Prevalence of specific language impairment in kindergarten children

Rethinking disorders of spoken and written language: generating workable hypotheses

Disorders of spoken and written language (DSWL) tend to overlap at multiple levels: manifestationally, procedurally, developmentally, and etiologically. In other words, these disorders exhibit a positive manifold of correlations expressed among their different procedural components and in prospective, concurrent, and retrospective comorbidity. There is no single accepted explanation for this positive manifold of correlations. The purpose of this article is to explore this multilayer overlap and to consider whether such a positive manifold can be explained by one or all of the three hypotheses delineated in the article.

Communication disorders: prevalence and comorbid intellectual disability, autism, and emotional/behavioral disorders

PURPOSE

To determine a population-based estimate of communication disorders (CDs) in children; the co-occurrence of intellectual disability (ID), autism, and emotional/behavioral disorders; and the impact of these conditions on the prevalence of CDs.

METHOD

Surveillance targeted 8-year-olds born in 1994 residing in 2002 in the 3 most populous counties in Utah (n = 26,315). A multiple-source record review was conducted at all major health and educational facilities.

RESULTS

A total of 1,667 children met the criteria of CD. The prevalence of CD was estimated to be 63.4 per 1,000 8-year-olds (95% confidence interval = 60.4-66.2). The ratio of boys to girls was 1.8:1. Four percent of the CD cases were identified with an ID and 3.7% with autism spectrum disorders (ASD). Adjusting the CD prevalence to exclude ASD and/or ID cases significantly affected the CD prevalence rate. Other frequently co-occurring emotional/behavioral disorders with CD were attention deficit/hyperactivity disorder, anxiety, and conduct disorder.

CONCLUSIONS

Findings affirm that CDs and co-occurring mental health conditions are a major educational and public health concern.

Neuropsychological profile of pre-schoolers with metaphonological difficulties: results from a non-clinical sample

BACKGROUND

The level of language development reached in pre-school age is considered the most reliable predictor of reading acquisition. In normally developing children, learning to read is strongly related to early language skills, and in particular to phonological processing abilities. In dyslexic children, reading abilities seem to show a correlation with phonological awareness.

METHODS

A group of 65 children (aged 5-6 years) were recruited and submitted to an in-depth neuropsychological assessment [i.e. metaphonological skills, intelligence, verbal short-term memory (VSTM) and other aspects of receptive and expressive language]. We were able to identify 14 children with significant metaphonological difficulties (MD): 11 children with exclusively MD, and the other three children with specific language impairment. This study compares the neuropsychological profile obtained from children with MD with that of a peer group without any language impairment (N).

RESULTS

The performances of the MD were within the normal ability range in almost all the administered tests but significantly lower compared with those of their peers without language impairment (N) in some items of the intelligence scale (Wechsler Preschool and Primary Scale of Intelligence) and in the tests of VSTM and of receptive/expressive language. Nevertheless, there were not statistically significant differences between MD and N in output phonology.

CONCLUSIONS

In pre-school age, in a group of non-clinical children, with a range of abilities, those with MD appear to be at the lower end of the normal range in many other verbal skills. These children could be considered at-risk for possible subsequent difficulties learning to read and thus need to be identified and to warrant prompt treatment.

Atypical long-latency auditory event-related potentials in a subset of children with specific language impairment

It has been proposed that specific language impairment (SLI) is the consequence of low-level abnormalities in auditory perception. However, studies of long-latency auditory ERPs in children with SLI have generated inconsistent findings. A possible reason for this inconsistency is the heterogeneity of SLI. The intraclass correlation (ICC) has been proposed as a useful statistic for evaluating heterogeneity because it allows one to compare an individual's auditory ERP with the grand average waveform from a typically developing reference group. We used this method to reanalyse auditory ERPs from a sample previously described by Uwer, Albrecht and von Suchodoletz (2002). In a subset of children with receptive SLI, there was less correspondence (i.e. lower ICC) with the normative waveform (based on the control grand average) than for typically developing children. This poorer correspondence was seen in responses to both tone and speech stimuli for the period 100-228 ms post stimulus onset. The effect was lateralized and seen at right- but not left-sided electrodes.

A review of association and linkage studies for genetical analyses of learning disorders

Learning disorders (LD) commonly comprise of a heterogeneous group of disorders manifested by unexpected problems in some children's experiences in the academic performance arena. These problems especially comprise of a variety of disorders which may be subclassified to attention-deficit hyperactivity disorder (ADHD), reading disability (RD), specific language impairment (SLI), speech-sound disorder (SSD), and dyspraxia. The aim of this review is to summarize the current molecular studies and some of the most exciting recent developments in molecular genetic research on LD. The findings for the association and linkage of LD with candidate genes will help to set the research agendas for future studies to follow.

Language development and mild-to-moderate hearing loss: does language normalize with age?

PURPOSE

The authors' purpose was to explore the nature of the link between hearing loss (HL) and language impairment in adolescents with mild-to-moderate hearing loss (MMHL). Does language performance (generally or in certain areas) normalize at adolescence?

METHOD

The language skills of 19 French-speaking adolescents (ages 11-15) with moderate or mild sensorineural HL were evaluated via a series of tests assessing oral and written language, including an experimental probe, and compared with typically developing adolescents and adolescents with specific language impairment (SLI).

RESULTS

Language disorders were found, notably in the areas of phonology and grammar, in more than half the adolescents with MMHL; affected domains and error patterns were identical to those found in adolescents with SLI. Language scores of the adolescents with MMHL were significantly linked with degree of HL, a correlation not generally found in studies of children with MMHL.

CONCLUSION

Normalization of language performance does not generalize at adolescence in the context of MMHL. The fact that an effect of the severity of HL was found only after childhood might be because linguistic development is basically complete at adolescence. Prior to this time, this effect could be obscured by developmental rhythms that vary from child to child.

Intervention for verb argument structure in children with persistent SLI: a randomized control trial

PURPOSE

The authors aimed to establish whether 2 theoretically motivated interventions could improve use of verb argument structure in pupils with persistent specific language impairment (SLI).

METHOD

Twenty-seven pupils with SLI (ages 11;0-16;1) participated in this randomized controlled trial with "blind" assessment. Participants were randomly assigned to 1 of 3 therapy groups: syntactic-semantic, semantic, and control. All pupils received 9 weekly half-hour individual therapy sessions. They were assessed on a specifically designed video test pretherapy, posttherapy, and at follow-up.

RESULTS

Pupils receiving the syntactic-semantic and semantic therapies made significant progress (d>1.0), which was maintained at follow-up and generalized to control verbs. Both therapies improved linking of arguments to syntax, and the syntactic-semantic therapy tended to increase use of optional arguments. Pupils receiving the control therapy made no progress.

