Working memory and specific language impairment: an update on the relation and perspectives on assessment and treatment

Cognitive vs. Linguistic Training in Children with Developmental Language Disorder: Exploring Their Effectiveness on Verbal Short-Term Memory and Verbal Working Memory

The present study explores comparatively the effectiveness of a cognitive (verbal short-term memory (vSTM), verbal working memory (vWM)) and of a linguistic training (10-week duration each) in the diffusion of gains in cognitive abilities (vSTM and vWM) of in school-aged Greek-speaking children with developmental language disorder (DLD). To this purpose, two computerized training programs i.e., a linguistic and a cognitive one, were developed and applied to three groups (A, B, and C) of children with DLD (N = 49, in total). There were three assessments with two vSTM tasks (non-word repetition and forward digit span) and a vWM task (backward digit span): pre-therapeutically (time 1), where no significant between-group differences were found, post-therapeutically I (time 2), and post-therapeutically II (time 3) and two training phases. In phase Ι, group A received meta-syntactic training, whereas group B vSTM/vWM training and group C received no training. In phase ΙΙ, a reversal of treatment was performed for groups A and B: group A received vSTM/vWM while group B meta-syntactic training. Again, group C received no training. Overall, the results indicated a significant performance improvement for the treatment groups and revealed beneficial far-transfer effects as language therapy can affect vSTM and vWM in addition to direct and near transfer effects. In addition, the intervention type order affected performance as follows: first, better performance on the vSTM task (non-word repetition) was shown when the linguistic treatment was delivered first; second, better performance on the vWM in Time 2 and Time 3 was shown by group B, for which the cognitive treatment was delivered first. Concluding, not only intervention type but also intervention type order can affect performance in DLD.

Exploring Spanish writing abilities of children with developmental language disorder in expository texts

Introduction

Numerous studies have shown that children with developmental language disorder (DLD), in addition to oral language difficulties, exhibit impaired writing abilities. Their texts contain problems in grammar, organization, cohesion, and length of written output. However, most of these studies have been conducted with English speakers. English is characterized by complex phonological structure, opaque orthography, poor morphology and strict word order. The aim of this research is to observe the writing abilities of children with DLD in a language with simple phonological structure, transparent orthography, rich morphology and flexible word order like Spanish in the production of expository texts.

Methods

Twenty-six children with DLD (mean age in months = 128.85) and 26 age-and sex-matched typically developing (TD) children (mean age in months = 124.61) wrote an expository text about their favorite animal.

Results

In order to analyze how the two groups plan and encode written texts, we looked at word frequency and sentence structure, grammatical complexity and lexical density, and omissions and errors. Compared to the TD group, the children with DLD omitted more content words; made more errors with functional words, verb conjugation and inflectional morphemes, and made a large number of spelling errors. Moreover, they wrote fewer words, fewer sentences, and less structurally and lexically complex texts.

Discussion

These results show that children with DLD who speak a transparent orthography language such as Spanish also have difficulties in most language areas when producing written texts. Our findings should be considered when planning and designing interventions.

Phonological Working Memory and Sentence Production in School-Age Children with Typical Language, Dyslexia, and Comorbid Dyslexia and Developmental Language Disorder

PURPOSE

Little is known about the relationship between sentence production and phonological working memory in school-age children. To fill this gap, we examined how strongly these constructs correlate. We also compared diagnostic groups' working memory abilities to see if differences co-occurred with qualitative differences in their sentences.

METHOD

We conducted Bayesian analyses on data from seven- to nine-year-old children (n = 165 typical language, n = 81 dyslexia-only, n = 43 comorbid dyslexia and developmental language disorder). We correlated sentence production and working memory scores and conducted t tests between groups' working memory scores and sentence length, lexical diversity, and complexity.

RESULTS

Correlations were positive but weak. The dyslexic and typical groups had dissimilar working memory and comparable sentence quality. The dyslexic and comorbid groups had comparable working memory but dissimilar sentence quality.

CONCLUSION

Contrary to literature-based predictions, phonological working memory and sentence production are weakly related in school-age children.

Cognitive processes associated with working memory in children with developmental language disorder

The current study examined how individual differences in language, nonverbal, and attention abilities relate to working memory in children with developmental language disorder (DLD) relative to age-matched typically developing (TD) peers using an interference-based model of working memory as our theoretical framework. Our experimental paradigm involved varying the domain (verbal/nonverbal) of recall items and an interference processing task, testing effects of interference. We examined the relative importance of language, nonverbal, and attention skills in predicting working memory performance by using Bayesian leave-one-out cross-validation to compare models with varied combinations of these skills as predictors. We then statistically tested selected models. Selected models were similar between groups for nonverbal, but not verbal, working memory. Language, nonverbal, and attention skills were associated with performance regardless of whether the working memory task was verbal or nonverbal for the DLD group, yet only attention was associated with verbal working memory for the TD group. A broader set of cognitive processes was involved in verbal recall in children with DLD than in TD peers, potentially reflecting diminished specialization of cognitive processes underlying language. The interference-based model of working memory accounted for interrelationships among language, processing speed, and inhibition of interference, revealing new insights into verbal processing.

