Working memory and specific language impairment: an update on the relation and perspectives on assessment and treatment

Parent-rating vs performance-based working memory measures: Association with spoken language measures in school-age children

Working memory (WM) assessment is often part of cognitive-linguistic test batteries. The author examined the relationship between parent rating of WM functioning and children's performance-based WM, and the relationship of each with receptive and expressive spoken language measures. Study participants were eighty-three 7- to 11-year-old children. The sample represented a broad range of cognitive abilities. No participating child had frank neurological or intellectual disabilities, autism, fluency disorder, or hearing loss. Parents completed a standardized executive function rating scale that included a WM subscale. Children completed a standardized WM task and an experimental WM task. Children also completed six standardized language measures. Results showed that there was no correlation between parent rating and either of the performance-based WM tasks as well as the composite WM performance score. Parent rating of WM functioning was not related to any of the language scores whereas the composite WM performance score showed significant links with language abilities. Although parent rating and performance-based WM measures are designed to reflect the same cognitive construct, they are not correlated. Potential reasons for the findings and implications of using parent-rating and performance-based WM measures in school-age children are discussed.

Pull the Andon Rope on Working Memory Capacity Interventions Until We Know More

Purpose

The purpose of this article is to discuss the current state of interventions for improving working memory (WM) capacity language and academic skills and to provide suggestions for speech-language pathologists working with students who have WM capacity limitations.

Method

Meta-analyses, systematic reviews, randomized controlled trials, and nonrandomized comparison studies investigating the role of WM interventions for improving WM capacity language and academic skills are reviewed. Strategies for improving WM are discussed.

Results

The use of interventions designed to improve WM capacity and other cognitive skills is currently not supported by the research. Direct WM interventions should be considered to be experimental at this time. Such interventions require further investigation before they are used regularly for children with developmental language disorders.

Discussion

Clinicians and practitioners should look to already established interventions for improving how students with developmental language disorders utilize organizational strategies and other well-researched methods for improving their cognitive and academic functioning in functional contexts.

Developmental dyslexia and specific language impairment: distinct syntactic profiles?

Recent work exploring syntax in developmental dyslexia (DD) has identified morphosyntactic deficits, striking parallelisms between children with DD and specific language impairment (SLI). The question remains open if the underlying causes for such deficits are related to difficulties in phonology, which is affected in DD, or to working memory, as has been previously reported for SLI. We focus on the production of third person accusative clitic pronouns (ACC3) and of homophonous definite determiners in French-speaking children with DD and SLI as well as typically developing (TD) controls. If syntactic complexity modulates performance of DD children, as has already been shown for SLI, we predict children with DD to perform significantly worse on ACC3 compared to definite determiners, which are homophonous but syntactically simpler. In addition, if impairment in ACC3 stems from phonology or working memory difficulties, we expect ACC3 performance in both clinical groups to relate to performance on non-word repetition or forward/backward digit spans. We studied 2 groups of 21 children and adolescents, with DD and SLI (7-15 years) and age-matched TD controls. Results reveal significant weaknesses with ACC3 in DD and SLI groups compared to TD controls, but no difficulty for homophonous definite determiners, confirming a deficit relating specifically to syntactic complexity. As for links to phonology and working memory, a single correlation emerged between ACC3 and the backward digit span in SLI, but not in DD, suggesting different underlying sources for syntactic deficits in these populations. Clinical implications of these results are discussed.

Parental perception of listening difficulties: an interaction between weaknesses in language processing and ability to sustain attention

(Central) auditory processing disorder ((C)APD) is a controversial diagnostic category which may be an artefact of referral route. Yet referral route must, to some extent, be influenced by a child’s profile of presenting symptoms. This study tested the hypothesis that parental perception of listening difficulty is associated with weaknesses in ability to sustain attention while listening to speech. Forty-four children (24 with listening difficulties) detected targets embedded in a 16-minute story. The targets were either mispronunciations or nonsense words. Sentence context was modulated to separate out effects due to deficits in language processing from effects due to deficits in attention. Children with listening difficulties missed more targets than children with typical listening abilities. Both groups of children were initially sensitive to sentence context, but this declined over time in the children with listening difficulties. A report-based measure of language abilities captured the majority of variance in a measure capturing time-related changes in sensitivity to context. Overall, the findings suggest parents perceive children to have listening, not language difficulties, because weaknesses in language processing only emerge when stressed by the additional demands associated with attending to, and processing, speech over extended periods of time.

Changes in verbal and visuospatial working memory from Grade 1 to Grade 3 of primary school: Population longitudinal study

BACKGROUND

Adaptive working memory training is being implemented without an adequate understanding of developmental trajectories of working memory. We aimed to quantify from Grade 1 to Grade 3 of primary school (1) changes in verbal and visuospatial working memory and (2) whether low verbal and visuospatial working memory in Grade 1 predicts low working memory in Grade 3.

METHOD

The study design includes a population-based longitudinal study of 1,802 children (66% uptake from all 2,747 Grade 1 students) at 44 randomly selected primary schools in Melbourne, Australia. Backwards Digit Recall (verbal working memory) and Mister X (visuospatial working memory) screening measures from the Automated Working Memory Assessment (M = 100; SD = 15) were used to assess Grades 1 and 3 (ages 6-7 and 8-9 years) students. Low working memory was defined as ≥1 standard deviation below the standard score mean. Descriptive statistics addressed Aim 1, and predictive parameters addressed Aim 2.

RESULTS

One thousand seventy (59%) of 1802 Grade 1 participants were reassessed in Grade 3. As expected for typically developing children, group mean standard scores were similar in Grades 1 and 3 for verbal, visuospatial, and overall working memory, but group mean raw scores increased markedly. Compared to "not low" children, those classified as having low working memory in Grade 1 showed much larger increases in both standard and raw scores across verbal, visuospatial, and overall working memory. Sensitivity was very low for Grade 1 low working memory predicting Grade 3 low classifications.

CONCLUSION

Although mean changes in working memory standard scores between Grades 1 and 3 were minimal, we found that individual development varied widely, with marked natural resolution by Grade 3 in children who initially had low working memory. This may render brain-training interventions ineffective in the early school year ages, particularly if (as population-based programmes usually mandate) selection occurs within a screening paradigm.

Procedural Motor Learning in Children With Specific Language Impairment

PURPOSE

Specific language impairment (SLI) is a developmental disorder that affects language and motor development in the absence of a clear cause. An explanation for these impairments is offered by the procedural deficit hypothesis (PDH), which argues that motor difficulties in SLI are due to deficits in procedural memory. The aim of this study was to test the PDH by examining the procedural motor learning abilities of children with and without SLI.

METHOD

Thirteen children with SLI and 14 age-matched typically developing children completed the following procedural measures: (a) a knot-tying task as a measure of motor sequencing and (2) a mirror-drawing task as a measure of visual-motor adaptation.

RESULTS

Although children with SLI produced significantly more errors on certain knot-tying tasks, they performed comparably on others. Also, children with SLI performed comparably with typically developing children on the mirror-drawing task.

CONCLUSIONS

The PDH requires reframing. The sequence learning deficits in SLI are modest and specific to more difficult tasks. Visual-motor adaptation, on the other hand, appears to be unaffected in SLI.

Developmental Associations Between Working Memory and Language in Children With Specific Language Impairment: A Longitudinal Study

PURPOSE

This longitudinal study examined differences in the development of working memory (WM) between children with specific language impairment (SLI) and typically developing (TD) children. Further, it explored to what extent language at ages 7-8 years could be predicted by measures of language and/or WM at ages 4-5 years.

