When words lead to solutions: executive function deficits in preschool children with specific language impairment

Far Transfer Effects of Trainings on Executive Functions in Neurodevelopmental Disorders: A Systematic Review and Metanalysis

Executive Functions are a set of interrelated, top-down processes essential for adaptive goal-directed behaviour, frequently impaired across different neurodevelopmental disorders with variable degrees of severity. Many executive-function-training studies in children with neurodevelopmental disorders have focused on near effects, investigating post-treatment improvements on directly trained processes, while enhancements of skills not directly trained, defined as far effects, are less considered, albeit these could be extremely relevant for reducing the negative impact of a disorder's core symptomatology. This systematic review and metanalysis aims to investigate the far effect outcomes after EF training in children with different types of neurodevelopmental disorders. 17 studies met the inclusion criteria for the systematic review, while 15 studies were selected in the metanalysis. An overall statistically significant effect size was found in the majority of far effect outcome measures considered in the studies. In particular, trainings on executive functions determine significant far effects on daily life functioning (0.46, 95% CI: [0.05-0.87]) and clinical symptoms (0.33, 95% CI: [0.15-0.51]). Despite a high variability of the results, intensity, frequency and the laboratory/life contexts dimension seem to be the most influential variables in determining far effects. This systematic review and metanalysis highlights the need to measure far effects of executive function training in neurodevelopmental disorders, selecting treatments not only on directly targeted processes, but also according to far impacts on the functional weakness of the disorder.

Cortical thickness in the right medial frontal gyrus predicts planning performance in healthy children and adolescents

The ability to plan is an important part of the set of the cognitive skills called "executive functions." To be able to plan actions in advance is of great importance in everyday life and constitutes one of the major key features for academic as well as economic success. The present study aimed to investigate the neuroanatomical correlates of planning in normally developing children, as measured by the cortical thickness of the prefrontal cortex. Eighteen healthy children and adolescents underwent structural MRI examinations and the Tower of London (ToL) task. A multiple regression analysis revealed that the cortical thickness of the right caudal middle frontal gyrus (cMFG) was a significant predictor of planning performance. Neither the cortical thickness of any other prefrontal area nor gender were significantly associated with performance in the ToL task. The results of the present exploratory study suggest that the cortical thickness of the right, but not the left cMFG, is positively correlated with performance in the ToL task. We, therefore, conclude that increased cortical thickness may be more beneficial for higher-order processes, such as information integration, than for lower-order processes, such as the analysis of external information.

Specific Language Impairment and Executive Functions in School-Age Children: A Systematic Review

This systematic review examines the relationship between specific language impairment (SLI) and executive functions (EFs) in school-age children. The study investigates the impact of SLI on EF in comparison to children who develop normally. A total of 2,658 articles from three databases (PubMed, Scopus, and Virtual Health Library) were assessed for inclusion. Ultimately, 22 articles were selected for analysis, which contained information on both SLI and EF. The findings indicate that children diagnosed with SLI exhibit deficits, low performance, and, in some cases, significant deterioration in the development of EF when compared to typically developing children in 62%-91% of cases as early as three to four years of age; the most commonly found alterations were in working memory (including phonological, auditory, and visual/verbal memory), followed by deficits in attention, processing speed, inhibition, planning, cognitive flexibility, and internalized speech. We also discuss the close relationship and importance between language and EF in SLI children.

Drama Therapy for Children and Adolescents with Psychosocial Problems: A Systemic Review on Effects, Means, Therapeutic Attitude, and Supposed Mechanisms of Change

Drama therapy is applied to children and adolescents with psychosocial problems. Drama therapy is an experimental form of treatment which methodologically uses drama and theatre processes to achieve psychological growth. Although in clinical practice, drama therapy has been applied successfully, little is known about how and why drama therapy contributes to a decrease in psychosocial problems. A systematic narrative review was performed to obtain more insight into this issue. Eight databases were systematically searched. Ten out of 3742 studies were included, of which there were four random controlled trails, three non-controlled trials, and three pre-and post-test design studies. We identified the results, drama therapeutic means, attitude, and mechanism of change. Positive effects were found on overall psychosocial problems, internalizing and externalizing problems, social functioning, coping and regulation processes, social identity, and cognitive development. An adaptive approach was mentioned as the therapeutic attitude. The means established contribute to a dramatic reality, which triggers the mechanisms of change. These are processes that arise during treatment and which facilitate therapeutic change. We found ten supposed mechanisms of change to be frequently used in all studies. No direct relations were found between the results, drama therapeutic attitude, means, and mechanisms of change.