CONCLUSION

Both methods of argument structure therapy were effective. Comparisons of their effectiveness in specific areas led to the hypotheses that the pupils' initial difficulties with linking resulted from ill-defined semantic representations, whereas their limited use of arguments may have resulted from syntactic difficulties. When therapy is theoretically grounded, it can inform theories, be time limited, and be effective for older children with SLI.

The broader language phenotype of autism: a comparison with specific language impairment

BACKGROUND

Some individuals with autism spectrum disorders (ASD) experience linguistic difficulties similar to those found in individuals with specific language impairment (SLI). Whether these behaviours are indicative of a common underlying genetic cause or a superficial similarity is unclear.

METHODS

Standardised language assessments were administered to three participant groups: parents of children with ASD (Par-A), parents of children with specific language/literacy impairment (Par-L) and parents of typically developing children (Par-T) (n = 30, in each group). Additionally, the Autism-Spectrum Quotient (AQ) was used to assess autism-like tendencies, in particular, social language use.

RESULTS

The Par-A group performed better than the Par-L group (and identical to the Par-T group) on all language tests. Conversely, the Par-A group was characterised by higher levels of pragmatic difficulties than the other two groups, as measured by the communication subscale of the AQ.

CONCLUSIONS

No evidence was found for a shared phenotype in parents of children with ASD and SLI. A model is presented describing the relation between SLI and ASD.

Recast density and acquisition of novel irregular past tense verbs

PURPOSE

Children with specific language impairment (SLI) lag behind children with typical language (TL) in their grammatical development, despite equivalent early exposure to recasts in conversation (M. E. Fey, T. E. Krulik, D. F. Loeb, & K. Proctor-Williams, 1999) and the ability to learn from recasts in intervention as quickly as do children with TL (K. E. Nelson, S. Camarata, J. Welsh, L. Butovsky, & M. Camarata, 1996). This experiment tested whether this apparent paradox could be attributed to variations in the density of recasts in conversation versus intervention.

METHOD

Thirteen children (7-8 years of age) with SLI and 13 language-similar children (5-6 years of age) with TL were exposed to 3 recast densities of novel irregular past tense verbs (none, conversation-like, intervention-like) over 5 sessions. Outcomes were based on spontaneous conversational productions and a post-test probe.

RESULTS

As predicted, at conversation-like densities, children with TL more accurately produced the target verbs they heard in recasts than in nonrecast models (d = 0.58), children with SLI showed no differences, and children with TL produced the verbs more accurately than did children with SLI (d = 0.54). Contrary to expectations, at higher intervention-like recast densities, the SLI group did not improve their accuracy, and the TL group performances were significantly poorer (d = 0.47).

CONCLUSION

At conversational levels, recasts facilitated greater verb learning than models alone but only in the TL group. Increasing recast density to the modest levels in this brief intervention experiment did not benefit children with SLI and led to poorer learning for children with TL. To optimize learning, efficiency of recast distribution as well as rate must be considered.

Subtyping stuttering II: contributions from language and temperament

This paper is the second in a series of two articles exploring subtypes of stuttering, and it addresses the question of whether and how language ability and temperament variables may be relevant to the study of subtypes within the larger population of children who stutter. Despite observations of varied profiles among young children who stutter, efforts to identify and characterize subtypes of stuttering have had limited influence on theoretical or clinical understanding of the disorder. This manuscript briefly highlights research on language and temperament in young children who stutter, and considers whether the results can provide guidance for efforts to more effectively investigate and elucidate subtypes in childhood stuttering. Issues from the literature that appear relevant to research on stuttering subtypes include: (a) the question of whether stuttering is best characterized as categorical or continuous; (b) interpretation of individual differences in skills and profiles; and (c) the fact that, during the preschool years, the interaction among domains such as language and temperament are changing very rapidly, resulting in large differences in developmental profiles within relatively brief chronological age periods.

EDUCATIONAL OBJECTIVES

The reader will be able to: (1) discuss possible associations of language ability and temperament to the development of stuttering in young children; (2) summarize the subtyping research from the literature on language ability and temperament in young children; (3) generate directions for future research of stuttering subtypes drawn from the literature related to language ability and temperament in young children.

Young L2 learners' performance on a novel morpheme task

The teaching of an invented language rule has been proposed as a possible non-biased, language-independent assessment technique useful in differentiating young L2 learners with specific language impairment from their typically developing peers. The current study explores these notions by testing typically developing sequential bilingual children's ability to learn an invented language rule in either L1 (Spanish) or L2 (English). Participants were 20 children, age 3:6-5:8, who attended a Head Start programme. For all children, Spanish was the primary language spoken in the home and English was the primary language of instruction. Children were randomly assigned two groups. Group L1 was taught the novel language rule in Spanish; Group L2 was taught the novel language rule in English. Performance was better for the L1 group than for the L2 group. Moreover, not all of these typical language learners were able to learn the new rule, even in their strongest language. These findings suggest that even for typically developing children, specific language proficiency as well as individual differences are closely linked to performance on this novel morpheme learning task.

Severe receptive language disorder in childhood--familial aspects and long-term outcomes: results from a Scottish study

BACKGROUND AND AIMS

Little is known about the familial characteristics of children with severe receptive specific language impairment (SLI). Affected children are more likely to have long-term problems than those with expressive SLI but to date they have only been described as small cohorts within SLI populations. We therefore aimed to describe the clinical and familial characteristics of severe receptive SLI as defined by a rigorous phenotype and to establish whether non-word repetition showed a relationship with language impairment in these families.

METHODS

Cross-sectional study of children who met ICD-10 (F80.2) criteria for receptive SLI at school entry, their siblings and genetic parents with standardised measures of language and non-verbal IQ, phonological auditory memory and speech sound inventory.

RESULTS

At a mean of 6 years after school entry with a severe receptive SLI, the 58 participants had a normal mean and standard deviation non-verbal IQ, but only 3% (two) had attained language measures in the normal range. One third still had severe receptive language impairment. One third of siblings not known to be affected had language levels outside the normal range. Phonological auditory memory was impaired in most family members.

CONCLUSION

Severe receptive SLI is nearly always associated with an equally severe reduction in expressive language skills. Language impairment in siblings may go undetected and yet they are at high risk. Family members had weak phonological auditory memory skills, suggesting that this could be a marker for language acquisition difficulties. Receptive SLI rarely resolves and trials of therapy are urgently needed.

The neuroradiological findings of children with developmental language disorder

PURPOSE

To investigate the general characteristics of glucose metabolism distribution and the functional deficit in the brain of children with developmental language delay (DLD), we compared functional neuroradiological studies such as positron emission tomography (PET) of a patient group of DLD children and a control group of attention- deficit hyperactivity disorder (ADHD) children.

PATIENTS AND METHODS

Seventeen DLD children and 10 ADHD children under 10 years of age were recruited and divided into separate groups consisting of children less than 5 years of age or between 5 and 10 years of age. The PET findings of 4 DLD children and 6 control children whose ages ranged from 5 to 10 years were compared by Statistical Parametric Mapping (SPM) analysis.