Assessment of Developmental Language Disorder in Multilingual Children: Results from an International Survey

INTRODUCTION

The Multilingual-Multicultural Affairs Committee of the International Association of Communication Disorders (IALP) conducted a survey of diagnostic criteria for developmental language disorder (DLD) in multilingual children to discover how clinicians apply terminology and diagnostic criteria to multilingual children in different parts of the world.

METHODS

An international web survey was used to survey 354 participants from 44 countries about their assessment practices, and clinical opinions about assessing multilingual children for DLD.

RESULTS

The findings show that most clinicians felt confident in assessing multilingual children, and they applied the DLD terminology and inclusionary criteria to multilingual children with difficulty learning language. Clinicians used different procedures to assess heritage and societal languages. Barriers to access to services included a lack of knowledge by parents and referral sources about services available and typical multilingual development, with additional reasons differing by geographical region.

DISCUSSION

Speech pathologists across the globe have many similarities in the way that they assess multilingual children. Differences may be attributed to clinical experience, professional education, the clinician's role, the system they work in, and the clinician's own language skills. This paper advances knowledge of current clinical practices, which can be used to evaluate frameworks in international and national contexts, with implications for policy and practice to improve access to clinical services.

Do Language-Related Cognitive Capacities Help Predict Adjustment in Children with Attention-Deficit/Hyperactivity Disorder?

The goal of this paper was to examine the role that language-related cognitive capacities (LRCC) might play in explaining adjustment of 7 to 12 year-old children (M_age = 9.24; SD_age = 0.91) with and without ADHD. The sample was comprised of 178 children with ADHD and 86 typically-developing children (77.3% male; 81.4% White; 9.5% Black; 1.9% Hispanic; 0.8% Asian; 5.7% multiracial; 0.8% did not report race/ethnicity). Using simultaneous regression, we examined whether LRCC accounted for unique variance in achievement, attention problems, oppositional problems, conduct problems, and internalizing, over and above what standard covariates and ADHD diagnostic status could explain. Finally, we examined LRCC as a mediator of the relation between ADHD diagnostic status and these adjustment measures. Results indicated that LRCC significantly predicted 6 of 7 and partially mediated 5 of 7 measures, suggesting that language-related constructs warrant greater attention in diagnosis and treatment of ADHD.

Relationship Between Numeracy and Vocabulary Skills in Indonesian Preschool Children and the Impacts of Learning Environments

Although many studies on early childhood have been conducted, there is still a need for further research on numeracy and vocabulary skills, particularly in Indonesia. This research aims to confirm the correlation between numeracy and vocabulary skills in preschool children and to disentangle the effects of environmental factors on both numeracy and vocabulary skills. This research was conducted at Early Childhood Education and Care (ECEC) in the Jatinangor district and followed the principle of simple random sampling. Children were given numeracy and vocabulary tests, parents were asked to fill out a questionnaire about sociodemographic aspects and the learning environment in their homes, and teachers were asked to fill out a questionnaire about preschool activities concerning numeracy and vocabulary. Data were analyzed using a structural equation model with numeracy and vocabulary as outcome variables. Covariates such as age, gender and social status were also included in the model. The results of this study show that numeracy is closely linked to vocabulary skills and that only a specific preschool activity can explain the variance of numeracy. On the other hand, both home numeracy activities and a specific preschool literacy activity are significant predictors of vocabulary skills.

Not only motor skill performance but also haptic function is impaired in children with developmental language disorder

BACKGROUND

Previous studies have found an association between motor immaturity and developmental language impairment in children. However, systematic investigations of somatosensory dysfunctions that might be linked to motor deficits in children with developmental language disorder (DLD) are lacking.

AIMS

Examined haptic perception and motor skills in school-age children with DLD and typically-developing (TD) children.

METHODS

Sixteen children with DLD and sixteen age-matched TD children performed a curvature detection task measuring haptic sensitivity and a curvature discrimination task measuring haptic acuity. The Movement Assessment Battery for Children, 2nd edition (MABC-2) was also conducted to evaluate children's motor ability.

RESULTS

The results revealed elevated thresholds of both haptic detection (67.5%) and haptic discrimination (67.9%) in the DLD group when compared to the TD group. In addition, the children with DLD performed significantly less well on the manual dexterity of MABC-2. Finally, a lower haptic acuity was associated with poorer manual dexterity scores of MABC-2.

CONCLUSIONS

This study demonstrates for the first time that not only motor skills, but also haptic function is altered in children with DLD. The observed association between manual dexterity and haptic acuity suggests a close relationship between haptic and motor skills in school-age children.

Speech-Language Pathology Interventions for Children With Executive Function Deficits: A Systematic Literature Review

PURPOSE

The purpose of this synthesis was to systematically review the research and guidance for school-based speech-language pathologists (SLPs) who provide intervention to children with developmental executive function (EF) deficits, particularly those children with co-occurring developmental language disorder (DLD).