Examining the relationship between oral language skills and executive functions: Evidence from Greek-speaking 4-5-year-old children with and without Developmental Language Disorder

BACKGROUND

Children with Developmental Language Disorder (DLD) have been found to demonstrate low performance in Executive Functions (EFs). However, the evidence-based data is so far scarce, especially for 4-5-year-old children. Most of the existing research involves English-speaking populations, while very few studies have been carried out with non-English-speaking populations. Nevertheless, it is documented that possible differences in the language-cognition relations may exist due to the specific characteristics of each language, and studies across different languages could contribute to the above.

AIMS

The present study aimed to systematically investigate the profile of oral language and EF skills (verbal and nonverbal) and the way these skills are related with each other in 4-5-year-old Greek-speaking children with and without DLD.

METHODS AND PROCEDURES

Fifty-three 4-5-year-old children (age range: 51- 57 months) with DLD, and 62 Typically Developing (TD) peers (age range: 51- 57 months) were assessed on a standardized psychometric battery for oral language skills (phonological and morphological awareness, oral language comprehension, vocabulary knowledge, narrative speech and pragmatics) and on a series of verbal (v) and nonverbal (nv) tasks tapping EFs skills (updating-accuracy, inhibition -accuracy and reaction time-, and cognitive flexibility).

OUTCOMES AND RESULTS

Children with DLD demonstrated statistically significant lower performance across all oral language measures in comparison to their TD peers. Additionally, they performed significantly lower in the updating (nv) task, as well as in cognitive flexibility (v & nv) in comparison to the TD group. Further regression analyses demonstrated that updating (nv), inhibition (nv) and cognitive flexibility (v) predicted oral language comprehension in children with DLD while updating (v & nv), inhibition-reaction time (nv) and cognitive flexibility (v & nv) predicted phonological and morphological awareness, oral language comprehension, narrative speech as well as total language score in TD children.

CONCLUSIONS AND IMPLICATIONS

These results provide important information about the profile of oral language and EF skills in children with DLD compared to their TD peers as well as on the relationship of these skills in both groups. The findings also suggest that improving EFs skills may be a possible way for improving oral language skills in young children with DLD. Our findings are discussed in terms of their theoretical as well as practical implications regarding the diagnostic and intervention procedures for children with DLD.

Cognitive flexibility in children with Developmental Language Disorder: Drawing of nonexistent objects

Cognitive flexibility is the ability to adapt thoughts and behaviors to new environments. Previous studies investigating cognitive flexibility in children with Developmental Language Disorder (DLD) present contradictory findings. In the current study, cognitive flexibility was assessed in 5- and 6-year-old preschoolers with DLD (n = 23) and peers with typical development (TD; n = 50) using a nonexistent object drawing (NEOD) task. The children were asked to draw a nonexistent man and a nonexistent house. The children with DLD did not differ from their peers with TD on simple category changes, which were comprised of changes in the size or shape of parts of the object, change of the whole shape of the object, and deletion of parts of the object. Nevertheless, children with DLD made fewer more complex, high-level category changes, which included same-category insertions, position exchange of object's parts, and cross-category insertions. The difference between DLD and TD on high-level category changes was related to differences between the two groups in verbal short-term memory and inhibition. Furthermore, children with DLD made no changes to their original drawings of an existing man and house more often than their peers with TD. It is concluded that children with DLD aged 5-6 years show less flexibility on the NEOD task than age-matched children with TD. This difference in cognitive flexibility may be related to lower levels of verbal short-term memory and inhibition ability of children with DLD, or to different use of these cognitive skills on the NEOD task.

