Adjective Learning in Young Typically Developing Children and Children With Developmental Language Disorder: A Retrieval-Based Approach

Purpose There are strong retention benefits when learners frequently test themselves during the learning period. This practice of repeated retrieval has recently been applied successfully to children's word learning. In this study, we apply a repeated retrieval procedure to the learning of novel adjectives by preschool-age children with developmental language disorder (DLD) and their typically developing (TD) peers. We ask whether the benefits of retrieval extend to children's ability to apply the novel adjectives to newly introduced objects sharing the same characteristics as the objects used during the learning period. Method Fourteen children with DLD (M age = 62.64 months) and 13 TD children (M = 62.54 months) learned novel adjectives in 2 sessions. For each child, half of the adjectives were learned in a repeated spaced retrieval condition, and half were learned in a repeated study-only condition. Recall was assessed immediately after the second learning session and 1 week later. A recognition test was also administered at the 1-week mark. Results On the recall tests, for both groups of children, recall was better for adjectives learned in the repeated spaced retrieval condition. Adjectives learned by the 2nd day were retained 1 week later. Every adjective correctly applied to an object used during the learning period was also extended accurately to new objects with the same characteristics. On these recall tests, the children with DLD did not differ from the TD group in the number of items recalled, though their phonetic accuracy was lower. On the recognition test, the DLD group showed greater accuracy for adjectives that had been learned in the repeated spaced retrieval condition than for those learned in the repeated study condition, whereas the TD group performed at high levels in both conditions. Conclusion Repeated spaced retrieval appears to provide an effective boost to word learning. Because its benefits are seen even when a word must be extended to new objects, the application of this procedure seems well suited for learning new language material rather than being limited to item-specific memorization.

Sentence Repetition: A Clinical Marker for Developmental Language Disorder in Danish

Purpose The aim of the study was to explore the potential of performance on a Danish sentence repetition (SR) task-including specific morphological and syntactic properties-to identify difficulties in children with developmental language disorder (DLD) relative to typically developing (TD) children. Furthermore, the potential of the task as a clinical marker for Danish DLD was explored. Method SR performance of children with DLD aged 5;10-14;1 (years;months; n = 27) and TD children aged 5;3-13;4 (n = 87) was investigated. Results Compared to TD same-age peers, children with DLD were less likely to repeat the sentences accurately but more likely to make ungrammatical errors with respect to verb inflection and use of determiners and personal pronouns. Younger children with DLD also produced more word order errors that their TD peers. Furthermore, older children with DLD performed less accurately than younger TD peers, indicating that the SR task taps into morphosyntactic areas of particular difficulty for Danish children with DLD. The classification accuracy associated with SR performance showed high levels of sensitivity and specificity (> 90%) and likelihood ratios indicating good identification potential for clinical and future research purposes. Conclusion SR performance has a strong potential for identifying children with DLD, also in Danish, and with a carefully designed SR task, performance has potential for revealing morphosyntactic difficulties. Supplemental Material https://doi.org/10.23641/asha.10314437.

Sleep Promotes Phonological Learning in Children Across Language and Autism Spectra

Purpose Establishing stable and flexible phonological representations is a key component of language development and one which is thought to vary across children with neurodevelopmental disorders affecting language acquisition. Sleep is understood to support the learning and generalization of new phonological mappings in adults, but this remains to be examined in children. This study therefore explored the time course of phonological learning in childhood and how it varies by structural language and autism symptomatology. Method Seventy-seven 7- to 13-year-old children, 30 with high autism symptomatology, were included in the study; structural language ability varied across the sample. Children learned new phonological mappings based on synthesized speech tokens in the morning; performance was then charted via repetition (without feedback) over 24 hr and followed up 4 weeks later. On the night following learning, children's sleep was monitored with polysomnography. Results A period of sleep but not wake was associated with improvement on the phonological learning task in childhood. Sleep was associated with improved performance for both trained items and novel items. Structural language ability predicted overall task performance, though language ability did not predict degree of change from one session to the next. By contrast, autism symptomatology did not explain task performance. With respect to sleep architecture, rapid eye movement features were associated with greater phonological generalization. Conclusions Children's sleep was associated with improvement in performance on both trained and novel items. Phonological generalization was associated with brain activity during rapid eye movement sleep. This study furthers our understanding of individual differences in the acquisition of new phonological mappings and the role of sleep in this process over childhood. Supplemental Material https://doi.org/10.23641/asha.11126732.

