A longitudinal investigation of morpho-syntax in children with Speech Sound Disorders

A meta-analysis of the relationship between speech and language development in children with nonsyndromic cleft palate with or without cleft lip

OBJECTIVE

Children with nonsyndromic cleft palate with or without cleft lip are at risk of speech production and language delays. In typical development, a strong relationship exists between speech and expressive language development. However, the understanding of this relationship in children with nonsyndromic cleft palate with or without cleft lip is incomplete. The objective of this study was to determine the average correlation between consonant inventory and two expressive language skills in children with NSCP ± L.

DESIGN

The study used a random effects meta-analyses design. Articles were included by searching PubMed, APA PsycINFO, and ERIC.

MAIN OUTCOME MEASURES

Correlations between consonant inventory and (1) expressive vocabulary and (2) mean length of utterance.

RESULT

Based on eight studies representing 187 children with nonsyndromic cleft palate with or without cleft lip, consonant inventory was positively correlated with expressive vocabulary size (k = 8, z = 0.74, SE = .16, p < .001, [0.424, 1.052]). Using data from four studies, representing 83 children with nonsyndromic cleft palate with or without cleft lip, consonant inventory had a positive nonsignificant correlation with mean length of utterance (k = 4, z = 0.513, SE = 0.293, p = .081, [-0.063, 1.088]).

CONCLUSION

Results support a connection between consonant inventory and expressive vocabulary size in children with nonsyndromic cleft palate with or without cleft lip across four languages. Small consonant inventories are often associated with expressive language delays.

Morphosyntactic profiles among preschoolers with and without speech sound disorders

The aim of the current study was to identify whether certain morphosyntactic constructs are more difficult for children with speech sound disorder than children with typical speech development. In this post-hoc study, we used chi-square analyses to identify group differences on individual questions on a standardised test of expressive morphosyntax. Participants included 80 preschool-age children, 40 with typical speech and language development (TD), and 40 with speech sound disorder and typical language development (SSD). A chi-square analysis revealed group (TD vs. SSD) differences in usage of subject pronouns, irregular past tense verbs, and yes/no interrogative formation. Ordinal logistic regression revealed that phonological awareness was related to irregular past tense verb use. Children with SSD may present with subclinical morphosyntax difficulties. Speech-language pathologists should consider incorporating morphosyntax assessment into test batteries for children with SSD.

The Relationship Between Speech Accuracy and Linguistic Measures in Narrative Retells of Children With Speech Sound Disorders

BACKGROUND

Speech and language are interconnected systems, and language disorder often co-occurs with childhood apraxia of speech (CAS) and non-CAS speech sound disorders (SSDs). Potential trade-off effects between speech and language in connected speech in children without overt language disorder have been less explored.

METHOD

Story retell narratives from 24 children (aged 5;0-6;11 [years;months]) with CAS, non-CAS SSD, and typical development were analyzed in Systematic Analysis of Language Transcripts (SALT) regarding morphosyntactic complexity (mean length of C-unit in words [MLCU]), lexical diversity (moving-average type-token ratio [MATTR]), and linguistic accuracy (any linguistic error/bound morpheme omissions) and compared to 128 age-matched children from the SALT database. Linear and mixed-effects logistic regressions were performed with speech accuracy (percent phonemes correct [PPC]) and diagnostic group as predictors of the narrative variables.

RESULTS

PPC predicted all narrative variables. Poorer PPC was associated with lower MLCU and MATTR as well as a higher likelihood of linguistic errors. Group differences were only observed for the error variables. Comparison to the SALT database indicated that 13 of 16 children with CAS and SSD showed a higher-than-expected proportion of linguistic errors, with a small proportion explained by individual speech errors only.

CONCLUSIONS

The high occurrence of linguistic errors, combined with the relationship between PPC and linguistic errors in children with CAS/SSD, suggests a trade-off between speech accuracy and language output. Longitudinal studies are needed to investigate whether children with SSDs without language disorder show more language difficulties over time as linguistic demands increase.

The relationship between mean length of utterance (MLU), Persian developmental sentence score (PDSS), and photographic expressive Persian grammar test (PEGT) in typically developing children and those with developmental language disorder (DLD)

PURPOSE

This study investigated the relationship between three practical measures for evaluating Persian grammar expression skills, MLU, PDSS, and PEGT, in preschool children with developmental language disorder (DLD) and their typically developing (TD) peers.

METHOD

Secondary data were obtained by re-analyzing language samples collected in previous studies. Previously audiotaped language samples of 25 monolingual 5-7 years-old Persian children with DLD and 25 TD children were transcribed and reanalyzed to calculate MLU in words (MLU-w) and PDSS for comparison with the results of PEGT.