METHOD

Thirty children with SLI and 33 TD children who were previously examined on measures of WM and language at ages 4-5 years (T1) were reexamined at ages 7-8 years (T2).

RESULTS

The developmental course of WM was mostly similar for the two groups; only the development of the verbal storage component differed. At T1, children with SLI performed significantly below their TD peers on all components of WM (verbal storage, verbal central executive [CE], visuospatial storage, and visuospatial CE), whereas at T2, the differences for the visuospatial components were no longer significant when age and intelligence were taken into account. Hierarchical regression showed language and verbal CE at T1 to be significant predictors of language at T2, with no differences in the developmental associations between language and WM for the two groups.

CONCLUSIONS

The results of this study suggest that particularly verbal CE is of importance for the acquisition of linguistic skills.

Encoding Deficits Impede Word Learning and Memory in Adults With Developmental Language Disorders

Purpose

The aim of this study was to determine whether the word-learning challenges associated with developmental language disorder (DLD) result from encoding or retention deficits.

Method

In Study 1, 59 postsecondary students with DLD and 60 with normal development (ND) took the California Verbal Learning Test-Second Edition, Adult Version (Delis, Kramer, Kaplan, & Ober, 2000). In Study 2, 23 postsecondary students with DLD and 24 with ND attempted to learn 9 novel words in each of 3 training conditions: uncued test, cued test, and no test (passive study). Retention was measured 1 day and 1 week later.

Results

By the end of training, students with DLD had encoded fewer familiar words (Study 1) and fewer novel words (Study 2) than their ND peers as evinced by word recall. They also demonstrated poorer encoding as evinced by slower growth in recall from Trials 1 to 2 (Studies 1 and 2), less semantic clustering of recalled words, and poorer recognition (Study 1). The DLD and ND groups were similar in the relative amount of information they could recall after retention periods of 5 and 20 min (Study 1). After a 1-day retention period, the DLD group recalled less information that had been encoded via passive study, but they performed as well as their ND peers when recalling information that had been encoded via tests (Study 2). Compared to passive study, encoding via tests also resulted in more robust lexical engagement after a 1-week retention for DLD and ND groups.

Conclusions

Encoding, not retention, is the problematic stage of word learning for adults with DLD. Self-testing with feedback lessens the deficit.

Supplemental Materials

https://doi.org/10.23641/asha.5435200.

Deficits in comprehending wh-questions in children with hearing loss - the contribution of phonological short-term memory and syntactic complexity

The aim of the study is to investigate if German children with hearing loss (HL) display persisting problems in comprehending complex sentences and to find out whether these problems can be linked to limitations in phonological short-term memory (PSTM). A who-question comprehension test (picture pointing) and a nonword repetition (NWR) task were conducted with 21 German children with bilateral sensorineural HL (ages 3-4) and with age-matched 19 normal hearing (NH) children. Follow-up data (ages 6-8) are reported for 10 of the children with HL. The data reveal that the comprehension of who-questions as well as PSTM was significantly more impaired in children with HL than in children with NH. For both groups of participants, there were no correlations between question comprehension scores and performance in the NWR test. Syntactic complexity (subject vs. object question) affected question comprehension in children with HL, however, these problems were overcome at school age. In conclusion, the data indicate that a hearing loss affects the comprehension of complex sentences. The observed problems did, however, not persist and were, therefore, unlikely to be caused by a genuine syntactic deficit. For the tested wh-questions, there is no indication that syntactic comprehension problems of children with HL are due to limitations in PSTM.

Language Proficiency and Sustained Attention in Monolingual and Bilingual Children with and without Language Impairment

Background: The language profiles of children with language impairment (LI) and bilingual children can show partial, and possibly temporary, overlap. The current study examined the persistence of this overlap over time. Furthermore, we aimed to better understand why the language profiles of these two groups show resemblance, testing the hypothesis that the language difficulties of children with LI reflect a weakened ability to maintain attention to the stream of linguistic information. Consequent incomplete processing of language input may lead to delays that are similar to those originating from reductions in input frequency. Methods: Monolingual and bilingual children with and without LI (N = 128), aged 5-8 years old, participated in this study. Dutch receptive vocabulary and grammatical morphology were assessed at three waves. In addition, auditory and visual sustained attention were tested at wave 1. Mediation analyses were performed to examine relationships between LI, sustained attention, and language skills. Results: Children with LI and bilingual children were outperformed by their typically developing (TD) and monolingual peers, respectively, on vocabulary and morphology at all three waves. The vocabulary difference between monolinguals and bilinguals decreased over time. In addition, children with LI had weaker auditory and visual sustained attention skills relative to TD children, while no differences between monolinguals and bilinguals emerged. Auditory sustained attention mediated the effect of LI on vocabulary and morphology in both the monolingual and bilingual groups of children. Visual sustained attention only acted as a mediator in the bilingual group. Conclusion: The findings from the present study indicate that the overlap between the language profiles of children with LI and bilingual children is particularly large for vocabulary in early (pre)school years and reduces over time. Results furthermore suggest that the overlap may be explained by the weakened ability of children with LI to sustain their attention to auditory stimuli, interfering with how well incoming language is processed.

The role of nonverbal working memory in morphosyntactic processing by children with specific language impairment and autism spectrum disorders

BACKGROUND

Both children with autism spectrum disorders (ASD) and children with specific language impairment (SLI) have been shown to have difficulties with grammatical processing. A comparison of these two populations with neurodevelopmental disorders was undertaken to examine similarities and differences in the mechanisms that may underlie grammatical processing. Research has shown that working memory (WM) is recruited during grammatical processing. The goal of this study was to examine morphosyntactic processing on a grammatical judgment task in children who varied in clinical diagnosis and language abilities and to assess the extent to which performance is predicted by nonverbal working memory (WM). Two theoretical perspectives were evaluated relative to performance on the grammatical judgment task-the "working memory" account and the "wrap-up" account. These accounts make contrasting predictions about the detection of grammatical errors occurring early versus late in the sentence.

METHODS

Participants were 84 school-age children with SLI (n = 21), ASD (n = 27), and typical development (TD, n = 36). Performance was analyzed based on diagnostic group as well as language status (normal language, NL, n = 54, and language impairment, LI, n = 30). A grammatical judgment task was used in which the position of the error in the sentence (early versus late) was manipulated. A visual WM task (N-back) was administered and the ability of WM to predict morphosyntactic processing was assessed.

RESULTS

Groups differed significantly in their sensitivity to grammatical errors (TD > SLI and NL > LI) but did not differ in nonverbal WM. Overall, children in all groups were more sensitive and quicker at detecting errors occurring late in the sentence than early in the sentence. Nonverbal WM predicted morphosyntactic processing across groups, but the specific profile of association between WM and early versus late error detection was reversed for children with and without language impairment.

CONCLUSIONS

Findings primarily support a "wrap up" account whereby the accumulating sentence context for errors positioned late in the sentence (rather than early) appeared to facilitate morphosyntactic processing. Although none of the groups displayed deficits in visual WM, individual differences in these nonverbal WM resources predicted proficiency in morphosyntactic processing.

Can you spell dyslexia without SLI? Comparing the cognitive profiles of dyslexia and specific language impairment and their roles in learning

The aim of the present study is to explore whether those with Specific Language Impairment (SLI) and dyslexia display distinct or overlapping cognitive profiles with respect to learning outcomes. In particular, we were interested in two key cognitive skills associated with academic performance - working memory and IQ. We recruited three groups of children - those with SLI, those with dyslexia, and a control group. All children were given standardized tests of working memory, IQ (vocabulary and matrix), spelling, and math. The pattern of results suggests that both children with dyslexia and SLI are characterized with poorer verbal working memory and IQ compared to controls, but preserved nonverbal cognitive skills. It appears that that these two disorder groups cannot be distinguished by the severity of their cognitive deficits. However, there was a differential pattern with respect to learning outcomes, where the children with dyslexia rely more on visual skills in spelling, while those with SLI use their relative strengths in vocabulary. These findings can have important implications for how intervention is tailored in the classroom, as disorder-specific support could yield important gains in learning.