RESULTS

All of the DLD children revealed grossly normal findings in brain MRIs, however, 87.5% of them showed grossly abnormal findings in their PET studies. Abnormal findings were most frequent in the thalamus. The patient group showed significantly decreased glucose metabolism in both frontal, temporal and right parietal areas (p < 0.005) and significantly increased metabolism in both occipital areas (p < 0.05) as compared to the control group.

CONCLUSION

This study reveals that DLD children may show abnormal findings on functional neuroradiological studies, even though structural neuroradiological studies such as a brain MRI do not show any abnormal findings. Frequent abnormal findings on functional neuroradiological studies of DLD children, especially in the subcortical area, suggests that further research with quantitative assessments of functional neuroradiological studies recruiting more DLD children and age-matched normal controls could be helpful for understanding the pathophysiology of DLD and other disorders confined to the developmental disorder spectrum.

Neuropsychology and genetics of speech, language, and literacy disorders

The authors review the neuropsychology, brain bases, and genetics of three related disorders of language development: reading disability, or developmental dyslexia (RD); language impairment (LI); and speech sound disorder (SSD). Over the past three decades, cognitive analysis has demonstrated that the reading difficulties of most children who have RD result from phonologic impairments (difficulties processing the sound structure of language). Although understanding of LI and SSD is somewhat less developed, both disorders are also associated with phonologic impairments, which may account for their comorbidity with RD. Research across levels of analysis is progressing rapidly to promote understanding not only of each disorder by itself but also of the relationships of the three disorders to each other.

Language disorders in children: classification and clinical syndromes

This article reviews the normal pattern of language development in infants and young children. Classifications of childhood language disorders are presented and common clinical syndromes are described. Etiologic and comorbid factors associated with the development of language disorder are discussed in relation to current understanding of genetic and neuroanatomic aspects of brain development. Finally, the long-term outcome of individuals with childhood-onset language disorders is discussed.

Effects of cueing in auditory temporal masking

PURPOSE

In a landmark study, B. A. Wright et al. (1997) reported an apparent backward-masking deficit in language-learning-impaired children. Subsequently, the controversial interpretation of those results has been influential in guiding treatments for childhood language problems. This study revisited the temporal-masking paradigm reported by B. A. Wright et al. to evaluate adult listener signal/masker uncertainty effects for some of their key stimulus conditions. New signal conditions presented off frequency from the masker also were evaluated to assess conditions of reduced signal/masker confusion.

METHOD

Masked detection was measured for 20-ms sinusoids (480, 1000, or 1680 Hz) presented at temporal positions before, during, or after a gated narrowband (bandwidth = 600-1400 Hz) masker. Listener uncertainty was investigated by cueing various stimulus temporal properties with a 6000-Hz sinusoid presented contralateral to the test ear.

RESULTS

The primary cueing effect was measured in the backward-masking condition for the cue gated simultaneously with the on-frequency 1000-Hz signal. The resulting cued masked-detection threshold was reduced to quiet threshold. No significant cueing effects were obtained for other signal temporal positions in the masker or for any off-frequency signal conditions.

CONCLUSIONS

These results for normal adult listeners indicate that on-frequency backward masking can be eliminated by cueing the signal, and thus, these findings raise the possibility that the deficit reported by B. A. Wright et al. for language-learning-impaired children may reflect inordinate signal/masker confusion, rather than a temporal-processing deficit per se.

Do children and adults with language impairment recognize prosodic cues?

PURPOSE

Prosodic cues are used to clarify sentence structure and meaning. Two studies, one of children with specific language impairment (SLI) and one of adults with a history of learning disabilities, were designed to determine whether individuals with poor language skills recognize prosodic cues on par with their normal-language peers.

METHOD

Participants were asked to determine whether low-pass filtered sentences matched unfiltered target sentences. Filtered sentences either matched the target sentence exactly or differed on between 1 and 3 parameters that affected the prosodic profile of the sentences.

RESULTS

Children with SLI were significantly poorer than their normal peers in determining whether low-pass filtered sentences matched or were different from unfiltered target sentences. The children's performance, measured in terms of response accuracy, deteriorated as the similarities between filtered and unfiltered sentences increased. Adults revealed a pattern of differential reaction time to sentence pairs that reflected their relative degree of similarity. There was no difference in performance accuracy for adults with a history of language/learning disabilities compared with their peers.

CONCLUSION

Given that prosodic cues are known to assist language processing, the weak prosodic skills of preschool children with SLI may limit the amount of benefit that these children derive from the presence of prosodic cues in spoken language. That the adult sample did not show a similar weakness in this skill may reflect developmental differences, sampling differences, or a combination of both.

Longitudinal relationships between lexical and grammatical development in typical and late-talking children

PURPOSE

This study examined the longitudinal relationships between lexical and grammatical development in typically developing (TD) and late-talking children for the purposes of testing the single-mechanism account of language acquisition and comparing the developmental trajectories of lexical and grammatical development in late-talking and TD children.

METHOD

Participants included 30 children identified as late talkers (LTs) at 2;0 (years;months), and 30 TD children matched on age, nonverbal cognition, socioeconomic status, and gender. Data were collected at 5 points between 2;0 and 5;6.

RESULTS

Cross-lagged correlational analyses indicated that TD children showed evidence of bidirectional bootstrapping between lexical and grammatical development between 2;0 and 3;6. Compared with the TD group, LTs exhibited less evidence of syntactic bootstrapping. Linear mixed-effects modeling of language sample data suggested that the relationship between lexical and grammatical growth was similar for the 2 groups.

CONCLUSION

Lexical and grammatical development were strongly related in both groups, consistent with the single-mechanism account of language acquisition. The results were mixed in terms of finding longitudinal differences in lexical-grammatical relationships between the TD and late-talking children; however, several analyses suggested that for late-talking children, syntactic growth may be less facilitative of lexical development.

Speed of processing, working memory, and language impairment in children

PURPOSE

Children with language impairment (LI) often perform below the level of typically developing peers on measures of both processing speed and working memory. This study examined the relationship between these 2 types of measures and attempted to determine whether such measures can account for the LI itself.

METHOD

Fourteen-year-old children with LI and their typically developing peers participated in a wide range of processing speed and working memory tasks and were administered a comprehensive language test battery. Confirmatory factor analyses were used to compare 3 nested models designed to examine the dimensionality of the speed and working memory measures. A model that included a general speed factor was also evaluated.

RESULTS

The models meeting our evaluation criteria treated speed and working memory as separable factors. Furthermore, nonverbal as well as verbal processing factors emerged from these analyses. Latent variable regression analyses showed that each of the appropriate models accounted for 62% of the variance in the children's concurrent composite language test scores, with verbal working memory making the largest contribution.