Executive Function, Working Memory, and Verbal Fluency in Relation to Non-Verbal Intelligence in Greek-Speaking School-Age Children with Developmental Language Disorder

Developmental Language Disorder (DLD) is often associated with impairments in working memory (WM), executive functions (EF), and verbal fluency. Moreover, increasing evidence shows poorer performance of children with DLD on non-verbal intelligence tests relative to their typically developing (TD) peers. Yet, the degree and generality of relevant difficulties remain unclear. The present study aimed at investigating WM capacity, key EFs and verbal fluency in relation to non-verbal intelligence in Greek-speaking school-age children with DLD, compared to TD peers (8–9 years). To our knowledge, the present study is the first to attempt a systematic relevant assessment with Greek-speaking school-age children, complementing previous studies mostly involving English-speaking participants. The results showed that children with DLD scored lower than TD peers on the non-verbal intelligence measure. Groups did not differ in the inhibition measures obtained (tapping resistance to either distractor or proactive interference), but children with DLD were outperformed by TD peers in the WM capacity, updating, monitoring (mixing cost), and verbal fluency (phonological and semantic) measures. The effects showed limited (in the case of backward digit recall) or no dependence on non-verbal intelligence. Findings are discussed in terms of their theoretical and practical implications as well as in relation to future lines of research.

Attentional shifting in children with developmental language disorder: A meta-analysis

PURPOSE

A meta-analysis investigating attentional shifting in children with developmental language disorder (DLD) was conducted. Task type, participant age, and dependent variable metric were examined as significant moderators.

METHOD

A systematic literature review identified 20 studies that met the following inclusionary criteria:(a) were published between 1994-2018; (b) included children with DLD aged 3;00 to 17;11 years; and (c) used behavioral performance-based measures of attentional shifting.

RESULTS

Children with DLD performed poorer than age-matched peers with typically developing language (TL) by 0.42 SD across attentional shifting studies. Moderator analyses showed an effect of task type, as children with DLD performed comparatively poorer on set-shifting (g = -.52) but not alternating tasks (g = -.18). Neither age nor dependent variable used to measure attentional shifting were significant moderators.

DISCUSSION

Children with DLD exhibit deficits in attentional shifting relative to same-age peers. Results of moderator analyses reveal that deficits were found on set-shifting but not alternating tasks and that these deficits remained consistent whether researchers measure accuracy or response time switch costs to ascertain attentional shifting ability. In addition, moderator analysis results suggest that attentional shifting deficits are consistent in preschool-age and school-age children with DLD.

Beyond the Senses: How Self-Directed Speech and Word Meaning Structure Impact Executive Functioning and Theory of Mind in Individuals With Hearing and Language Problems

Many individuals with developmental language disorder (DLD) and individuals who are deaf or hard of hearing (D/HH) have social–emotional problems, such as social difficulties, and show signs of aggression, depression, and anxiety. These problems can be partly associated with their executive functions (EFs) and theory of mind (ToM). The difficulties of both groups in EF and ToM may in turn be related to self-directed speech (i.e., overt or covert speech that is directed at the self). Self-directed speech is thought to allow for the construction of non-sensory representations (i.e., representations that do not coincide with direct observation). Such non-sensory representations allow individuals to overcome the limits set upon them by the senses. This ability is constrained by the development of word meaning structure (i.e., the way words are understood). We argue that the greater ability to construct non-sensory representations may result in more enhanced forms of EF and ToM. We conclude that difficulties in EF, ToM, and social–emotional functioning in those with hearing and language problems may be accounted for in terms of word meaning impairments. We propose that word meaning structure and self-directed speech should be considered in assigning EF and ToM treatments to individuals with DLD and those who are D/HH.