METHOD

We conducted a structured search of four major electronic databases, as well as a manual review of references and journals, which yielded 4,571 nonduplicate articles. We screened first titles and abstracts and then full texts to identify peer-reviewed articles, dissertations, and theses containing research or guidance for SLPs' interventions for children with co-occurring DLD and EF deficits; this process yielded 27 articles for analysis. We categorized these studies by type of publication and synthesized their contents to assess the evidence base for EF interventions in children with DLD and to evaluate the guidance for SLP-implemented direct and indirect interventions.

RESULTS

A small body of research explores the efficacy of SLPs' intervention for children with co-occurring DLD and EF deficits, generally finding modest but inconsistent effects of cognitive interventions and strategy training to improve language outcomes. Meanwhile, nonempirical articles (e.g., tutorials) offer guidance to SLPs to support students with EF deficits through direct and indirect services.

CONCLUSIONS

A growing body of literature equips SLPs with the principles and strategies of EF intervention. Many of these articles are sourced from literature about children with EF deficits or attention-deficit/hyperactivity disorder, but few empirical studies measure the efficacy of these interventions for children with co-occurring DLD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21401901.

Relationship among Connectivity of the Frontal Aslant Tract, Executive Functions, and Speech and Language Impairment in Children with Childhood Apraxia of Speech

Childhood apraxia of speech (CAS) is a subtype of motor speech disorder usually co-occurring with language impairment. A supramodal processing difficulty, involving executive functions (EFs), might contribute to the cognitive endophenotypes and behavioral manifestations. The present study aimed to profile the EFs in CAS, investigating the relationship between EFs, speech and language severity, and the connectivity of the frontal aslant tract (FAT), a white matter tract involved in both speech and EFs. A total of 30 preschool children with CAS underwent speech, language, and EF assessments and brain MRIs. Their FAT connectivity metrics were compared to those of 30 children without other neurodevelopmental disorders (NoNDs), who also underwent brain MRIs. Alterations in some basic EF components were found. Inhibition and working memory correlated with speech and language severity. Compared to NoND children, a weak, significant reduction in fractional anisotropy (FA) in the left presupplementary motor area (preSMA) FAT component was found. Only speech severity correlated and predicted FA values along with the FAT in both of its components, and visual-spatial working memory moderated the relationship between speech severity and FA in the left SMA. Our study supports the conceptualization of a composite and complex picture of CAS, not limited to the speech core deficit, but also involving high-order cognitive skills.

Effectiveness of cloud-based rehabilitation in children with developmental language disorder during the COVID-19 pandemic: A prospective cohort study

During the coronavirus disease 2019 pandemic, we considered the case of a child with developmental language disorder (DLD) who could not go to the hospital on time to receive timely rehabilitation treatment due to disrupted hospital operations. The application of cloud-based rehabilitation platforms has provided significant advantages and convenience for children with DLD in-home remote rehabilitation. Among them, the JingYun Rehab Cloud Platform is the most widely used in mainland China. It is an interactive telerehabilitation system developed by Weixin Huang that delivers personalized home rehabilitation for special education children. In this study, we used the JingYun Rehab Cloud Platform to investigate the extent to which cloud-based rehabilitation is effective for children with DLD in terms of language and cognitive outcomes. This was a prospective cohort study including all children who were evaluated and diagnosed with DLD through Sign-Significant Relations and were followed up at the rehabilitation clinic of our institute. We followed 162 children with DLD for 3 months, including 84 children with DLD who participated in remote cloud-based rehabilitation on the JingYun Rehab Cloud Platform and 78 children with DLD as the control group who underwent home-based rehabilitation. Language abilities of both groups were assessed using the Chinese version of the Peabody Picture Vocabulary Test-Revised. Several measures of training performance (language, memory, and cognition tasks) were assessed before and after cloud-based rehabilitation in the remote cloud-based rehabilitation group. Children with DLD in the cloud-based rehabilitation group performed significantly better in language abilities, as assessed by the Peabody Picture Vocabulary Test-Revised, than children with DLD in the control group. Furthermore, for children who participated in remote cloud-based rehabilitation, the frequency of training sessions was proportional to their performance on language, memory, and cognition tasks. This study demonstrated the effectiveness of cloud-based rehabilitation on the JingYun Rehab Cloud Platform in treating children with DLD.

A Short and Engaging Adaptive Working-Memory Intervention for Children with Developmental Language Disorder: Effects on Language and Working Memory

Recent research has suggested that working-memory training interventions may benefit children with developmental language disorder (DLD). The current study investigated a short and engaging adaptive working-memory intervention that targeted executive skills and aimed to improve both language comprehension and working-memory abilities in children with DLD. Forty-seven 6- to 10-year-old children with DLD were randomly allocated to an executive working-memory training intervention (n = 24) or an active control group (n = 23). A pre-test/intervention/post-test/9-month-follow-up design was used. Outcome measures included assessments of language (to evaluate far transfer of the training) and working memory (to evaluate near transfer of the training). Hierarchical multiple regression analyses controlling for pre-intervention performance and age found the group to be a significant predictor of sentence comprehension and of performance on six untrained working-memory measures at post-intervention and 9-month follow-up. Children in the intervention group showed significantly higher language comprehension and working-memory scores at both time points than children in the active control group. The intervention programme showed the potential to improve working memory and language comprehension in children with DLD and demonstrated several advantages: it involved short sessions over a short period, caused little disruption in the school day, and was enjoyed by children.