Bilingualism and Attention in Typically Developing Children and Children With Developmental Language Disorder

Purpose The aim of the current study was to investigate whether dual language experience modulates the efficiency of the 3 attentional networks (alerting, orienting, and executive control) in typically developing (TD) children and in children with developmental language disorder (DLD). Method We examined the attentional networks in monolingual and bilingual school-aged children (ages 8-12 years) with and without DLD. TD children (35 monolinguals, 23 bilinguals) and children with DLD (17 monolinguals, 9 bilinguals) completed the Attention Network Test (Fan et al., 2002; Fan, McCandliss, Fossella, Flombaum, & Posner, 2005). Results Children with DLD exhibited poorer executive control than TD children, but executive control was not modified by bilingual experience. The bilingual group with DLD and both TD groups exhibited an orienting effect, but the monolingual group with DLD did not. No group differences were found for alerting. Conclusions Children with DLD have weak executive control skills. These skills are minimally influenced by dual language experience, at least in this age range. A potential bilingual advantage in orienting may be present in the DLD group.

The Effect of Working Memory Training on a Clinical Marker of French-Speaking Children With Developmental Language Disorder

Purpose Our work investigates the production of 3rd-person accusative clitic pronouns in French-speaking typically developing (TD) children and children with developmental language disorder (DLD) following a novel working memory (WM) training program (12 hrs of effective training) that specifically targets the components of WM that have been shown to be impaired in children with DLD and to be directly related to the mastery of clitics (Delage & Frauenfelder, submitted for publication; Durrleman & Delage, 2016). Method Sixteen TD children aged 5-12 years and 26 age-matched children with DLD completed our 8-week WM training program. Furthermore, an age-matched control group of 16 TD children and 17 children with DLD followed a scholastic training regime matched for intensity and frequency. Syntax and WM were assessed prior to and following the WM/scholastic training. Results Significant posttraining WM gains were found in TD children and children with DLD who took part in the WM training, and the production rate of 3rd-person accusative clitics significantly increased in children with DLD following the WM training. No significant WM or syntax gains were observed in the control group. Conclusion These findings are noteworthy as Melby-Lervåg and Hulme's (2013) meta-analysis concluded that existing WM training programs show short-lived generalized effects to other comparable measures of WM, but that there is no evidence that such training generalizes to less directly related tasks. That our study led to gains in skills that were not trained (i.e., syntax) suggests that a WM training regime that is firmly grounded in theory and that targets the specific mechanisms shown to underpin the acquisition of syntax may indeed provide effective remediation for children with DLD.

Differential Long-Term Outcomes for Individuals With Histories of Preschool Speech Sound Disorders

Purpose The goal of this study was to determine whether adolescent outcomes for individuals with histories of early speech sound disorders (SSD) could be differentiated by speech and language skills at earlier ages (preschool, 4-6 years, and school age, 7-10 years). Method The study used a retrospective longitudinal design. Participants with and without histories of early SSD were classified in adolescence as having no SSD, resolved SSD, low multisyllabic word (MSW; difficulty with MSW repetition but no errors in conversational speech), or persistent speech disorders (errors in both conversational speech and MSW repetition). Analysis of variance was employed to determine whether early speech, language, and literacy skills distinguished these adolescent outcome groups. Results Preschool and school-age skills differed for adolescents whose SSD had resolved from those who had persistent speech errors. Adolescents with errors solely in production of MSWs (Low MSW) did not differ in early speech and language skills from adolescents who had difficulty with both MSWs and persistent errors in conversation. Conclusions Speech and language assessments earlier in childhood can help establish risks for persistent SSD and other language and literacy difficulties in adolescence. Early identification of these clinically relevant subgroups of SSD may allow for early targeted interventions. Supplemental Material https://doi.org/10.23641/asha.9932279.