Executive Functions and Morphosyntax: Distinguishing DLD From ADHD in French-Speaking Children

Attention deficit hyperactivity disorder (ADHD) is commonly associated with deficits in executive functions executive functions (EF), but children with this disorder frequently demonstrate co-occurring morphosyntactic impairment when assessed using standardized tests. On the other hand, children with developmental language disorder (DLD), a population defined by impaired linguistic functioning, are often diagnosed with comorbid EF deficits. We investigated EF and morphosyntax in 60 French-speaking children aged six to 12: 20 with typical development (TD), 20 with ADHD, and 20 with DLD. To obtain an EF profile for the different cognitive groups, we used standardized tests to assess lower-order EF skills, (i) selective attention and (ii) short-term memory capacity, and higher-order EF skills, (i) working memory capacity and (ii) attention shifting. To test morphosyntax, we used (i) a standardized omnibus test that elicited a variety of complex structures and (ii) a more fine-grained probe test that assessed the production of third person object clitic pronouns, a clinical marker of DLD in French. Children with ADHD and DLD were associated with different EF and morphosyntactic profiles: children in the ADHD group demonstrated higher-order EF weakness and difficulty on the omnibus morphosyntax task, whereas children with DLD showed both lower- and higher-order limitations and struggled with both morphosyntax tasks. Our findings indicate that deficits in morphosyntax are not characteristic of ADHD but that the performance of children with ADHD can mimic morphosyntactic impairment when all-encompassing omnibus tests evaluating various and unpredictable structures are used. If morphosyntax is tested using reliable markers of atypical language development and external cognitive-load factors are optimally reduced, there are significant discrepancies in the observed ADHD-DLD outcomes. Clinical implications that include perspectives for the differential diagnosis of ADHD and DLD are discussed.

Funciones Ejecutivas en Estudiantes con Trastorno Específico del Lenguaje al Comienzo de la Escolarización Básica

Las funciones ejecutivas (FE) constituyen un conjunto de habilidades implicadas en el control y regulación del funcionamiento cognitivo. La relación entre FE y desarrollo del lenguaje es especialmente relevante en la conceptualización de los trastornos lingüísticos. El objetivo del estudio consistía en explorar el uso diferencial de FE en dos grupos: Desarrollo Lingüístico Típico (DLT) y Trastorno Específico del Lenguaje (TEL). Participaron 44 estudiantes (56,82% niños), 22 DLT y 22 TEL, con edades entre 6,00–6,92 años (M=6.17, DT=.19). El factor diagnóstico previo mostró efectos significativos en atención ejecutiva (p<.001, η2 parcial =.77), memoria de trabajo (p<.001, η2 parcial =.67), flexibilidad cognitiva (p<.01, η2 parcial =.15), y planificación (p<.001, η2 parcial =.63). En todos los casos, salvo en flexibilidad cognitiva, el tamaño del efecto fue fuerte. Los resultados avalarían la tesis de no especificidad en TEL y la posible presencia de disfunciones cognitivas generales que subyacen al trastorno

Cognitive and Linguistic Predictors of Language Control in Bilingual Children

In order to communicate effectively with a variety of conversation partners and in a variety of settings, bilingual children must develop language control, the ability to control which language is used for production. Past work has focused on linguistic skills as the limiting factor in children's ability to control their language choice, while cognitive control has been the focus of adult models of language control. The current study examined the effects of both language ability and cognitive control on language control in 4-6 year old Spanish/English bilingual children with a broad range of language skills, including those with low skills in both languages. To measure language control, children participated in an interactive scripted confederate dialogue paradigm in which they took turns describing picture scenes with video partners who presented themselves as monolingual speakers of English or monolingual speakers of Spanish. The paradigm had two conditions: a single-language context, in which children interacted with only one partner, and a dual-language context, in which children needed to switch between languages to address different partners. The Dimensional Change Card Sort (DCCS) indexed cognitive control. The findings revealed an overall effect of language ability, such that children with lower language skills were more likely to produce words in the language not understood by their conversation partner. There was also an effect of cognitive control on children's ability to adjust to the dual-language context. Based on these findings, we suggest that a model of language control in children should consider both linguistic and cognitive factors. However, language ability appears to be the main limiting factor, with cognitive control playing a more restricted role in adapting to a dual-language context.