Working Memory Predicts New Word Learning Over and Above Existing Vocabulary and Nonverbal IQ

PURPOSE

The purpose of this study was to use an established model of working memory in children to predict an established model of word learning to determine whether working memory explained word learning variance over and above the contributions of expressive vocabulary and nonverbal IQ.

METHOD

One hundred sixty-seven English-speaking second graders (7- to 8-year-olds) with typical development from two states participated. They completed a comprehensive battery of working memory assessments and six word learning tasks that assessed the creation, storage, retrieval, and production of phonological and semantic representations of novel nouns and verbs and the ability to link those representations.

RESULTS

A structural equation model with expressive vocabulary, nonverbal IQ, and three working memory factors predicting two word learning factors fit the data well. When working memory factors were entered as predictors after expressive vocabulary and nonverbal IQ, they explained 45% of the variance in the phonological word learning factor and 17% of the variance in the semantic word learning factor. Thus, working memory explained a significant amount of word learning variance over and above expressive vocabulary and nonverbal IQ.

CONCLUSION

Results show that working memory is a significant predictor of dynamic word learning over and above the contributions of expressive vocabulary and nonverbal IQ, suggesting that a comprehensive working memory assessment has the potential to identify sources of word learning difficulties and to tailor word learning interventions to a child's working memory strengths and weaknesses.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19125911.

The Effects of a Multitiered System of Language Support on Kindergarten Oral and Written Language: A Large-Scale Randomized Controlled Trial

PURPOSE

The purpose of this randomized controlled trial was to examine the effects of a multitiered system of language support (MTSLS) on kindergarteners' narrative retelling, personal stories, writing, and expository language.

METHOD

Participants were 686 kindergarten students from four school districts in the United States. Twenty-eight classrooms were randomly assigned to treatment (n = 337 students) or control (n = 349 students) conditions. The treatment group received 14 weeks of oral narrative language instruction using Story Champs, a multitiered language program. Classroom teachers delivered large group (Tier 1) instruction for 15-20 min a day for 4 weeks. After this short-duration whole-class instruction, speech-language pathologists began small group Story Champs (Tier 2) intervention with a random sample of students who did not make adequate progress from the large group instruction (n = 49). These students received Tier 2 intervention for 20 min twice a week in addition to continued Tier 1 instruction.

RESULTS

Results indicated that the students in the treatment group had significantly higher scores on all outcome measures compared to the students in the control group. Analyses of outcomes from the 49 students who received Tier 2 intervention compared to a matching sample of at-risk control students revealed that the treatment group had significantly higher scores on narrative retells, personal stories, and expository retells. When compared to matched average-performing and advanced-performing control peers, the students who received Tier 2 intervention had significantly higher narrative retell scores and no longer had significantly lower personal story, expository, or writing scores.

CONCLUSION

This effectiveness study demonstrated that MTSLS can lead to meaningful improvements in kindergarteners' oral and written language skills, even helping at-risk students catch up to high-achieving peers.

Intervention for oral language comprehension skills in preschoolers with developmental language disorder

BACKGROUND

There is a clear predominance of programmes aimed at improving aspects related to language production in pupils with developmental language disorder (DLD). However, programmes aimed at improving their receptive skills are limited.

AIMS

The main aim was to assess the effectiveness of an intervention programme for oral language comprehension skills in preschoolers with typical development (TD) and pupils with DLD.

METHODS & PROCEDURES

Participants were 99 five-year-old pupils, with and without DLD, divided into four groups: two control groups (TD-C = 25; DLD-C = 25) and two experimental groups (TD-T = 24; DLD-T = 25), from schools on the Spanish island of Tenerife. The study used, as pre- and post-measures, the receptive language subtests of the CELF-4-Spanish: Concepts and Following Directions, Word Classes-Receptive and Sentence Structure, as well as two tasks assessing comprehension of paragraphs and narratives. Due to the strong link between oral comprehension skills and executive functions, working memory and semantic fluency are included in this research. The Backward Digit Span subtest of the Wechsler Intelligence Scale for Children (WISC-IV) and Semantic Fluency subtest of the Controlled Oral Word Association Test (COWAT) were used to assess working memory and semantic fluency, respectively. The intervention programme followed a multitiered system of support (MTSS) model, with 95 sessions lasting 60 min each delivered jointly by teachers and speech and language therapists, and focused on lexical-semantic, morphological, syntactic and narrative skills; inferences; verbal working memory; and semantic fluency.

