Children with specific language impairment and their contribution to the study of language development

Language phenotypes in children with autism spectrum disorder, expressive language disorder, and typical language development

The aim of this study was to compare language abilities in 4-6-year-old Georgian-speaking children with typical language development (TLD), expressive language disorder (ELD), and autism spectrum disorder (ASD). Language linguistic components, such as phonology, semantics, syntax, morphology, and pragmatics, were examined along with verbal behavior types like "mand," "tact," "echoic," and "intraverbal." Our sample comprised 148 children, with a gender distribution of 50 girls and 98 boys. Significant differences were observed in the application of various parts of speech across the three groups. Children with ELD were found to use pronouns more frequently compared to TLD and ASD groups. Conversely, children exhibiting typical language development displayed a greater usage of conjunctions and particles than the other groups. Notably, linguistic error patterns varied across groups: children with ELD predominantly committed errors in phonetics and morphosyntax, while children with ASD had more pragmatic errors and also struggled with morphosyntax. Moreover, the ASD group was found to use "mands" and "echoics" more frequently than both the TLD and ELD groups.

Testing the Continuum/Spectrum Model in Russian-Speaking Children With and Without Developmental Language Disorder

PURPOSE

Previously, Lancaster and Camarata (2019) showed that the continuum/spectrum model of the developmental language disorder (DLD) best explained the high heterogeneity of symptoms in children with DLD. We hypothesize that the continuum/spectrum approach can include not only children with DLD but also typically developing (TD) children with different timelines and patterns of language acquisition. This model can explain individual language profiles and deficits in children.

METHOD

We assessed language abilities in a group of Russian-speaking children with DLD aged 4-7 years (n = 53) and their age- and gender-matched peers without speech and language diagnoses (n = 53, TD). We evaluated the children's performance at four language levels in production and comprehension domains, using 11 subtests of the standardized language assessment for Russian: Russian Child Language Assessment Battery (RuCLAB). Using the k-means cluster method and RuCLAB scores, we obtained two clusters of children and analyzed their language performance in individual subtests.

RESULTS

The analysis revealed that the two clusters of children both included DLD and TD participants: Group 1, with higher test scores (TD = 45, DLD = 24 children), and Group 2, with lower scores (TD = 8, DLD = 29). Children from Group 1 mostly had lower scores at one of the language levels, whereas those from Group 2 struggled at several language levels. Furthermore, children with DLD from both groups tended to be more sensitive to linguistic features such as word length, noun case, and sentence reversibility compared to TD children.

CONCLUSIONS

The presence of two mixed groups shows that children with diagnosed DLD could perform on par with TD children, whereas some younger TD children could perform similarly to children with DLD. Our findings support the continuum/spectrum model: Linguistic skills in preschool children are a continuum, varying from high to poor skills at all language levels in comprehension and production. To describe a child's language profile, the tasks assessing all language levels should be used.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25521400.

Phonological awareness training and phonological therapy approaches for specific language impairment children with speech sound disorders: a comparative outcome study

PURPOSE

Children with specific language impairment (SLI) might present with speech sound disorder (SSD) and phonological awareness (PA) deficits which put them at risk of potential reading problems. This work aimed to organize an intervention program in Arabic for phonological training and to assess the effect of PA training versus the phonological therapy (PT) for children with SLI and SSD.

METHODS

The study was carried out on 60 children with comorbid SLI and SSD, aged 5-7 years. Children were equally divided into two groups; each group received language therapy combined with (PT or PA training). Measures of language development, phonological output, and PA were taken before therapy and at 4 month post-therapy for all children.

RESULTS

The two therapy groups made nearly the same amount of progress in the development of language and phonological production, with no significant differences regarding language age and percent of consonants correct (PCC). The PA training group progressed more on the PA skills than children who received PT over the same time.

CONCLUSIONS

PA training could facilitate the development of phonological skills by targeting the child's awareness of phonemes and improving the production of sound patterns.

The Relationship between Language and Technology: How Screen Time Affects Language Development in Early Life-A Systematic Review

Screen time refers to the amount of time a child is exposed to a screen, that is, television, computer, smartphone, or any other digital medium. Prolonged screen time in the first years of life may affect a child's cognitive abilities, especially language acquisition. A systematic review was conducted, following the PRISMA-P guidelines, with the aim to explore the available literature relating to the impact of screen time on children's language development. This review identified 18 articles. The articles reviewed showed that prolonged screen time and exposure to screens in the first 2 years of life can negatively affect language development and communication skills, in terms of comprehension and vocabulary range. In addition, overexposure to screens in the early years can affect overall cognitive development, especially attention to environmental stimuli, social experiences, problem solving, and communication with others, e.g., the alternance of rhythms and roles in a conversation. In conclusion, our systematic review supports the idea that preschool screen time has negative effects on children's cognitive and language development. Television seems to be the medium most detrimental to children's skills, as it is used in a passive manner and is often characterised by language and content that do not suit the child's processing mode. Future studies should increasingly focus on the digital media that children possess at an early age, such as mobile phones and tablets, and on how children relate to the online world, such as social networks.

Bridging the Divide: Brain and Behavior in Developmental Language Disorder

Developmental language disorder (DLD) is a heterogenous neurodevelopmental disorder that affects a child's ability to comprehend and/or produce spoken and/or written language, yet it cannot be attributed to hearing loss or overt neurological damage. It is widely believed that some combination of genetic, biological, and environmental factors influences brain and language development in this population, but it has been difficult to bridge theoretical accounts of DLD with neuroimaging findings, due to heterogeneity in language impairment profiles across individuals and inconsistent neuroimaging findings. Therefore, the purpose of this overview is two-fold: (1) to summarize the neuroimaging literature (while drawing on findings from other language-impaired populations, where appropriate); and (2) to briefly review the theoretical accounts of language impairment patterns in DLD, with the goal of bridging the disparate findings. As will be demonstrated with this overview, the current state of the field suggests that children with DLD have atypical brain volume, laterality, and activation/connectivity patterns in key language regions that likely contribute to language difficulties. However, the precise nature of these differences and the underlying neural mechanisms contributing to them remain an open area of investigation.

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.

Reading and Math Achievement in Children With Dyslexia, Developmental Language Disorder, or Typical Development: Achievement Gaps Persist From Second Through Fourth Grades

We examined how children (N = 448) with separate or co-occurring developmental language disorder (DLD) and dyslexia performed on school-based measures of academic functioning between second and fourth grades. Children were recruited from 1 school district in the U.S. state of South Carolina via classroom screenings and met common research criteria for DLD and dyslexia. Growth curve models were used to examine the overall form of growth and differences between groups. Children with DLD and/or dyslexia in second grade showed early and persistent deficits on school-administered measures of reading and math. In second grade, children with typical development (TD) scored significantly higher than children with dyslexia-only and DLD-only, who did not differ from each other. Children with DLD+dyslexia scored significantly lower than all other groups. Only small differences in growth rates were observed, and gaps in second grade did not close. Despite lower academic performance, few children (20%-27%) with dyslexia and/or DLD had received specialized support services. Children with DLD-only received services at less than half the rate of dyslexia-only or DLD+dyslexia despite similar impacts on academic performance. Evidence of significant and persistent functional impacts in the context of low rates of support services in these children-especially those with DLD-only-highlights the need to raise awareness of these disorders.

"Early detection of Spanish-speaking children with developmental language disorders: Concurrent validity of a short questionnaire and a screening test"

BACKGROUND

. Under-identification of Developmental Language Disorder (DLD) is a significant problem in monolingual Latin American Spanish-speaking children. We evaluated the identification utility of the sequential use of two screening tools, the "Parental Questionnaire (PQ)" and the "Screening for Language Problems (TPL)", to identify children who require confirmatory diagnosis of DLD.