Assessing Lebanese bilingual children: The use of Cross-linguistic Lexical Tasks in Lebanese Arabic

Since norms for vocabulary acquisition in Lebanese bilingual children (L1: Lebanese, L2: French and/or English) do not yet exist, clinical assessment based on normative data and using appropriate tools remains difficult for speech and language therapists. The current study focuses on exploring and comparing lexical performances of typically developing Lebanese bilingual children (32 Bi-TD, aged 5;7 to 6;9) and those with specific language impairment (10 Bi-SLI, aged 5;9 to 7;10), using Cross-Linguistic Lexical Tasks (LITMUS-CLT, COST Action IS0804, 2011) in Lebanese Arabic language (CLT-LB), specific to the Lebanese context. The results confirm that typically developing children have better lexical skills, especially expressive skills, than their peers with specific language impairment. Expressive and receptive performance by both groups of children was found to depend on word class (nouns and verbs). Bi-TD children were more accurate at naming and recognising verbs than the Bi-SLI group. The results of these lexical tasks reveal aspects of the nature of bilingual lexical variation, as well as similarities and differences between the Bi-TD and Bi-SLI groups.

Childhood Language Disorder and Social Anxiety in Early Adulthood

Language disorder is associated with anxiety and with social problems in childhood and adolescence. However, the relation between language disorder and adult social anxiety is not well known. This study examines social anxiety in early adulthood in a 26-year prospective longitudinal study following individuals identified with a communication disorder at age 5 and a control group. Social anxiety diagnoses and subthreshold symptoms were examined at ages 19, 25, and 31 using a structured diagnostic interview; social anxiety symptoms related to social interaction and social performance were also assessed dimensionally at age 31. Multiple imputation was used to address attrition. Compared to controls, participants with childhood language disorder had higher rates of subthreshold social phobia at ages 19 and 25 and endorsed higher levels of social interaction anxiety symptoms at age 31, with particular difficulty talking to others and asserting their perspectives. Childhood language disorder is a specific risk factor for a circumscribed set of social anxiety symptoms in adulthood, which are likely associated with communication challenges.

Executive and intellectual functioning in school-aged children with specific language impairment

BACKGROUND

Earlier research and clinical practice show that specific language impairment (SLI) is often associated with nonverbal cognitive deficits and weakened skills in executive functions (EFs). Executive deficits may have a remarkable influence on a child's everyday activities in the home and school environments. However, research information is still limited on EFs in school-aged children with SLI, mostly conducted among English- and Dutch-speaking children.

AIMS

To study whether there are differences in EFs between Finnish-speaking children with SLI and typically developing (TD) peers at school age. EFs are compared between the groups with and without controlling for nonverbal intelligence.

METHODS & PROCEDURES

Parents and teachers of children with SLI (n = 22) and age- and gender-matched TD peers (n = 22) completed The Behavior Rating Inventory of Executive Functions (BRIEF). The mean age of the children was 8,2 years. BRIEF ratings of parents and teachers were compared between the children with SLI and with TD peers by paired analysis using conditional logistic regression models with and without controlling for nonverbal IQ. Intellectual functioning was assessed with the Wechsler Intelligence Scale for Children.

OUTCOMES & RESULTS

Children with SLI had weaker scores in all parent and teacher BRIEF scales compared with TD peers. Statistically significant differences between the groups were found in BRIEF scales Shift, Emotional Control, Initiate, Working Memory, Plan/Organize and Monitor. Differences between the groups were statistically significant also in intellectual functioning. On BRIEF scales some group differences remained statistically significant after controlling for nonverbal IQ.

CONCLUSIONS & IMPLICATIONS

This study provides additional evidence that also Finnish-speaking school-aged children with SLI are at risk of having deficits in EFs in daily life. EFs have been proposed to have an impact on developmental outcomes later in life. In clinical practice it is important to pay attention to EFs in school-aged children with SLI when making diagnostic evaluations and planning interventions for them.

Weaknesses in Lexical-Semantic Knowledge Among College Students With Specific Learning Disabilities: Evidence From a Semantic Fluency Task

Purpose

The purpose of this study is to determine whether deficits in executive function and lexical-semantic memory compromise the linguistic performance of young adults with specific learning disabilities (LD) enrolled in postsecondary studies.

Method

One hundred eighty-five students with LD (n = 53) or normal language development (ND, n = 132) named items in the categories animals and food for 1 minute for each category and completed tests of lexical-semantic knowledge and executive control of memory. Groups were compared on total names, mean cluster size, frequency of embedded clusters, frequency of cluster switches, and change in fluency over time. Secondary analyses of variability within the LD group were also conducted.

Results

The LD group was less fluent than the ND group. Within the LD group, lexical-semantic knowledge predicted semantic fluency and cluster size; executive control of memory predicted semantic fluency and cluster switches. The LD group produced smaller clusters and fewer embedded clusters than the ND group. Groups did not differ in switching or change over time.

Conclusions

Deficits in the lexical-semantic system associated with LD may persist into young adulthood, even among those who have managed their disability well enough to attend college. Lexical-semantic deficits are associated with compromised semantic fluency, and the two problems are more likely among students with more severe disabilities.

Complex sentence profiles in children with Specific Language Impairment: Are they really atypical?

Children with Specific Language Impairment (SLI) have language difficulties of unknown origin. Syntactic profiles are atypical, with poor performance on non-canonical structures, e.g. object relatives, suggesting a localized deficit. However, existing analyses using ANOVAs are problematic because they do not systematically address unequal variance, or fully model random effects. Consequently, a Generalised Linear Model (GLM) was used to analyze data from a Sentence Repetition (SR) task involving relative clauses. seventeen children with SLI (mean age 6;7), twenty-one Language Matched (LM) children (mean age 4;8), and seventeen Age Matched (AM) children (mean age 6;5) repeated 100 canonical and non-canonical sentences. ANOVAs found a significant Group by Canonicity interaction for the SLI versus AM contrast only. However, the GLM found no significant interaction. Consequently, arguments for a localized deficit may depend on statistical methods which are prone to exaggerate profile differences. Nonetheless, a subgroup of SLI exhibited particularly severe structural language difficulties.

Learning and Overnight Retention in Declarative Memory in Specific Language Impairment

We examined learning and retention in nonverbal and verbal declarative memory in Hungarian children with (n = 21) and without (n = 21) SLI. Recognition memory was tested both 10 minutes and one day after encoding. On nonverbal items, only the children with SLI improved overnight, with no resulting group differences in performance. In the verbal domain, the children with SLI consistently showed worse performance than the typically-developing children, but the two groups showed similar overnight changes. The findings suggest the possibility of spared or even enhanced declarative memory consolidation in SLI.

Syntactic Versus Memory Accounts of the Sentence Comprehension Deficits of Specific Language Impairment: Looking Back, Looking Ahead

Purpose

Compared with same-age typically developing peers, school-age children with specific language impairment (SLI) exhibit significant deficits in spoken sentence comprehension. They also demonstrate a range of memory limitations. Whether these 2 deficit areas are related is unclear. The present review article aims to (a) review 2 main theoretical accounts of SLI sentence comprehension and various studies supporting each and (b) offer a new, broader, more integrated memory-based framework to guide future SLI research, as we believe the available evidence favors a memory-based perspective of SLI comprehension limitations.