OUTCOMES & RESULTS

The results showed, as expected, that pupils diagnosed with DLD initially performed worse on oral language comprehension and executive functions than pupils with TD. Further, the DLD-T and TD-T groups showed greater gains following the programme, especially in word classes-receptive, sentence structure, verbal working memory and semantic fluency. Finally, a significant positive correlation was found between the gains obtained by the participants in verbal working memory and semantic fluency, with the gains obtained in the three CELF-4-Spanish subtests.

CONCLUSIONS & IMPLICATIONS

An intervention programme applied at an early age fosters oral language comprehension skills and executive functions in pupils with DLD and TD. The intervention organized at different levels of support, following an MTSS model, showed clear progress of the DLD and TD groups in oral language comprehension and executive functions.

WHAT THIS PAPER ADDS

Pupils with DLD present deficits in linguistic comprehension and executive functions. There are many intervention programs focused on improving language production skills. It is also necessary to consider the skills underlying language problems in pupils with DLD. Oral language, inference, working memory and semantic fluency activities improve comprehension. A collaborative and inclusive intervention of teachers and speech language therapists. Psycholinguistic and neuropsychological skills training should become part of the academic curriculum as early as preschool age. What is already known on the subject Pupils with DLD show problems related to both comprehension and production language. However, there is a clear predominance of programs just aimed at improving aspects related to language production. Clinical implications of this study An intervention program applied at an early age fosters oral language comprehension skills and executive function in pupils with DLD. The intervention organized at different levels of support, following an adaptation of the Response Tier Intervention models, showed clear progress of the DLD in comprehension oral language and executive functions.

Variation in Auditory Experience Affects Language and Executive Function Skills in Children Who Are Hard of Hearing

OBJECTIVE

Children who are hard of hearing (CHH) experience delays in spoken language and executive function, but the mechanisms for these deficits remain unresolved. Differences in auditory experience and language skills have been examined as contributing factors to deficits in executive function, primarily with children who are deaf and children with cochlear implants. The theoretical model of cumulative auditory experience quantifies auditory dosage as how much speech is audible and how often children wear their hearing aids. CHH with higher auditory dosage have better language outcomes than peers with less auditory dosage. However, the effects of auditory experience on executive function have not been studied in CHH. The goal of this study was to examine the influences of auditory experience and language skills on the development of executive function in CHH.

DESIGN

We collected measures of aided speech audibility, hearing aid use, executive function, and receptive vocabulary in 177 CHH and 86 children with typical hearing who were 5- to 10 years old and matched for socioeconomic status and nonverbal intelligence. Auditory dosage was calculated by combining each child's average hours of hearing aid use with their audibility for speech to create a variable that quantifies individual differences in auditory access.

RESULTS

CHH had lower receptive vocabulary and deficits in executive function related to working memory and selective attention compared to peers with typical hearing. CHH with greater auditory dosage had higher receptive vocabulary than CHH with lower auditory dosage. Better receptive vocabulary was associated with better scores on executive function measures related to working memory and attention. Auditory dosage was also directly associated with measures of verbal working memory.

CONCLUSIONS

CHH have deficits in language and some, but not all, areas of executive function related to working memory and attention. Auditory dosage was associated with language abilities and verbal working memory. Language was associated with individual differences in executive function skills related to attention and working memory. These results provide support for systems theories regarding the development of executive function in CHH. Interventions that improve auditory access and language may be effective for improving executive function related to working memory and attention in CHH.

Word Learning by Preschool-Age Children With Developmental Language Disorder: Impaired Encoding and Robust Consolidation During Slow Mapping

Purpose Learning novel words, including the specific phonemes that make up word forms, is a struggle for many individuals with developmental language disorder (DLD). Building robust representations of words includes encoding during periods of input and consolidation between periods of input. The primary purpose of the current study is to determine differences between children with DLD and with typical development (TD) in the encoding and consolidation of word forms during the slow mapping process. Method Preschool-age children (DLD = 9, TD = 9) were trained on nine form-referent pairs across multiple consecutive training days. Children's ability to name referents at the end of training days indicated their ability to encode forms. Children's ability to name referents at the beginning of training days after a period of overnight sleep indicated their ability to consolidate forms. Word learning was assessed 1 month after training to determine long-term retention of forms. Results Throughout training, children with DLD produced fewer forms correctly and produced forms with less phonological precision than children with TD. Thus, children with DLD demonstrated impaired encoding. However, children with and without DLD demonstrated a similar ability to consolidate forms between training days and to retain forms across a 1-month delay. Conclusions Difficulties with word form learning are primarily driven by deficits in encoding for children with DLD. Clinicians and educators can support encoding by providing children with adequate exposures to target words via robust training that occurs across multiple sessions. Supplemental Material https://doi.org/10.23641/asha.16746454.