METHODS

Parents of children (4 to 6 years) were contacted in schools and public health centers in Mexico. Monolingual Spanish-speaking children with no auditory and cognitive disorders were eligible. The reference diagnosis of DLD was established using BESA (Bilingual English-Spanish Assessment) or SCELF-4 (Spanish Clinical Evaluation of Language Fundamentals), combined with data from the narrative samples that yielded the percentage of ungrammaticality and the clinical judgment of two Speech-Language Pathologists (SLPs). Responses to the PQ were obtained as a parental report, and the TPL was applied by a trained SLPs.

RESULTS

. Both PQ and TPL presented a significant difference between the groups of children with DLD and typical language development (TLD). By combining the two instruments, a notable improvement in diagnostic utility was shown.

CONCLUSION

. The combination of these two procedures provides an efficient method for screening children having the risk of DLD and contributes to resolving the problem of under-identification.

Phonological and Articulatory Deficits in the Production of Novel Signs in Children With Developmental Language Disorder

PURPOSE

Sign language, like spoken language, incorporates phonological and articulatory (or motor) processing components. Thus, the learning of novel signs, like novel spoken word forms, may be problematic for children with developmental language disorder (DLD). In the present work, we hypothesize that phonological and articulatory deficits in novel sign repetition and learning would differentiate preschool-age children with DLD from their typical peers.

METHOD

Children with DLD (n = 34; aged 4-5 years) and their age-matched typical peers (n = 21) participated. Children were exposed to four novel signs, all iconic, but only two linked to a visual referent. Children imitatively produced these novel signs multiple times. We obtained measures of phonological accuracy and articulatory motion stability as well as of learning of the associated visual referent.

RESULTS

Children with DLD showed an increased number of phonological feature (i.e., handshape, path, and orientation of the hands) errors when compared with their typical peers. While articulatory variability did not overall differentiate children with DLD from typical peers, children with DLD showed instability in one novel sign that obligated bimanual oppositional movement. Semantic aspects of novel sign learning were unaffected in children with DLD.

CONCLUSIONS

Deficits that have been documented in phonological organization of spoken words in children with DLD are also evident in the manual domain. Analyses of hand motion variability suggest that children with DLD do not show a generalized motor deficit, but one that is restricted to the implementation of coordinated and sequential hand motion.

Vietnamese children with and without DLD: Classifier use and grammaticality over time

INTRODUCTION

One way to identify Developmental Language Disorder (DLD) is to establish clinical markers in a language to serve as reliable indicators of the disorder. This study embarks on the search for clinical markers for Vietnamese using longitudinal data from children with and without DLD.

METHODS

We matched ten children previously classified with DLD to ten with typical development (TD) by age and gender. Participants completed a story generation task at three time points: kindergarten, first, and second grade. Overall grammatical development was measured using mean length of utterance, MLU, and proportion of grammatical utterances, PGU. We examined a language-specific feature, classifiers, in terms of accuracy (omission errors), diversity (number of different classifiers), and productivity, or the use of classifiers in constructions of two-to-three elements (classifier+noun, numeral+classifier+noun). Longitudinal change and group differences were examined using linear mixed modeling, supplemented by linguistic analysis.

RESULTS

Both groups increased in MLU and PGU over time. The DLD group performed lower in kindergarten and continued to show lower performance over time on these measures. Classifier omission errors decreased over time with no group differences. Classifier diversity increased across groups, with lower performance by the DLD group in kindergarten and over time. For classifier productivity, TD children used classifiers in multiple constructions in kindergarten and maintained the same level over time. In contrast, children with DLD had minimal use of three-element constructions in kindergarten but increased in productivity over time.

CONCLUSIONS

Children with DLD produce shorter utterances with relatively more grammatical errors compared to their TD peers in the early school years. Though no longer committing classifier omission errors, children with DLD showed more restricted use of classifiers in terms of the number of different classifiers and constructions produced. Findings inform the search for Vietnamese clinical markers of DLD.

Psychometric Properties of the Cyprus Lexical List in the Greek Language for Infants and Preschool Children and Preliminary Results

The aim of this study was to evaluate the psychometric properties of the adapted Cyprus Greek Lexical List a-CYLEX (GR) in a sample of 194 Greek toddlers from the island of Crete with Standard Modern Greek (SMG) as their primary language. The a-CYLEX (GR) is a parental report checklist for assessing the receptive and expressive vocabulary skills of children aged 12 months to 3:6 years. Concurrent validity of the instrument was tested via correlations with the adapted Greek version of the Receptive One-Word Picture Vocabulary Test-II (ROWPVT-II), which was administered to 124 SMG-speaking children between the ages of 2 and 3:6 years. Test-retest reliability was tested by administering the instrument two times within a 2-week interval to 59 parents (30.41% of the total sample). Statistical analyses provided strong evidence for the high internal consistency and test-retest reliability of the a-CYLEX (GR). The role of the demographic variables in vocabulary performance and the frequency of each a-CYLEX (GR) word category by age were also investigated. In conclusion, the a-CYLEX (GR) is a parental report checklist that can be used by clinicians who are interested in assessing receptive and expressive vocabulary of children during toddlerhood.

Efficacy, model of delivery, intensity and targets of pragmatic interventions for children with developmental language disorder: A systematic review

BACKGROUND

It is widely acknowledged that children with developmental language disorder (DLD) predominantly have difficulties in the areas of grammar and vocabulary, with preserved pragmatic skills. Consequently, few studies focus on the pragmatic skills of children with DLD, and there is a distinct lack of studies examining the effectiveness of pragmatic interventions.

AIMS

To carry out a systematic review of the literature on pragmatic interventions for children with DLD.

METHODS & PROCEDURES

This systematic review was registered with PROSPERO (ID = CRD42017067239). A systematic search in seven databases yielded 1031 papers, of which 11 met our inclusion criteria. The included papers focused on interventions for children with DLD (mean = 3-18 years), enhancing oral language pragmatic skills, published between January 2006 and May 2020, and were based on a group-study design such as randomized control trial or pre-post-testing. Study participants were monolingual speakers. The quality of papers was appraised using the Cochrane Risk of bias tool for randomized controlled trials.

OUTCOMES & RESULTS

There was a high degree of variability between the included intervention studies, especially regarding intensity, intervention targets and outcomes. The evidence suggested that pragmatic intervention is feasible for all models of delivery (individual, small and large group) and that interventions for pragmatic language are mostly focused on encouragement of conversation and narrative skills observed through parent-child interaction or shared book-reading activities.

CONCLUSIONS & IMPLICATIONS

This study highlights the importance of promoting and explicitly teaching pragmatic skills to children with DLD in structured interventions. A narrative synthesis of the included studies revealed that in addition to direct intervention, indirect intervention can also contribute to improving oral pragmatic skills of children with DLD.

WHAT THIS PAPER ADDS

What is already known on the subject? An increasing number of studies have shown that difficulties in acquiring pragmatic language is not only present in children with autism. What this study adds to existing knowledge? Interventions for pragmatic language in children with DLD are mostly focused on encouragement of conversation and narrative skills, very often through parent-child interaction or shared book-reading activities. Interventions that target language pragmatic are feasible for all models of delivery (individual, small and large group). What are the potential or actual clinical implications of this work? The efficacy of the existing studies varies, and it is difficult to give recommendations regarding the intensity and duration of the specific intervention. In addition to offering pragmatic intervention directly from a specialist, pragmatic interventions can also be carried out indirectly if the intervention is under the continuous supervision of a specialist.