You have the right to remain silent: The ability of adolescents with developmental language disorder to understand their legal rights

PURPOSE

This study compared Miranda Rights comprehension of adolescents with developmental language disorder (DLD) and their typically developing (TD) peers.

METHOD

Instruments for Assessing Understanding and Appreciation of Miranda Rights (Grisso, 1998) was administered to 20 adolescents with DLD and 20 age-matched TD peers.

RESULTS

The DLD group exhibited significantly greater difficulty in understanding and appreciating Miranda Rights than their TD peers. Adolescents with DLD were 7 times more likely to be at risk of failing to sufficiently understand the Miranda warnings than adolescents in the TD group.

DISCUSSION

Adolescents with DLD are particularly vulnerable to failing to understand Miranda Rights and the consequences of waiving them. Future work should determine if there is a link between difficulty comprehending legal rights and the high prevalence of adolescents with language disorder in juvenile detention facilities.

A Comparison of the Storage-Only Deficit and Joint Mechanism Deficit Hypotheses of the Verbal Working Memory Storage Capacity Limitation of Children With Developmental Language Disorder

Purpose The storage-only deficit and joint mechanism deficit hypotheses are 2 possible explanations of the verbal working memory (vWM) storage capacity limitation of school-age children with developmental language disorder (DLD). We assessed the merits of each hypothesis in a large group of children with DLD and a group of same-age typically developing (TD) children. Method Participants were 117 children with DLD and 117 propensity-matched TD children 7-11 years of age. Children completed tasks indexing vWM capacity, verbal short-term storage, sustained attention, attention switching, and lexical long-term memory (LTM). Results For the DLD group, all of the mechanisms jointly explained 26.5% of total variance. Storage accounted for the greatest portion (13.7%), followed by controlled attention (primarily sustained attention; 6.5%) and then lexical LTM (5.6%). For the TD group, all 3 mechanisms together explained 43.9% of total variance. Storage accounted for the most variance (19.6%), followed by lexical LTM (16.0%), sustained attention (5.4%), and attention switching (3.0%). There was a significant LTM × Group interaction, in which stronger LTM scores were associated with significantly higher vWM capacity scores for the TD group as compared to the DLD group. Conclusions Results support a joint mechanism deficit account of the vWM capacity limitation of children with DLD. Results provide substantively new insights into the underlying factors of the vWM capacity limitation in DLD. Supplemental Material https://doi.org/10.23641/asha.9932312.

Vocal Communication With Canonical Syllables Predicts Later Expressive Language Skills in Preschool-Aged Children With Autism Spectrum Disorder

Purpose We examined associations between vocal communication with canonical syllables and expressive language and then examined 2 potential alternative explanations for such associations. Method Specifically, we tested whether the associations remained when excluding canonical syllables in identifiable words and controlling for the number of communication acts. Participants included 68 preverbal or low verbal children with autism spectrum disorder (M _age = 35.26 months). Results Vocal communication with canonical syllables and expressive language were concurrently and longitudinally associated with moderate to strong (R ²s = .13-.70) and significant (ps < .001) effect sizes. Even when excluding spoken words from the vocal predictor and controlling for the number of communication acts, vocal communication with canonical syllables predicted expressive language. Conclusions The findings provide increased support for measuring vocal communication with canonical syllables and for examining a causal relation between vocal communication with canonical syllables and expressive language in children with ASD who are preverbal or low verbal. In future studies, it may be unnecessary to eliminate identifiable words when measuring vocal communication in this population. Following replication, vocal communication with canonical syllables may be considered when making intervention- planning decisions.

