Narrative skills in Swedish children with language impairment

Narrative skills and language comprehension in preschool children with cochlear implants: A comparison with children with Developmental Language Disorder or typical development

INTRODUCTION

The narrative skills of children with cochlear implants (CIs) are fragile, but the factors at play and whether these difficulties could be similar to those detected in language impairment are not clear. The present study aims to assess, at the microstructural level, narrative skills, comparing children with CIs with children with Developmental Language Disorder (DLD) or Typical Development (TD). Furthermore, the relationship between verbal (lexical and morphosyntactic) comprehension and narrative skills across groups is investigated.

METHODS

The narratives of 19 children with CIs (Mage = 62.42 months, SD = 6.83), 13 children with DLD (Mage = 65.38 months, SD = 4.27), and 18 preschool children with TD (Mage = 63.67 months, SD = 4.31) were assessed in a standardized task. Articles, prepositions, pronouns, gender and number agreement, accuracy in the use of verbs, and number of arguments in each sentence were analysed. Lexical and morphosyntactic comprehension were also assessed. Performance was compared across groups using ANOVAs or Kruskal-Wallis tests. The role of lexical and morphosyntactic comprehension in predicting each morphological and syntactic element in the narrative task was examined using linear regressions.

RESULTS

Data analysis showed that both children with CIs and DLD had fragilities in narration, both in the morphological and syntactic components. Although some differences between children with CIs and those with DLD emerged in descriptive analyses, these were not statistically significant. Regressions showed that morphosyntactic comprehension predicted the number of pronouns produced only in the TD group.

CONCLUSIONS

The scarce differences between CI and DLD groups and the absence of an effect of morphosyntactic comprehension on pronoun production may be due to their low production of these elements in the narrative task and/or to a difficulty in managing pronouns in an expressive task regardless of their ability to comprehend them. Potential implications of these results are discussed.

Narrative retells in Swedish school-aged children - a clinical pilot study

AIM

The aim of this pilot study was to evaluate two new retelling tasks intended for clinical use in terms of language sample size, effects of picture support, and order of presentation.

METHODS

Forty Swedish-speaking children in grades 4-6 participated in the study, 31 children with typical language development (TLD, mean age 11;1), and nine children with developmental language disorder (DLD, mean age 11;5). Two oral retells, one with and one without picture support, were analyzed with regards to productivity, syntactic complexity, basic Story Grammar (SG) units, and Internal Responses (IR).

RESULTS

Results showed no systematic order effects in the TLD group, although this needs to be investigated further, and good inter-rater reliability. Both tasks elicited sufficiently large language samples, except from one participant with DLD whose samples were excluded from subsequent comparisons. When appropriate, data were analyzed with ANOVA (productivity, mean length of C-unit/MLCU), otherwise t-tests (TLD-group) or non-parametric tests (DLD-group) were used. As expected, retells from participants with DLD were shorter, with shorter MLCU and fewer SG units compared to the TLD group. There were also task effects: in the task with picture support, all participants had longer MLCU, and participants with TLD also showed a higher proportion of subordinate clauses, indicating that pictures may function as a support for syntactic complexity. The task without picture support, on the other hand, elicited more C-units indicated by a significant main effect, and more SG units, which was a significant effect in the TLD group.

CONCLUSIONS

>We conclude that both tasks might be useful for Swedish speech-language pathologists.

Investigating Narrative Performance in Children With Developmental Language Disorder: A Systematic Review and Meta-Analysis

PURPOSE

Narrative assessment is one potentially underutilized and inconsistent method speech-language pathologists may use when considering a diagnosis of developmental language disorder (DLD). However, narration research encompasses many varied methodologies. This systematic review and meta-analysis aimed to (a) investigate how various narrative assessment types (e.g., macrostructure, microstructure, and internal state language) differentiate children with typical development (TD) from children with DLD, (b) identify specific narrative assessment measures that result in greater group differences, and (c) evaluate participant and sample characteristics that may influence performance differences.