Development and Validation of a Language Screening for Implementation in Pre-School Settings

Background

To prevent or mitigate long-lasting learning problems and emotional, behavioral, and social-adaption difficulties associated with language disorders, age-appropriate German language competence at school entry level is essential. Therefore, universal screening of children in their penultimate year of pre-school has been established in Upper Austria. So far, the screenings administered by speech and language pathologists to identify risk of language disorder (LD) were not based on standardized materials.

Objective

To develop a screening instrument to identify increased risk of LD and to evaluate its validity and feasibility within the constraints of regular universal pre-school language screening.

Design

A two-component screening instrument including direct assessment of expressive and receptive grammar was used in a sample of 374 children with German as their dominant language attending a public pre-school in their penultimate year (age 4-5 ½ years) in the state of Upper Austria. Assessment by use of standardized German language tests including a variety of linguistic domains was considered reference standard for diagnosing LD. Feasibility was assessed by a self-developed questionnaire completed by the administrators of the screening.

Results

The combination of the expressive and receptive grammar scales demonstrated excellent accuracy (area under the curve score 0.928). A cut-off of 18 resulted in a failing rate of 21.8% and showed good sensitivity (84.2%) and specificity (85.3%). Acceptance by children and testers, time-economy and sustainability of the screening were mostly rated as high.

Phonological characteristics of novel gesture production in children with developmental language disorder: Longitudinal findings

Children with developmental language disorder (DLD; aka specific language impairment) are characterized based on deficits in language, especially morphosyntax, in the absence of other explanatory conditions. However, deficits in speech production, as well as fine and gross motor skill, have also been observed, implicating both the linguistic and motor systems. Situated at the intersection of these domains, and providing insight into both, is manual gesture. In the current work, we asked whether children with DLD showed phonological deficits in the production of novel gestures and whether gesture production at 4 years of age is related to language and motor outcomes two years later. Twenty-eight children (14 with DLD) participated in a two-year longitudinal novel gesture production study. At the first and final time points, language and fine motor skills were measured and gestures were analyzed for phonological feature accuracy, including handshape, path, and orientation. Results indicated that, while early deficits in phonological accuracy did not persist for children with DLD, all children struggled with orientation while handshape was the most accurate. Early handshape and orientation accuracy were also predictive of later language skill, but only for the children with DLD. Theoretical and clinical implications of these findings are discussed.

Language Screening in 3-Year-Olds: Development and Validation of a Feasible and Effective Instrument for Pediatric Primary Care

Objective: The study was aimed at evaluating the validity and feasibility of SPES-3 (Sprachentwicklungsscreening), a language screening in 3-year-old children within the constraints of regular preventive medical check-ups. Methods: A four-component screening measure including parental reports on the child's expressive vocabulary and grammar based on the MacArthur Communicative Development Inventory and pediatrician-administered standardized assessments of noun plurals and sentence comprehension was used in a sample of 2,044 consecutively seen children in 30 pediatric offices. One-hundred forty-four children (70 who failed and 74 who passed the screener) comprised the validation sample and also underwent follow-up gold standard assessment. To avoid verification and spectrum bias multiple imputation of missing diagnosis for children who did not undergo gold standard assessment was used. Independent diagnoses by two experts blinded to the screening results were considered gold standard for diagnosing language disorder. Screening accuracy of each of the four subscales was analyzed using receiver operator characteristic (ROC) curves. Feasibility was assessed by use of a questionnaire completed by the pediatricians. Results: The two parental screening subscales demonstrated excellent accuracy with area under the curve (AUC) scores of 0.910 and 0.908 whereas AUC scores were significantly lower for the subscales directly administered by the pediatricians (0.816 and 0.705). A composite score based on both parental screening scales (AUC = 0.946) outperformed single subscales. A cut off of 41.69 on a T-scale resulted in about 20% positive screens and showed good sensitivity (0.878) and specificity (0.876). Practicability, acceptability and sustainability of the screening measure were mostly rated as high. Conclusion: The parent-reported subscales of the SPES-3 language screener are a promising screening tool for use in primary pediatric care settings.

Word-learning trajectories influence long-term recall in children with developmental language disorder and typical development

INTRODUCTION

Children with developmental language disorder (DLD) have difficulties learning words. However, the severity of these difficulties can be reduced through word learning procedures that incorporate repeated spaced retrieval (RSR). Previous studies have shown positive outcomes with RSR but we still know very little about how learning unfolds with this procedure. In this study, we focus on the process of learning under RSR.

METHODS

We analyze the learning data from children with DLD and with typical development (TD) from three recent studies using RSR. We fit growth curves to the trial-by-trial learning data for immediate and spaced retrieval trials and use the characteristics of children's individual word-learning trajectories to predict their long-term recall.

RESULTS

We found that children in both groups demonstrated linear growth during learning, despite breaks within and across days. Success on early immediate retrieval trials promoted success on subsequent spaced retrieval trials. Children's trial-by-trial RSR learning trajectories were related to their long-term recall: both cumulative success and growth over time on the spaced retrieval trials positively predicted long-term recall. Consecutive success was also highly correlated with growth over time.

CONCLUSIONS

Repeated spaced retrieval supplemented with immediate retrieval trials during learning promotes long-term recall.

Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review

BACKGROUND

Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children.

METHODS

We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies.

RESULTS

Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy.

CONCLUSIONS

Monitoring risk situations and employing caregivers' reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.

Bayonet-shaped language development in autism with regression: a retrospective study

Background

Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language level and socio-communicative ability is uncertain. This study aimed to establish the predictive value of ELR on the progression of language development and socio-communicative outcomes to guide clinicians in addressing parents’ concerns at the time of diagnosis.

Methods

We used socio-communicative, language, and cognitive data of 2,047 autism spectrum participants from the Simons Simplex Collection, aged 4–18 years (mean = 9 years; SD = 3.6). Cox proportional hazard and logistic regression models were used to evaluate the effect of ELR on language milestones and the probability of using complex and flexible language, as defined by the choice of ADOS module at enrollment. Linear models were then used to evaluate the relationship of ELR and non-verbal IQ with socio-communicative and language levels.

Results

ELR is associated with earlier language milestones but delayed attainment of fluent, complex, and flexible language. However, this language outcome can be expected for almost all autistic children without intellectual disability at 18 years of age. It is mostly influenced by non-verbal IQ, not ELR. The language and socio-communicative level of participants with flexible language, as measured by the Vineland and ADOS socio-communicative subscales, was not affected by ELR.

Limitations

This study is based on a relatively coarse measure of ultimate language level and relies on retrospective reporting of early language milestones and ELR. It does not prospectively document the age at which language catches up, the relationship between ELR and other behavioral areas of regression, nor the effects of intervention.

Conclusions

For autistic individuals with ELR and a normal level of non-verbal intelligence, language development follows a “bayonet shape” trajectory: early first words followed by regression, a plateau with limited progress, and then language catch up.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13229-021-00444-8.