Online Statistical Learning in Developmental Language Disorder

Purpose: The vulnerability of statistical learning (SL) in developmental language disorder (DLD) has mainly been demonstrated with metacognitive offline measures which give little insight into the more specific nature and timing of learning. Our aims in this study were to test SL in children with and without DLD with both online and offline measures and to compare the efficiency of SL in the visual and acoustic modalities in DLD. Method: We explored SL in school-age children with and without DLD matched on age and sex (n = 36). SL was investigated with the use of acoustic verbal and visual nonverbal segmentation tasks relying on online (reaction times and accuracy) and offline (two-alternative forced choice, 2AFC and production) measures. Results: In online measures, learning was evident in both groups in both the visual and acoustic modalities, while offline measures showed difficulties in DLD. The visual production task showed a significant learning effect in both groups, while the visual two-alternative forced choice (2AFC) and the two acoustic offline tasks only showed evidence of learning in the control group. The comparison of learning indices revealed an SL impairment in DLD, which is present in both modalities. Conclusions: Our findings suggest that children with DLD are comparable to typically developing (TD) children in their ability to extract acoustic verbal and visual nonverbal patterns that are cued only by transitional probabilities in online tasks, but they show impairments on metacognitive measures of learning. The pattern of online and offline measures implies that online tests can be more sensitive and valid indices of SL than offline tasks, and the combined use of different measures provides a better picture of learning efficiency, especially in groups where metacognitive tasks are challenging.

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.

Structure of Cognitive Functions in Monolingual Preschool Children With Typical Development and Children With Developmental Language Disorder

Purpose Developmental language disorder (DLD) is defined by persistent difficulties with language, but a growing body of evidence suggests that it is also associated with domain-general and nonverbal information-processing deficits. However, the interconnections between cognitive functions, both nonverbal and language related, are still unclear. With the aim of gaining more comprehensive insight into the cognitive deficits related to DLD, we investigated and compared the cognitive structure of children with DLD and typically developing (TD) children. Method As a part of the Helsinki longitudinal SLI study, monolingual Finnish preschoolers (N = 154; TD group: n = 66, DLD group: n = 88) were assessed with 23 tasks measuring nonverbal and verbal reasoning, language processing, memory, visuomotor functions, attention, and social cognition. Exploratory factor analysis and structural equation modeling were performed to examine latent constructs and to test measurement invariance between the TD and DLD groups. Results Measurement invariance was not found across the TD and DLD groups. Best fitting structure for TD children included factors reflecting verbal abilities, processing speed/short-term memory, visuomotor functions, and visuoconstructive abilities/nonverbal reasoning. The DLD group's structure comprised nonverbal abilities, naming/expressive language, verbal comprehension, and verbal/declarative memory. Conclusions The findings suggest that the structure of cognitive functions differs in TD children and children with DLD already at preschool age. Nonverbal functions seem more unified, whereas verbal functions seem more varying in preschoolers with DLD compared to TD children. The results can be used in future research for prognosis of DLD and planning interventions.

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.

Short-Term Memory for Serial Order Moderates Aspects of Language Acquisition in Children With Developmental Language Disorder: Findings From the HelSLI Study

Previous studies of verbal short-term memory (STM) indicate that STM for serial order may be linked to language development and developmental language disorder (DLD). To clarify whether a domain-general mechanism is impaired in DLD, we studied the relations between age, non-verbal serial STM, and language competence (expressive language, receptive language, and language reasoning). We hypothesized that non-verbal serial STM differences between groups of children with DLD and typically developing (TD) children are linked to their language acquisition differences. Fifty-one children with DLD and sixty-six TD children participated as part of the HelSLI project in this cross-sectional study. The children were 4-6-year-old monolingual native Finnish speakers. They completed several tests of language and cognitive functioning, as well as new game-like tests of visual and auditory non-verbal serial STM. We used regression analyses to examine how serial STM moderates the effect of age on language. A non-verbal composite measure of serial visual and auditory STM moderated cross-sectional development of receptive language in the children with DLD. This moderation was not observed in the TD children. However, we found more rapid cross-sectional development of non-verbal serial STM in the TD children than in the children with DLD. The results suggest that children with DLD may be more likely to have compromised general serial STM processing and that superior non-verbal serial STM may be associated with better language acquisition in children with DLD.

Generalized Slowing Rather Than Inhibition Is Associated With Language Outcomes in Both Late Talkers and Children With Typical Early Development

Purpose While most of the children who are identified as late talkers at the age of 2 years catch up with their peers before school age, some continue to have language difficulties and will later be identified as having developmental language disorder. Our understanding of which children catch up and which do not is limited. The aim of the current study was to find out if inhibition is associated with late talker outcomes at school age. Method We recruited 73 school-aged children (ages 7-10 years) with a history of late talking (n = 38) or typical development (n = 35). Children completed measures of language skills and a flanker task to measure inhibition. School-age language outcome was measured as a continuous variable. Results Our analyses did not reveal associations between inhibition and school-age language index or history of late talking. However, stronger school-age language skills were associated with shorter overall response times on the flanker task, in both congruent and incongruent trials. This effect was not modulated by history of late talking, suggesting that a relationship between general response times and language development is similar in both children with typical early language development and late talkers. Conclusions Inhibition is not related to late talker language outcomes. However, children with better language outcomes had shorter general response times. We interpret this to reflect differences in general processing speed, suggesting that processing speed holds promise for predicting school-age language outcomes in both late talkers and children with typical early development. Supplemental Material https://doi.org/10.23641/asha.14226722.