The Complex Relation between Executive Functions and Language in Preschoolers with Developmental Language Disorders

Backgrounds: The relationship between linguistic difficulties and cognitive impairments in children with developmental language disorders (DLDs) is receiving growing interest in international research. Executive functions (EF) appear to be weak in these children. The current investigation aims at exploring the relationship between difficulties in two components of EF (i.e., updating and inhibition) and the linguistic and narrative skills of 16 DLD preschoolers matched with 24 typically developing peers. Methods: Updating skills were tested by administering the forward and backward digit recall subtests of the Wechsler Scales, while children's inhibition abilities were assessed by completion of Developmental Neuropsychological Assessment (NEPSY-II) inhibition tasks. Information on the linguistic skills of the participants was collected through a set of subtests included in the Batteria per la Valutazione del Linguaggio in bambini dai 4 ai 12 anni (Batteria per la Valutazione del Linguaggio; BVL_4-12), assessing articulatory and phonological discrimination skills, lexical production/comprehension, grammatical production/comprehension, and narrative production skills. Results: Findings revealed that DLD children performed significantly lower than their peers on both updating and inhibitory tasks. Linguistic difficulties were found in the DLD group on articulatory/phonological skills, grammatical production/comprehension, and lexical informativeness on narrative production. Measures of EF correlated with linguistic and narrative measures. Conclusion: The current study confirms a significant association between DLD's performances on EF and displayed linguistic skills, suggesting the need to include the assessment of executive functions to target early intervention rehabilitation programs for children with DLDs.

Considering the Role of Executive Function in Reading Comprehension: A Structural Equation Modeling Approach

In the present study, we used latent variable structural equation modeling to investigate relations between oral language, decoding, and two components of executive function (cognitive flexibility and working memory) and reading comprehension in a sample of 271 native English-speaking 9.00- to 14.83-year-olds. Results of the mediation analyses indicated that both oral language and decoding fully mediated the relations between working memory and cognitive flexibility and reading comprehension. These findings suggest that executive function is likely associated with reading comprehension through its relation with decoding and oral language and provide additional support for the role of executive function in reading comprehension as a potentially crucial precursor to skilled reading.

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

BACKGROUND

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

AIMS

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

METHODS & PROCEDURES

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

OUTCOMES & RESULTS

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

CONCLUSIONS & IMPLICATIONS

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

The Impact of Manipulating Attentional Shifting Demands on Preschool Children With Specific Language Impairment

Purpose This study investigated attentional shifting in preschool children with specific language impairment (SLI) compared to their typically developing peers. Children's attentional shifting capacity was assessed by varying attentional demands. Method Twenty-five preschool children with SLI and 25 age-matched, typically developing controls participated. A behavioral task measuring attentional shifting within and across multiple dimensions (auditory, linguistic, and visual) was employed. Demands on attentional shifting were increased based on input dimension (low load: staying within dimension; medium load: shifting between 2 dimensions; and high load: shifting among 3 dimensions). Results Compared to controls, the group with SLI made more erroneous responses and exhibited longer response times. Although both groups' error rates were similarly affected by shifting compared to nonshifting trials, their response speed was not. The group with SLI exhibited a larger comparative decrement to their response speed in the high-attentional load condition. Discussion When demands on attentional shifting increase, children with SLI struggle to shift their attention as efficiently to changing stimuli as their unimpaired peers. Potential implications for the assessment and treatment of this population are discussed.

The impact of speech and language problems in kindergarten on academic learning and special education status in grade three

PURPOSE

This study addressed the implications of experiencing early speech-language pathologies (SLPs) in kindergarten on special education needs (SEN) and academic outcomes in grade three.

METHOD

Early Development Instrument (EDI) kindergarten data on development and the presence or absence of SLPs were matched with grade three school-system standardised tests of reading, writing and maths, and SEN classification in Ontario, Canada for 59 015 students. Children were classified as having a Persistent speech language pathology (SLP), Remittent SLP, Latent SEN or as a typically developing Control.