METHOD

Electronic databases (PsycINFO, ERIC, and PubMed) and ASHAWire were searched on July 30, 2019, to locate studies that reported oral narrative language measures for both DLD and TD groups between ages 4 and 12 years; studies focusing on written narration or other developmental disorders only were excluded. We extracted data related to sample participants, narrative task(s) and assessment measures, and research design. Group differences were quantified using standardized mean differences. Analyses used mixed-effects meta-regression with robust variance estimation to account for effect size dependencies.

RESULTS

Searches identified 37 eligible studies published between 1987 and 2019, including 382 effect sizes. Overall meta-analysis showed that children with DLD had decreased narrative performance relative to TD peers, with an overall average effect of -0.82 SD, 95% confidence interval [-0.99, -0.66]. Effect sizes showed significant heterogeneity both between and within studies, even after accounting for effect size-, sample-, and study-level predictors. Across model specifications, grammatical accuracy (microstructure) and story grammar (macrostructure) yielded the most consistent evidence of TD-DLD group differences.

CONCLUSIONS

Present findings suggest some narrative assessment measures yield significantly different performance between children with and without DLD. However, researchers need to improve consistency of inclusionary criteria, descriptions of sample characteristics, and reporting of correlations between measures to determine which assessment measures reliably distinguish between groups.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21200380.

The development of narrative skills in monolingual Swedish-speaking children aged 4 to 9: a longitudinal study

This longitudinal study investigated the development of oral narrative skills in monolingual Swedish-speaking children (N = 17). The MAIN Cat/Dog stories were administered at four timepoints between age 4 and 9. Different narrative aspects were found to develop differently. In story comprehension, the children performed high already at T1 (4;4) and were at ceiling at T2 (5;10), whereas story structure developed significantly until T4 (9;4). Narrative length and syntactic complexity reached a plateau at T3 (7;4). Referent introduction was not mastered until T4. The results suggest that general conclusions regarding the development of narrative skills depend on the specific aspects studied.

Predictors of narrative text quality in students with hearing loss

AIM

Students with hearing loss (HL) often fall behind hearing peers in complex language tasks such as narrative writing. This study explored the effects of school grade, gender, cognitive and linguistic predisposition and audiological factors on narrative text quality in this target group.

METHOD

Eleven students with HL in Grades 5-6 and 7-8 (age 12-15) who took part in a writing intervention wrote four narrative texts over six months. A trained panel rated text quality. The effects of the students' working memory capacity, language comprehension, reading comprehension, school grade and gender and the intervention were analyzed as a mixed-effects regression model. Audiological factors were considered separately.

RESULTS

The analysis showed that throughout the period, texts written by female students in Grade 7-8 received the highest text quality ratings, while those written by male students in Grade 7-8 received the lowest ratings. There was no effect of the intervention, or of the linguistic and cognitive measures. The students with the lowest text quality ratings received amplification later than those with high ratings, but HL severity was not associated with text quality.

CONCLUSION

Hearing loss severity was not a decisive factor in narrative text quality. The intervention which the students took part in is potentially effective, with some adaptation to the special needs of students with HL. The strong gender effects are discussed.

Narrative Language Markers of Arabic Language Development and Impairment

Purpose We examined indices of narrative microstructure as metrics of language development and impairment in Arabic-speaking children. We examined their age sensitivity, correlations with standardized measures, and ability to differentiate children with average language and language impairment. Method We collected story narratives from 177 children (54.2% boys) between 3.08 and 10.92 years old (M = 6.25, SD = 1.67) divided into six age bands. Each child also received standardized measures of spoken language (Receptive and Expressive Vocabulary, Sentence Imitation, and Pseudoword Repetition). Several narrative indices of microstructure were examined in each age band. Children were divided into (suspected) developmental language disorder and typical language groups using the standardized test scores and compared on the narrative indicators. Sensitivity and specificity of the narrative indicators that showed group differences were calculated. Results The measures that showed age sensitivity included subject omission error rate, number of object clitics, correct use of subject-verb agreement, and mean length of utterance in words. The developmental language disorder group scored higher on subject omission errors (Cohen's d = 0.55) and lower on correct use of subject-verb agreement (Cohen's d = 0.48) than the typical language group. The threshold for impaired performance with the highest combination of specificity and sensitivity was 35th percentile. Conclusions Several indices of narrative microstructure appear to be valid metrics for documenting language development in children acquiring Gulf Arabic. Subject omission errors and correct use of subject-verb agreement differentiate children with typical and atypical levels of language development.