CONCLUSIONS

These findings shed light on the relationship among different types of processing and suggest that processing factors can contribute to the understanding of language disorders.

Multivariate linkage analysis of specific language impairment (SLI)

Specific language impairment (SLI) is defined as an inability to develop appropriate language skills without explanatory medical conditions, low intelligence or lack of opportunity. Previously, a genome scan of 98 families affected by SLI was completed by the SLI Consortium, resulting in the identification of two quantitative trait loci (QTL) on chromosomes 16q (SLI1) and 19q (SLI2). This was followed by a replication of both regions in an additional 86 families. Both these studies applied linkage methods to one phenotypic trait at a time. However, investigations have suggested that simultaneous analysis of several traits may offer more power. The current study therefore applied a multivariate variance-components approach to the SLI Consortium dataset using additional phenotypic data. A multivariate genome scan was completed and supported the importance of the SLI1 and SLI2 loci, whilst highlighting a possible novel QTL on chromosome 10. Further investigation implied that the effect of SLI1 on non-word repetition was equally as strong on reading and spelling phenotypes. In contrast, SLI2 appeared to have influences on a selection of expressive and receptive language phenotypes in addition to non-word repetition, but did not show linkage to literacy phenotypes.

Infant information processing and family history of specific language impairment: converging evidence for RAP deficits from two paradigms

An infant's ability to process auditory signals presented in rapid succession (i.e. rapid auditory processing abilities [RAP]) has been shown to predict differences in language outcomes in toddlers and preschool children. Early deficits in RAP abilities may serve as a behavioral marker for language-based learning disabilities. The purpose of this study is to determine if performance on infant information processing measures designed to tap RAP and global processing skills differ as a function of family history of specific language impairment (SLI) and/or the particular demand characteristics of the paradigm used. Seventeen 6- to 9-month-old infants from families with a history of specific language impairment (FH+) and 29 control infants (FH-) participated in this study. Infants' performance on two different RAP paradigms (head-turn procedure [HT] and auditory-visual habituation/recognition memory [AVH/RM]) and on a global processing task (visual habituation/recognition memory [VH/RM]) was assessed at 6 and 9 months. Toddler language and cognitive skills were evaluated at 12 and 16 months. A number of significant group differences were seen: FH+ infants showed significantly poorer discrimination of fast rate stimuli on both RAP tasks, took longer to habituate on both habituation/recognition memory measures, and had lower novelty preference scores on the visual habituation/recognition memory task. Infants' performance on the two RAP measures provided independent but converging contributions to outcome. Thus, different mechanisms appear to underlie performance on operantly conditioned tasks as compared to habituation/recognition memory paradigms. Further, infant RAP processing abilities predicted to 12- and 16-month language scores above and beyond family history of SLI. The results of this study provide additional support for the validity of infant RAP abilities as a behavioral marker for later language outcome. Finally, this is the first study to use a battery of infant tasks to demonstrate multi-modal processing deficits in infants at risk for SLI.

Phonological short-term memory, language and literacy: developmental relationships in early adolescence in young people with SLI

BACKGROUND

Research has consistently documented a relationship between phonological short-term memory skills (STM) and specific language impairment (SLI). This study reports on the development of phonological STM abilities over 3 years in 80 young adolescents with a history of SLI, investigating the nature of the relationship between phonological STM abilities and language and literacy skills, and vice versa.

METHODS

Tests of nonverbal ability, expressive and receptive language, reading and nonword repetition were administered at 11 and 14 years of age.

RESULTS

There was striking longitudinal stability of phonological STM capacity in young people with SLI. This finding was consistent for the group as a whole, for subgroups, and at the individual level. Regression analyses revealed reciprocal relationships between phonological STM abilities and language/literacy measures. In particular, phonological STM abilities contributed significantly to later expressive language skills and basic reading skills contributed to later phonological STM abilities. Poor phonological STM abilities related to Expressive-Receptive profiles of SLI (ER-SLI) and to the presence of reading difficulties.

CONCLUSIONS

Relationships among the processes involved in language, literacy and memory in young adolescents with SLI indicate complex reciprocal interactions across development.

The Prevalence of Stuttering, Voice, and Speech-Sound Disorders in Primary School Students in Australia

Purpose

The aims of this study were threefold: to report teachers' estimates of the prevalence of speech disorders (specifically, stuttering, voice, and speech-sound disorders); to consider correspondence between the prevalence of speech disorders and gender, grade level, and socioeconomic status; and to describe the level of support provided to schoolchildren with speech disorders.

Method

Students with speech disorders were identified from 10,425 students in Australia using a 4-stage process: training in the data collection process, teacher identification, confirmation by a speech-language pathologist, and consultation with district special needs advisors.

Results

The prevalence of students with speech disorders was estimated; specifically, 0.33% of students were identified as stuttering, 0.12% as having a voice disorder, and 1.06% as having a speech-sound disorder. There was a higher prevalence of speech disorders in males than in females. As grade level increased, the prevalence of speech disorders decreased. There was no significant difference in the pattern of prevalence across the three speech disorders and four socioeconomic groups; however, students who were identified with a speech disorder were more likely to be in the higher socioeconomic groups. Finally, there was a difference between the perceived and actual level of support that was provided to these students.

Conclusion

These prevalence figures are lower than those using initial identification by speech-language pathologists and similar to those using parent report.

Predicting academic performance in children with language impairment: the role of parent report

This study examines the ability of preschool speech-language measures and parent report in predicting later academic performance. Preschool measures of speech, language and communication for 35 children with language impairment were analyzed for their ability to predict reading, writing, spelling, and mathematics in these same children at age nine. Regression analyses revealed that scores from the Vineland Adaptive Behavior Scales Communication Domain (a parent report instrument) were the best predictors of scores on measures of reading, writing, and math, while the scores from the Photo Articulation Test best predicted spelling outcomes. The results are discussed relative to the value of parent report in assessing and managing language impairment, and predicting scholastic performance in preschool children.

Factors associated with specific language impairment and later language development during early life: a literature review

It has been reported that 50% of children with specific language impairment (SLI) have persistent SLI, which has been associated with various risk factors. To date, however, there has not been a comprehensive review of studies into different risk factors that could be used by clinicians to facilitate parental counseling and individual case-management. Several studies about the factors associated with SLI were reviewed based on study design. This article presents a review of factors associated with later language development and SLI, and reviews the risk for children who have SLI during early life. The summary provides data including specific biologic and environmental factors that are significantly associated with SLI, to ensure early intervention for children with SLI in the presence of identified risk factors.

