The contribution of processing impairments to SLI: insights from attention-deficit/hyperactivity disorder

Links Among Attention-Deficit/Hyperactivity Disorder Symptoms and Psycholinguistic Abilities Are Different for Children With and Without Developmental Language Disorder

PURPOSE

Both developmental language disorder (DLD) and attention-deficit/hyperactivity disorder (ADHD) represent relatively common and chronic neurodevelopmental conditions associated with increased risk for poor academic and interpersonal outcomes. Reports of common co-occurrence suggest these neurodevelopmental disruptions might also be linked. Most of the data available on the issue have been based on case-control studies vulnerable to ascertainment and other biases.

METHOD

Seventy-eight children, representing four neurodevelopmental profiles (DLD, ADHD, co-occurring ADHD + DLD, and neurotypical development), were administered a battery of psycholinguistic tests. Parents provided standardized ratings of the severity of their children's inattention, hyperactivity/impulsivity, and executive function symptoms. Examiners were blinded to children's clinical status. Group differences, correlations, and best subset regression analyses were used to examine potential impacts of children's ADHD symptoms on their psycholinguistic abilities.

RESULTS

For children with DLD, significant links between their ADHD symptoms and psycholinguistic abilities were limited to the contributions of elevated hyperactivity/impulsivity symptoms to lower pragmatic abilities. For children without DLD, inattention symptoms contributed to lower levels of performance in pragmatic, sentence recall, receptive vocabulary, and narrative abilities.

DISCUSSION

Links among children's ADHD symptoms and their psycholinguistic abilities were different for children with and without DLD. Implications for the provision of clinical services are discussed.

Language and reading in attention-deficit/hyperactivity disorder and comorbid attention-deficit/hyperactivity disorder + developmental language disorder

Background

The current study sought to examine whether psycholinguistic assessments could discriminate children and adolescents with developmental language disorder (DLD) from those with attention-deficit/hyperactivity disorder (ADHD; combined or inattentive subtype) and comorbid DLD + ADHD.

Methods

The Clinical Evaluation of Language Fundamentals-Screening Test (CELFST; Wiig et al., 2013), the Comprehensive Test of Phonological Processing (nonword repetition subtest; Wagner et al., 2013), and the Test of Word Reading Efficiency (sight word and phonemic decoding subtests; Torgesen et al., 2012) were examined in 441 children and adolescents between 6 and 16 years of age.

Results

The presence of a language disorder (with or without ADHD) predicted poor performance across tasks. Children and adolescents with ADHD (combined vs. inattentive) only significantly differed in sight word reading, in favor of those with combined type. Measures of reading efficiency could distinguish between the two types of ADHD, but not between other groups. Interestingly, scores on the standard language screener were no worse for children with ADHD + DLD than children with DLD only.

Conclusions

The combination of comorbid ADHD + DLD did not appear to be associated with lower language abilities, sight word reading, or phonemic decoding relative to DLD alone. Reading efficiency was effective in discriminating between ADHD subtypes. These findings offer valuable insights into differential diagnosis and the identification of comorbidity.

Language abilities in children and adolescents with DLD and ADHD: A scoping review

PURPOSE

There is an emerging view that attention-deficit/hyperactivity disorder (ADHD) is marked by problems with language difficulties, an idea reinforced by the fact that ADHD is highly comorbid with developmental language disorder (DLD). This scoping review provides an overview of literature on language abilities in children with DLD and ADHD while highlighting similarities and differences.

METHOD

A comprehensive search was performed to examine the literature on language abilities in the two disorders, yielding a total of 18 articles that met the inclusion criteria for the present review. Qualitative summaries are provided based on the language domain assessed.

RESULTS

The current literature suggests children and adolescents with ADHD have better morphosyntax/grammar, general/core language abilities, receptive, and expressive abilities than those with DLD. Further, that performance is comparable on assessments of semantic and figurative language but varies by sample on assessments of phonological processing, syntax, narrative language, and vocabulary.

CONCLUSION

Evidence presented points to children and adolescents with DLD as having greater language difficulties compared to those with ADHD, but with some important caveats. Despite limitations related to the paucity of studies and inconsistencies in how the two types of disorders are identified, our review provides a necessary and vital step in better understanding the language profiles of these two highly prevalent childhood disorders. These findings are useful in optimizing language outcomes and treatment efficacy for children and adolescents with ADHD and DLD.