RESULTS

Children with DLD had lower scores in PEGT, PDSS, and MLU-w than TD children (p < 0.001). In addition, there was a strong correlation between PDSS and MLU-w in both DLD (r = 0.91) and TD groups (r = 0.79). There was a significant correlation between PEGT and MLU (r = 0.76) and PDSS (r = 0.78) in the DLD group, while these correlations were not significant in TD group.

CONCLUSIONS

Considering the positive and significant correlation between MLU, PDSS, and PEGT in children with DLD, the use of PEGT, as a valid, reliable, and accurate test of grammar, which can be implemented quickly and easily, is suggested for clinical purposes of identification and screening of Persian children with DLD.

Language Development in Sex Chromosome Trisomies: Developmental Profiles at 2 and 4 Years of Age, and Predictive Measures

PURPOSE

Describing language development in children with sex chromosome trisomies (SCT) and testing the predictive value of early language measures on later outcomes.

METHOD

Thirteen children with SCT were followed longitudinally. Their developmental profile was assessed, with particular attention to language, at 2 and 4 years. The predictive value of direct (spontaneous speech analysis) and indirect (communicative development inventory) language measures at 2 on performances at 4 was tested.

RESULTS

Language performances at both ages were lower than non-verbal development. At 2, more than 50% of the group produced less than 50 words. At 4, impaired performances were observed in speech sound development and expressive morpho-syntax. Direct measures of Pre-syntactic development predicted later global language outcomes and Sentence Repetition. The number of consonants used at 2 was significantly related to Nonword Repetition at 4.

CONCLUSIONS

The study highlights the importance of early detection and careful follow-up for children with SCT.

Interventions for pre-school children with co-occurring phonological speech sound disorder and expressive language difficulties: A scoping review

BACKGROUND

Recent evidence suggests that pre-school children with co-occurring phonological speech sound disorder (SSD) and expressive language difficulties are at a higher risk of ongoing communication and literacy needs in comparison with children with these difficulties in isolation. However, to date there has been no systematic or scoping review of the literature specific to interventions for children with this dual profile.

AIMS

To explore the evidence regarding interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties, including the content/delivery of such interventions, areas of speech and language targeted, and a broad overview of study quality.

METHODS & PROCEDURES

A scoping review methodology was used in accordance with the guidance from the Joanna Briggs Institute. Following a systematic search of Ovid Medline, Ovid Emcare, OVID Embase, CINAHL, Psychinfo and ERIC, 11 studies were included in the review. A researcher-developed data extraction form was used to extract specific information about each intervention, with the JBI appraisal tools used to provide a broad overview of the quality of each study.

MAIN CONTRIBUTION

Included papers consisted of six randomized controlled trials (RCTs), two cohort studies, two case studies and one case series. Interventions fell into two main categories: (1) integrated interventions that combined content for both speech and language targets and/or explicitly used the same type of technique to improve both domains; and (2) single-domain interventions that explicitly included content to target speech or language only, but also aimed to improve the other domain indirectly. Study quality varied, with detail on the content, context and delivery of interventions often underspecified, hampering the replication and clinical applicability of findings.

CONCLUSIONS & IMPLICATIONS

Early emerging evidence was identified to support both integrated speech and language interventions as well as single-domain interventions. However, caution should be exercised due to the variation in the quality and level of detail reported for the interventions. Future intervention studies may seek to address this by reporting in accordance with Template for Intervention Description and Replication (TIDieR) reporting guidelines. This approach would enable clinicians to consider the applicability of the intervention to individual children within differing settings.

WHAT THIS PAPER ADDS

What is already known on the subject Pre-school children with co-occurring phonological SSD and expressive language difficulties frequently present within speech and language therapy services. These children are at a higher risk of long-term communication and literacy difficulties compared with children with these needs in isolation. Some emerging evidence suggests that interventions for children with this co-occurring profile may exist within the literature; however, this evidence may not be known to clinicians in everyday practice. What this paper adds to existing knowledge This review is the first to systematically examine evidence of interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties. The review identified a small number of intervention studies that varied in research quality and level of detail provided regarding the content and delivery of interventions. What are the potential or actual clinical implications of this work? The findings of this study highlight published evidence for interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties. These may take the form of integrating techniques for speech/language into a single intervention, or the explicit targeting of one domain with the aim of also influencing the other. However, there is a need for further high-quality research in this area. Such studies should provide sufficient detail to enable replication. This would enable clinicians to understand the relevance and applicability of such intervention findings to the individual children they see within their clinical practice.