Communicative competence in parents of children with autism and parents of children with specific language impairment

While the primary language deficit in autism has been thought to be pragmatic, and in specific language impairment (SLI) structural, recent research suggests phenomenological and possibly genetic overlap between the two syndromes. To compare communicative competence in parents of children with autism, SLI, and down syndrome (DS), we used a modified pragmatic rating scale (PRS-M). Videotapes of conversational interviews with 47 autism, 47 SLI, and 21 DS parents were scored blind to group membership. Autism and SLI parents had significantly lower communication abilities than DS parents. Fifteen percent of the autism and SLI parents showed severe deficits. Our results suggest that impaired communication is part of the broader autism phenotype and a broader SLI phenotype, especially among male family members.

Children's history of speech-language difficulties: genetic influences and associations with reading-related measures

PURPOSE

This study examined (a) the extent of genetic and environmental influences on children's articulation and language difficulties and (b) the phenotypic associations between such difficulties and direct assessments of reading-related skills during early school-age years.

METHOD

Behavioral genetic analyses focused on parent-report data regarding the speech-language skills of 248 twin pairs (M = 6.08 years) from the Western Reserve Reading Project. In addition, phenotypic associations between children's speech-language status and direct assessments of early reading-related abilities were examined through hierarchical linear modeling (HLM).

RESULTS

Probandwise concordance rates and intraclass tetrachoric correlations indicated high heritability for children's difficulties in expressive language and articulation, with estimates of .54 and .97 accordingly. HLM results indicated that children with histories of speech-language difficulties scored significantly lower than unaffected children on various measures of early reading-related abilities.

CONCLUSIONS

Results from the parent-report survey provided converging evidence of genetic effects on children's speech and language difficulties and suggest that children with a history of speech-language difficulties are at risk for lower performance on early reading-related measures. The extent of risk differed across measures and appeared greatest for children who demonstrated a history of difficulties across articulation, expressive language, and receptive language. Implications for future genetic research and clinical practice are discussed.

The genetic bases of speech sound disorders: evidence from spoken and written language

The purpose of this article is to review recent findings suggesting a genetic susceptibility for speech sound disorders (SSD), the most prevalent communication disorder in early childhood. The importance of genetic studies of SSD and the hypothetical underpinnings of these genetic findings are reviewed, as well as genetic associations of SSD with other language and reading disabilities. The authors propose that many genes contribute to SSD. They further hypothesize that some genes contribute to SSD disorders alone, whereas other genes influence both SSD and other written and spoken language disorders. The authors postulate that underlying common cognitive traits, or endophenotypes, are responsible for shared genetic influences of spoken and written language. They review findings from their genetic linkage study and from the literature to illustrate recent developments in this area. Finally, they discuss challenges for identifying genetic influence on SSD and propose a conceptual framework for study of the genetic basis of SSD.

Growth of infant communication between 8 and 12 months: a population study

AIM

To describe changes in infant prelinguistic communication skills between 8 and 12 months, and identify factors associated with those skills.

DESIGN

Parent questionnaire data for a prospective population-based cohort of infants in metropolitan Melbourne, Australia.

PARTICIPANTS

1911 infants born November 2002-August 2003.

OUTCOME

Infant communication (Communication and Symbolic Behaviour Scales (CSBS)) at 8 and 12 months. Potential risk factors: sex; prematurity; multiple birth; sociodemographic indicators; maternal mental health, vocabulary and education; non-English speaking background; and family history of speech-language difficulties. Linear regression models were fitted to total standardised CSBS scores at 8 and 12 months.

RESULTS

Social communication, especially the use of gesture, developed rapidly from 8 to 12 months. Female sex, twin birth, and family history were strongly associated with CSBS scores. The combined model accounted for 5% and 6% of the total variation at 8 and 12 months, respectively. CSBS score at 8 months strongly predicted CSBS score at 12 months (coefficient = 0.56, partial R(2) = 37.0).

CONCLUSIONS

There is a dramatic increase in communication skills between 8 and 12 months, particularly the development of gesture, which (as in previous studies) predates and predicts future language development. Risk factors explained little variation in early communication trajectories and therefore, based on our findings, this developmental course is more likely to be biologically predetermined. Rather than focusing on risk factors, we suggest that language promotion activities in otherwise healthy young infants should either be universal or, if targeted, be based on the level of communication skills displayed.

The dimensionality of language ability in school-age children

PURPOSE

This study asked if children's performance on language tests reflects different dimensions of language and if this dimensionality changes with development.

METHOD

Children were given standardized language batteries at kindergarten and at second, fourth, and eighth grades. A revised modified parallel analysis was used to determine the dimensionality of these items at each grade level. A confirmatory factor analysis was also performed on the subtest scores to evaluate alternate models of dimensionality.

RESULTS

The revised modified parallel analysis revealed a single dimension across items with evidence of either test specific or language area specific minor dimensions at different ages. The confirmatory factor analysis tested models involving modality (receptive or expressive) and domain (vocabulary or sentence use) against a single-dimension model. The 2-dimensional model involving domains of vocabulary and sentence use fit the data better than the single-dimensional model; however, the single-dimension model also fit the data well in the lower grades.

CONCLUSIONS

Much of the variance in standardized measures of language appears to be attributable to a single common factor or trait. There is a developmental trend during middle childhood for grammatical abilities and vocabulary abilities to become differentiated. These measures do not provide differential information concerning receptive and expressive abilities.

The clinical spectrum of developmental language impairment in school-aged children: language, cognitive, and motor findings

OBJECTIVE

Our goal was to evaluate detailed school-age language, nonverbal cognitive, and motor development in children with developmental language impairment compared with age-matched controls.

METHODS

Children with developmental language impairment or normal language development (controls) aged 7 to 13 years were recruited. Children underwent language assessment (Clinical Evaluation of Language Fundamentals-4, Peabody Picture Vocabulary-3, Goldman-Fristoe Test of Articulation-2), nonverbal cognitive assessment (Wechsler Intelligence Scale for Children-IV), and motor assessment (Movement Assessment Battery for Children). Exclusion criteria were nonverbal IQ below the 5th percentile or an acquired language, hearing, autistic spectrum, or neurologic disorder.

RESULTS

Eleven children with developmental language impairment (7:4 boys/girls; mean age: 10.1 +/- 0.8 years) and 12 controls (5:7 boys/girls; mean age: 9.5 +/- 1.8 years) were recruited. Children with developmental language impairment showed lower mean scores on language (Clinical Evaluation of Language Fundamentals-4--developmental language impairment: 79.7 +/- 16.5; controls: 109.2 +/- 9.6; Goldman-Fristoe Test of Articulation-2--developmental language impairment: 94.1 +/- 10.6; controls: 104.0 +/- 2.8; Peabody Picture Vocabulary-3--developmental language impairment: 90.5 +/- 13.8; controls: 100.1 +/- 11.6), cognitive (Wechsler Intelligence Scale for Children-IV--developmental language impairment: 99.5 +/- 15.5; controls: 113.5 +/- 11.9), and motor measures (Movement Assessment Battery for Children percentile--developmental language impairment: 12.7 +/- 16.7; controls: 66.1 +/- 30.6) and greater discrepancies between cognitive and language scores (Wechsler Intelligence Scale for Children-IV/Clinical Evaluation of Language Fundamentals-4--developmental language impairment: 17.8 +/- 17.8; controls: 1.2 +/- 12.7). Motor impairment was more common in children with developmental language impairment (70%) than controls (8%).

