprehensive language and cognition data were available for all participants (NLD and SLI) concurrently and also longitudinally for those with SLI.

RESULTS

A clear increased risk of emotional health symptoms was found for the SLI group on both self- and parental-report. Girls scored less favourably than boys when groups were combined, but these were due to the effect of the NLD group, with no gender differences found in the SLI group. Direct links with language and cognition were not obvious. Instead, more diffuse factors such as family history of emotional health difficulties may warrant further investigation.

CONCLUSION

There is a marked higher rate of anxiety and depression symptoms in adolescents with SLI. However, these do not appear to be a direct result of impoverished communicative experiences.

Neural mechanisms of selective auditory attention are enhanced by computerized training: electrophysiological evidence from language-impaired and typically developing children

Recent proposals suggest that some interventions designed to improve language skills might also target or train selective attention. The present study examined whether six weeks of high-intensity (100 min/day) training with a computerized intervention program designed to improve language skills would also influence neural mechanisms of selective auditory attention previously shown to be deficient in children with specific language impairment (SLI). Twenty children received computerized training, including 8 children diagnosed with SLI and 12 children with typically developing language. An additional 13 children with typically developing language received no specialized training (NoTx control group) but were tested and retested after a comparable time period to control for maturational and test-retest effects. Before and after training (or a comparable delay period for the NoTx control group), children completed standardized language assessments and an event-related brain potential (ERP) measure of selective auditory attention. Relative to the NoTx control group, children receiving training showed increases in standardized measures of receptive language. In addition, children receiving training showed larger increases in the effects of attention on neural processing following training relative to the NoTx control group. The enhanced effect of attention on neural processing represented a large effect size (Cohen's d=0.8), and was specific to changes in signal enhancement of attended stimuli. These findings indicate that the neural mechanisms of selective auditory attention, previously shown to be deficient in children with SLI, can be remediated through training and can accompany improvements on standardized measures of language.

Profile and aetiology of children diagnosed with auditory processing disorder (APD)

OBJECTIVE

Auditory processing disorder (APD) is characterised by listening difficulties despite a normal audiogram. APD is becoming ever more widely diagnosed in children, though there is a controversy over definition, diagnosis and aetiology. This study sought to describe presenting features and investigate aetiological factors for children diagnosed with APD compared to those for whom APD was excluded.

METHODS

Medical notes for children referred to a specialist hospital-based APD clinic were reviewed in relation to presenting features and potential aetiological factors.

RESULTS

32 children diagnosed with APD and 57 non-APD children were compared. They reported similar symptoms and similarly had high rates of co-morbid learning problems. No aetiological factor (including history of otitis media, adverse obstetric history or familial history of listening problems) predicted APD group membership.

CONCLUSIONS

Children identified with APD on the basis of commonly used APD tests cannot be distinguished on the basis of presenting features or the aetiological factors examined here. One explanation is that learning problems exist independently of auditory processing difficulties and the aetiological factors do not have a strong causal role in APD. However, no gold standard for APD testing exists and an alternative explanation is that the commonly used APD tests used as selection criteria in this study may be unreliable.

Difficulty in SLI diagnosis: a case study of identical twins

This paper examines identical 12-year-old twins with language difficulties, one of whom falls into the diagnostic remit of SLI while the others does not due to IQ differences. Further diagnostic testing was carried out and their language was analysed to determine whether their diagnosis were reflected by different linguistic abilities. Results show a strong similarity in linguistic profiles, leading to a questioning of IQ use in SLI diagnosis.

Language outcomes of 7-year-old children with or without a history of late language emergence at 24 months

PURPOSE

The aim of this study was to investigate the language outcomes of 7-year-old children with and without a history of late language emergence at 24 months.

METHOD

One hundred twenty-eight children with a history of late language emergence (LLE) at 24 months and 109 children with a history of normal language emergence (NLE) at 24 months participated in direct behavioral assessment of multiple dimensions of language at 7 years. The children were recruited from a prospective cohort study of 1,766 epidemiologically ascertained 24-month-old singleton children.

RESULTS

The group mean for the LLE children was within the typical range on an omnibus measure of general language ability and measures of specific dimensions of language. However, a greater percentage of LLE children, relative to NLE children, performed below normative expectations on a measure of general language ability (20% versus 11%), speech (7% versus 2%), syntax (18% versus 8%), and morphosyntax (9%-23% versus 2%-14%), but not vocabulary or semantics.

CONCLUSION

The results provide support for growth models of language impairment that predict that late onset of language foretells a protracted growth difference for some LLE children relative to NLE children, particularly for syntax and morphosyntax.

Heritability of specific language impairment depends on diagnostic criteria

Heritability estimates for specific language impairment (SLI) have been inconsistent. Four twin studies reported heritability of 0.5 or more, but a recent report from the Twins Early Development Study found negligible genetic influence in 4-year-olds. We considered whether the method of ascertainment influenced results and found substantially higher heritability if SLI was defined in terms of referral to speech and language pathology services than if defined by language test scores. Further analysis showed that presence of speech difficulties played a major role in determining whether a child had contact with services. Childhood language disorders that are identified by population screening are likely to have a different phenotype and different etiology from clinically referred cases. Genetic studies are more likely to find high heritability if they focus on cases who have speech difficulties and who have been referred for intervention.