RESULT

Even though 72.3% of children's SLPs remitted by grade three, kindergarten SLPs conveyed higher likelihood of having an SEN, and of lower achievement levels in grade three. The degree of impact varied between Persistent and Remittent groups. Children in the Latent group had lower scores in kindergarten on all five EDI domains than Control children.

CONCLUSION

These population level results provide strong evidence to indicate that all children who present with an SLP in kindergarten face further academic challenges, even if their SLP resolves over time. Findings have implications for early intervention and treatment for children with early SLPs.

Sensorimotor lateralization scaffolds cognitive specialization

In this chapter, we review hemispheric differences for sensorimotor function and cognitive abilities. Specifically, we examine the left-hemisphere specialization for visuomotor control and its interplay with language, executive function, and musical training. Similarly, we discuss right-hemisphere lateralization for haptic processing and its relationship to spatial and numerical processing. We propose that cerebral lateralization for sensorimotor functions served as a foundation for the development of higher cognitive abilities and their hemispheric functional specialization. We further suggest that sensorimotor and cognitive functions are inextricably linked. Based on the studies discussed in this chapter our view is that sensorimotor control serves as a loom upon which the fibers of language, executive function, spatial, and numerical processing are woven together to create the fabric of cognition.

Articulation Speaks to Executive Function: An Investigation in 4- to 6-Year-Olds

Executive function (EF) and language learning play a prominent role in early childhood development. Empirical research continues to point to a concurrent relation between these two faculties. What has been given little attention, however, is the association between EF and speech articulation abilities in children. This study investigated this relation in children aged 4-6 years. Significant correlations indicated that children with better EF [via parental report of the Behavior Rating Inventory of Executive Function (BRIEF) inventory] exhibited stronger speech sound production abilities in the articulation of the "s" and "sh" sounds. Furthermore, regression analyses revealed that the Global Executive Composite (GEC) of EF as measured by the BRIEF, served as a predictor for speech sound proficiency and that speech sound proficiency served as a predictor for the GEC. Together, these results demonstrate the imbricated nature of EF and speech sound production while bearing theoretical and practical implications. From a theoretical standpoint, the close link between EF and speech articulation may indicate a common ontogenetic pathway. From a practical perspective, the results suggest that children with speech difficulties could be at higher risk for EF deficits.

Which Preschool Children With Specific Language Impairment Receive Language Intervention?

Purpose

Potential biases in service provision for preschool children with specific language impairment (SLI) were explored.

Method

In Study 1, children with SLI receiving treatment (SLI-T) and those with SLI not receiving treatment (SLI-NT) were compared on demographic characteristics and developmental abilities. Study 2 recruited children with articulation disorders receiving treatment (ARTIC-T) to determine if knowing service provision status influenced the results of Study 1.

Results

In Study 1, the SLI-T group was rated by teachers as having poorer executive functioning than children in the SLIT-NT group, and the SLI-T group also came from families whose mothers had more education. These 2 variables alone predicted SLI-T and SLI-NT group membership with 84% accuracy. In Study 2, the ARTIC-T group were perceived as having comparable executive functioning to the SLI-NT group and better than the SLI-T group, indicating that teachers' knowledge of service provision did not influence their ratings of children's executive functioning.

Discussion

Preschool children with SLI, whose mothers have higher education levels and whose teachers perceive them as having poorer executive functioning, are more likely to receive intervention. Recognizing service delivery biases is critical for improving early provision of intervention for this population.

Applying an Integrative Framework of Executive Function to Preschoolers With Specific Language Impairment

Purpose

The first goal of this research was to compare verbal and nonverbal executive function abilities between preschoolers with and without specific language impairment (SLI). The second goal was to assess the group differences on 4 executive function components in order to determine if the components may be hierarchically related as suggested within a developmental integrative framework of executive function.

Method

This study included 26 4- and 5-year-olds diagnosed with SLI and 26 typically developing age- and sex-matched peers. Participants were tested on verbal and nonverbal measures of sustained selective attention, working memory, inhibition, and shifting.