Developmental Language Disorder Is Associated With Slower Processing Across Domains: A Meta-Analysis of Time-Based Tasks

PURPOSE

Individuals with developmental language disorder (DLD) often exhibit slower processing on time-based tasks in comparison with age-matched peers. Processing speed has been linked to various linguistic skills and might serve as a global indicator of individual differences in language abilities. Despite an extensive literature on processing speed in DLD, it remains unclear whether slower processing is domain general or restricted to linguistic and/or auditory tasks.

METHOD

This meta-analysis used robust variance estimation to compare response/reaction times (RTs) of DLD and age-matched groups (N = 812 DLD, 870 neurotypical; M _age [DLD] = 8.9 years, range: 4.3-22.7 years). Moderators included task (simple RT, choice RT, naming, congruent/baseline conditions of interference control tasks), stimulus type (linguistic/nonlinguistic), stimulus modality (auditory/nonauditory), and response modality (verbal/nonverbal). Age and publication year were covariates.

RESULTS

The overall effect based on 46 studies and 144 estimates indicated longer mean RTs in DLD groups (g = .47, p < .001, 95% CI [.38, .55]). Moderator analyses indicated larger effects when tasks required verbal as opposed to nonverbal responses. No other moderators approached significance. All subgroup analyses were significant, indicating longer mean RTs in DLD groups across tasks, stimulus types, stimulus modalities, and response modalities.

CONCLUSIONS

Individuals with DLD exhibit longer RTs across verbal and nonverbal tasks, which may contribute to observed difficulties in language, motor skills, and executive functioning. Simple processing speed measures should be included in screening for language delays but may not be suitable for differential diagnosis, given that slower processing may occur across multiple disorders.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809355.

Temporal processing deficit in children and adolescents with autism spectrum disorder: An online assessment

Objective

The sensory deficit has been considered as one of the core features in children and adolescents with autism spectrum disorder (ASD). The present study aimed to examine the temporal processing of simple and more complex auditory inputs in ASD children and adolescents with an online assessment that can be conducted remotely.

Methods

One hundred fifty-eight children and adolescents aged 5-17 years participated in this study, including 79 ASD participants and 79 typically developing (TD) participants. The online assessment consisted of two temporal-order judgment tasks that required repeating the sequence of two pure tones or consonant-vowel (CV) syllabic pairs at varying interstimulus intervals (ISIs).

Results

Significantly lower accuracy rates were found in ASD than TD participants in the pure tone and the CV conditions with both short and long ISI. In addition, ASD participants (M  =  245.97 ms) showed a significantly higher passing threshold than TD participants (M  =  178.84 ms) in the CV task. Receiver operating characteristic analysis found that the age × ISI passing threshold composite yielded a sensitivity of 74.7% and a specificity of 50.6% at the cutoff point of -0.307 in differentiating ASD participants from TD participants.

Conclusion

In sum, children and adolescents with ASD showed impaired temporal processing of both simple and more complex auditory stimuli, and the online assessment seems to be sensitive in differentiating individuals with ASD from those with TD.

Temporal processing tele-intervention improves language, attention, and memory in children with neurodevelopmental disorders

Objective

Temporal processing is the brain's ability to process rapid successive stimuli, and children with neurodevelopmental disorders showed temporal processing deficits. Empirical evidence suggests that in-person intervention on temporal processing improves various cognitive functions of these children, and the present study aimed to study the effects of temporal processing tele-intervention (TPT) on the cognitive functions of children with neurodevelopmental disorders.

Methods

Ninety-five children with neurodevelopmental disorders were recruited and randomly assigned to remotely receive either TPT or conventional language remediation (CLR) in 20 parallel group-based intervention sessions once per week. Their cognitive functions were assessed before and after the intervention.

Results

The TPT group demonstrated a specific and significant improvement in working memory (p < .001). While there was an overall significant improvement in sustained attention in terms of processing speed after both types of intervention (p = .006), the positive effects of TPT might be more prominent than that of CLR given the significant pre-post difference after receiving TPT (p = .012) but not CLR (p = .21). Regarding rapid naming accuracy which had marginally significant improvement after the intervention (p = .03), the trend of improvement in TPT (p = .05) also seemed more apparent than that of CLR (p = .18). Finally, the TPT group had significant improvement in word knowledge (p < .001), rapid naming speed (p < .001), sustained attention in terms of accuracy (p < .001), and verbal learning and memory (p < .01) to an extent similar to that of the CLR group.