Relaciones entre habilidades de percepción y producción de habla y el desarrollo morfosintáctico en niños con Trastorno Fonológico que hablan español

La investigación sobre el desarrollo gramatical y su posible relación con los déficits de procesamiento de habla en niños con Trastorno Fonológico (TF) es escasa, especialmente para la lengua española. El objetivo es analizar la influencia de las habilidades de percepción y producción de habla en el desarrollo morfosintáctico de los niños con TF sin Trastorno del Lenguaje (TL). Participaron 52 niños de habla española de 4 a 6 años: 26 con TF y 26 con desarrollo típico (DT) emparejados en edad cronológica, cociente de inteligencia no verbal y nivel de vocabulario receptivo. El desarrollo morfosintáctico se evaluó con el test de lenguaje CELF-Preschool-2-Spanish. Los niños realizaron una tarea de percepción de habla en concreto de discriminación y reconocimiento fonológico y la producción se analizó mediante un análisis fonológico a partir de una tarea de denominación de imágenes. Los niños con TF obtuvieron puntuaciones significativamente más pobres que los niños con DT en todas las variables. Un análisis de mediación mostró un efecto positivo entre la percepción del habla y el desarrollo gramatical con la mediación de la producción del habla. Los niños con TF presentan peor desarrollo morfosintáctico que los niños con DT. Parecen aprender el lenguaje de forma diferente porque son menos eficaces extrayendo, manipulando y produciendo las características del habla. En ellos, el desarrollo gramatical parece depender de varios factores incluyendo la percepción y producción de habla y del efecto sinérgico que estos dos procesos tienen el uno sobre el otro.

The Neurocognition of Developmental Disorders of Language

Developmental disorders of language include developmental language disorder, dyslexia, and motor-speech disorders such as articulation disorder and stuttering. These disorders have generally been explained by accounts that focus on their behavioral rather than neural characteristics; their processing rather than learning impairments; and each disorder separately rather than together, despite their commonalities and comorbidities. Here we update and review a unifying neurocognitive account—the Procedural circuit Deficit Hypothesis (PDH). The PDH posits that abnormalities of brain structures underlying procedural memory (learning and memory that rely on the basal ganglia and associated circuitry) can explain numerous brain and behavioral characteristics across learning and processing, in multiple disorders, including both commonalities and differences. We describe procedural memory, examine its role in various aspects of language, and then present the PDH and relevant evidence across language-related disorders. The PDH has substantial explanatory power, and both basic research and translational implications.

Realisation of grammatical morphemes by children with phonological impairment

The aim of this research was to explore how preschool-aged children with phonological impairment (PI) realise grammatical morphemes across different phonological contexts (i.e. singleton consonant, consonant cluster, syllable), conditions of finiteness and individual morpheme types. Factors accounting for children's realisation of grammatical morphemes were also examined. Eighty-seven Australian English-speaking preschoolers (aged 4-5 years) with PI completed the Children's Assessment of Morphophonology (CHAMP)-an elicited response task-in addition to standardised tests of speech and receptive language. The most challenging grammatical morphemes were finite morphemes (particularly past tense) and grammatical morphemes realised in consonant clusters. The ability to produce consonant clusters in single words significantly accounted for children's ability to realise grammatical morphemes, regardless of whether grammatical morphemes were realised in singleton, consonant cluster or syllable contexts. Realisation of grammatical morphemes by preschoolers with PI is influenced by phonological and morphological factors. The findings have implications regarding the assessment and differential diagnosis of preschoolers with concomitant phonological and language difficulties.

Eliciting the Language Sample for Developmental Sentence Scoring: A Comparison of Play With Toys and Elicited Picture Description

PURPOSE

This study investigated whether language samples elicited during play and description of pictured events would yield the same results for developmental sentence scoring (DSS).

METHOD

Two language samples were elicited from 58 three-year-olds. One sample was elicited during play with a parent, and the other sample was elicited by an examiner asking children to talk about pictured events in response to elicitation questions.

RESULTS

DSS scores were not significantly different between the play and event description samples. However, sentence points were significantly higher for the play sample than for the event description sample. Although there was a correlation between sample types for both DSS and sentence points, the correlation for DSS (r = .52) was below an acceptable level, and the correlation for sentence points (r = .71) was at a minimally acceptable level. Agreement between sample types for pass-fail decisions on the DSS scores using the 10th percentile cutoff recommended by Lee (1974) was only moderate (78%).

CONCLUSION

The current study shows that type of language samples could affect DSS and sentence point scores of 3-year-olds and, hence, the passing and failing decisions for their performance on DSS.