Does the narrative ability during retelling differ in 5-year-olds born with and without unilateral cleft lip and palate?

BACKGROUND

A previous study has indicated poorer narrative ability during retelling in 5-year-olds with unilateral cleft lip and palate (UCLP) as a group, compared to peers without UCLP.

AIM

To investigate if there are any differences between 5-year-olds with and without UCLP in narrative ability during retelling.

METHODS

A total of 83 children participated, 51 with UCLP and 32 without. They had no known additional malformations or syndromes. The children were audio recorded while performing the Bus Story Test (BST). The recordings were orthographically transcribed. From the transcriptions the BST information score was calculated. The macrostructure of the narratives was assessed with the Narrative Scoring Scheme (NSS), and the microstructure with mean length of utterance in words, grammaticality, grammatical complexity and lexical diversity. Results for children with and without UCLP were compared.

RESULTS

The group with UCLP performed better than the group without UCLP in the NSS sub-category Conclusion. No other significant differences were seen between the groups. The UCLP group had a larger standard deviation for the information score than the group without UCLP.

CONCLUSIONS

The group with UCLP displayed at least as good results as the group without UCLP, but the information score was more varied for the UCLP group than for the group without UCLP.

Foetal growth restriction has negative influence on narrative skills in 8-10-year-old children

AIM

The risk for neurocognitive difficulties is increased in children born with foetal growth restriction (FGR), but no data exist yet on their narrative skills. The narrative skills of 8- to 10-year-old children born with FGR between 24 and 40 weeks were compared with those of children born with appropriate growth for gestational age (AGA).

METHODS

A prospectively collected cohort of 36 children with FGR was recruited prenatally at a Finnish tertiary hospital from 1998-2001, and 31 children with AGA served as controls. Narrative skills were assessed using a standardised test, and correlations between narrative, communication, reading and spelling skills were studied.

RESULTS

Children born with FGR produced significantly less information and shorter utterances in their narratives than the AGA group. Children born preterm with FGR performed significantly more poorly in their narratives than the preterm AGA group. Poor narrative skills correlated with poor communication, reading and spelling skills.

CONCLUSION

Children born with FGR had poorer narrative skills compared with their AGA peers at the age of 8-10 years, and narrative skills were linked to other language-based skills, which underlines the importance of early detection and preventive measures to optimise the educational outcome of children born with FGR.

Narrative Production in Mandarin-Speaking Children: Effects of Language Ability and Elicitation Method

Purpose We compared the narrative production in Mandarin-speaking children at risk (AR) for developmental language disorder (DLD) and typically developing (TD) controls to address two goals: (a) further our understanding of the Mandarin DLD phenotype and (b) examine the role of elicitation method in differentiating AR from TD. Method Twenty-one AR children and 21 age- and nonverbal IQ-matched peers produced two stories from the Multilingual Assessment Instrument of Narrative, first following an adult model (i.e., story-retell) and then without a model (i.e., story-tell). Group and task effects were analyzed on macrostructure and microstructure measures. Results For general macrostructure score and sentence complexity, children in the AR group performed more poorly than TD children on the more challenging story-tell task and showed decreased scores from retell to tell tasks. In addition, children in the AR group showed poorer performance on number of different words. Productivity and grammaticality measures did not show group differences. Discussion Consistent with previous findings, grammaticality and productivity were relatively preserved but story macrostructure, lexical diversity, and sentence complexity were vulnerable in Mandarin-speaking children with or AR for DLD. Having an adult model benefited both groups in sentence complexity and story macrostructure and potentially helped maintain the performance in TD children as they engaged in the more challenging story-telling task.