Code-Switching and Language Proficiency in Bilingual Children With and Without Developmental Language Disorder

Purpose This study examined the frequency of code-switching by Spanish-English-speaking children as a function of language proficiency in each language and diagnosis (developmental language disorder [DLD] or typical language development [TLD]). Method Sixty-two Spanish-English-speaking children, 5-7 years of age, participated in this study (24 with DLD and 38 with TLD). Language samples were used to determine the level of language proficiency in each language as a continuum of performance. Correlational analyses were conducted to evaluate the relationship between Spanish and English language proficiency and the frequency of code-switching considering the total number of code-switched words, intrasentential code-switching (i.e., number of sentences/C-units with code-switched parts), and intersentential code-switching (i.e., code-switched sentences/C-units). Negative binomial and zero-inflated Poisson regressions were conducted to evaluate whether the frequency of code-switched words, code-switched parts, and code-switched sentences is different across children with DLD and their peers with TLD, controlling for Spanish and English proficiency. Results When Spanish was the target language, lower proficiency in Spanish was associated with higher frequency of code-switches to English for the group with DLD, but not for their peers with TLD who code-switched to English regardless of their Spanish and English proficiency. There were no statistically significant effects of diagnosis on the frequency of code-switches. Conclusion Results indicate that code-switching occurs similarly across children with DLD and their peers with TLD; therefore, the frequency and type of code-switches should not be used as an indicator of DLD.

Moving towards accurate and early prediction of language delay with network science and machine learning approaches

Due to wide variability of typical language development, it has been historically difficult to distinguish typical and delayed trajectories of early language growth. Improving our understanding of factors that signal language disorder and delay has the potential to improve the lives of the millions with developmental language disorder (DLD). We develop predictive models of low language (LL) outcomes by analyzing parental report measures of early language skill using machine learning and network science approaches. We harmonized two longitudinal datasets including demographic and standardized measures of early language skills (the MacArthur-Bates Communicative Developmental Inventories; MBCDI) as well as a later measure of LL. MBCDI data was used to calculate several graph-theoretic measures of lexico-semantic structure in toddlers' expressive vocabularies. We use machine-learning techniques to construct predictive models with these datasets to identify toddlers who will have later LL outcomes at preschool and school-age. This approach yielded robust and reliable predictions of later LL outcome with classification accuracies in single datasets exceeding 90%. Generalization performance between different datasets was modest due to differences in outcome ages and diagnostic measures. Grammatical and lexico-semantic measures ranked highly in predictive classification, highlighting promising avenues for early screening and delineating the roots of language disorders.

Marking of Tense and Agreement in Language Samples by Children With and Without Specific Language Impairment in African American English and Southern White English: Evaluation of Scoring Approaches and Cut Scores Across Structures

Purpose As follow-up to a previous study of probes, we evaluated the marking of tense and agreement (T/A) in language samples by children with specific language impairment (SLI) and typically developing controls in African American English (AAE) and Southern White English (SWE) while also examining the clinical utility of different scoring approaches and cut scores across structures. Method The samples came from 70 AAE- and 36 SWE-speaking kindergartners, evenly divided between the SLI and typically developing groups. The structures were past tense, verbal -s, auxiliary BE present, and auxiliary BE past. The scoring approaches were unmodified, modified, and strategic; these approaches varied in the scoring of forms classified as nonmainstream and other. The cut scores were dialect-universal and dialect-specific. Results Although low numbers of some forms limited the analyses, the results generally supported those previously found for the probes. The children produced a large and diverse inventory of mainstream and nonmainstream T/A forms within the samples; strategic scoring led to the greatest differences between the clinical groups while reducing effects of the children's dialects; and dialect-specific cut scores resulted in better clinical classification accuracies, with measures of past tense leading to the highest levels of classification accuracy. Conclusions For children with SLI, the findings contribute to studies that call for a paradigm shift in how children's T/A deficits are assessed and treated across dialects. A comparison of findings from the samples and probes indicates that probes may be the better task for identifying T/A deficits in children with SLI in AAE and SWE. Supplemental Material https://doi.org/10.23641/asha.13564709.

Consistency of a Nonword Repetition Task to Discriminate Children with and without Developmental Language Disorder in Catalan-Spanish and European Portuguese Speaking Children

Nonword repetition has been proposed as a diagnostic marker of developmental language disorder (DLD); however, the inconsistency in the ability of nonword repetition tasks (NRT) to identify children with DLD raises significant questions regarding its feasibility as a clinical tool. Research suggests that some of the inconsistency across NRT may be due to differences in the nature of the nonword stimuli. In this study, we compared children's performance on NRT between two cohorts: the children in the Catalan-Spanish cohort (CS) were bilingual, and the children in the European Portuguese cohort (EP) were monolingual. NRT performance was assessed in both Spanish and Catalan for the bilingual children from Catalonia-Spain and in Portuguese for the monolingual children from Portugal. Results show that although the absolute performance differed across the two cohorts, with NRT performance being lower for the CS, in both Catalan and Spanish, as compared to the EP cohort in both, the cut-points for the likelihood ratios (LH) were similar across the three languages and mirror those previously reported in previous studies. However, the absolute LH ratio values for this study were higher than those reported in prior research due in part to differences in wordlikeness and frequency of the stimuli in the current study. Taken together, the findings from this study show that an NRT consisting of 3-, 4-, and 5-syllable nonwords, which varies in wordlikeness ratings, when presented in a random order accurately identifies and correctly differentiates children with DLD from TD controls the child is bilingual or monolingual.

The relationship between developmental language disorder and dyslexia in European Portuguese school-aged children

Developmental Language Disorder (DLD) [Also referred to as Specific Language Impairment (SLI)] and dyslexia are neurodevelopmental disorders which show similar behavioral manifestations. In this study, between-group comparisons and frequency analysis were combined to investigate the relationship between DLD and dyslexia. European Portuguese children aged 7-10 years, with DLD (N = 7) or dyslexia (N = 11) were recruited and compared to age-matched typically developing (TD) children (N = 21) on phonological processing, language andf literacy measures. The between-group comparison revealed that for phonological processing, the clinical groups scored significantly below TD children on most tasks, yet the DLD group performed similarly to TD children for RAN speed and digit span. The clinical groups did not statistically differ in their phonological processing abilities. For language abilities, children with dyslexia did not differ from TD children, whilst children with DLD performed significantly below TD children on all measures and significantly below children with dyslexia for vocabulary. Finally, for literacy measures, there were no statistical differences between clinical groups which underperformed on all measures when compared to TD children. The frequency analysis showed that children with DLD exhibited a lower prevalence of RAN difficulties when compared to children with dyslexia, whilst children with DLD tended to show more frequent nonword repetition and phoneme deletion deficits. Additionally, whilst children with DLD consistently showed more prevalent language impairments, both clinical groups demonstrated similar prevalence rates of literacy deficits compared to TD children.These findings lend support to the additional deficit model as children with DLD show more severe and prevalent language impairments than those with dyslexia, despite similar phonological and literacy difficulties.

Sentence Imitation With Masked Morphemes in Czech: Memory, Morpheme Frequency, and Morphological Richness

Purpose This study examined two markers of language impairment (LI) in a single experiment, testing sentence imitation and grammatical morphology production using an imitation task with masked morphemes. One goal was to test predictions of the morphological richness account of LI in Czech. We also tested the independent contributions of language and memory skills to sentence imitation performance. Method Seventeen children with LI (5;1-7;6 [years;months]) and 17 vocabulary-matched typically developing (TD) children (3;8-4;11) were administered a sentence imitation task where each sentence had one noun or verb ending replaced by a coughing sound. In addition, a receptive vocabulary and the digit span (backward and forward) tasks were administered. Results Children with LI were significantly less accurate than TD children in sentence imitation task. Both vocabulary and digit span had unique effects on sentence imitation scores. Children with LI were less successful in imitating the target words, especially verbs. However, if they succeeded, their completions of the masked morphemes were no less accurate than in TD children. The accuracy of completions was affected by the morpheme frequency and homophony, but these effects were similar in TD and affected children. Conclusions Sentence imitation is a measure of language skills and verbal memory. Results on morpheme completions are consistent with processing models of LI, but some predictions of the morphological richness model were not confirmed. The results suggest that children with LI might have a deficit in organizing morphosyntactic relations in sentences, rather than in morphological processing proper.