Method

We reviewed the literature on the sentence comprehension abilities of English-speaking children with SLI from 2 theoretical perspectives.

Results

The sentence comprehension limitations of children with SLI appear to be more fully captured by a memory-based perspective than by a syntax-specific deficit perspective.

Conclusions

Although a memory-based view appears to be the better account of SLI sentence comprehension deficits, this view requires refinement and expansion. Current memory-based perspectives of adult sentence comprehension, with proper modification, offer SLI investigators new, more integrated memory frameworks within which to study and better understand the sentence comprehension abilities of children with SLI.

Learning by listening to lectures is a challenge for college students with developmental language impairment

BACKGROUND

Increasing numbers of students with developmental language impairment (LI) are pursuing post-secondary education.

OBJECTIVE

To determine whether college students with LI find spoken lectures to be a challenging learning context.

METHOD

Study participants were college students, 34 with LI and 34 with normal language development (ND). Each took a baseline test of general topic knowledge, watched and listened to a 30min lecture, and took a posttest on specific information from the lecture. Forty additional college students served as control participants. They completed the tests that covered the lecture information without being exposed to the lectures.

RESULTS

With baseline performance controlled, students with LI performed more poorly than students with ND on multiple choice and fill-in-the-blank questions that tapped the lecture material. Nevertheless, students with LI out-performed the control participants whose scores were at floor. A self-rating of attention to the lecture predicted learning performance for both study groups; performance on a sentence repetition test, a measure that taps both prior linguistic knowledge and operations in short-term memory, was an additional predictor for participants with LI.

CONCLUSION

College students with LI learn less from listening to lectures than other students. Working memory deficits, especially those that reflect weaknesses in the central executive and the episodic buffer, may contribute to the problem.

Interrelationships Between Working Memory, Processing Speed, and Language Development in the Age Range 2-4 years

PURPOSE

This study explored associations between working memory and language in children aged 2-4 years.

METHOD

Seventy-seven children aged 24-30 months were assessed on tests measuring language, visual cognition, verbal working memory (VWM), phonological short-term memory (PSTM), and processing speed. A standardized test of receptive and expressive language was used as the outcomes measure 18 months later.

RESULTS

There were moderate-to-strong longitudinal bivariate relationships between the 3 processing measures and language outcomes. Early VWM showed the strongest bivariate relationship with both later expressive (r = .71) and receptive language (r = .72). In a hierarchical multiple regression analysis, adding early VWM, PSTM, and processing speed improved prediction of receptive and expressive language outcomes (12%-13% additional variance) compared with models consisting only of early receptive or expressive language, parent education, and age.

CONCLUSIONS

Unique associations in hierarchical regression analyses were demonstrated between VWM at age two years and receptive and expressive language skills at age four, and between early processing speed and later receptive language. However, early PSTM did not predict unique variance in language outcomes, as it shared variance with other measures.

Examining the cognitive demands of analogy instructions compared to explicit instructions

PURPOSE

In many learning domains, instructions are presented explicitly despite high cognitive demands associated with their processing. This study examined cognitive demands imposed on working memory by different types of instruction to speak with maximum pitch variation: visual analogy, verbal analogy and explicit verbal instruction.

METHOD

Forty participants were asked to memorise a set of 16 visual and verbal stimuli while reading aloud a Cantonese paragraph with maximum pitch variation. Instructions about how to achieve maximum pitch variation were presented via visual analogy, verbal analogy, explicit rules or no instruction. Pitch variation was assessed off-line, using standard deviation of fundamental frequency. Immediately after reading, participants recalled as many stimuli as possible.

RESULT

Analogy instructions resulted in significantly increased pitch variation compared to explicit instructions or no instructions. Explicit instructions resulted in poorest recall of stimuli. Visual analogy instructions resulted in significantly poorer recall of visual stimuli than verbal stimuli.

CONCLUSION

The findings suggest that non-propositional instructions presented via analogy may be less cognitively demanding than instructions that are presented explicitly. Processing analogy instructions that are presented as a visual representation is likely to load primarily visuospatial components of working memory rather than phonological components. The findings are discussed with reference to speech therapy and human cognition.

Executive control in spoken noun-phrase production: Contributions of updating, inhibiting, and shifting

The present study examined how the updating, inhibiting, and shifting abilities underlying executive control influence spoken noun-phrase production. Previous studies provided evidence that updating and inhibiting, but not shifting, influence picture-naming response time (RT). However, little is known about the role of executive control in more complex forms of language production like generating phrases. We assessed noun-phrase production using picture description and a picture–word interference procedure. We measured picture description RT to assess length, distractor, and switch effects, which were assumed to reflect, respectively, the updating, inhibiting, and shifting abilities of adult participants. Moreover, for each participant we obtained scores on executive control tasks that measured verbal and nonverbal updating, nonverbal inhibiting, and nonverbal shifting. We found that both verbal and nonverbal updating scores correlated with the overall mean picture description RTs. Furthermore, the length effect in the RTs correlated with verbal but not nonverbal updating scores, while the distractor effect correlated with inhibiting scores. We did not find a correlation between the switch effect in the mean RTs and the shifting scores. However, the shifting scores correlated with the switch effect in the normal part of the underlying RT distribution. These results suggest that updating, inhibiting, and shifting each influence the speed of phrase production, thereby demonstrating a contribution of all three executive control abilities to language production.

A systematic review on diagnostic procedures for specific language impairment: The sensitivity and specificity issues

Background:

Identification of children with specific language impairment (SLI) has been viewed as both necessity and challenge. Investigators and clinicians use different tests and measures for this purpose. Some of these tests/measures have good psychometric properties, but it is not sufficient for diagnostic purposes. A diagnostic procedure can be used for identification a specific population with confidence only when its sensitivity and specificity are acceptable. In this study, we searched for tests/measures with predefined sensitivity and specificity for identification of preschool children with SLI from their typically developing peers.

Materials and Methods:

A computerized search in bibliographic databases from 2000 to August 2015 was performed with the following keywords: “specific language impairment” or SLI” and “primary language impairment” or ‘PLI’ with at least one of the followings: “diagnosis,” “identification,” “accuracy,” “sensitivity,” and “specificity.” In addition, the related citations and reference lists of the selected articles were considered.

Results:

The results of reviewing 23 included studies show that the index measures used in studies vary in accuracy with the sensitivity ranging from 16% to 100% and the specificity ranging from 14% to 100%.

Conclusion:

These varieties in sensitivity and specificity of different tests/measures confirm the necessity of attention to the diagnostic power of tests/measures before their use as diagnostic tool. Further, the results indicate there are some promising tests/measures that the available evidence supports their performances in the diagnosis of SLI in preschool-aged children, yet the place of a reference standard for the diagnosis of SLI is vacant among investigations.

Why do children with language impairment have difficulties with narrative macrostructure?

BACKGROUND

Research has produced conflicting findings about the effects of language impairment (LI) on narrative macrostructure outcomes.

AIMS

The present study investigated if children with LI perform weaker than typically developing (TD) controls on narrative macrostructure in different tasks, whether this changes over time and if between-group differences stem from linguistic or cognitive factors.

METHODS AND PROCEDURES

A group of monolingual Dutch children with LI (n=84) and a TD control group (n=45) were tested with a story comprehension and a story generation task. All children were five or six at wave 1 and six or seven at wave 2. Information was collected on vocabulary, grammar, verbal memory and sustained attention.

OUTCOMES AND RESULTS

At wave 1, the LI group performed weaker than the TD group in both tasks. At wave 2, the groups performed similarly on story comprehension. On story generation, the TD group still outperformed the LI group. Sustained attention mediated the relationship between group and story generation.