Conclusions

These findings suggest that TPT can be a potential intervention for improving cognitive functions in children with neurodevelopmental disorders. Clinical trial registration number: NCT05428657 at ClinicalTrials.gov (https://clinicaltrials.gov/).

Temporal processing deficit in children with attention-deficit/hyperactivity disorder: An online assessment

Objective

Temporal processing deficits were found among children with attention-deficit/hyperactivity disorder (ADHD). The present study aims to develop an online temporal processing assessment that can be conducted remotely, and the sensitivity of the test was assessed on a group of children with ADHD.

Methods

A total of 188 children were recruited, including 94 typically developing (TD) children, and 94 children with ADHD. The online assessment consists of two temporal-order judgment (TOJ) tasks. One task used tone pairs presented with two interstimulus intervals (ISIs) (305ms and 40ms). Another task used pairs of consonant-vowel (CV) syllables with 20 varying ISI levels. Participants were asked to determine the sequence of the sound pairs.

Results

The results showed that ADHD children were less accurate (ISI 305ms: M = 83.90%; ISI 40ms: M = 66.28%) than TD children (ISI 305ms: M = 89.36%; ISI 40ms: M = 77.16%) in the tone task. Similarly, ADHD children showed a higher ISI passing threshold (M = 283.64ms) than TD children (M = 199.76ms) and higher accuracy in the CV task. Hierarchical binary logistic regression suggested a model to predict ADHD children using accuracy in ISI 40ms in the tone task and ISI passing threshold in the CV task. Receiver operating characteristic (ROC) analysis yielded a sensitivity of 75.58% and a specificity of 51.11%.

Conclusion

ADHD children showed temporal processing deficits of both tones and CVs. The online assessment may be a valid tool for differentiating ADHD children from TD children.

Investigating the Role of Inattention and/or Hyperactivity/impulsivity in Language and Social Functioning Using a Dimensional Approach

The current study parsed out the distinct components of attention-deficit/hyperactivity disorder (ADHD) symptomatology to examine differential relations with language and social ability. Using a research domain criteria (RDoC) framework, we administered standardized tests and previously developed and validated questionnaires to assess levels of inattention and/or hyperactivity/impulsivity symptomatology, language, social responsivity and social competency in 98 young adults. Those with higher inattention and/or hyperactivity/impulsivity symptomatology had reduced language comprehension, social responsivity, and social competency. Inattention and hyperactivity/impulsivity both predicted language comprehension, but not language production. Interestingly, inattention uniquely contributed to social responsiveness and social competency, but hyperactivity/impulsivity did not. Findings suggest that inattention and/or hyperactivity/impulsivity symptoms, inattention in particular, may be especially important for social skills programs geared towards individuals with attention limitations.

Relationship between working memory and complex syntax in children with Developmental Language Disorder

Some theories of Developmental Language Disorder (DLD) explain the linguistic deficits observed in terms of limitations in non-linguistic cognitive systems such as working memory. The goal of this research is to clarify the relationship between working memory and the processing of complex sentences by exploring the performance of 28 French-speaking children with DLD aged five to fourteen years and 48 typically developing children of the same age in memory and linguistic tasks. We identified predictive relationships between working memory and the comprehension and repetition of complex sentences in both groups. As for syntactic measures in spontaneous language, it is the complex spans that explain the major part of the variance in the control children. In children with DLD, however, simple spans are predictive of these syntactic measures. Our results thus reveal a robust relationship between working memory and syntactic complexity, with clinical implications for the treatment of children with DLD.

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.

Distributed Training Enhances Implicit Sequence Acquisition in Children With Specific Language Impairment

PURPOSE

This study explored the effects of 2 different training structures on the implicit acquisition of a sequence in a serial reaction time (SRT) task in children with and without specific language impairment (SLI).

METHOD

All of the children underwent 3 training sessions, followed by a retention session 2 weeks after the last session. In the massed-training condition, the 3 training sessions were in immediate succession on 1 day, whereas in the distributed-training condition, the 3 training sessions were spread over a 1-week period in an expanding schedule format.

RESULTS

Statistical analyses showed that the children with normal language were unaffected by the training conditions, performing the SRT task similarly in both training conditions. The children with SLI, however, were affected by the training structure, performing the SRT task better when the training sessions were spaced over time rather than clustered on 1 day.