Disruptive mutations in TANC2 define a neurodevelopmental syndrome associated with psychiatric disorders

Postsynaptic density (PSD) proteins have been implicated in the pathophysiology of neurodevelopmental and psychiatric disorders. Here, we present detailed clinical and genetic data for 20 patients with likely gene-disrupting mutations in TANC2-whose protein product interacts with multiple PSD proteins. Pediatric patients with disruptive mutations present with autism, intellectual disability, and delayed language and motor development. In addition to a variable degree of epilepsy and facial dysmorphism, we observe a pattern of more complex psychiatric dysfunction or behavioral problems in adult probands or carrier parents. Although this observation requires replication to establish statistical significance, it also suggests that mutations in this gene are associated with a variety of neuropsychiatric disorders consistent with its postsynaptic function. We find that TANC2 is expressed broadly in the human developing brain, especially in excitatory neurons and glial cells, but shows a more restricted pattern in Drosophila glial cells where its disruption affects behavioral outcomes.

The mediating role of joint attention in the relationship between motor skills and receptive and expressive language in siblings at risk for autism spectrum disorder

Language problems are highly prevalent in younger siblings of children with autism spectrum disorder (HR-sibs), yet little is known about early predictors. There is growing evidence that motor and language development are linked and this connection might be mediated by joint attention. Developmental changes in motor abilities change how children interact with objects and people (e.g., by showing), which may influence language development. This association has however not yet been studied in HR-sibs. The interrelationship between motor, joint attention and language skills was explored in younger siblings of typically developing children (LR-sibs, N = 31) and HR-sibs (N = 32). In both groups, motor skills (composite of fine and gross motor skills) at 10 months influenced receptive and expressive language at 36 months directly and indirectly through joint attention at 14 months. Group status moderated this direct and indirect effect with mainly significant effects in HR-sibs. This indicates that lower motor skills can have cascading effects on joint attention and language in HR-sibs. Consequently, assessment of early motor skills in HR-sibs might hold promise for early identification of motor difficulties but can also be indicative of language difficulties later in life, especially when difficulties with joint attention are also present.

Not All Nonverbal Tasks Are Equally Nonverbal: Comparing Two Tasks in Bilingual Kindergartners With and Without Developmental Language Disorder

Purpose This study investigates the interaction of language ability status, cultural experience, and nonverbal cognitive skill performance in Spanish-English bilinguals with typical development (TD) and developmental language disorder (DLD). Method One hundred sixty-nine Spanish-English bilingual kindergartener's scores on the Symbolic Memory and Cube Design subtests from the Universal Nonverbal Intelligence Test (Bracken & McCallum, 1998) were analyzed by language ability (TD vs. DLD). Results t tests and analysis of variance showed bilingual children with TD and DLD performed comparably to the Universal Nonverbal Intelligence Test norming sample on the cube design task, while children with DLD had significantly lower performance on the symbolic memory task. Conclusion These results suggest that cultural experience minimally impacted performance for bilingual children with typically developing language. Bilingual children with DLD were differentially impacted on symbolic memory, a task that is verbally mediated despite nonverbal administration and performance. Findings are discussed within the Cattell-Horn-Carroll theory of cognitive abilities.

Relationships between concurrent language ability and mental health outcomes in a South African sample of 13-year-olds

Children and adolescents with delayed or disordered language development are at increased risk of a number of negative outcomes, including social and emotional problems and mental health difficulties. Yet, in low- and middle- income countries, where risk factors for compromised language development are known to be prevalent, there is a lack of research on the association between child and adolescent language ability and mental health outcomes. This study evaluates data from a cross-sectional study in Khayelitsha, a semi-urban impoverished community near Cape Town, South Africa. To measure language ability, behaviour and mental health, adolescents aged 13 (n = 200) were assessed using the Riddles subtest of the Kaufman Assessment Battery for Children Version 2, the parent report Child Behaviour Checklist, and the self-report Moods and Feelings Questionnaire and the Self-Esteem Questionnaire. We conducted univariate and multivariate analyses to determine associations between language skills, self-esteem and mental health in this group of adolescents. Poor language ability was related to a range of concurrent adverse difficulties, such as attention deficits, self-esteem problems, social withdrawal, and depressive symptoms. Increased levels of language ability were related to better psychosocial profiles. In some cases, only individuals with a low level of language (bottom 10% of sample) were at increased risk of maladaptive outcomes. This study replicates the well-established relationship between language ability and poorer mental health found within high income countries in an upper middle-income country setting. Locally accessible support for children with reduced language ability is required, given the longer-term consequences of poorer mental health.