Language Sampling for Preschoolers With Severe Speech Impairments

Purpose

The purposes of this investigation were to determine if measures such as mean length of utterance (MLU) and percentage of comprehensible words can be derived reliably from language samples of children with severe speech impairments and if such measures correlate with tools that measure constructs assumed to be related.

Method

Language samples of 15 preschoolers with severe speech impairments (but receptive language within normal limits) were transcribed independently by 2 transcribers. Nonparametric statistics were used to determine which measures, if any, could be transcribed reliably and to determine if correlations existed between language sample measures and standardized measures of speech, language, and cognition.

Results

Reliable measures were extracted from the majority of the language samples, including MLU in words, mean number of syllables per utterance, and percentage of comprehensible words. Language sample comprehensibility measures were correlated with a single word comprehensibility task. Also, language sample MLUs and mean length of the participants' 3 longest sentences from the MacArthur-Bates Communicative Development Inventory (Fenson et al., 2006) were correlated.

Conclusion

Language sampling, given certain modifications, may be used for some 3-to 5-year-old children with normal receptive language who have severe speech impairments to provide reliable expressive language and comprehensibility information.

Syntax in Spanish-speaking children with Williams syndrome

The syntactic skills of Spanish-speaking children with Williams syndrome (WS) were assessed in different areas (phrase structure, recursion, and bound anaphora). Children were compared to typically-developing peers matched either in chronological age (CA-TD) or in verbal age (VA-TD). In all tasks children with WS performed significantly worse than CA-TD children, but similarly to VA-TD children. However, significant differences were observed in specific domains, particularly regarding sentences with cross-serial dependencies. At the same time, children with WS were less sensitive to syntactic constraints and exhibited a poorer knowledge of some functional words (specifically, of nonreflexive pronouns). A processing bottleneck or a computational constraint may account for this outcome.

Universal Grammar and Biological Variation: An EvoDevo Agenda for Comparative Biolinguistics

Recent advances in genetics and neurobiology have greatly increased the degree of variation that one finds in what is taken to provide the biological foundations of our species-specific linguistic capacities. In particular, this variation seems to cast doubt on the purportedly homogeneous nature of the language faculty traditionally captured by the concept of "Universal Grammar." In this article we discuss what this new source of diversity reveals about the biological reality underlying Universal Grammar. Our discussion leads us to support (1) certain hypotheses advanced in evolutionary developmental biology that argue for the existence of robust biological mechanisms capable of canalizing variation at different levels, and (2) a bottom-up perspective on comparative cognition. We conclude by sketching future directions for what we call "comparative biolinguistics," specifying which experimental directions may help us succeed in this new research avenue.

Developmental Sentence Scoring for Japanese (DSSJ)

This paper reports on the development and use of the Developmental Sentence Scoring for Japanese (DSSJ), a new morpho-syntactical measure for Japanese constructed after the model of the English Developmental Sentence Scoring model (Lee, 1974). Using this measure, we calculated DSSJ scores for 84 children divided into six age groups between 2;8 and 5;2 on the basis of 100-sentence samples collected from free-play child-adult conversations. The analysis showed a high correlation of the DSSJ overall score with the Mean Length of Utterance. The analysis of the DSSJ subarea scores revealed large variations between these subarea scores for children with similar overall DSSJ scores. When investigating the high-scoring children (over 1 SD over group average), most children scored high in three to five subareas, but the combination of scores for these subareas varied from child to child. It is concluded that DSSJ is a valuable tool especially for the language acquisition research. The overall DSSJ score reliably reflects the overall morpho-syntactic development of Japanese children, and the subarea scores provide specific information on individual acquisition patterns.

Contributions of morphological awareness skills to word-level reading and spelling in first-grade children with and without speech sound disorder

PURPOSE

In this study, the authors compared the morphological awareness abilities of children with speech sound disorder (SSD) and children with typical speech skills and examined how morphological awareness ability predicted word-level reading and spelling performance above other known contributors to literacy development.

METHOD

Eighty-eight first-grade students--44 students with SSD and no known history of language deficiencies, and 44 students with typical speech and language skills--completed an assessment battery designed to measure speech sound production, morphological awareness, phonemic awareness, letter-name knowledge, receptive vocabulary, word-level reading, and spelling abilities.

RESULTS

The children with SSD scored significantly lower than did their counterparts on the morphological awareness measures as well as on phonemic awareness, word-level reading, and spelling tasks. Regression analyses suggested that morphological awareness predicted significant unique variance on the spelling measure for both groups and on the word-level reading measure for the children with typical skills.

CONCLUSION

These results suggest that children with SSD may present with a general linguistic awareness insufficiency, which puts them at risk for difficulties with literacy and literacy-related tasks.