CONCLUSION

This study demonstrated that although intensive training does not increase learning in children with SLI, distributing training sessions over time does increase learning. The implications of these results on the learning abilities of children with SLI are discussed, as are the mechanisms involved in massed versus distributed learning.

Research Review: Language problems in children with Attention-Deficit Hyperactivity Disorder - a systematic meta-analytic review

BACKGROUND

Children with Attention-Deficit Hyperactivity Disorder (ADHD) appear to have a higher risk of language problems compared with typically developing children, although the types of language problems experienced are less clear. This review aims to establish the types of language problems experienced by children with ADHD according to systematically reviewed literature and determine the empirical evidence for language problems in children with ADHD compared with non-ADHD controls.

METHODS

A standardized search protocol was used on databases: CINAHL, Medline, and PsychINFO. We identified studies with the following inclusion criteria: (a) confirmed ADHD status at the time of the study, (b) inclusion of a non-ADHD control group, (c) use of a validated language measure, and (d) age ≤ 18. t-Tests, Pearson's r, and Hedges g effect sizes (ES) were calculated using summary statistics. Random effects meta-analyses were conducted for the language domain suitable for analysis. Publication bias was investigated using both the trim and fill and p-curve techniques.

RESULTS

Twenty-one studies were included in the systematic review (ADHD = 1,209; Control = 1,101), within which 60 of 68 separate analyses found significant differences between the ADHD and control group on the language measures (p < .05). Follow-up meta-analyses found evidence for large deficits in the ADHD groups overall (10/11 studies met p < .05; weighted mean ES [WMES]: 1.04); expressive (10/10 met p < .05; WMES: 1.23); receptive (12/14 met p < .05; WMES: 0.97), and pragmatic language (4/4 studies met p < .05; WMES: 0.98) compared with controls.

CONCLUSIONS

This study demonstrates that children with ADHD have poorer performance on measures of overall, expressive, receptive, and pragmatic language compared with controls. A screening of language functioning may be a valuable addition to the assessment of ADHD.

Executive Functions in Children With Specific Language Impairment: A Meta-Analysis

PURPOSE

Mounting evidence demonstrates deficits in children with specific language impairment (SLI) beyond the linguistic domain. Using meta-analysis, this study examined differences in children with and without SLI on tasks measuring inhibition and cognitive flexibility.

METHOD

Databases were searched for articles comparing children (4-14 years) with and without SLI on behavioral measures of inhibition or cognitive flexibility. Weighted average effect size was calculated using multilevel modeling to measure potential group differences.

RESULTS

The analysis included 46 studies. Of those, 34 included inhibitory control measures and 22 included cognitive flexibility tasks. Children with SLI performed below same-aged peers on both inhibitory control tasks (g = -.56) and cognitive flexibility tasks (g = -.27). Moderator analyses showed no effect of linguistic task demands, participant age, or severity of language impairment on the degree of difference between children with SLI and controls on measures of inhibitory control.

CONCLUSION

Reliable differences between children with and without SLI were found on inhibition and cognitive flexibility tasks. A moderate group effect was found for inhibition tasks, but there was only a small effect for cognitive flexibility tasks. Results of moderator analyses suggest that these deficits are present throughout development despite task demands or severity of linguistic impairment.

Learning to drive in young adults with language impairment

Language impairment (LI) is a common developmental disorder which affects many aspects of young people's functional skills and engagement with society. Little is known of early driving behaviour in those with this disability. This longitudinal study examines early driving experience in a sample of young adults with LI, compared with a sample of typically developing age-matched peers (AMPs). At age 24 years, significantly fewer participants with LI had acquired a driving licence. A crucial hurdle for those with LI appeared to be the Theory part of the (UK) test. Logistic regression analysis indicated that language ability and a measure of independence at age 17 contributed to the prediction of licence possession at age 24. There was no evidence of differences in traffic violations or accident rates between those with and without LI. There is little evidence that young people with LI are at greater risk on the roads than peers without LI, but some individuals with LI might benefit from support in the course of preparation for driving and in the driving test.