CONCLUSIONS

Developmental language impairment is characterized by a broad spectrum of developmental impairments. Children identified on the basis of language impairment show significant motor comorbidity. Motor assessment should form part of the evaluation and follow-up of children with developmental language impairment.

Dynamic assessment of school-age children's narrative ability: an experimental investigation of classification accuracy

Two experiments examined reliability and classification accuracy of a narration-based dynamic assessment task.

PURPOSE

The first experiment evaluated whether parallel results were obtained from stories created in response to 2 different wordless picture books. If so, the tasks and measures would be appropriate for assessing pretest and posttest change within a dynamic assessment format. The second experiment evaluated the extent to which children with language impairments performed differently than typically developing controls on dynamic assessment of narrative language.

METHOD

In the first experiment, 58 1st- and 2nd-grade children told 2 stories about wordless picture books. Stories were rated on macrostructural and microstructural aspects of language form and content, and the ratings were subjected to reliability analyses. In the second experiment, 71 children participated in dynamic assessment. There were 3 phases: a pretest phase, in which children created a story that corresponded to 1 of the wordless picture books from Experiment 1; a teaching phase, in which children attended 2 short mediation sessions that focused on storytelling ability; and a posttest phase, in which children created a story that corresponded to a second wordless picture book from Experiment 1. Analyses compared the pretest and posttest stories that were told by 2 groups of children who received mediated learning (typical and language impaired groups) and a no-treatment control group of typically developing children from Experiment 1.

RESULTS

The results of the first experiment indicated that the narrative measures applied to stories about 2 different wordless picture books had good internal consistency. In Experiment 2, typically developing children who received mediated learning demonstrated a greater amount of pretest to posttest change than children in the language impaired and control groups. Classification analysis indicated better specificity and sensitivity values for measures of response to intervention (modifiability) and posttest storytelling than for measures of pretest storytelling. Observation of modifiability was the single best indicator of language impairment. Posttest measures and modifiability together yielded no misclassifications.

CONCLUSION

The first experiment supported the use of 2 wordless picture books as stimulus materials for collecting narratives before and after mediation within a dynamic assessment paradigm. The second experiment supported the use of dynamic assessment for accurately identifying language impairments in school-age children.

The ordering of milestones in language development for children from 1 to 6 years of age

PURPOSE

To scale language milestones in a group of 527 children to provide an instrument for screening language development. Procedure The questionnaire regarding these milestones was completed by parental report. It was evaluated whether the scaled milestones satisfied the assumptions of the Mokken item response model.

RESULTS

The scalability of the final scale of 14 milestones was strong (H = .95), its reliability was high (rho = .96), and it satisfied the assumptions of the Mokken model.

CONCLUSIONS

A single, unidimensional scale of diverse milestones was developed. It taps lexical, syntactic, and phonological skills, as well as both receptive and expressive language skills, and is well suited for mapping progress in language ability.

Development of the Grammar and Phonology Screening (GAPS) test to assess key markers of specific language and literacy difficulties in young children

BACKGROUND

Despite a large body of evidence regarding reliable indicators of language deficits in young children, there has not been a standardized, quick screen for language impairment. The Grammar and Phonology Screening (GAPS) test was therefore designed as a short, reliable assessment of young children's language abilities.

AIMS

GAPS was designed to provide a quick screening test to assess whether pre- and early school entry children have the necessary grammar and pre-reading phonological skills needed for education and social development. This paper reports the theoretical background to the test, the pilot study and reliability, and the standardization.

METHODS

This 10-min test comprises 11 test sentences and eight test nonsense words for direct imitation and is designed to highlight significant markers of language impairment and reading difficulties. To standardize the GAPS, 668 children aged 3.4-6.6 were tested across the UK, taking into account population distribution and socio-economic status. The test was carried out by a range of health and education professionals as well as by students and carers using only simple, written instructions.

RESULTS

GAPS is effective in detecting a range of children in need of further in-depth assessment or monitoring for language difficulties. The results concur with those from much larger epidemiological studies using lengthy testing procedures.

CONCLUSIONS

The GAPS test (1) provides a successful screening tool; (2) is designed to be administered by professionals and non-professionals alike; and (3) facilitates identification of language impairment or at-risk factors of reading impairment in the early educational years. Thus, the test affords a first step in a process of assessment and targeted intervention to enable children to reach their potential.

Spanish-English Bilingual Children with Psychopathology: Language Deficits and Academic Language Proficiency

BACKGROUND: The aim was to study the language profiles of a well-characterised sample (n = 50) of Spanish-English bilingual children consecutively referred to psychiatric services. METHODS: Spanish and English language profiles were assessed with the Woodcock Language Proficiency Battery-Revised (WLPB). Profiles included language ability levels, deficits and dominance in five expressive and receptive/expressive domains, and academic (school-related) language proficiency levels. RESULTS: General language ability was low for 69% in either language and for 51% in both. Language dominance data suggested that expressive skills were dominant in English. In 73% of the children, ability to function at school in the strongest language is 'limited', defined by the WLPB as incorrect responses to 50% of the items typically answered correctly by children of the same age. Classroom language demands, also according to the WLPB, would be 'extremely difficult' to 'impossible' for 40% of the children in at least one language, and for 19% in either language. CONCLUSIONS: Language deficits, present in many psychiatrically-referred bilingual children, ought to be suspected by the clinician. The typical language demands of schooling appear to be overwhelming for many of these children, with ensuing implications for psychosocial adaptation and educational attainment. Thorough language ability assessments of both languages are often necessary for the early detection of language deficits and for understanding how dual language abilities relate to psychiatric symptoms. Therefore, language assessment services need to be closely linked to programs serving psychiatrically-referred bilingual children. Other implications of this research for clinical practice are discussed.

Working memory and sentence comprehension of Hong Kong Chinese children with specific language impairment

Children with Specific Language Impairment present with delayed language development, but do not have a history of hearing impairment, mental deficiency, or associated social or behavioral problems. Non-word repetition was suggested as an index to reflect the capacity of phonological working memory. There is a paucity of such studies among Hong Kong Chinese children. This preliminary study aimed to examine the relationship between phonological working memory and Specific Language Impairment, through the processes of non-word repetition and sentence comprehension, of children with Specific Language Impairment and pre-school children with normal language development. Both groups of children were screened by a standardized language test. A list of Cantonese (the commonest dialect used in Hong Kong) multisyllabic nonsense utterances and a set of 18 sentences were developed for this study. t-tests and Pearson correlation were used to study the relationship between non-word repetition, working memory and specific language impairment. Twenty-three pre-school children with Specific Language Impairment (mean age = 68.30 months; SD = 6.90) and another 23 pre-school children (mean age = 67.30 months; SD = 6.16) participated in the study. Significant difference performance was found between the Specific Language Impairment group and normal language group in the multisyllabic nonsense utterances repetition task and the sentence comprehension task. Length effect was noted in Specific Language Impairment group children, which is consistent with the findings of other literature. In addition, correlations were also observed between the number of nonsense utterances repeated and the number of elements comprehended. Cantonese multisyllabic nonsense utterances might be worth further developing as a screening tool for the early detection of children with Specific Language Impairment.