L2 vocabulary acquisition of early sequentially bilingual children with TD and DLD affected differently by exposure and age of onset

BACKGROUND

Language exposure is known to be a key factor influencing bilingual vocabulary development in typically developing (TD) children. There is, however, a lack of knowledge in terms of exposure effects in children with developmental language disorder (DLD) and, especially, in interaction with age of onset (AoO) of second language acquisition.

AIMS

In the Helsinki longitudinal SLI study (HelSLI), we investigated the receptive and expressive second language (L2) vocabulary performance and cross-sectional vocabulary development of sequentially bilingual children with TD and DLD in order to resolve whether the groups could be differentiated based on their vocabulary performance. More importantly, we examined the effects of AoO and exposure in the vocabulary performance of these two bilingual groups.

METHODS & PROCEDURES

A total of 70 children with DLD from a hospital clinic and 82 with TD from kindergartens were recruited. Children were 3-7 years old with different AoOs for the L2 and varying degrees of language exposure. Multiple regression analysis was used to compare the groups in two receptive and three expressive vocabulary tests while considering the effects of AoO and language exposure.

OUTCOMES & RESULTS

Children with TD outperformed children with DLD in both receptive and expressive vocabulary measures. Exposure predicted vocabulary but AoO did not. The effect of exposure was different in TD and DLD groups in receptive but not in expressive vocabulary. Additionally, the interaction of exposure and AoO was found for receptive vocabulary, but similarly in both groups. With increasing exposure, a difference in performance between the groups became more notable in receptive vocabulary compared with the expressive vocabulary.

CONCLUSIONS & IMPLICATIONS

Bilingual children with TD and DLD can be differentiated by using L2 vocabulary tests when exposure is taken into consideration. Non-significant AoO effects in 3-7 year olds suggest flexibility in terms of when to start L2 immersion. However, exposure is important, and especially children with DLD would need a substantial amount of it relative to their TD peers, so that they would not fall even further behind over time. Differences in benefiting from exposure in receptive mode might offer clinicians and kindergarten personnel an insight for evaluating challenges in bilingual development. Severe challenges in vocabulary development in the DLD group also call for both individually targeted small-group activities for learning words as well as strategies for strengthening vocabulary in various environments and everyday life situations. What this paper adds What is already known on the subject Language exposure is often found to explain more of the variation compared with AoO in early L2 vocabulary. On the other hand, it has been suggested by some researchers, but not all, that AoO effects would be found. Exposure and AoO might also interact differently depending on the task and whether the development is typical or disordered. Contrary to the clinical observation, diagnostic value of receptive vocabulary has often been questioned. What this paper adds to existing knowledge This study indicates that receptive vocabulary might be useful in differentiating bilingual TD and DLD. Language exposure effects differ between TD and DLD groups, but depending on task. Lower performance, but also slower cross-sectional development, is found in receptive vocabulary for children with DLD. Interaction between language exposure and AoO stresses the importance of taking both into consideration when studying bilingual development. What are the potential or actual clinical implications of this work? L2 vocabulary tests can be used in differentiating bilingual children with TD and DLD when exposure is taken into consideration. Difficulties using exposure and, hence, slower development in children with DLD suggest that especially receptive vocabulary might be diagnostic by the accumulating exposure. Investing in ways of supporting vocabulary development through small-group activities and in everyday situations of bilingual children at risk of DLD is highly recommended. This is important to prevent them from incrementally falling further behind their TD peers over time. A limited AoO effect suggests that families have more flexibility in terms of when to place their child in L2 immersion in their early years.

Vowel Accuracy and Segmental Variability Differentiate Children With Developmental Language Disorder in Nonword Repetition

Purpose Poor nonword repetition accuracy is a hallmark of children with developmental language disorder (DLD). However, other diagnostic categories also show impaired nonword repetition performance relative to children with typical development (TD); therefore, this task is currently a sensitive but nonspecific index of DLD. In this study, we investigated segmental and kinematic aspects of nonword repetition performance to further specify the diagnostic utility of nonword repetition tasks (NRTs) in diagnosing DLD. Method Forty children, ages 48-86 months, participated, including children with DLD (n = 12), speech sound disorder (SSD; n = 14), and TD (n = 14). All children completed an assessment battery to determine group classification, a classic NRT (Dollaghan & Campbell, 1998), and an experimental NRT designed to measure segmental and articulatory (specifically lip aperture) variability. We assessed nonword repetition accuracy in the classic and experimental NRTs and segmental and kinematic variability in the experimental NRT. Results In both the classic and experimental NRTs, children with SSD and DLD produced nonwords with lower phoneme and consonant accuracy compared to children with TD. Children with DLD produced more vowel errors compared to children with TD in both tasks. In the experimental NRT, children with DLD produced nonwords with high levels of segmental variability compared to children with TD. Children with SSD did not differ from children with TD or children with DLD in the vowel accuracy or the segmental variability measures. The articulatory variability measure did not reveal any group differences. Conclusions In the presence of speech sound difficulties, low nonword repetition accuracy does not aid in the diagnosis of DLD. However, vowel accuracy and segmental variability appear specific to DLD status in NRTs.

Sustained Attention in Developmental Language Disorder and Its Relation to Working Memory and Language

Purpose Based on evidence of deficits in domain-general cognitive abilities associated with developmental language disorder (DLD), the current study examined sustained attention performance in children with DLD compared to children with typical language development (TLD) and the interrelations between visual-spatial sustained attention, visual-spatial working memory, and language abilities across groups. Method Participants included 67 children at 7 years of age: 25 children with DLD (13 girls and 12 boys) and 42 children with TLD (23 girls and 19 boys). We assessed children's visual-spatial sustained attention, visual-spatial working memory, and language ability on a test of narrative language. Result Children with DLD scored significantly below their peers on a measure of visual-spatial sustained attention. Significant intercorrelations were observed between sustained attention, working memory, and language ability within the DLD group, but no correlations were observed between these measures in the TLD group. Conclusion Children with DLD have domain-general deficits in sustained attention, and correlational results have implications for whether and how language abilities are supported by domain-general cognition in both typical and disordered development.

Lexical-Semantic Cues Induce Sound Pattern Stability in Children With Developmental Language Disorder

Purpose When learning novel word forms, preschoolers with developmental language disorder (DLD; also known as specific language impairment) produce speech targets inaccurately and with a high degree of intraword variability. The aim of the current study is to specify whether and how layering lexical-semantic information onto novel phonological strings would induce increased organization of sound production patterns. Method Twenty-one preschoolers with DLD and 21 peers with typical language (ranging in age from 4;1 to 5;11 [years;months]) imitated multiple renditions of novel words, half with (i.e., words) and half without (i.e., nonwords) a linked visual referent. Methods from network science were used to assess the stability and patterning of syllable sequences. Sound accuracy was also measured. Results Children with DLD were less accurate and more variable than their typical peers. However, once word forms were associated with a visual referent, network stability, but not accuracy, improved for children with DLD. Conclusions Children with DLD showed significant word form deficits as they acquired novel words and nonwords. The inclusion of a meaningful referent resulted in increased sound sequence stability, suggesting that lexical-semantic information provides a bootstrap for phonological organization in children with DLD.