Empirically derived combinations of tools and clinical cutoffs: an illustrative case with a sample of culturally/linguistically diverse children

PURPOSE

Using a sample of culturally/linguistically diverse children, we present data to illustrate the value of empirically derived combinations of tools and cutoffs for determining eligibility in child language impairment.

METHOD

Data were from 95 4- and 6-year-olds (40 African American, 55 White; 18 with language impairment, 77 without) who lived in the rural South; they involved primarily scores from the Comprehension subtest of the Stanford-Binet Intelligence Scale-Fourth Edition (CSSB; R. Thorndike, E. Hagen, & J. Sattler, 1986), but scores from an experimental nonword repetition task (NRT; C. Dollaghan & T. Campbell, 1998) were also included as supplements to these scores.

RESULTS

Although the CSSB led to low fail rates in children without impairment and a statistically reliable group difference as a function of the children's clinical status but not their race, only 56% of children with impairment were accurately classified when -1 SD was employed as the cutoff. Diagnostic accuracy improved to 81% when an empirically derived cutoff of -.5 SD was used. When scores from the NRT were added to those from the CSSB, diagnostic accuracy increased to 90%.

IMPLICATIONS

This illustrative case adds to the growing number of studies that call for empirically derived combinations of tools and cutoffs as one option within an evidence-based practice framework.

Parental perspectives during the transition to adulthood of adolescents with a history of specific language impairment (SLI)

PURPOSE

This is the 2nd article of a companion set (the 1st article being on language and independence). It presents research examining parental perspectives on aspects of impairment in their offspring involving families rearing children with specific language impairment (SLI).

METHOD

The same sample as that of the 1st study participated in this investigation: a total of 238 parents and their offspring (120 offspring with a history of SLI and 118 typically developing [TD] offspring). Parents were interviewed using the Transition Daily Rewards and Worries questionnaire (L. M. Glidden & B. M. Jobe, 2007; J. Menard, S. Schoolcraft, L. M. Glidden, & C. Lazarus, 2002). Measures of the adolescents' receptive and expressive language, reading, nonverbal IQ, and socioemotional functioning were obtained.

RESULTS

Parents of adolescents with a history of SLI had more negative expectations in the areas of future/adult life, socialization, and community resources. An exception was family relations, which was a source of reward for both sets of parents.

CONCLUSIONS

Parents of adolescents with SLI have a range of perspectives regarding their offspring; some raise concerns, some are more positive. In addition, there is striking heterogeneity in the experiences of parents in the SLI group. Variables that influence being a concerned parent involve the adolescent's level of independence, quality of peer relations, his or her prosocial behavior, and the presence of conduct problems.

The efficacy of Fast ForWord Language intervention in school-age children with language impairment: a randomized controlled trial

PURPOSE

A randomized controlled trial was conducted to compare the language and auditory processing outcomes of children assigned to receive the Fast ForWord Language intervention (FFW-L) with the outcomes of children assigned to nonspecific or specific language intervention comparison treatments that did not contain modified speech.

METHOD

Two hundred sixteen children between the ages of 6 and 9 years with language impairments were randomly assigned to 1 of 4 conditions: (a) Fast ForWord Language (FFW-L), (b) academic enrichment (AE), (c) computer-assisted language intervention (CALI), or (d) individualized language intervention (ILI) provided by a speech-language pathologist. All children received 1 hr and 40 min of treatment, 5 days per week, for 6 weeks. Language and auditory processing measures were administered to the children by blinded examiners before treatment, immediately after treatment, 3 months after treatment, and 6 months after treatment.

RESULTS

The children in all 4 conditions improved significantly on a global language test and a test of backward masking. Children with poor backward masking scores who were randomized to the FFW-L condition did not present greater improvement on the language measures than children with poor backward masking scores who were randomized to the other 3 conditions. Effect sizes, analyses of standard error of measurement, and normalization percentages supported the clinical significance of the improvements on the Comprehensive Assessment of Spoken Language (E. Carrow-Woolfolk, 1999). There was a treatment effect for the Blending Words subtest of the Comprehensive Test of Phonological Processing (R. K. Wagner, J. K. Torgesen, & C. A. Rashotte, 1999). Participants in the FFW-L and CALI conditions earned higher phonological awareness scores than children in the ILI and AE conditions at the 6-month follow-up testing.

CONCLUSION

Fast ForWord Language, the intervention that provided modified speech to address a hypothesized underlying auditory processing deficit, was not more effective at improving general language skills or temporal processing skills than a nonspecific comparison treatment (AE) or specific language intervention comparison treatments (CALI and ILI) that did not contain modified speech stimuli. These findings call into question the temporal processing hypothesis of language impairment and the hypothesized benefits of using acoustically modified speech to improve language skills. The finding that children in the 3 treatment conditions and the active comparison condition made clinically relevant gains on measures of language and temporal auditory processing informs our understanding of the variety of intervention activities that can facilitate development.