The use of evaluative expressions in the narratives of adolescents with a history of SLI

Typically, young children diagnosed with specific language impairment (SLI; also called Developmental language disorder, DLD) have been found to show weakness in narrative development, and such weakness has been judged to be unlikely to resolve over time. However, developmental outcomes for adolescents with a prior SLI diagnosis have not been thoroughly studied. In particular, studies on the evaluative aspects of narratives of such persons are almost non-existent. Here we examine the question whether narrative evaluation of adolescents formerly diagnosed with SLI remains problematic into adolescence or comes to resemble more typical narrative performance. We compare the use of evaluative expressions in the narratives of 19 adolescents diagnosed with SLI against 19 typically language developing (TLD) peers. Spoken narratives by the SLI group (Mean age = 14.3; SD = 0.64) and TLD group (Mean age = 14.5; SD = 0.84) using the wordless picture storybook "Frog, where are you?" ( https://childes.talkbank.org/access/Clinical-MOR/Conti/Conti4.html ) were analysed. Each narrative was coded for evaluative clauses, types of evaluative devices (frames of mind, character speech, hedges, negatives, and causal connectives), as well as evaluative perspectives (global vs. local). Although the quantitative analysis did not reveal any significant differences between the two groups, the qualitative analysis showed certain notable strengths in the narrative skills of the focal group of SLI adolescents. Results suggest that adolescents with a history of SLI may approximate TLD narrative skill in evaluating their own narratives, but additional work with more sensitive measures applied at intervals are needed to illuminate developmental pathways of narrative production and of evaluative capacities in adolescents formerly diagnosed with SLI.

A Narrative Evaluation of Mandarin-Speaking Children With Language Impairment

PURPOSE

We aimed to study narrative skills in Mandarin-speaking children with language impairment (LI) to compare with children with LI speaking Indo-European languages.

METHOD

Eighteen Mandarin-speaking children with LI (mean age 6;2 [years;months]) and 18 typically developing (TD) age controls told 3 stories elicited using the Mandarin Expressive Narrative Test (de Villiers & Liu, 2014). We compared macrostructure-evaluating descriptions of characters, settings, initiating events, internal responses,plans, actions, and consequences. We also studied general microstructure, including productivity, lexical diversity, syntactic complexity, and grammaticality. In addition, we compared the use of 6 fine-grained microstructure elements that evaluate particular Mandarin linguistic features.

RESULTS

Children with LI exhibited weaknesses in 5 macrostructure elements, lexical diversity, syntactic complexity, and 3 Mandarin-specific, fine-grained microstructure elements. Children with LI and TD controls demonstrated comparable performance on 2 macrostructure elements, productivity, grammaticality, and the remaining 3 fine-grained microstructure features.

CONCLUSIONS

Similarities and differences are noted in narrative profiles of children with LI who speak Mandarin versus those who speak Indo-European languages. The results are consistent with the view that profiles of linguistic deficits are shaped by the ambient language. Clinical implications are discussed.

Error Type and Lexical Frequency Effects: Error Detection in Swedish Children With Language Impairment

PURPOSE

The first aim of this study was to investigate if Swedish-speaking school-age children with language impairment (LI) show specific morphosyntactic vulnerabilities in error detection. The second aim was to investigate the effects of lexical frequency on error detection, an overlooked aspect of previous error detection studies.

METHOD

Error sensitivity for grammatical structures vulnerable in Swedish-speaking preschool children with LI (omission of the indefinite article in a noun phrase with a neuter/common noun, and use of the infinitive instead of past-tense regular and irregular verbs) was compared to a control error (singular noun instead of plural). Target structures involved a high-frequency (HF) or a low-frequency (LF) noun/verb. Grammatical and ungrammatical sentences were presented in headphones, and responses were collected through button presses.

RESULTS

Children with LI had similar sensitivity to the plural control error as peers with typical language development, but lower sensitivity to past-tense errors and noun phrase errors. All children showed lexical frequency effects for errors involving verbs (HF > LF), and noun gender effects for noun phrase errors (common > neuter).

CONCLUSIONS

School-age children with LI may have subtle difficulties with morphosyntactic processing that mirror expressive difficulties in preschool children with LI. Lexical frequency may affect morphosyntactic processing, which has clinical implications for assessment of grammatical knowledge.