Altered brain structures in the dorsal and ventral language pathways in individuals with and without developmental language disorder (DLD)

Developmental Language Disorder (DLD) is a neurodevelopmental disorder characterized by difficulty learning and using language, and this difficulty cannot be attributed to other developmental conditions. The aim of the current study was to examine structural differences in dorsal and ventral language pathways between adolescents and young adults with and without DLD (age range: 14-27 years) using anatomical magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Results showed age-related structural brain differences in both dorsal and ventral pathways in individuals with DLD. These findings provide evidence for neuroanatomical correlates of persistent language deficits in adolescents/young adults with DLD, and further suggest that this brain-language relationship in DLD is better characterized by taking account the dynamic course of the disorder along development.

Automated Phenotyping Tool for Identifying Developmental Language Disorder Cases in Health Systems Data (APT-DLD): A New Research Algorithm for Deployment in Large-Scale Electronic Health Record Systems

Purpose Data mining algorithms using electronic health records (EHRs) are useful in large-scale population-wide studies to classify etiology and comorbidities (Casey et al., 2016). Here, we apply this approach to developmental language disorder (DLD), a prevalent communication disorder whose risk factors and epidemiology remain largely undiscovered. Method We first created a reliable system for manually identifying DLD in EHRs based on speech-language pathologist (SLP) diagnostic expertise. We then developed and validated an automated algorithmic procedure, called, Automated Phenotyping Tool for identifying DLD cases in health systems data (APT-DLD), that classifies a DLD status for patients within EHRs on the basis of ICD (International Statistical Classification of Diseases and Related Health Problems) codes. APT-DLD was validated in a discovery sample (N = 973) using expert SLP manual phenotype coding as a gold-standard comparison and then applied and further validated in a replication sample of N = 13,652 EHRs. Results In the discovery sample, the APT-DLD algorithm correctly classified 98% (concordance) of DLD cases in concordance with manually coded records in the training set, indicating that APT-DLD successfully mimics a comprehensive chart review. The output of APT-DLD was also validated in relation to independently conducted SLP clinician coding in a subset of records, with a positive predictive value of 95% of cases correctly classified as DLD. We also applied APT-DLD to the replication sample, where it achieved a positive predictive value of 90% in relation to SLP clinician classification of DLD. Conclusions APT-DLD is a reliable, valid, and scalable tool for identifying DLD cohorts in EHRs. This new method has promising public health implications for future large-scale epidemiological investigations of DLD and may inform EHR data mining algorithms for other communication disorders. Supplemental Material https://doi.org/10.23641/asha.12753578.

Wahrgenommene Belastung von Müttern sprachentwicklungsgestörter Kinder

Hintergrund Sprachentwicklungsstörungen beeinflussen nicht nur die betroffenen Kinder, sondern das gesamte familiäre Umfeld. Insbesondere Mütter sprachentwicklungsgestörter Kinder erleben hohe psychische und physische Belastungen.

Methode Es wurden n = 40 Mütter von sprachauffälligen und n = 39 Mütter von sprachunauffälligen Kindern zu einem Erhebungszeitpunkt untersucht. Anhand von multivariaten Varianzanalysen und Regressionsanalysen wurden Gruppenunterschiede und mögliche, das Belastungserleben beeinflussende, Prädiktoren ermittelt.

Ergebnisse Die Ergebnisse zeigen, dass Mütter von sprachlich auffälligen Kindern deutlich höhere Belastungswerte insbesondere hinsichtlich depressiver Symptome aufweisen als Mütter von unauffällig entwickelten Kindern.

Diskussion Die Behandlung und Förderung von Sprachentwicklungsstörungen sollte sich zukünftig nicht nur auf kindzentrierte Maßnahmen beschränken, sondern vermehrt auch Eltern gezielt in die Therapie integrieren.

Individualized Narrative Intervention for School-Age Children With Specific Language Impairment

Purpose This study extends the research on narrative intervention by evaluating the effect of a standard treatment protocol, Story Champs (Petersen & Spencer, 2012), on personal narrative generations of school-age children with specific language impairment (SLI). Method Four second-grade, 8- to 9-year-old boys with SLI participated in this multiple baseline across behaviors, single-case design study that was repeated across participants. Each one-on-one intervention session involved eight steps across two intervention segments: story retell and personal story generation. The interventionist provided systematic scaffolding (visual and verbal supports) that was faded within each session. Three individualized story grammar elements per participant were targeted sequentially across the weeks of intervention based on each participant's needs identified in baseline. The dependent variable probe (personal narrative generation) was administered at the beginning of each twice-weekly session, and individualized story grammar elements were scored on a 4-point rubric (dependent variable). Results In this single-case research design study, a functional relation was evaluated for each participant (i.e., replication of an effect across three story grammar elements). A functional relation between Story Champs intervention and the dependent variable was observed for two participants. Conclusion Results provide preliminary evidence for the efficacy of individually administered Story Champs intervention for children with SLI.

Procedural and declarative memory brain systems in developmental language disorder (DLD)

The aim of the current study was to examine microstructural differences in white matter relevant to procedural and declarative memory between adolescents/young adults with and without Developmental Language Disorder (DLD) using diffusion tensor imaging (DTI). The findings showed atypical age-related changes in white matter structures in the corticostriatal system, in the corticocerebellar system, and in the medial temporal region in individuals with DLD. Results highlight the importance of considering the age factor in research on DLD. Future studies are needed to examine the developmental relationship between long-term memory and individual differences in language development and learning.

The Utility of an English Semantics Measure for Identifying Developmental Language Disorder in Spanish-English Bilinguals

Purpose We examined the English semantic performance of three hundred twenty-seven 7- to 10-year-old Spanish-English bilinguals with (n = 66) and without (n = 261) developmental language disorder (DLD) with varying levels of English experience to classify groups. Method English semantic performance on the Bilingual English-Spanish Assessment-Middle Extension Experimental Test Version (Peña et al., 2008) was evaluated by language experience, language ability, and task type. Items that best identified DLD for children with balanced and high English experience were selected. Separately, items that best identified children with high Spanish experience were selected. Results Typically developing bilingual children performed significantly higher than their peers with DLD across semantic tasks, with differences associated with task type. Classification accuracy was fair when item selection corresponded to balanced or high level of experience in English, but poor for children with high Spanish experience. Selecting items specifically for children with high Spanish experience improved classification accuracy. Conclusions Tailoring semantic items based on children's experience is a promising direction toward organizing items on a continuum of exposure. Here, classification effectively ruled in impairment. Future work to refine semantic items that more accurately represent the continuum of exposure may help rule out language impairment.

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.

The Effects of Frequency and Predictability on Repetition in Children With Developmental Language Disorder

Purpose Studies have shown that children with typical development (TD) respond to frequency and predictability when repeating nonidiomatic multiword sequences (e.g., go wash your hands). We extended these findings by explicitly examining the interaction between frequency and predictability in a repetition task for children with developmental language disorder (DLD) and children with TD. Method We created 48 four-word phrases, manipulating two factors: the frequency of occurrence of the entire four-word phrase (e.g., look in the mirror vs. look in the basket) and the predictability of the fourth word in the phrase given the preceding three words (e.g., corn on the ___ vs. look in the ___). These phrases were presented in a repetition task to 17 children with DLD (M age = 58.89 months), 19 same-age children with TD (M age = 59.79 months), and 17 younger children with TD matched to the DLD group on nonword repetition and mean length of utterance (M age = 38.94 months). Children's repetitions were judged for the presence or absence of word and morphological errors. Only the first three words of the sequence were scored (e.g., look in the). Results We found a main effect of sequence frequency, with high-frequency sequences being repeated more accurately than low-frequency sequences, modulated by a significant interaction with predictability, where the effect of sequence frequency was larger for sequences with high-predictability contexts than for sequences with low-predictability contexts. We also found a significant effect of group, with children with DLD demonstrating poorer overall performance, particularly when compared to the same-age group with TD. Conclusions Frequency and predictability are strong predictors of language production in children with TD. These factors also have effects for children with DLD, raising important clinical questions about the design of facilitative contexts for the teaching of difficult linguistic forms.