The sensitivity of children with SLI to phonotactic probabilities during lexical access

The procedural deficit hypothesis (Ullman & Pierpont, 2005) has been proposed to account for the combination of linguistic and nonlinguistic deficits observed in specific language impairment (SLI). According to this proposal, SLI results from a deficit in procedural memory that prevents children from developing sensitivity to probabilistic sequences, amongst other deficits. We tested the ability of children with SLI to rely on a specific type of probabilities characterizing sequences that occur in a given language: phonotactic probabilities. Twenty French-speaking children with SLI (M=10;1), 20 typically developing children matched for chronological age (M=10;0) and 20 typically developing children matched for receptive vocabulary (M=7;4) performed an auditory lexical decision task. Pseudoword stimuli were built with combinations of either frequently associated phonemes (high phonotactic probability) or infrequently associated phonemes (low phonotactic probability). Phonotactic probabilities had a significant impact on the accuracy and speed of pseudoword rejection in children with SLI, but not in the two control groups. SLI children's greater reliance on phonotactic probabilities relative to typically developing children appears to contradict the PD hypothesis. Phonotactic probabilities may help them to partially overcome their difficulties in developing and accessing the phonological lexicon during spoken word recognition.

LEARNING OUTCOMES

After reading this article, readers will understand the importance of sensitivity to phonotactic probabilities in language processing. They will also learn that such sensitivity is preserved in children with SLI. Finally, readers will understand that children with SLI are more prone to use phonotactic information when accessing their lexicon than typically-developing children.

Temporal Attention as a Scaffold for Language Development

Language is one of the most fascinating abilities that humans possess. Infants demonstrate an amazing repertoire of linguistic abilities from very early on and reach an adult-like form incredibly fast. However, language is not acquired all at once but in an incremental fashion. In this article we propose that the attentional system may be one of the sources for this developmental trajectory in language acquisition. At birth, infants are endowed with an attentional system fully driven by salient stimuli in their environment, such as prosodic information (e.g., rhythm or pitch). Early stages of language acquisition could benefit from this readily available, stimulus-driven attention to simplify the complex speech input and allow word segmentation. At later stages of development, infants are progressively able to selectively attend to specific elements while disregarding others. This attentional ability could allow them to learn distant non-adjacent rules needed for morphosyntactic acquisition. Because non-adjacent dependencies occur at distant moments in time, learning these dependencies may require correctly orienting attention in the temporal domain. Here, we gather evidence uncovering the intimate relationship between the development of attention and language. We aim to provide a novel approach to human development, bridging together temporal attention and language acquisition.

Language Impairment in the Attention-Deficit/Hyperactivity Disorder Context

PURPOSE

Attention-deficit/hyperactivity disorder (ADHD) is a ubiquitous designation that affects the identification, assessment, treatment, and study of pediatric language impairments (LIs).

METHOD

Current literature is reviewed in 4 areas: (a) the capacity of psycholinguistic, neuropsychological, and socioemotional behavioral indices to differentiate cases of LI from ADHD; (b) the impact of co-occurring ADHD on children's LI; (c) cross-etiology comparisons of the nonlinguistic abilities of children with ADHD and specific LI (SLI); and (d) the extent to which ADHD contributes to educational and health disparities among individuals with LI.

RESULTS

Evidence is presented demonstrating the value of using adjusted parent ratings of ADHD symptoms and targeted assessments of children's tense marking, nonword repetition, and sentence recall for differential diagnosis and the identification of comorbidity. Reports suggest that the presence of ADHD does not aggravate children's LI. The potential value of cross-etiology comparisons testing the necessity and sufficiency of proposed nonlinguistic contributors to the etiology of SLI is demonstrated through key studies. Reports suggest that children with comorbid ADHD+LI receive speech-language services at a higher rate than children with SLI.

CONCLUSION

The ADHD context is multifaceted and provides the management and study of LI with both opportunities and obstacles.

Specific Language Impairment, Nonverbal IQ, Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Cochlear Implants, Bilingualism, and Dialectal Variants: Defining the Boundaries, Clarifying Clinical Conditions, and Sorting Out Causes

PURPOSE

The purpose of this research forum article is to provide an overview of a collection of invited articles on the topic "specific language impairment (SLI) in children with concomitant health conditions or nonmainstream language backgrounds." Topics include SLI, attention-deficit/hyperactivity disorder, autism spectrum disorder, cochlear implants, bilingualism, and dialectal language learning contexts.

METHOD

The topic is timely due to current debates about the diagnosis of SLI. An overarching comparative conceptual framework is provided for comparisons of SLI with other clinical conditions. Comparisons of SLI in children with low-normal or normal nonverbal IQ illustrate the unexpected outcomes of 2 × 2 comparison designs.