Teacher identification of speech and language impairment in kindergarten students using the Kindergarten Development Check

The purpose of this paper was to profile the extent and accuracy of teacher identification of speech and language impairment within a kindergarten student population in Tasmania, Australia, using the Kindergarten Development Check (KDC). A total of 286 kindergarten students (aged 4-5 years and in their first year of formal schooling) were screened by teachers with the KDC on two separate occasions over their kindergarten year. In the following academic year, each of the same 286 students were assessed by a speech-language pathologist, and diagnosed with either typically developing or impaired speech and/or language skills. Review of KDC data determined the number of students identified by teachers with speech and language impairment at each occasion during their kindergarten year. Comparison of data from the later KDC administration and speech-language pathology assessment then determined the correspondence between identification of speech and language impairment by teachers and speech-language pathologists. Upon initial administration of the KDC, 51 (17.8%) students were identified by teachers with language impairment and 47 (16.4%) students with speech impairment. Following the second administration of the KDC 3 months later, 20 (7.0%) students continued to be identified with language impairment, and 39 (13.6%) with speech impairment. Comparison of speech-language pathology testing results and KDC data from the second administration found the overall validity of teacher identification was 86.4% and 71% for speech and language impairment respectively. Specificity rates were high, with 93% and 97% of students with typically developing speech and language skills respectively, correctly classified on the KDC. However, the sensitivity was only 50% for speech impairment and 15% for language impairment, indicating that 50% of students presenting with speech impairment and 85% of students with language impairment in their subsequent academic year were not recorded by teachers as having such a difficulty on the later KDC administration during their kindergarten year. The KDC appears to be ineffective in supporting kindergarten teachers to identify students with ongoing speech and to a greater extent, language impairment. Measures to improve the sensitivity of the KDC in particular need to be considered by speech-language pathologists and educational professionals in Tasmania.

Identifying Language Comprehension Impairment in Preschool Children

Purpose

This study examined the validity of 3 discourse comprehension measures for preschool children and the ability of a combination of them to classify children with and without language impairment.

Method

Thirty-seven children with typical language and 12 children with language impairment completed 3 measures of oral story comprehension: the Joint Story Retell task, the Expectancy Violation Detection task, and comprehension questions.

Results

Discriminant analyses revealed that each measure successfully classified pre-identified groups. The clinical combination of all 3 measures resulted in 96% accurate identification of the language status of this cohort.

Conclusion

Results support these procedures as valid measures of discourse comprehension and monitoring and provide preliminary evidence that their combination can be validly employed for identifying young children with language comprehension impairment.

Prevalence of speech and/or language impairment in preparatory students in northern Tasmania

The purpose of this paper is to report the prevalence of speech and/or language impairment in a sample of preparatory students in northern Tasmania, Australia. A total of 308 preparatory students attending 30 public schools in northern Tasmania were administered assessments by a speech-language pathologist, and subsequently diagnosed with either typical or impaired speech and/or language skills. Overall, 41.2% of assessed preparatory students were identified as having either speech and/or language impairment. Specifically, 8.7% of students were found to have isolated speech impairment, 18.2% were diagnosed with isolated language impairment, and 14.3% were identified as having comorbid speech and language impairment. Compared to prior Australian and international research, the present data reflect one of the highest prevalence estimates for speech and/or language impairment reported to date. Given the relative paucity of Australian prevalence data, further epidemiological research specifically of Australian children is needed to validate the current findings.

Relationship between speech-sound disorders and early literacy skills in preschool-age children: impact of comorbid language impairment

OBJECTIVE

Disorders of articulation or speech-sound disorders (SSD) are common in early childhood. Children with these disorders may be at risk for reading difficulties because they may have poor auditory, phonologic, and verbal memory skills.

METHODS

We sought to characterize the reading and writing readiness of preschool children with SSD and identify factors associated with preliteracy skills. Subjects were 125 children aged 3 to 6 years with moderate to severe SSD; 53% had comorbid language impairment (LI). Reading readiness was measured with the Test of Early Reading Ability-2 (TERA) and writing skills with the Test of Early Written Language-2 (TEWL), which assessed print concept knowledge. Linear regression was used to examine the association between SSD severity and TERA and TEWL scores and analysis of variance to examine the effect of comorbid LI. Performance on a battery of speech and language tests was reduced by way of factor analysis to composites for articulation, narrative, grammar, and word knowledge skills.

RESULTS

Early reading and writing scores were significantly lower for children with comorbid LI but were not related to SSD severity once language status was taken into account. Composites for grammar and word knowledge were related to performance on the TERA and TEWL, even after adjusting for Performance IQ. Below average language skills in preschool place a child at risk for deficits in preliteracy skills, which may have implications for the later development of reading disability.

CONCLUSION

Preschool children with SSD and LI may benefit from instruction in preliteracy skills in addition to language therapy.