CONCLUSIONS AND IMPLICATIONS

Effects of LI on narrative macrostructure are moderated by age and task and may stem from sustained attention weaknesses. These findings have implications for using narrative tasks in educational and diagnostic settings and may direct future interventions.

Cognitive functions in preschool children with specific language impairment

OBJECTIVE

A growing body of research has focused on executive functions in children with specific language impairment (SLI). However, results show limited convergence, particularly in preschool age. The current neuropsychological study compared performance of cognitive functions focused on executive components and working memory in preschool children with SLI to typically developing controls.

METHOD

Performance on the measures cognitive flexibility, inhibition, processing speed and phonological short-term memory was assessed. The monolingual, Caucasian study sample consisted of 30 children with SLI (Mage = 63.3 months, SD = 4.3 months) and 30 healthy controls (Mage = 62.2 months, SD = 3.7 months). Groups were matched for age and nonverbal IQ. Socioeconomic status of the participating families was included.

RESULTS

Children with SLI had significantly poorer abilities of phonological short-term memory than matched controls. A tendency of poorer abilities in the SLI group was found for inhibition and processing speed.

CONCLUSIONS

We confirmed phonological short-term memory to be a reliable marker of SLI in preschoolers. Our results do not give definite support for impaired executive function in SLI, possibly owing to limited sensitivity of test instruments in this age group. We argue for a standardization of executive function tests for research use.

Speech Databases of Typical Children and Children with SLI

The extent of research on children’s speech in general and on disordered speech specifically is very limited. In this article, we describe the process of creating databases of children’s speech and the possibilities for using such databases, which have been created by the LANNA research group in the Faculty of Electrical Engineering at Czech Technical University in Prague. These databases have been principally compiled for medical research but also for use in other areas, such as linguistics. Two databases were recorded: one for healthy children’s speech (recorded in kindergarten and in the first level of elementary school) and the other for pathological speech of children with a Specific Language Impairment (recorded at a surgery of speech and language therapists and at the hospital). Both databases were sub-divided according to specific demands of medical research. Their utilization can be exoteric, specifically for linguistic research and pedagogical use as well as for studies of speech-signal processing.

The relationship between phonological short-term memory, receptive vocabulary, and fast mapping in children with specific language impairment

BACKGROUND

Children with specific language impairment (SLI) often experience word-learning difficulties, which are suggested to originate in the early stage of word learning: fast mapping. Some previous research indicates significantly poorer fast mapping capabilities in children with SLI compared with typically developing (TD) counterparts, with a range of methodological factors impacting on the consistency of this finding. Research has explored key issues that might underlie fast mapping difficulties in children with SLI, with strong theoretical support but little empirical evidence for the role of phonological short-term memory (STM). Additionally, further research is required to explore the influence of receptive vocabulary on fast mapping capabilities. Understanding the factors associated with fast mapping difficulties that are experienced by children with SLI may lead to greater theoretically driven word-learning intervention.

AIMS

To investigate whether children with SLI demonstrate significant difficulties with fast mapping, and to explore the related factors. It was hypothesized that children with SLI would score significantly lower on a fast mapping production task compared with TD children, and that phonological STM and receptive vocabulary would significantly predict fast mapping production scores in both groups of children.

METHODS & PROCEDURES

Twenty-three children with SLI (mean = 64.39 months, SD = 4.10 months) and 26 TD children (mean = 65.92 months, SD = 2.98) were recruited from specialist language and mainstream schools. All participants took part in a unique, interactive fast-mapping task whereby nine novel objects with non-word labels were presented and production accuracy was assessed. A non-word repetition test and the Peabody Picture Vocabulary Test-Fourth Edition (PPVT-IV) were also administered as measures of phonological STM capacity and receptive vocabulary, respectively.

OUTCOMES & RESULTS

Results of the fast-mapping task indicated that children with SLI had significantly poorer fast mapping production scores than TD children. Scores from the non-word repetition task were also significantly lower for the SLI group, revealing reduced phonological STM capacity. Phonological STM capacity and receptive vocabulary emerged as significant predictors of fast mapping performance when the group data were combined in a multiple regression analysis.

CONCLUSIONS & IMPLICATIONS

These results suggest that the word-learning difficulties experienced by children with SLI may originate at the fast mapping stage, and that phonological STM and receptive vocabulary significantly predict fast mapping ability. These findings contribute to the theoretical understanding of word-learning difficulties in children with SLI and may inform lexical learning intervention.

Language recovery after left hemispherotomy for Rasmussen encephalitis

PURPOSE

Hemispherotomy (H) is the gold standard treatment to cure epilepsy in Rasmussen encephalitis (RE). Linguistic prognosis after surgery remains the main issue when the dominant hemisphere is involved. The topic of the present research is to specify the long-term linguistic profile of the right hemisphere after left dominant H for RE.

METHODS

We followed 6 children 8.4 to 14.6 years of age who underwent left H for RE. Preoperatively, four children experienced aphasia, but for two, worsening occurred after surgery. Age at H ranged from 4.1 to 8.4 years. The mean duration of epilepsy was 1.2 years and 5.6 years for follow-up. Neuropsychological evaluation included longitudinal follow-up of intellectual efficiency measurement and a long-term outcome of language using various components of receptive and expressive oral speech with computerized tasks.

KEY FINDINGS

Preoperatively, verbal comprehension index (VCI) was dramatically decreased in 4/6 patients, and performance reasoning index (PRI) was low in 5/6 participants, demonstrating a global impact of RE itself. Postoperatively, all children recovered sufficiently to attend a regular VCI (above 70) in a mean of 5 years after H, and 5/6 recovered normal or adapted school. There was a dissociation in favor of VCI, while PRI decreased in 5/6 patients. We found a specific linguistic profile for these children recovering language in the right hemisphere: normal verbal comprehension, and weakness of grammatical judgment, word repetition, statement production, semantic verbal fluency and metaphonological abilities. Language recovery scores were statistically correlated with those of Working Memory Index.

SIGNIFICANCE

This study emphasizes for the first time the ability of the right hemisphere to functionally reorganize language over a long period of time following left H for RE. Syntactic abilities and phonology remain low and support the hypothesis of an early left hemispheric specialization. Nevertheless, lexico-semantic processes recover in the right hemisphere that could reflect a pre-existing potential of both hemispheres. Our results support a decision to proceed to H in classical left RE disease until the late childhood even if there is no complete aphasia before surgery. These data should be taken in account in the overall postoperative follow-up and rehabilitation strategy.

Executive functioning in preschoolers with specific language impairment

The pathogenesis of Specific Language Impairment (SLI) is still largely beyond our understanding. In this review, a neuropsychological perspective on language impairments in SLI is taken, focusing specifically on executive functioning (EF) in preschoolers (age range: 2.6-6.1 years) with SLI. Based on the studies described in this review, it can be concluded that similar to school-aged children with SLI, preschoolers with SLI show difficulties in working memory, inhibition and shifting, as revealed by both performance based measures and behavioral ratings. It seems plausible that a complex, reciprocal relationship exists between language and EF throughout development. Future research is needed to examine if, and if yes how, language and EF interact in SLI. Broad neuropsychological assessment in which both language and EF are taken into account may contribute to early detection of SLI. This in turn can lead to early and tailored treatment of children with (suspected) SLI aimed not only at stimulating language development but also at strengthening EF.