RESULTS

Comparative studies reveal unexpected relationships among speech, language, cognitive, and social dimensions of children's development as well as precise ways to identify children with SLI who are bilingual or dialect speakers.

CONCLUSIONS

The diagnosis of SLI is essential for elucidating possible causal pathways of language impairments, risks for language impairments, assessments for identification of language impairments, linguistic dimensions of language impairments, and long-term outcomes. Although children's language acquisition is robust under high levels of risk, unexplained individual variations in language acquisition lead to persistent language impairments.

Later learning stages in procedural memory are impaired in children with Specific Language Impairment

BACKGROUND

According to the Procedural Deficit Hypothesis (PDH), difficulties in the procedural memory system may contribute to the language difficulties encountered by children with Specific Language Impairment (SLI). Most studies investigating the PDH have used the sequence learning paradigm; however these studies have principally focused on initial sequence learning in a single practice session.

AIMS

The present study sought to extend these investigations by assessing the consolidation stage and longer-term retention of implicit sequence-specific knowledge in 42 children with or without SLI.

METHODS AND PROCEDURES

Both groups of children completed a serial reaction time task and were tested 24h and one week after practice.

OUTCOMES AND RESULTS

Results showed that children with SLI succeeded as well as children with typical development (TD) in the early acquisition stage of the sequence learning task. However, as training blocks progressed, only TD children improved their sequence knowledge while children with SLI did not appear to evolve any more. Moreover, children with SLI showed a lack of the consolidation gains in sequence knowledge displayed by the TD children.

CONCLUSIONS AND IMPLICATIONS

Overall, these results were in line with the predictions of the PDH and suggest that later learning stages in procedural memory are impaired in SLI.

The Application of Timing in Therapy of Children and Adults with Language Disorders

A number of evidence revealed a link between temporal information processing (TIP) and language. Both literature data and results of our studies indicated an overlapping of deficient TIP and disordered language, pointing to the existence of an association between these two functions. On this background the new approach is to apply such knowledge in therapy of patients suffering from language disorders. In two studies we asked the following questions: (1) can the temporal training reduce language deficits in aphasic patients (Study 1) or in children with specific language impairment (SLI, Study 2)? (2) can such training ameliorate also the other cognitive functions? Each of these studies employed pre-training assessment, training application, post-training and follow-up assessment. In Study 1 we tested 28 patients suffering from post-stroke aphasia. They were assigned either to the temporal training (Group A, n = 15) in milliseconds range, or to the non-temporal training (Group B, n = 13). Following the training we found only in Group A improved TIP, accompanied by a transfer of improvement to language and working memory functions. In Study 2 we tested 32 children aged from 5 to 8 years, affected by SLI who were classified into the temporal training (Group A, n = 17) or non-temporal training (Group B, n = 15). Group A underwent the multileveled audio-visual computer training Dr. Neuronowski^®, recently developed in our laboratory. Group B performed the computer speech therapy exercises extended by playing computer games. Similarly as in Study 1, in Group A we found significant improvements of TIP, auditory comprehension and working memory. These results indicated benefits of temporal training for amelioration of language and other cognitive functions in both aphasic patients and children with SLI. The novel powerful therapy tools provide evidence for future promising clinical applications.

Control of Auditory Attention in Children With Specific Language Impairment

PURPOSE

Children with specific language impairment (SLI) appear to demonstrate deficits in attention and its control. Selective attention involves the cognitive control of attention directed toward a relevant stimulus and simultaneous inhibition of attention toward irrelevant stimuli. The current study examined attention control during a cross-modal word recognition task.

METHOD

Twenty participants with SLI (ages 9-12 years) and 20 age-matched peers with typical language development (TLD) listened to words through headphones and were instructed to attend to the words in 1 ear while ignoring the words in the other ear. They were simultaneously presented with pictures and asked to make a lexical decision about whether the pictures and auditory words were the same or different. Accuracy and reaction time were measured in 5 conditions, in which the stimulus in the unattended channel was manipulated.

RESULTS

The groups performed with similar accuracy. Compared with their peers with TLD, children with SLI had slower reaction times overall and different within-group patterns of performance by condition.

CONCLUSIONS

Children with TLD showed efficient inhibitory control in conditions that required active suppression of competing stimuli. Participants with SLI had difficulty exerting control over their auditory attention in all conditions, with particular difficulty inhibiting distractors of all types.