Mosaic trisomy 20 and mitigation in capital crimes sentencing: A review and case report

Trisomy 20 is a genetic abnormality in which individuals have an extra copy of chromosome 20. Complete trisomy 20 is rare and believed to be incompatible with life. A mosaic form of trisomy 20, in which only some cells or tissues contain the extra chromosome, is a relatively commonly encountered chromosomal abnormality found during prenatal testing, and c. 90% result in a normal phenotype. However, despite the absence of a consistent phenotype, certain findings have been reported across multiple cases of mosaic trisomy 20. These include an array of morphological findings, developmental delays, and learning disabilities. Beyond physical manifestations, a wide range of developmental and learning delays have also been reported. In this work, we provide an overview of the trisomy 20 literature and a case report of a young adult male with mosaic trisomy 20 who committed homicide. His developmental and life history, eventual diagnosis of mosaic trisomy 20, similarities and differences in his condition compared with prior research findings, and potentially new phenotypic findings associated with trisomy 20 that he manifested (childhood visual hallucinations, self-injury, polydactyly) are presented. Additionally, the potential role of this genetic diagnosis in his neuropsychiatric history and its successful application as a mitigating factor at his capital sentencing trial are described. We did not identify other similar cases during our search of major scientific and legal databases. As a backdrop, the use of genetics in criminal trials is on the rise, and courts are increasingly likely to accept behavioral genetics evidence; therefore, it is crucial that the legal system is well acquainted with the opportunities and limitations of these approaches.

Exploring the speech and language of individuals with non-syndromic submucous cleft palate: a preliminary report

BACKGROUND

Submucous cleft palate (SMCP) has a heterogeneous presentation and is often identified late or misdiagnosed. Diagnosis is prompted by speech, resonance or feeding symptoms associated with velopharyngeal insufficiency. However, the broader impacts of SMCP on communication have rarely been examined and therefore are poorly understood.

AIM

To describe the communicative profile of individuals with non-syndromic SMCP by examining speech, language and pragmatics (social language).

METHODS & PROCEDURES

Fifteen participants with SMCP aged 5;1-12;8, without a genetic diagnosis, participated in the study. Participants completed standardized assessments examining language, resonance, speech and non-verbal intellect. Parents also completed the Children's Communication Checklist (CCC-2), which provided a measure of overall communicative ability, including pragmatic skills. Formal language outcomes were compared with two cohorts: 36 individuals with overt non-syndromic clefts and 129 individuals with no history of clefting.

OUTCOMES & RESULTS

Speech intelligibility was reduced secondary to hypernasality, disordered articulation and/or impaired phonology (n = 7) in children with SMCP. Poorer overall language outcomes were observed for children with SMCP compared with both those with overt clefts and no history of clefting (p < 0.001). Language scores for children with SMCP ranged from impaired (n = 6) to above the standardized mean (n = 4). Receptive and expressive language performance were independently correlated with non-verbal IQ (p < 0.01). Those with severe language impairment (n = 4) also had borderline or impaired non-verbal IQ. Parents reported that speech and semantics were the most affected sub-domains of communication, while scores were the highest for the initiation domain. Speech and language skills were correlated strongly with pragmatics (r = 0.877, p < 0.01).

CONCLUSIONS & IMPLICATIONS

Overall, performance was variable within the SMCP group across speech, language and pragmatic assessments. In addition to well-documented speech difficulties, children with SMCP may have language or pragmatic impairments, suggesting that further neurodevelopmental influences may be at play. As such, for individuals with SMCP, additional clinical screening of language and pragmatic abilities may be required to ensure accurate diagnosis and guide both cleft and non-cleft related therapy programmes.