Skill Profiles of College Students With a History of Developmental Language Disorder and Developmental Dyslexia

Developmental language disorder (DLD) and developmental dyslexia (DD) are two prevalent subtypes of Specific Learning Disabilities (SLDs; Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5]). Yet, little information is available regarding the distinct challenges faced by adults with DLD and/or DD in college. The purpose of the present report is to characterize the relative strengths and challenges of college students with a history of DLD and/or DD, as this information is critical for providing appropriate institutional support. We examined the cognitive skill profiles of 352 college students (ages 18-35 years), using standardized and research-validated measures of reading, spoken language, nonverbal cognition, and self-reported childhood diagnostic history. We classified college students as having DLD (n = 50), and/or DD (n = 40), or as typically developed adults (n = 132) according to procedures described for adults with DLD and DD. A structural equation model determined the cognitive, language, and reading measures predicted by the classification group. Adults with DLD demonstrated poor verbal working memory and speeded sentence-level reading. Adults with DD primarily demonstrated deficits in phonology-based skills. These results indicate that adults with DLD and/or DD continue to face similar challenges as they did during childhood, and thus may benefit from differentially targeted accommodations in college.

If we don't look, we won't see: Measuring language development to inform literacy instruction

Oral language abilities enable children to learn to read, and they predict future academic achievement and life outcomes. However, children with language impairment frequently go unidentified because schools do not systematically measure oral language development. Given that identification paves the way for treatment, schools should increase attention to oral language development, particularly within response to intervention (RTI) frameworks, which aim to prevent learning disabilities by identifying and intervening at early stages. Formal schooling should address language comprehension (in addition to word reading) to ensure an adequate foundation for future reading comprehension. In support, we overview the developmental relations between oral language abilities and reading skills, review current school-based assessment frameworks, and discuss how these frameworks can include language assessments. Measuring language skills early and often benefits not only those who have language impairment but also all children, as it documents language variability to inform differentiated instruction.

Comparative Expression Analysis of Human Endogenous Retrovirus Elements in Peripheral Blood of Children with Specific Language Impairment

Specific language impairment (SLI) is a psychiatric condition with a complex etiology and a substantial genetic basis that affects children's verbal communication abilities. In this study, we examined the expression of five different human endogenous retrovirus elements (HERVs) in a cohort of 25 children with SLI and 25 healthy children in the control group. Human endogenous retrovirus elements, a diverse group of repetitive DNA sequences, can potentially cause considerable genetic heterogeneity. They had been integrated in the genome of our ancestors throughout evolution and now consist of about 8.0% of the human genome. Several HERV loci are transcribed in various cell types. Their expression in peripheral blood and in the brain is altered in many neurological and psychiatric diseases. To date, HERV expression profiles have never been studied in patients with SLI. This study aimed to elucidate differentially regulated human endogenous retroelements in peripheral blood of children with SLI, in comparison with healthy controls, through quantitative reverse tran-scription-polymerase chain reaction (qRT-PCR) methodology. Our results show that two genes: HERV-K (HLM-2) gag and HERV-P env were expressed at lower levels in the blood samples from SLI children in comparison with those in the control group.

Desempeño en tareas de memoria procedimental en niños con trastorno especifico del lenguaje: Una revisión de literatura

Introducción. La Frontal Assesment Battery (FAB) es una herramienta de screening de valoración rápida de las funciones ejecutivas. Estudios previos evidencian que variables sociodemográficas como la edad, el sexo y el nivel educativo podrían influir en el rendimiento de la FAB. El objetivo del estudio es analizar, en adultos mayores argentinos provenientes de la población general y sin deterioro cognitivo (evaluados según el Minimental, pruebas de fluidez verbal semántica y fonológica y el Test del Reloj) si existe diferencia en la FAB a partir de dichas variables. Metodología. Se analizó el rendimiento de 145 adultos mayores provenientes de la población general y sin deterioro cognitivo entre 60 y 90 años. Se realizaron estudios de diferencias de medias (t de Student y ANOVA), análisis univariante de la varianza, correlaciones (r de Pearson) y regresiones lineales simples para analizar la influencia de la edad, el sexo, el nivel educativo y el rendimiento cognitivo en la FAB. Resultados. Se observaron diferencias estadísticamente significativas en el puntaje total de la FAB en función del nivel educativo, pero no en función de la edad, ni el sexo.  Asimismo, se encontró que el puntaje de la FAB se correlacionó con otras pruebas de screening cognitivo, como el Minimental, el Test del Reloj y fluidez verbal (fonológica y semántica). Conclusiones. El presente estudio presenta resultados que señalan la importancia de considerar el nivel educativo en la valoración de la FAB.

Developmental language disorder: Maternal stress level and behavioural difficulties of children with expressive and mixed receptive-expressive DLD

PURPOSE

The current study aimed to compare bullying and victimisation behaviour, levels of emotional and behavioural problems and maternal stress in children with expressive and mixed receptive-expressive language disorders.

METHODS

We measured the bullying and victimisation behaviour, the emotional and behavioural problems as well as the maternal stress in a sample of 4-9-year-old children with language disorders (N = 65).

RESULTS

Our main findings were that although bullying and victimisation were common in both groups; the children with expressive language disorders tended to be perpetrators (teacher-reported) while the children with mixed language disorders experienced more bullying and tended to be victims (self-reported); the latters' mothers perceived significantly more stress compared to mothers of children with expressive language disorders. Furthermore, the results of the study indicate that, although the number of children within the family was identified as the strongest predictor explaining maternal stress, maternal stress is a multifactorial concept influenced by many factors.

CONCLUSION

For a successful intervention in children with developmental language disorders, it seems to be very important to identify parental stressors beyond the treatment of the child's problems.

Speech profiles of Spanish-Catalan children with developmental language disorder

Children with developmental language disorders (DLD) are especially characterised by morphosyntactic difficulties. Nevertheless, previous studies have also shown that children with DLD have phonological difficulties. This paper aims to describe the productive and perceptive phonological speech profile of Spanish-Catalan children with DLD at the age of six in order to characterise the underlying nature of their difficulties. Fourteen Spanish-Catalan six-year-old children with DLD and 14 control children without language difficulties who attended the same class were assessed with the screening and discrimination tasks of the A-RE-HA: Análisis del Retraso del Habla (Speech Delay Analysis - Catalan and Spanish version). We analysed the production of words, syllables and phonemes, phoneme discrimination and phonological simplification processes used by these children. The results showed that children with DLD have a lower percentile in correct word structures, syllabic structures and phonemes, and have more difficulty discriminating phonemes. Detailed analyses revealed more difficulties with the most complex word and syllabic templates, and with almost all phonemes. Furthermore, children with DLD applied more phonological simplification processes than the control group. An individual analysis showed that only ten of the children with DLD also had a speech delay (percentile < 25), while four had scores in line with their age. These results show that most of the six-year-old children with DLD maintain speech difficulties, which are mainly phonological and not (or not only) articulatory. Therefore, individual differences with respect to speech delay in DLD must be taken into consideration to better detect these children.