Nonword Repetition and Speech Motor Control in Children

This study examined how familiarity of word structures influenced articulatory control in children and adolescents during repetition of real words (RWs) and nonwords (NWs). A passive reflective marker system was used to track articulator movement. Measures of accuracy were obtained during repetition of RWs and NWs, and kinematic analysis of movement duration and variability was conducted. Participants showed greater consonant and vowel accuracy during RW than NW repetition. Jaw movement duration was longer in NWs compared to RWs across age groups, and younger children produced utterances with longer jaw movement duration compared to older children. Jaw movement variability was consistently greater during repetition of NWs than RWs in both groups of participants. The results indicate that increases in phonological short-term memory demands affect articulator movement. This effect is most pronounced in younger children. A range of skills may develop during childhood, which supports NW repetition skills.

Association between temporal resolution and Specific Language Impairment: The role of nonsensory processing

INTRODUCTION

Many authors have suggested that a perceptual auditory disorder involving temporal processing is the primary cause of Specific Language Impairment (SLI). The aim of this study was to compare the performance of children with and without SLI on a temporal processing task controlling for the confounding of verbal short-term memory and working memory.

METHOD

Thirty participants with SLI aged 6 years were selected, along with 30 age- and gender-matched participants with typical language development. The Adaptive Test of Temporal Resolution (ATTR) was used to evaluate temporal resolution ability (an aspect of temporal processing), and the digit span subtest of the Wechsler Intelligence Scale for Children was used to evaluate auditory short-term memory and working memory.

RESULTS

The analysis of covariance showed that children with SLI performed significantly worse than children with typical language development on the temporal resolution task (ATTR), even when controlling for short-term memory and working memory. Statistically significant correlations between ATTR and digit span were found for the group of children with SLI but not for the children with typical language development.

CONCLUSION

Children with SLI showed significantly worse temporal resolution ability than their peers with typical language development. Such differences cannot be attributed solely to the immediate memory deficit associated with SLI.

Phonological memory and word learning deficits in children with specific language impairment: A role for perceptual context?

BACKGROUND

Sensitivity to perceptual context (anchoring) has been suggested to contribute to the development of both oral- and written-language skills, but studies of this idea in children have been rare.

AIMS

To determine whether deficient anchoring contributes to the phonological memory and word learning deficits of children with specific language impairment (SLI).

METHODS AND PROCEDURES

84 preschool children with and without SLI participated in the study. Anchoring to repeated items was evaluated in two tasks - a phonological memory task and a pseudo-word learning task.

OUTCOMES AND RESULTS

Compared to children with typical development, children with SLI had poorer phonological memory spans and learned fewer words during the word learning task. In both tasks the poorer performance of children with SLI reflected a smaller effect of anchoring that was manifested in a smaller effect of item repetition on performance. Furthermore, across the entire sample anchoring was significantly correlated with performance in vocabulary and grammar tasks.

CONCLUSIONS AND IMPLICATIONS

These findings are consistent with the hypothesis that anchoring contributes to language skills and that children with SLI have impaired anchoring, although further studies are required to determine the role of anchoring in language development.

The relation between receptive grammar and procedural, declarative, and working memory in specific language impairment

What memory systems underlie grammar in children, and do these differ between typically developing (TD) children and children with specific language impairment (SLI)? Whilst there is substantial evidence linking certain memory deficits to the language problems in children with SLI, few studies have investigated multiple memory systems simultaneously, examining not only possible memory deficits but also memory abilities that may play a compensatory role. This study examined the extent to which procedural, declarative, and working memory abilities predict receptive grammar in 45 primary school aged children with SLI (30 males, 15 females) and 46 TD children (30 males, 16 females), both on average 9;10 years of age. Regression analyses probed measures of all three memory systems simultaneously as potential predictors of receptive grammar. The model was significant, explaining 51.6% of the variance. There was a significant main effect of learning in procedural memory and a significant group × procedural learning interaction. Further investigation of the interaction revealed that procedural learning predicted grammar in TD but not in children with SLI. Indeed, procedural learning was the only predictor of grammar in TD. In contrast, only learning in declarative memory significantly predicted grammar in SLI. Thus, different memory systems are associated with receptive grammar abilities in children with SLI and their TD peers. This study is, to our knowledge, the first to demonstrate a significant group by memory system interaction in predicting grammar in children with SLI and their TD peers. In line with Ullman's Declarative/Procedural model of language and procedural deficit hypothesis of SLI, variability in understanding sentences of varying grammatical complexity appears to be associated with variability in procedural memory abilities in TD children, but with declarative memory, as an apparent compensatory mechanism, in children with SLI.

Syntactic comprehension and working memory in children with specific language impairment, autism or Down syndrome

This study examined syntactic assignment for predicates and reflexives as well as working memory effects in the sentence comprehension of children with Specific Language Impairment (SLI), Down syndrome (DS), high functioning Autism (HFA) and Typical Language Development (TLD). Fifty-seven children (35 boys and 22 girls) performed a computerised picture-selection sentence comprehension task. Predicate attachment and reflexive antecedent assignment (with working memory manipulations) were investigated. The results showed that SLI, HFA and DS children exhibited poorer overall performance than TLD children. Children with SLI exhibited similar performance to the DS and HFA children only when working memory demands were higher. We conclude that children with SLI, HFA and DS differ from children with TLD in their comprehension of predicate and reflexive structures where the knowledge of syntactic assignment is required. Working memory manipulation had different effects on syntactic comprehension depending on language disorder. Intelligence was not an explanatory factor for the differences observed in performance.

The relationship between bilingual exposure and morphosyntactic development

PURPOSE

The study examined the effect of bilingual input on the grammatical development of bilingual children in comparison to monolingual peers.

METHOD

Spontaneous language samples were collected in English and French from typically-developing bilingual and monolingual pre-schoolers aged 3 years (n = 56) and 5 years (n = 83). Within each age group, children varied in bilingual exposure patterns but were matched on age, non-verbal cognition, maternal education and language status, speaking two majority languages. Measures included mean length of utterance (MLU) in words and morphemes, and accuracy and diversity of morphological use.

RESULT

Grammatical development in each language was strongly influenced by amount of same-language experience. Children with equal exposure to both languages scored comparably to monolingual children in both languages, whereas children with unequal exposure evidenced similarly unequal performance across languages and scored significantly lower than monolinguals in their weaker language. Scoring significantly lower than monolinguals in both languages may, therefore, be a sign of language impairment. Each language followed a strongly language-specific sequence of acquisition and error patterns. Five-year-old children with low exposure to English displayed an optional infinitive pattern, a strong clinical marker for Primary Language Impairment in monolingual English-speaking children.

CONCLUSION

Descriptive normative data are presented that permit more accurate interpretation of bilingual assessment data.

Sustained attention in language production: An individual differences investigation

Whereas it has long been assumed that most linguistic processes underlying language production happen automatically, accumulating evidence suggests that these processes do require some form of attention. Here we investigated the contribution of sustained attention: the ability to maintain alertness over time. In Experiment 1, participants’ sustained attention ability was measured using auditory and visual continuous performance tasks. Subsequently, employing a dual-task procedure, participants described pictures using simple noun phrases and performed an arrow-discrimination task while their vocal and manual response times (RTs) and the durations of their gazes to the pictures were measured. Earlier research has demonstrated that gaze duration reflects language planning processes up to and including phonological encoding. The speakers’ sustained attention ability correlated with the magnitude of the tail of the vocal RT distribution, reflecting the proportion of very slow responses, but not with individual differences in gaze duration. This suggests that sustained attention was most important after phonological encoding. Experiment 2 showed that the involvement of sustained attention was significantly stronger in a dual-task situation (picture naming and arrow discrimination) than in simple naming. Thus, individual differences in maintaining attention on the production processes become especially apparent when a simultaneous second task also requires attentional resources.