Analogical mapping across modalities in children with specific language impairment (SLI)

Analogical mapping is a domain-general cognitive process found in language development, and more particularly in the abstraction of construction schemas. Analogical mapping is considered as the general cognitive process which consists in the alignment of two or several sequences in order to detect their common relational structure and generalize it to new items. The current study investigated analogical mapping across modalities in children with specific language impairment (SLI). Nineteen children with SLI and their age-matched peers were administered two tasks: a linguistic analogical reasoning task (composed of syllables) and a similar non-linguistic analogical reasoning task (composed of pictures). In the two tasks, the items presented were divided into two groups: items with perceptual cues and items without perceptual cues. Children had to complete a sequence sharing the same relational structure as previously presented sequences. Results showed an expected group effect with poorer performance for children with SLI compared to children with typical language development (TLD). Results corroborate hypotheses suggesting that children with SLI have difficulties with analogical mapping, which may hinder the abstraction of construction schemas. Interestingly, whereas no interaction effect between group and modality (linguistic vs. non-linguistic) was revealed, a triple interaction Group*Modality*Perceptual support was observed. In the non-linguistic task, the performance of children with SLI was the same for items with and without perceptual clues, but in the linguistic task they performed more poorly for items without perceptual cues compared to items with perceptual cues. The results and limits of the study are discussed.

A cross-etiology comparison of the socio-emotional behavioral profiles associated with attention-deficit/hyperactivity disorder and specific language impairment

Cross-etiology comparisons provide important information that can help practitioners establish criteria for differential diagnosis and tailor interventions towards the source of children's difficulties. This study examined the extent to which parent rating scales of socioemotional behavioral difficulties differentiate cases of attention-deficit/hyperactivity disorder (ADHD) from cases of specific language impairment (SLI), and typical development (TD). Parents of 60 children (7-8 years) completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) and the Conners Parent Rating Scale-Revised (Conners, 2004). Significant differences were observed between ratings provided for the children with ADHD and the children with SLI and TD across several scales which assessed behavioral and emotional difficulties. Most of the observed differences between ratings provided for the SLI and TD groups were not significant when nonverbal IQ was treated as a covariate or when syndrome scales were adjusted for the presence of language and academic items. In contrast, these adjustments had little impact on observed differences between the children with ADHD and the other groups. These results highlight important and clinically useful differences between the scope and the scale of socioemotional behavior difficulties associated with ADHD and SLI.

Procedural learning in specific language impairment: effects of sequence complexity

According to the procedural deficit hypothesis (PDH), abnormal development in the procedural memory system could account for the language deficits observed in specific language impairment (SLI). Recent studies have supported this hypothesis by using a serial reaction time (SRT) task, during which a slower learning rate is observed in children with SLI compared to controls. Recently, we obtained contrasting results, demonstrating that children with SLI were able to learn a sequence as quickly and as accurately as controls. These discrepancies could be related to differences in the statistical structure of the SRT sequence between these studies. The aim of this study was to further assess, in a group of 21 children with SLI, the PDH with second-order conditional sequences, which are more difficult to learn than those used in previous studies. Our results show that children with SLI had impaired procedural memory, as evidenced by both longer reaction times and no sign of sequence-specific learning in comparison with typically developing controls. These results are consistent with the PDH proposed by Ullman and Pierpont (2005) and suggest that procedural sequence-learning in SLI children depends on the complexity of the to-be-learned sequence.

Early language and behavioral regulation skills as predictors of social outcomes

PURPOSE

In the present study, the authors examined the prospective associations among early language skills, behavioral regulation skills, and 2 aspects of school-age social functioning (adaptability and social skills).

METHOD

The study sample consisted of children with and without a familial risk for dyslexia. The authors analyzed the relations among children's language (at age 2;6 [years;months] and age 5;0), behavioral regulation skills (at age 5;0), and social functioning (at age 8;0) using structural equation modeling. Subgroups of children with respect to language and behavioral regulation skills (at age 5;0) were identified through the use of mixture modeling.

RESULTS

Among at-risk children, behavioral regulation skills mediated the association between early language skills and social outcomes. A subgroup of children with poor regulatory and weak language skills scored lower in adaptability, whereas a subgroup having only poor language skills (with normal behavioral regulation) did not differ from a group with age-appropriate skills.