A Vocabulary Acquisition and Usage for Late Talkers Treatment Efficacy Study: The Effect of Input Utterance Length and Identification of Responder Profiles

Purpose This study examined the efficacy of the Vocabulary Acquisition and Usage for Late Talkers (VAULT) treatment in a version that manipulated the length of clinician utterance in which a target word was presented (dose length). The study also explored ways to characterize treatment responders versus nonresponders. Method Nineteen primarily English-speaking late-talking toddlers (aged 24-34 months at treatment onset) received VAULT and were quasirandomly assigned to have target words presented in grammatical utterances matching one of two lengths: brief (four words or fewer) or extended (five words or more). Children were measured on their pre- and posttreatment production of (a) target and control words specific to treatment and (b) words not specific to treatment. Classification and Regression Tree (CART) analysis was used to classify responders versus nonresponders. Results VAULT was successful as a whole (i.e., treatment effect sizes of greater than 0), with no difference between the brief and extended conditions. Despite the overall significant treatment effect, the treatment was not successful for all participants. CART results (using participants from the current study and a previous iteration of VAULT) provided a dual-node decision tree for classifying treatment responders versus nonresponders. Conclusions The input-based VAULT treatment protocol is efficacious and offers some flexibility in terms of utterance length. When VAULT works, it works well. The CART decision tree uses pretreatment vocabulary levels and performance in the first two treatment sessions to provide clinicians with promising guidelines for who is likely to be a nonresponder and thus might need a modified treatment plan. Supplemental Material https://doi.org/10.23641/asha.14226641.

Efficacy of the Treatment of Developmental Language Disorder: A Systematic Review

Background. Language disorder is the most frequent developmental disorder in childhood and it has a significant negative impact on children’s development. The goal of the present review was to systematically analyze the effectiveness of interventions in children with developmental language disorder (DLD) from an evidence-based perspective. Methods. We considered systematic reviews, meta-analyses of randomized controlled trials (RCTs), control group cohort studies on any type of intervention aimed at improving children’s skills in the phono-articulatory, phonological, semantic-lexical, and morpho-syntactic fields in preschool and primary school children (up to eight years of age) that were diagnosed with DLD. We identified 27 full-length studies, 26 RCT and one review. Results. Early intensive intervention in three- and four-year-old children has a positive effect on phonological expressive and receptive skills and acquisitions are maintained in the medium term. Less evidence is available on the treatment of expressive vocabulary (and no evidence on receptive vocabulary). Intervention on morphological and syntactic skills has effective results on expressive (but not receptive) skills; however, a number of inconsistent results have also been reported. Only one study reports a positive effect of treatment on inferential narrative skills. Limited evidence is also available on the treatment of meta-phonological skills. More studies investigated the effectiveness of interventions on general language skills, which now appears as a promising area of investigation, even though results are not all consistent. Conclusions. The effectiveness of interventions over expressive and receptive phonological skills, morpho-syntactic skills, as well as inferential skills in narrative context underscores the importance that these trainings be implemented in children with DLD.

A comparison of the performance of Persian speaking children who do and do not stutter on three nonwords repetition tasks

PURPOSE

The purpose of the study was to examine the performance of Persian speaking children who stutter (CWS) and children who do not stutter (CWNS) on three nonword repetition tasks, while also focusing on which task and scoring method best differentiates the two groups of children.

METHOD

Thirty CWS and 30 CWNS between the ages of 5;0 to 6;6 completed three nonword repetition tasks that varied in complexity. Each task was scored using two methods: nonwords correct and phonemes correct. Between-group differences in performance on each task were examined, along with disfluencies for CWS and the task and scoring method that best differentiated the CWS and CWNS.

RESULTS

The findings revealed that, across all three nonword repetition tasks, the CWS consistently produced fewer nonwords correct and phonemes correct than the CWNS group at virtually all syllable lengths. The CWS produced more disfluencies on longer nonwords than shorter nonwords in all three nonword repetition tasks. The nonword repetition task with lower wordlikeness and more phonologically complex items best differentiated the two groups of children. Findings further revealed that discriminative accuracy was highest for scoring based on the number of phonemes produced correctly.

CONCLUSION

Findings provide further evidence to suggest that CWS may have difficulty with phonological working memory and/or phonological processing.

Word learning and verbal working memory in children with developmental language disorder

BACKGROUND AND AIMS

Previous research into word learning in children with developmental language disorder (DLD) indicates that the learning of word forms and meanings, rather than form-referent links, is problematic. This difficulty appears to arise with impaired encoding, while retention of word knowledge remains intact. Evidence also suggests that word learning skills may be related to verbal working memory. We aimed to substantiate these findings in the current study by exploring word learning over a series of days.