At the intersection of cognition and grammar: deficits comprehending counterfactuals in Turkish children with specific language impairment

PURPOSE

This study investigated the comprehension of counterfactual conditionals in monolingual Turkish children with specific language impairment (SLI) and typically developing (TD) children. Comprehending counterfactuals requires a well-developed cognitive system (Beck, Riggs, & Gorniak, 2009). Children with SLI have impaired cognitive functioning (Im-Bolter, Johnston, & Pascual-Leone, 2006), which affects their ability to comprehend counterfactuals.

METHOD

The sample consisted of 13 children (9 boys, 4 girls) with SLI who were matched in age and nonverbal intelligence with 13 TD children (8 boys, 5 girls; mean age 6;9 [years; months] for both groups). Each group completed a sentence comprehension and repetition task with 3 sentence conditions: nonconditional, factual, and counterfactual. Nonconditionals did not have if-embedding, whereas factual and counterfactual conditionals were morphosyntactically equivalent if-clauses, but only the latter was cognitively complex.

RESULTS

Conditionals were more difficult to comprehend than nonconditionals for both groups. Counterfactuals were more difficult to comprehend than the morphosyntactically equivalent factual counterparts for the SLI group. There was no discrepancy between the groups for repetition of counterfactuals and factuals.

CONCLUSIONS

Children with SLI have difficulty processing counterfactuals due to morphosyntactic complexity (if-embedding) and the cognitive processes involved in comprehending counterfactuals. This indicates that cognitive complexity adds to sentence comprehension deficits in SLI.

The role of memory in processing relative clauses in children with specific language impairment

PURPOSE

This study investigated the relationship between 2 components of memory--phonological short-term memory (pSTM) and working memory (WM)--and the control of relative clause constructions in children with specific language impairment (SLI).

METHOD

Children with SLI and 2 control groups--an age-matched and a younger group of children with typical development--repeated sentences, including relative clauses, representing 5 syntactic roles and 2 levels of matrix clause complexity. The Working Memory Test Battery for Children was administered.

RESULTS

All 3 groups showed significant associations between pSTM and both types of matrix clause construction. For children with SLI, significant associations emerged between (a) WM and more complex matrix clause constructions, (b) WM and relative clauses including a range of syntactic roles, and (c) pSTM and the least difficult syntactic role. In contrast, the age-matched control group could repeat almost all syntactic roles without invoking the use of either memory component.

CONCLUSIONS

The role of pSTM and WM in the production of relative clauses by children with SLI is influenced by the degree of difficulty of the structure to be recalled. In therapy, the effect of WM limitations can be minimized by approaching each structure within the context of a simple matrix clause.

Attention, memory, and auditory processing in 10- to 15-year-old children with listening difficulties

PURPOSE

The aim of this study was to examine attention, memory, and auditory processing in children with reported listening difficulty in noise (LDN) despite having clinically normal hearing.

METHOD

Twenty-one children with LDN and 15 children with no listening concerns (controls) participated. The clinically normed auditory processing tests included the Frequency/Pitch Pattern Test (FPT; Musiek, 2002), the Dichotic Digits Test (Musiek, 1983), the Listening in Spatialized Noise-Sentences (LiSN-S) test (Dillon, Cameron, Glyde, Wilson, & Tomlin, 2012), gap detection in noise (Baker, Jayewardene, Sayle, & Saeed, 2008), and masking level difference (MLD; Wilson, Moncrieff, Townsend, & Pillion, 2003). Also included were research-based psychoacoustic tasks, such as auditory stream segregation, localization, sinusoidal amplitude modulation (SAM), and fine structure perception. All were also evaluated on attention and memory test batteries.

RESULTS

The LDN group was significantly slower switching their auditory attention and had poorer inhibitory control. Additionally, the group mean results showed significantly poorer performance on FPT, MLD, 4-Hz SAM, and memory tests. Close inspection of the individual data revealed that only 5 participants (out of 21) in the LDN group showed significantly poor performance on FPT compared with clinical norms. Further testing revealed the frequency discrimination of these 5 children to be significantly impaired.

CONCLUSION

Thus, the LDN group showed deficits in attention switching and inhibitory control, whereas only a subset of these participants demonstrated an additional frequency resolution deficit.

Differential verbal working memory effects on linguistic production in children with Specific Language Impairment

Deficits in verbal working memory (vWM) have often been reported in children with Specific Language Impairments (SLIs) and might significantly contribute to their linguistic difficulties. The linguistic and narrative skills of a group of children with diagnosis of SLI were compared to those of a group of children with typical development. The linguistic assessment included a comprehensive analysis of their lexical, grammatical and narrative abilities. Overall, the participants with SLI had difficulties at all three levels of linguistic processing. The effect of vWM was marginal on lexical processing, significant on grammatical structuring, and null on narrative construction.

Training understanding of reversible sentences: a study comparing language-impaired children with age-matched and grammar-matched controls

Introduction. Many children with specific language impairment (SLI) have problems with language comprehension, and little is known about how to remediate these. We focused here on errors in interpreting sentences such as "the ball is above the cup", where the spatial configuration depends on word order. We asked whether comprehension of such short reversible sentences could be improved by computerized training, and whether learning by children with SLI resembled that of younger, typically-developing children. Methods. We trained 28 children with SLI aged 6-11 years, 28 typically-developing children aged from 4 to 7 years who were matched to the SLI group for raw scores on a test of receptive grammar, and 20 typically-developing children who were matched to the SLI group on chronological age. A further 20 children with SLI were given pre- and post-test assessments, but did not undergo training. Those in the trained groups were given training on four days using a computer game adopting an errorless learning procedure, during which they had to select pictures to correspond to spoken sentences such as "the cup is above the drum" or "the bird is below the hat". Half the trained children heard sentences using above/below and the other half heard sentences using before/after (with a spatial interpretation). A total of 96 sentences was presented over four sessions. Half the sentences were unique, whereas the remainder consisted of 12 repetitions of each of four sentences that became increasingly familiar as training proceeded. Results. Age-matched control children performed near ceiling (≥ 90% correct) in the first session and were excluded from the analysis. Around half the trained SLI children also performed this well. Training effects were examined in 15 SLI and 16 grammar-matched children who scored less than 90% correct on the initial training session. Overall, children's scores improved with training. Memory span was a significant predictor of improvement, even after taking into account performance on training session 1. Unlike the grammar-matched controls, children with SLI showed greater accuracy with repeated sentences compared with unique sentences. Training did not improve children's performance on a standardized test of receptive grammar. Discussion. Overall, these results indicate that a subset of children with SLI perform well below ceiling on reversible sentences with three key words and simple syntactic structure. For these children, weak verbal short-term memory appears to impair comprehension of spoken sentences. In contrast to the general finding that rule-learning benefits from variable input, these children seem to do best if given repeated exposure to the same nouns used with a given sentence frame. Generalisation to other sentences using the same syntactic frame may be more effective if preceded by such item-specific learning.

Predicting the outcome of specific language impairment at five years of age through early developmental assessment in preterm infants

BACKGROUND

Very preterm infants (<30 weeks of gestation) are at increased risk of specific language impairment and systematic developmental follow-up is essential for the provision of targeted early intervention.

AIMS

To define the predictive value of early language testing and stability of language development, and perinatal and demographic risk factors for the diagnosis of SLI at 5 years, in a cohort of preterm infants.

STUDY DESIGN

We used a retrospective hospital based cohort study.

SUBJECTS

Preterm infants <30 weeks of gestation, were cared for in NICU at RPAH, between 2004 and 2007, and prospectively enrolled in developmental follow-up. Standardised developmental assessment was done at 3 years utilising the Bayley Scales of Infant and Toddler Development-III and the Wechsler Preschool and Primary Scale of Intelligence-III was done at 5 years.