Does Inattention and Hyperactivity Moderate the Relation Between Speed of Processing and Language Skills?

The causal role of speed of processing (SOP) in developmental language disorder (DLD) is unclear given that SOP has been implicated in other neurodevelopmental disorders such as attention-deficit/hyperactivity disorder. This study investigated associations between SOP, language, and inattention/hyperactivity in a U.K. epidemiological cohort (N = 528). Monolingual children from a range of socioeconomic backgrounds were assessed longitudinally; at ages 5-6 (2012/2013) and 7-8 years (2014/2015). Persistent weaknesses in SOP characterized children with DLD but did not predict language longitudinally. Ratings of inattention/hyperactivity moderated the association between SOP and language, indicating that SOP deficits are particularly detrimental for language when coupled with poor attention/hyperactivity. SOP may be a shared risk factor for DLD and inattention/hyperactivity or a general marker of neurodevelopmental disorder.

The evaluation of word-learning abilities in people with developmental language disorder: a scoping review

BACKGROUND

The ability to learn new words is critical in the development of oral and written language, and significantly impacts engagement in social, academic and vocational situations. Many studies have evaluated the word-learning process in people with developmental language disorder (DLD). However, methodologies for assessment are heterogeneous, creating difficulties in synthesizing findings and identifying gaps in the knowledge base.

AIMS

To scope systematically the literature and identify key methodological parameters considered in evaluations of word learning in people with DLD; and to identify gaps in the literature to guide further research in this area.

METHODS & PROCEDURES

Twelve databases were searched and a total of 70 studies that met eligibility criteria were identified. The studies were evaluated according to key parameters that researchers varied in their word-learning methodologies.

MAIN CONTRIBUTION

Most research has focused on word learning in the oral modality, and specifically in children with DLD. Fewer studies have explored word learning in adults and adolescents with DLD, and in the written modality. Depending on the research question and theoretical perspective driving the investigation, methodologies for assessing word learning considered a range of parameters, including words being learned, learning context and cues to support learning in the tasks.

CONCLUSIONS & IMPLICATIONS

This review aggregates a variety of methods used previously to assess word learning. Findings highlight the need for further research to explore areas such as: the learning of varied word types (e.g., adjectives and adverbs); learning in the written modality; and word learning (both oral and written) in adolescents and adults with DLD.

Early Risk Factors and Emotional Difficulties in Children at Risk of Developmental Language Disorder: A Population Cohort Study

Purpose This study evaluated the pathways between developmental language disorder (DLD), psychosocial risk factors, and the development of emotional difficulties from ages 3 to 11 years within the Millennium Cohort Study. Method A total of 14,494 singletons (49.4% female) from the Millennium Cohort Study were evaluated within this study. Risk of DLD (rDLD) was defined as age 5 parent-reported language problems and/or -1.5 SDs on a Naming Vocabulary subtest at the age of 5 years. Children without rDLD formed the general population comparison group. Psychosocial risk factors included 9-month temperamental traits, parental psychological distress, and maternal attachment as well as age 3 emotional regulation abilities, parent-child relationship, and peer problems. The parent report Strengths and Difficulties Questionnaire Emotional Difficulty subscale at 3, 5, 7, and 11 years of age was the outcome variable. The trajectory of emotional difficulties was evaluated within a variable-centered approach and a person-centered approach, using growth mixture modeling. Results Children with rDLD (n = 884) had increased levels of emotional problems when compared to the general population group (n = 13,344). Psychosocial risk factors were increased in children with rDLD, fully mediated the increased emotional difficulties at 3 years, and partially mediated the increased emotional difficulties at 11 years. Children with rDLD were more likely to be included in emotional trajectory subgroups with an increasing pattern of emotional problems. rDLD was an additional risk factor for lower levels of emotional self-regulation and increased peer problems when controlling for the emotional difficulties trajectory subgroup. Conclusion This article indicates that the increased emotional difficulties found in children with rDLD are likely a function of early language difficulties influencing other domains of development, specifically social interactions (parent and peer) and emotional self-regulation abilities. Clinically, this reiterates the importance of early identification and treatment of children with language delays or clinical level language disorders. Supplemental Material https://doi.org/10.23641/asha.8323598.