CONCLUSIONS

The present findings indicate that behavioral regulation skills play an important role in predicting social outcomes among children at risk for language difficulties. Furthermore, it is suggested that various aspects of social functioning may be influenced differently by self-regulation skills and that predictive relationships vary with the degree of language development deficits and accompanying risks.

Delayed motor skill acquisition in kindergarten children with language impairment

The acquisition and consolidation of a new grapho-motor symbol into long-term memory was studied in 5-year-old children with language impairment (LI) and peers matched for age and visual-motor integration skills. The children practiced the production of a new symbol and were tested 24h and two weeks post-practice day. Differences in performance speed emerged between the groups: children with LI showed a later onset of rapid learning in the practice phase, and only the comparison group exhibited delayed, consolidation, gains 24h post-training. At two weeks post-training, children with LI improved, closing the gap in performance speed. Speed-accuracy trade-off was characteristic of speed improvements in LI. These results indicate atypical and delayed acquisition in children with LI, and support the view that deficient skill acquisition in LI goes beyond the language system.

Peer victimization among students with specific language impairment, attention-deficit/hyperactivity disorder, and typical development

PURPOSE

The potential contributions of behavioral and verbal liabilities to social risk were examined by comparing peer victimization levels in children with specific language impairment (SLI) to those in children with attention-deficit/hyperactivity disorder (ADHD) and typically developing (TD) children.

METHOD

Sixty children (age range: 7-8 years) participated in the study. Standardized verbal measures and parent ratings of behavioral difficulties were combined with children's self-reports of their school and peer environments to examine the risk for negative peer experiences associated with clinical status.

RESULTS

Clinical status was associated with elevated levels of victimization, especially for participants with SLI. A potential buffering effect for number of close friendships was found for participants with ADHD and TD participants, but not for participants with SLI. Peer victimization was associated with elevated levels of hyperactivity and stronger narrative skills for participants with SLI.

CONCLUSION

These results highlight the importance of peer victimization in the social adjustment of students with developmental language disorders.

Sustained Attention in Children with Primary Language Impairment: A Meta-Analysis

Purpose

This study provides a meta-analysis of the difference between children with primary or specific language impairment (LI) and their typically developing peers on tasks of sustained attention. The meta-analysis seeks to determine if children with LI demonstrate subclinical deficits in sustained attention and, if so, under what conditions.

Methods

Articles that reported empirical data from the performance of children with LI, in comparison to typically developing peers, on a task assessing sustained attention were considered for inclusion. Twenty-eight effect sizes were included in the meta-analysis. Two moderator analyses addressed the effects of stimulus modality and ADHD exclusion. In addition, reaction time outcomes and the effects of task variables were summarized qualitatively.

Results

The meta-analysis supports the existence of sustained attention deficits in children with LI in both auditory and visual modalities, as demonstrated by reduced accuracy compared to typically developing peers. Larger effect sizes are found in tasks that use auditory and linguistic stimuli than in studies that use visual stimuli.

Conclusions

Future research should consider the role that sustained attention weaknesses play in LI, as well as the implications for clinical and research assessment tasks. Methodological recommendations are summarized.

Psycholinguistic profiling differentiates specific language impairment from typical development and from attention-deficit/hyperactivity disorder

PURPOSE

Practitioners must have confidence in the capacity of their language measures to discriminate developmental language disorders from typical development and from other common disorders. In this study, psycholinguistic profiles were collected from 3 groups: children with specific language impairment (SLI), children with attention-deficit/hyperactivity disorder (ADHD), and children with typical development (TD). The capacity of different language indices to successfully discriminate SLI cases from TD and ADHD cases was examined through response operating characteristics curves, likelihood ratios, and binary logistic regression.

METHOD

The Test of Early Grammatical Impairment (Rice & Wexler, 2001a), Dollaghan and Campbell's (1998) nonword repetition task, Redmond's (2005) sentence recall task, and the Test of Narrative Language (Gillam & Pearson, 2004) were administered to 60 children (7-8 years of age).

RESULTS

Diagnostic accuracy was high for all 4 psycholinguistic measures, although modest reductions were observed with the SLI versus ADHD discriminations. Classification accuracy associated with using the Test of Early Grammatical Impairment and the Sentence Recall task was equivalent to using all 4 measures.

IMPLICATIONS

Outcomes confirmed and extended previous investigations, documenting high levels of diagnostic integrity for these particular indices and supporting their incorporation into eligibility decisions, differential diagnosis, and the identification of comorbidity.