OUTCOME MEASURES

Predictive value and stability of early language testing were assessed with respect to SLI at 5 years, using measures of diagnostic accuracy and kappa values. Multivariate logistic regression was performed during the distribution of perinatal and demographic risk factors for SLI.

RESULTS

One-in-five met diagnostic criteria for SLI (19%, n=24). Limited diagnostic accuracy was found with early expressive language and the stability of language scores demonstrated only fair agreement (Cohen's κ .383). Multilingual status and extreme gestational age at 24-25 weeks were associated with a six-fold increased risk of SLI (OR 6.09, 95% CI 1.89-19.56; OR 6.09, 95% CI 1.28-29.0).

CONCLUSION

We defined a high incidence of SLI among our cohort, but only a limited diagnostic accuracy of early language testing. Multilingual status and extreme prematurity were independent risk factors for SLI. It remains imperative to perform continued developmental assessments beyond pre-school age to identify language impairment with greater accuracy.

Verbal strategies and nonverbal cues in school-age children with and without specific language impairment (SLI)

BACKGROUND

Considerable evidence suggests that performance across a variety of cognitive tasks is effectively supported by the use of verbal and nonverbal strategies. Studies exploring the usefulness of such strategies in children with specific language impairment (SLI) are scarce and report inconsistent findings.

AIMS

To examine the effects of induced labelling and auditory cues on the performance of children with and without SLI during a categorization task.

METHODS & PROCEDURES

Sixty-six school-age children (22 with SLI, 22 age-matched controls, 22 language-matched controls) completed three versions of a computer-based categorization task: one baseline, one requiring overt labelling and one with auditory cues (tones) on randomized trial blocks.

OUTCOMES & RESULTS

Labelling had no effect on performance for typically developing children but resulted in lower accuracy and longer reaction time in children with SLI. The presence of tones had no effect on accuracy but resulted in faster reaction time and post-error slowing across groups.

CONCLUSIONS & IMPLICATIONS

Verbal strategy use was ineffective for typically developing children and negatively affected children with SLI. All children showed faster performance and increased performance monitoring as a result of tones. Overall, effects of strategy use in children appear to vary based on task demands, strategy domain, age and language ability. Results suggest that children with SLI may benefit from auditory cues in their clinical intervention but that further research is needed to determine when and how verbal strategies might similarly support performance in this population.

Aspectos da fluência da fala em crianças com distúrbio específico de linguagem

Objetivo Avaliar aspectos específicos da fluência da fala em crianças com DEL, quanto à tipologia de rupturas comuns e velocidade de fala (em palavras e sílabas por minuto), considerando as diferentes faixas etárias. Métodos Participaram 50 crianças de ambos os gêneros, na faixa etária de 3 a 7 anos, com QI não verbal e limiares auditivos dentro da normalidade e ausência de gagueira. As crianças foram divididas em dois grupos: G1 (DEL), com 25 crianças (sete meninas e 18 meninos, com idades entre 3 e 7 anos) e G2 (desenvolvimento típico), com 25 crianças pareadas em idade e gênero ao GI. Foi apresentada uma figura à criança e solicitado que falasse o que quisesse sobre ela. Cada amostra de fala foi composta por 200 sílabas fluentes ou 100 palavras fluentes. Resultados A análise intergrupos demonstrou que crianças de 3 e 4 anos do G1 apresentaram menor velocidade de fala que seus pares em desenvolvimento típico. Na análise intragrupos, no que se refere à tipologia de rupturas, o G1 não apresentou diferenças em nenhuma das faixas etárias. Já o G2, para as faixas etárias de 4 e 5 anos, a hesitação foi mais frequente e aos 6 e 7 anos, a hesitação e a repetição de palavras se diferenciaram das demais tipologias. Conclusão Crianças com suspeita de DEL nas idades de 3 e 4 anos, aqui estudadas, apresentaram redução da produção de palavras e sílabas. As rupturas de fala, do tipo hesitação, foram recursos usados pelas crianças com desenvolvimento típico de todas as faixas etárias, o que não ocorreu nas crianças com DEL.

Executive functioning skills in preschool-age children with cochlear implants

PURPOSE

The purpose of this study was to determine whether deficits in executive functioning (EF) in children with cochlear implants (CIs) emerge as early as the preschool years.

METHOD

Two groups of children ages 3 to 6 years participated in this cross-sectional study: 24 preschoolers who had CIs prior to 36 months of age and 21 preschoolers with normal hearing (NH). All were tested on normed measures of working memory, inhibition-concentration, and organization-integration. Parents completed a normed rating scale of problem behaviors related to EF. Comparisons of EF skills of children with CIs were made to peers with NH and to published nationally representative norms.

RESULTS

Preschoolers with CIs showed significantly poorer performance on inhibition-concentration and working memory compared with peers with NH and with national norms. No group differences were found in visual memory or organization-integration. When data were controlled for language, differences in performance measures of EF remained, whereas differences in parent-reported problems with EF were no longer significant. Hearing history was generally unrelated to EF.

CONCLUSIONS

This is the first study to demonstrate that EF deficits found in older children with CIs begin to emerge as early as preschool years. The ability to detect these deficits early has important implications for early intervention and habilitation after cochlear implantation.

Children with differing developmental trajectories of prelinguistic communication skills: language and working memory at age 5

PURPOSE

In this article, the authors examine the developmental continuity from prelinguistic communication to kindergarten age in language and working memory capacity.

METHOD

Following work outlining 6 groups of children with different trajectories of early communication development (ECD; Määttä, Laakso, Tolvanen, Ahonen, & Aro, 2012), the authors examined their later development by psychometric assessment. Ninety-one children first assessed at ages 12-21 months completed a battery of language and working memory tests at age 5;3 (years;months).

RESULTS

Two of the ECD groups previously identified as being at risk for language difficulties continued to show weaker performance at follow-up. Seventy-nine percent of the children with compromised language skills at follow-up were identified on the basis of the ECD groups, but the number of false positives was high. The 2 at-risk groups also differed significantly from the typically developing groups in the measures tapping working memory capacity.

CONCLUSIONS

In line with the dimensional view of language impairment, the accumulation of early delays predicted the amount of later difficulties; however, at the individual level, the prediction had rather low specificity. The results imply a strong link between language and working memory and call for further studies examining the early developmental interaction between language and memory.

A pilot study of the effects of RightStart instruction on early numeracy skills of children with specific language impairment

This pilot study investigated the effects of an early numeracy program, RightStart Mathematics (RS), on Finnish kindergartners with specific language impairment (SLI). The study applied a pre-test-instruction-post-test design. The children with SLI (n=9, Mage=82.11 months) received RS instruction two to three times a week for 40 min over seven months, which replaced their business-as-usual mathematics instruction. Mathematical skill development among children with SLI was examined at the individual and group levels, and compared to the performance of normal language-achieving age peers (n=32, Mage=74.16 months) who received business-as-usual kindergarten mathematics instruction. The children with SLI began kindergarten with significantly weaker early numeracy skills compared to their peers. Immediately after the instruction phase, there was no significant difference between the groups in counting skills. In Grade 1, the children with SLI performed similarly to their peers in addition and subtraction skills (accuracy) and multi-digit number comparison, but showed weaker skills in arithmetical reasoning and in matching spoken and printed multi-digit numbers. Our pilot study showed encouraging signs that the early numeracy skills of children with SLI can be improved successfully in a kindergarten small-classroom setting with systematic instruction emphasizing visualization.