Response time in 14-year-olds with language impairment

PURPOSE

To determine whether children with language impairment were slower than typically developing peers at age 14, and whether slowing, if present, was similar across task domains; whether differences in response time (RT) across domains were the same for children with specific language impairment (SLI) and nonspecific language impairment (NLI); and whether RT performance at age 9 predicted performance at age 14.

METHOD

Fourteen-year-old children with SLI (n = 20), NLI (n = 15), and typical development (NLD; n = 31) were administered several linguistic and nonlinguistic speeded tasks. The children had received the same tasks at age 9. RT performance was examined.

RESULTS

Both the SLI and the NLI groups were significantly slower than the NLD group in motor, nonverbal cognitive, and language task domains, and there was no significant difference among domains. Individual analyses showed that most, but not all, children with SLI and NLI were slower than the NLD group mean. Slowing at age 9 and age 14 were moderately correlated.

CONCLUSIONS

The results suggest that slow RT is a persistent characteristic of many children with language impairment; however, the nature of the relationship between RT and language performance requires further investigation.

The composition of normative groups and diagnostic decision making: shooting ourselves in the foot

PURPOSE

The normative group of a norm-referenced test is intended to provide a basis for interpreting test scores. However, the composition of the normative group may facilitate or impede different types of diagnostic interpretations. This article considers who should be included in a normative sample and how this decision must be made relative to the purpose for which a test is intended.

METHOD

The way in which the composition of the normative sample affects classification accuracy is demonstrated through a test review followed by a simulation study. The test review examined the descriptions of the normative group in a sample of 32 child language tests. The mean performance reported in the test manual for the sample of language impaired children was compared with the sample's norms, which either included or excluded children with language impairment. For the simulation, 2 contrasting normative procedures were modeled. The first procedure included a mixed group of representative cases (language impaired and normal cases). The second procedure excluded the language impaired cases from the norm.

RESULTS

Both the data obtained from test manuals and the data simulation based on population characteristics supported our claim that use of mixed normative groups decreases the ability to accurately identify language impairment. Tests that used mixed norms had smaller differences between the normative and language impaired groups in comparison with tests that excluded children with impairment within the normative sample. The simulation demonstrated mixed norms that lowered the group mean and increased the standard deviation, resulting in decreased classification accuracy.

CONCLUSIONS

When the purpose of testing is to identify children with impaired language skills, including children with language impairment in the normative sample can reduce identification accuracy.

Familial loading in specific language impairment: patterns of differences across proband characteristics, gender and relative type

There is now little doubt that both environmental factors and genes are likely to make important contributions to the aetiology of specific language impairment (SLI). The most commonly proposed model for understanding these influences is the multifactorial model. In the present study we examine two expectations based on this model: that there will be a systematic relationship between the severity of proband language scores and the rate and severity of SLI in relatives and that relatives will be more strongly affected if they are relatives of a proband of the more rarely affected gender (female) because the latter require a higher genetic liability to become equally impaired. Ninety-three probands and their 300 first-degree relatives participated in this study. Results showed a relationship between proband severity at age 14 and an increased rate of SLI in relatives. This relationship was strong for child siblings and was significant with respect to both rate of SLI and severity over a range of language and literacy measures. In contrast, higher levels of SLI among relatives of female rather than male probands was entirely disproved.

Measuring Preschool Attainment of Print-Concept Knowledge: A Study of Typical and At-Risk 3- to 5-Year-Old Children Using Item Response Theory

Purpose

This research determined the psychometric quality of a criterion-referenced measure that was thought to measure preschoolers' print-concept knowledge (PCK).

Method

This measure, titled the Preschool Word and Print Awareness (PWPA), was examined using the partial credit model (PCM) to determine its suitability for use by clinicians, educators, and researchers. The extent to which the PWPA differentiated estimates of PCK for at-risk populations on the basis of socioeconomic status (SES) and language ability was also studied. The sample population was one-hundred twenty-eight 3- to 5-year-old children who varied in SES (middle, low) and language ability (typical language, language impairment) as derived from several previous or ongoing studies of emergent literacy intervention.

Results

The PCM fit analyses showed good fit between the overall data and the PCM, indicating that the PWPA provided a valid estimate of the latent PCK trait. SES and language ability were significant predictors of PWPA scores when age was used as a covariate. These results showed the PWPA to be suitable for measuring preschoolers' PCK and to be sensitive to differences among children as a function of risk status.

Clinical Implications

The results show the PWPA to be an appropriate instrument for clinical and educational use with preschool children.

Educational provision for children with specific speech and language difficulties: perspectives of speech and language therapy service managers

BACKGROUND

Children with specific speech and language difficulties (SSLD) pose a challenge to the education system, and to speech and language therapists who support them, as a result of their language needs and associated educational and social-behavioural difficulties. The development of inclusion raises questions regarding appropriate provision, whether the tradition of language units or full inclusion into mainstream schools.

AIMS

To gather the views of speech and language therapy service managers in England and Wales regarding approaches to service delivery, terminology and decision-making for educational provision, and the use of direct and indirect (consultancy) models of intervention.

METHOD AND PROCEDURES

The study reports on a national survey of speech and language therapy (SLT) services in England and Wales (129 respondents, 72.1% response rate) and interviews with 39 SLT service managers.

OUTCOMES AND RESULTS

Provision varied by age group with support to children in the mainstream common from pre-school to the end of Key Stage 2 (up to 11 years), and to those in designated specialist provision, common at Key Stages 1/2 (ages 5-11 years), but less prevalent at Key Stages 3/4 (11-16 years). Decision-making regarding provision was influenced by the lack of common terminology, with SSLD and specific language impairment (SLI) the most common, and criteria, including the use of the discrepancy model for defining SSLD. Practice was influenced by the difficulties in distinguishing children with SSLD from those with autistic spectrum disorder, and difficulties translating policies into practice.

CONCLUSIONS

The implications of the study are discussed with reference to SLT practice, including consultancy models, and the increasingly prevalent policy in local education authorities of inclusion of children with special educational needs.