Neighborhood Density and Word Production in Delayed and Advanced Learners

Purpose This study reexamines the claim that difficulty forming memories of words comprising uncommon sound sequences (i.e., low phonological neighborhood density words) is a determinant of delayed expressive vocabulary development (e.g., Stokes, 2014). Method We modeled communicative development inventory data from (N = 442) 18-month-old children, with expressive lexicon sizes between 0 and 517 words (Mdn = 84). We fitted a Bayesian regression model in which the production of each communicative inventory word (N = 680) by each child was predicted by interactions between that child's expressive lexicon size and the word's (a) phonological neighborhood density, (b) frequency in child-directed speech, (c) length, (d) babiness, and (e) concreteness. Results Children with larger expressive lexicons were more likely to produce words comprising uncommon sound sequences than age-matched children with smaller lexicons. However, the magnitude of the interaction between expressive lexicon size and phonological neighborhood density was modest relative to interactions between expressive lexicon size and word frequency, length, babiness, and concreteness. Conclusion Emphasis on a difficulty with the memorization of low-neighborhood density words as a determinant of slow vocabulary growth may be unwarranted, and the current evidence base in this direction is not robust enough to strongly support the development of possible interventions for late talkers.

A Review of Language, Executive Function, and Intervention in Autism Spectrum Disorder

Difficulties with both executive functions and language skills are common but variable in autism spectrum disorder (ASD). Executive functions and language skills are related to one another, such that vocabulary, syntax, and pragmatics are related to domains of working memory, shifting, and inhibition in ASD, although the directionality of these relationships remains unclear. Moreover, interventions that target pragmatic ability have been found to improve executive function skills, and conversely, executive function interventions are linked with improvements in social skills in children with ASD. We review the literature on executive functions, language skills, and their relationship in ASD; discuss factors that may be driving inconsistent findings; and explore clinical applications from the research thus far.

Diagnostic Accuracy of Sentence Recall and Past Tense Measures for Identifying Children's Language Impairments

Purpose Measures of linguistic processing and grammatical proficiency represent strong candidates for adaptation into language screeners for early elementary students. One key barrier, however, has been the lack of consensus around the preferred reference standard for assigning affected status. Diagnostic accuracies associated with sentence recall and past tense marking index measures were examined relative to 5 different reference standards of language impairment: receipt of language services, clinically significant levels of parental concern, low performance on language measures, a composite requiring at least 2 of these indicators, and a composite requiring convergence across all indicators. Method One thousand sixty grade K-3 students participated in school-based language screenings. All students who failed the screenings and a random sampling of those who passed were invited to participate in confirmatory assessments. The community-based sample was supplemented by a clinical sample of 58 students receiving services for language impairment. Two hundred fifty-four students participated in confirmatory testing. Examiners were naive to participants' status. Results Diagnostic accuracies for the sentence recall and past tense marking index measures varied across the different reference standards (areas under receiver operating characteristic curves: .67-.95). Higher levels of convergence occurred with reference standards based on behavioral measures. When affected status was defined by receipt of services and/or parental ratings, cases presented with higher levels of performance on the language measures than when affected status was based on behavioral criteria. Conclusion These results provide additional support for the adaptation of sentence recall and past tense marking to screen for language impairments in early elementary students. Supplemental Material https://doi.org/10.23641/asha.8285786.