Results

The SLI group performed worse compared with typically developing children on both verbal and nonverbal measures of sustained selective attention and working memory, the verbal inhibition task, and the nonverbal shifting task. Comparisons of standardized group differences between executive function measures revealed a linear increase with the following order: working memory, inhibition, shifting, and sustained selective attention.

Conclusion

The pattern of results suggests that preschoolers with SLI have deficits in executive functioning compared with typical peers, and deficits are not limited to verbal tasks. A significant linear relationship between group differences across executive function components supports the possibility of a hierarchical relationship between executive function skills.

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.

Executive Function in Preschoolers with Primary Language Impairment

PURPOSE

The purpose of this study was to evaluate whether preschoolers with primary language impairment (PLI) show deficits in executive function (EF) compared with their peers with typical development (TD) when inhibition, updating, and mental-set shifting are examined using both linguistically based and visually based tasks.

METHOD

Twenty-two 4- and 5-year-old preschoolers with PLI and 30 preschoolers with TD completed 2 sets of computerized EF tasks: 3 that were linguistically based and 3 that were visually based. This permitted us to test the hypothesis that poor performance on EF tasks in preschoolers with PLI results from impaired language rather than impaired EF.

RESULTS

The PLI group scored significantly lower than the TD group on linguistically and visually based updating tasks and mental-set shifting tasks. The PLI and TD groups did not differ significantly for accuracy or response time on linguistically and visually based inhibition tasks.

CONCLUSION

Results suggest that preschool-age children with PLI have domain-general EF deficits in updating and mental-set shifting but not inhibition deficits, as measured by our tasks.

Lexical Processing in School-Age Children with Autism Spectrum Disorder and Children with Specific Language Impairment: The Role of Semantics

Children with autism spectrum disorder (ASD) and specific language impairment (SLI) often have immature lexical-semantic knowledge; however, the organization of lexical-semantic knowledge is poorly understood. This study examined lexical processing in school-age children with ASD, SLI, and typical development, who were matched on receptive vocabulary. Children completed a lexical decision task, involving words with high and low semantic network sizes and nonwords. Children also completed nonverbal updating and shifting tasks. Children responded more accurately to words from high than from low semantic networks; however, follow-up analyses identified weaker semantic network effects in the SLI group. Additionally, updating and shifting abilities predicted lexical processing, demonstrating similarity in the mechanisms which underlie semantic processing in children with ASD, SLI, and typical development.

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.

Life habits of school-aged children with specific language impairment as perceived by their parents and by school professionals

PURPOSE

Describe social participation of a group of children with specific language impairment.

METHOD

26 parents of children with specific language impairment (SLI) aged from 5 to 13 years and 11 school professionals participated in the study. Data collection was performed with the adapted version for children aged from 5 to 13 years old of the Assessment of Life Habits (Fougeyrollas et al., 2001). The questionnaire encompasses 196 life habits, grouped in 12 dimensions: nutrition, fitness, personal care, communication, housing, mobility, responsibilities, interpersonal relationships, community life, education, work and recreation (Fougeyrollas, 2010).

RESULTS

According to their parents and school professionals, children in this study carried out without difficulty life habits related to housing and mobility. However, they experienced difficulty with life habits related to interpersonal relationships, recreation and responsibilities, in addition to communication and education.

CONCLUSIONS

Children with SLI are perceived by their parents and school professionals as having reduced social participation in many aspects of their daily life. Social participation should be considered as a major outcome when offering services in school to these children. This study proposes specific ways to help children with SLI.

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.

Executive Function in SLI: Recent Advances and Future Directions

This paper provides a review of recent research on executive function abilities in children with specific language impairment (SLI). Across several studies, children with SLI are reported to perform worse than typically developing peers on measures of sustained attention, working memory, inhibition, and attention shifting. However, few studies have considered multiple executive function components simultaneously and even fewer have examined the underlying relationship between executive function deficits and impaired language acquisition. We argue that in order to fully understand the nature of executive function deficits in SLI, the field must move past simply identifying weaknesses to instead test models of executive function development and explore the nature of the relationship between executive function and language. Future research directions are recommended in order to achieve these goals.