Perceptual organization and visual immediate memory in children with specific language impairment

Children with specific language impairment (LI) have deficits on some nonverbal tasks, but it is not clear if these are related to specific visuospatial deficits or to more general deficits in processing strategies. Children with LI were given two visuospatial tasks that we have shown to be sensitive to strategy use as well as specific processing deficits. In Study 1, children with LI (N=29, ages 6 to 12 years) performed significantly worse than typically developing children (N=26) on the Hierarchical Forms Memory task. In Study 2, children with LI (N=15; ages 9 to 12 years) performed significantly worse than typically developing children (N=40) on the Rey-Osterrieth Complex Figure task. Children with LI were less accurate and tended to use a fairly piecemeal (immature) strategy when copying the figure and were less likely to draw the core rectangle in a more integrated fashion during the immediate memory condition. These results suggest children with LI have subtle deficits on visuospatial tasks that may be more indicative of limitations associated with processing load and planning than of specific visuospatial processing deficits.

Structural priming in children with and without specific language impairment

PRIMARY OBJECTIVE

To determine if structural priming can be demonstrated in young children with and without specific language impairment (SLI).

RESEARCH DESIGN

A mixed-model design was used to compare children with SLI to two groups of typically developing (TD) children, and to compare priming conditions.

METHODS AND PROCEDURES

Eighteen children with SLI and 36 TD children (18 matched on age and 18 matched on MLU) participated. Children were asked to describe drawings compatible with both a transitive or an intransitive sentence structure, after being primed with one of the structures.

RESULTS

All groups of children were more likely to produce transitive sentences when they had just heard and repeated a transitive prime. Children with SLI did not differ from the other groups.

CONCLUSIONS

Children with SLI show similar priming effects to TD children. Priming has promise as a method for investigating production factors in typical and atypical language development.

Speech sound disorder influenced by a locus in 15q14 region

Despite a growing body of evidence indicating that speech sound disorder (SSD) has an underlying genetic etiology, researchers have not yet identified specific genes predisposing to this condition. The speech and language deficits associated with SSD are shared with several other disorders, including dyslexia, autism, Prader-Willi Syndrome (PWS), and Angelman's Syndrome (AS), raising the possibility of gene sharing. Furthermore, we previously demonstrated that dyslexia and SSD share genetic susceptibility loci. The present study assesses the hypothesis that SSD also shares susceptibility loci with autism and PWS. To test this hypothesis, we examined linkage between SSD phenotypes and microsatellite markers on the chromosome 15q14-21 region, which has been associated with autism, PWS/AS, and dyslexia. Using SSD as the phenotype, we replicated linkage to the 15q14 region (P=0.004). Further modeling revealed that this locus influenced oral-motor function, articulation and phonological memory, and that linkage at D15S118 was potentially influenced by a parent-of-origin effect (LOD score increase from 0.97 to 2.17, P=0.0633). These results suggest shared genetic determinants in this chromosomal region for SSD, autism, and PWS/AS.

The prevalence of autistic spectrum disorders in adolescents with a history of specific language impairment (SLI)

BACKGROUND

Traditionally, autism and specific language impairment (SLI) have been regarded as distinct disorders but, more recently, evidence has been put forward for a closer link between them: a common set of language problems, in particular receptive language difficulties and the existence of intermediate cases including pragmatic language impairment. The present study aimed to examine the prevalence of autism spectrum disorders in a large sample of adolescents with a history of SLI.

METHOD

The presence of autism spectrum disorders was examined in seventy-six 14-year-olds with a confirmed history of SLI. A variety of instruments were employed, including the Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS) and the Family History Interview (FHI).

RESULTS

The prevalence of autism spectrum disorders in young people with SLI was found to be 3.9%, about 10 times what would be expected from the general population. In addition, a much larger number of young people with a history of SLI showed only some autism spectrum symptoms or showed them in a mild form.

CONCLUSIONS

Young people with SLI have an increased risk of autism. The magnitude of this risk is considerable. In addition, a larger proportion (a quarter of individuals) present with a number of behaviours consistent with autism spectrum disorders.

Distinct genetic influences on grammar and phonological short-term memory deficits: evidence from 6-year-old twins

Children with language impairments have limitations of phonological short-term memory (STM) and have distinctive problems with certain aspects of grammar. Both deficits have been proposed as phenotypic markers of heritable language impairment. We studied 173 twin pairs, selected to be over-representative of children with risk of developmental language impairment, using a battery of standardized language and intelligence tests, a test of nonword repetition to index phonological STM and two elicitation tasks to assess use of verb tense marking. As predicted, the phonological STM and the verb tense measures both discriminated children with risk of language impairment from low risk children, and DeFries-Fulker analysis showed that impairments on both tasks were significantly heritable. However, there was minimal phenotypic and etiological overlap between the two deficits, suggesting that different genes are implicated in causing these two kinds of language difficulty. From an evolutionary perspective, these data are consistent with the view that language is a complex function that depends on multiple underlying skills with distinct genetic origins.

Pro-nominal reference skills of second and fourth grade children with language impairment

Pro-nominal referencing was evaluated in a sample of 569 children comprising four diagnostic subgroups: typical language (TL), specific language impairment (SLI), nonspecific language impairment (NLI), and typical language with low nonverbal IQ (LNIQ). Participants generated oral narratives in second grade and again in fourth grade. The narratives of the females in the TL group included a significantly higher rate of pro-nominal references than the narratives of both the males in the TL group and the females in the NLI group. A higher percentage of complete pro-nominal references was found in the TL group compared to the SLI group. These findings suggest that pro-nominal referencing measures are not sensitive enough to differentiate school-aged children with typical language development from those with language impairment.

LEARNING OUTCOMES

The reader will: (1) become familiar with narrative language measures and (2) learn how groups of children with varying language and cognitive profiles perform on measures of referential cohesion.

Neuropsychiatric and neurodevelopmental outcome of children at age 6 and 7 years who screened positive for language problems at 30 months

We present a prospective study at school age of neuropsychiatric and neurodevelopmental outcome of language delay suspected at child health screening around 30 months of age. In a community sample, 25 children (21 males, 4 females) screening positive and 80 children (38 males, 42 females) screening negative for speech and language problems at age 30 months were examined in detail for language disorders at age 6 years. The screen-positive children were then followed for another year and underwent in-depth neuropsychiatric examination by assessors blind to the results of previous testing. Detailed follow-up results at age 7 years were available for 21 children. Thirteen of these 21 children (62%) had a major neuropsychiatric diagnosis (autism, atypical autism, Asperger's syndrome, attention-deficit-hyperactivity disorder [ADHD]), or combinations of these. Two further children (10%) had borderline IQ with no other major diagnosis. We conclude that children in the general population who screen positive for speech and language problems before age 3 years appear to be at very high risk of autism spectrum disorders or ADHD, or both, at 7 years of age. Remaining language problems at age 6 years strongly predict the presence of neuropsychiatric or neurodevelopmental disorders at age 7 years.