Optimized and Predictive Phonemic Interfaces for Augmentative and Alternative Communication

Purpose We empirically assessed the results of computational optimization and prediction in communication interfaces that were designed to allow individuals with severe motor speech disorders to select phonemes and generate speech output. Method Interface layouts were either random or optimized, in which phoneme targets that were likely to be selected together were located in proximity. Target sizes were either static or predictive, such that likely targets were dynamically enlarged following each selection. Communication interfaces were evaluated by 36 users without motor impairments using an alternate access method. Each user was assigned to 1 of 4 interfaces varying in layout and whether prediction was implemented (random/static, random/predictive, optimized/static, optimized/predictive) and participated in 12 sessions over a 3-week period. Six participants with severe motor impairments used both the optimized/static and optimized/predictive interfaces in 1-2 sessions. Results In individuals without motor impairments, prediction provided significantly faster communication rates during training (Sessions 1-9), as users were learning the interface target locations and the novel access method. After training, optimization acted to significantly increase communication rates. The optimization likely became relevant only after training when participants knew the target locations and moved directly to the targets. Participants with motor impairments could use the interfaces with alternate access methods and generally rated the interface with prediction as preferred. Conclusions Optimization and prediction led to increases in communication rates in users without motor impairments. Predictive interfaces were preferred by users with motor impairments. Future research is needed to translate these results into clinical practice. Supplemental Material https://doi.org/10.23641/asha.8636948.

Assessing Pragmatic Skills Using Checklists with Children who are Deaf and Hard of Hearing: A Systematic Review

This paper investigates the use of checklists to assess pragmatics in children and adolescents who are deaf and hard of hearing. A systematic literature review was undertaken to identify all of the published research articles between 1979 and 2018 on the topic of the assessment of pragmatics for this population of children and adolescents. The 67 papers identified in this review were analyzed and all papers that utilized a checklist to assess pragmatic skills were identified. Across the 18 different published papers on the use of pragmatic skills among children who are deaf and hard of hearing, nine checklists were identified. These nine checklists were then compared and contrasted on six key features including identification of a theoretical framework or model; the type of pragmatic skills measured; the age range of the child assessed; the information/outputs generated; the primary informant for the assessment; and reliability, validity, and normative data. The resulting analysis provides a comprehensive guide to aid clinicians, educators, and researchers in selecting an appropriate checklist to assess pragmatic skills for children and adolescents who are deaf and hard of hearing.

Executive control in language production by children with and without language impairment

BACKGROUND

Accumulating evidence suggests that the updating, inhibiting and shifting abilities underlying executive control are important for spoken language production in adults. However, little is known about this in children.

AIMS

To examine whether children with and without language impairment differ in all or only some of these executive abilities, and whether they show corresponding differences when these abilities are engaged in language production.

METHODS & PROCEDURES

Thirty-three children with specific language impairment (SLI) and 41 typically developing (TD) children (age matched, aged 8-12 years) completed standard executive control tests that measure the updating, inhibiting and shifting abilities. All children were native speakers of Dutch. Moreover, they performed a noun-phrase production task involving picture description within a picture-word interference paradigm. We measured their production accuracy and speed to assess length, distractor and switch effects, which reflect the updating, inhibiting and shifting abilities underlying executive control.

OUTCOMES & RESULTS

Compared with TD children, the children with SLI had lower scores on all executive control tests. Moreover, they were overall slower and made more errors in the noun-phrase production task. Additionally, the magnitude of the distractor and switch effects was larger for the SLI than for the TD group.

CONCLUSIONS & IMPLICATIONS

The results suggest that children with SLI have impaired language production and executive control abilities, and that some of the differences in the executive control abilities between SLI and TD groups were reflected in their language production.

Visual sequential processing and language ability in children who are deaf or hard of hearing

This study investigated the role of sequential processing in spoken language outcomes for children who are deaf or hard of hearing (DHH), ages 5;3-11;4, by comparing them to children with typical hearing (TH), ages 6;3-9;7, on sequential learning and memory tasks involving easily nameable and difficult-to-name visual stimuli. Children who are DHH performed more poorly on easily nameable sequencing tasks, which positively predicted receptive vocabulary scores. Results suggest sequential learning and memory may underlie delayed language skills of many children who are DHH. Implications for language development in children who are DHH are discussed.