What Machine Learning Can Tell Us About the Role of Language Dominance in the Diagnostic Accuracy of German LITMUS Non-word and Sentence Repetition Tasks

The present study investigates the performance of 21 monolingual and 56 bilingual children aged 5;6-9;0 on German LITMUS-sentence-repetition (SRT; Hamann et al., 2013) and non-word-repetition-tasks (NWRT; Grimm et al., 2014), which were constructed in accordance with the LITMUS-principles (Language Impairment Testing in Multilingual Settings; Armon-Lotem et al., 2015). Both tasks incorporate phonologically and syntactically complex structures shown to be cross-linguistically challenging for children with Specific Language Impairment (SLI) and aim at minimizing bias against bilingual children while still being indicative of the presence of language impairment across language combinations (see Marinis and Armon-Lotem, 2015; for sentence-repetition; Chiat, 2015 for non-word-repetition). Given the great variability in bilingual language exposure and the potential effect of language experience on language performance in bilingual children, we examined whether background variables related to bilingualism, particularly, the degree language dominance as measured by relative amount of use and exposure, could compromise the diagnostic accuracy of the German LITMUS-SRT and NWRT. We further investigated whether a combination of the two tasks provides better diagnostic accuracy and helps avoid cases of misdiagnosis. To address this, we used an unsupervised machine learning algorithm, the Partitioning-Around-Medoids (PAM, Kaufman and Rousseeuw, 2009), for deriving a clinical category for the children as ± language-impaired based on their performance scores on SRT and NWRT (in isolation and combined) while withholding information about their clinical status based on standardized assessment in their first (home language, L1) and second language (societal language, L2). Subsequently, we calculated diagnostic accuracy and used regression analysis to investigate which background variables (age of onset, length of exposure, degree of language dominance, socio-economic-status, and risk factors for SLI) best explained clinical-group-membership yielded from the PAM-analysis based on the children's NWRT and SRT performance scores. Results show that although language-dominance clearly influences the performance of bilingual typically developing children, especially in the SRT, the diagnostic accuracy of the tools is not compromised by language dominance: while risk factors for SLI were significant predictors for clinical group membership in all models, language dominance did not contribute at all to explaining clinical cluster membership as typically developing or SLI based on any of the combinations of the SRT and NWRT variables. Additionally, results confirm that a combination of SRT scored by correct target structure and the structurally more complex language-dependent part of the NWRT yields better diagnostic accuracy than single measures and is only sensitive to risk factors for SLI and not to dominance levels or SES.

When morphological ability exceeds syntactic ability: A case study

This article addresses the question of whether children classified as having a specific language impairment are such due to a particular problem in inflectional morphology. This has been claimed to be the case for some time. An effort is made here to propose that there may be an age effect behind that result. To support this possibility, a case study of a much older child with specific language impairment is presented. The participant is Tom, a child with a language impairment who underwent language intervention between the ages 9;4 and 10;3. During that period, language samples were taken at five different times (MLUs 5.3-6.0). They were analyzed to examine both Tom's morphological and syntactic abilities. The results indicated that he did quite well with English noun and verb inflections, but was unable to generate complex sentence structures. If there were a period when he had such difficulties, it was overcome by the time of the sampling. A lexical explanation is given which argues that bound morphology will appear better than syntax in cases where children are older and thus have had time to acquire the various inflected words as individual lexical items.

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.

Learning and Overnight Retention in Declarative Memory in Specific Language Impairment

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

Longitudinal trajectories of the representation and access to phonological information in bilingual children with specific language impairment

PURPOSE

Language development in children with Specific Language Impairment (SLI) is still poorly understood, especially if children with SLI are bilingual. This study describes the longitudinal trajectory of several linguistic abilities in bilingual children with SLI relative to bilingual control children matched by their age and socioeconomic status.

METHOD

A set of measures of non-word repetition, sentence repetition, phonological awareness, rapid automatic naming and verbal fluency were collected at three time points, from 6-12 years of age using a prospective longitudinal design.

RESULT

Results revealed that, at all ages, children with SLI obtained lower values in measures of sentence repetition, non-word repetition, phonological fluency and phonological awareness (without visual cues) when compared to typically-developing children. Other measures, such as rapid automatic naming, improved over time, given that differences at 6 years of age did not persist at further moments of testing. Other linguistic measures, such as phonological awareness (with visual cues) and semantic fluency were equivalent between both groups across time.

CONCLUSION

Children with SLI manifest persistent difficulties in tasks involved in manipulating segments of words and in maintaining verbal units active in phonological working memory, while other abilities, such as the access to underlying phonological representations are unaffected.

An Item Analysis of the French Version of the Test for Reception of Grammar Among Children and Adolescents With Down Syndrome or Intellectual Disability of Undifferentiated Etiology

PURPOSE

An item analysis of Bishop's (1983) Test for Reception of Grammar (TROG) in its French version (F-TROG; Lecocq, 1996) was conducted to determine whether the difficulty of items is similar for participants with or without intellectual disability (ID).

METHOD

In Study 1, responses to the 92 F-TROG items by 55 participants with Down syndrome (DS), 55 with ID of undifferentiated etiology (UND), and 55 typical children (TYP) matched on their F-TROG total score were compared using the transformed item difficulties method, a statistical approach designed to detect differential item functioning (DIF) between groups. In Study 2, an additional comparison involving 526 TYP participants and 526 participants with UND was conducted to increase the statistical power of the analysis.

RESULTS

The difficulty of items was highly similar whatever the sample size or clinical status of participants. Fewer than 3.5% of the items were flagged as showing DIF.

CONCLUSIONS

Tests such as the TROG can be used with confidence in clinical practice as well as in research studies comparing participants with or without ID. Methods designed for investigating potential internal test bias-such as done here-should be more regularly employed in the developmental disability field to affirm the absence of DIF.

Common Genetic Variants in FOXP2 Are Not Associated with Individual Differences in Language Development

Much of our current knowledge regarding the association of FOXP2 with speech and language development comes from singleton and small family studies where a small number of rare variants have been identified. However, neither genome-wide nor gene-specific studies have provided evidence that common polymorphisms in the gene contribute to individual differences in language development in the general population. One explanation for this inconsistency is that previous studies have been limited to relatively small samples of individuals with low language abilities, using low density gene coverage. The current study examined the association between common variants in FOXP2 and a quantitative measure of language ability in a population-based cohort of European decent (n = 812). No significant associations were found for a panel of 13 SNPs that covered the coding region of FOXP2 and extended into the promoter region. Power analyses indicated we should have been able to detect a QTL variance of 0.02 for an associated allele with MAF of 0.2 or greater with 80% power. This suggests that, if a common variant associated with language ability in this gene does exist, it is likely of small effect. Our findings lead us to conclude that while genetic variants in FOXP2 may be significant for rare forms of language impairment, they do not contribute appreciably to individual variation in the normal range as found in the general population.

Theory of Mind in Children With Specific Language Impairment: A Systematic Review and Meta-Analysis

The relation between language and theory of mind (ToM) has been debated for more than two decades. In a similar vein, ToM has been examined in children with specific language impairment (SLI), albeit with inconsistent results. This meta-analysis of 17 studies with 745 children between the ages of 4 and 12 found that children with SLI had substantially lower ToM performance compared to age-matched typically developing children (d = .98). This effect size was not moderated by age and gender. By revealing that children with SLI have ToM impairments, this finding emphasizes the need for further investigation into the developmental interface between language and ToM as well as the extended consequences of atypical language development.