METHODS

Fifty children with DLD (mean age 6; 11, 72% male) and 54 age-matched typically developing (TD) children (mean age 6; 10, 56% male) were taught eight novel words across a four-day word learning protocol. Day 1 measured encoding, Days 2 and 3 measured re-encoding, and Day 4 assessed retention. At each day, word learning success was evaluated using Naming, Recognition, Description, and Identification tasks.

RESULTS

Children with DLD showed comparable performance to the TD group on the Identification task, indicating an intact ability to learn the form-referent links. In contrast, children with DLD performed significantly worse for Naming and Recognition (signifying an impaired ability to learn novel word forms), and for Description, indicating problems establishing new word meanings. These deficits for the DLD group were apparent at Days 1, 2, and 3 of testing, indicating impairments with initial encoding and re-encoding; however, the DLD and TD groups demonstrated a similar rate of learning. All children found the retention assessments at Day 4 difficult, and there were no significant group differences. Finally, verbal working memory emerged as a significant moderator of performance on the Naming and Recognition tasks, such that children with DLD and poor verbal working memory had the lowest levels of accuracy.

CONCLUSIONS

This study demonstrates that children with DLD struggle with learning novel word forms and meanings, but are unimpaired in their ability to establish new form-referent links. The findings suggest that the word learning deficit may be attributed to problems with encoding, rather than with retention, of new word knowledge; however, further exploration is required given the poor performance of both groups for retention testing. Furthermore, we found evidence that an impaired ability to learn word forms may only be apparent in children who have DLD and low levels of verbal working memory.

IMPLICATIONS

When working with children with DLD, speech-language pathologists should assess word learning using tasks that evaluate the ability to learn word forms, meanings, and form-referent links to develop a profile of individual word learning strengths and weaknesses. Clinicians should also assess verbal working memory to identify children at particular risk of word learning deficits. Future research should explore the notion of optimal intervention intensity for facilitating word learning in children with poor language and verbal working memory.

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.

Working, Declarative, and Procedural Memory in Children With Developmental Language Disorder

Purpose Previous research into the working, declarative, and procedural memory systems in children with developmental language disorder (DLD) has yielded inconsistent results. The purpose of this research was to profile these memory systems in children with DLD and their typically developing peers. Method One hundred four 5- to 8-year-old children participated in the study. Fifty had DLD, and 54 were typically developing. Aspects of the working memory system (verbal short-term memory, verbal working memory, and visual-spatial short-term memory) were assessed using a nonword repetition test and subtests from the Working Memory Test Battery for Children. Verbal and visual-spatial declarative memory were measured using the Children's Memory Scale, and an audiovisual serial reaction time task was used to evaluate procedural memory. Results The children with DLD demonstrated significant impairments in verbal short-term and working memory, visual-spatial short-term memory, verbal declarative memory, and procedural memory. However, verbal declarative memory and procedural memory were no longer impaired after controlling for working memory and nonverbal IQ. Declarative memory for visual-spatial information was unimpaired. Conclusions These findings indicate that children with DLD have deficits in the working memory system. While verbal declarative memory and procedural memory also appear to be impaired, these deficits could largely be accounted for by working memory skills. The results have implications for our understanding of the cognitive processes underlying language impairment in the DLD population; however, further investigation of the relationships between the memory systems is required using tasks that measure learning over long-term intervals. Supplemental Material https://doi.org/10.23641/asha.13250180.

The Effects of Phonological Short Term Memory on Lexical and Grammatical Production Skills in Persian Children with Developmental Language Disorder

The deficit in verbal working memory (vWM) skills has been frequently reported in children with developmental language disorder (DLD) and may contribute to their problems in language. This study aimed to compare the phonological short-term memory (pSTM) and linguistic skills between Persian-speaking children with DLD and typical language development (TLD) to explore the role that pSTM plays in lexical and grammatical problems of children with DLD. This study included 32 Persian-speaking children who were divided into two groups of DLD (n = 16) and TLD (n = 16) within the age range from 6 to 8 years. The Persian non-word repetition test was employed as the measure of pSTM. Lexical and grammatical indices were extracted from narrative generations. Independent-samples t test was used to analyze the group-related differences in vWM, lexical, and grammatical skills. Moreover, the one-way ANCOVA analysis by controlling for NWR was utilized as the covariate to investigate the effects of vWM on linguistic performances. According to the results, the children with DLD scored significantly lower on NWR task and all lexical and grammatical measures, compared to TLD children (P < 0.01, d > 1). The group-related differences disappeared after controlling for NWR (P > 0.05). The results show that Persian-speaking children with DLD experience significant difficulties in pSTM skills, which affect their lexical and grammatical performances.

Inhibitory Control of Lexical Selection in Adults who Stutter

PURPOSE

Based on previous evidence that lexical selection may operate differently in adults who stutter (AWS) versus typically-fluent adults (TFA), and that atypical attentional processing may be a contributing factor, the purpose of this study was to investigate inhibitory control of lexical selection in AWS.

METHOD

12 AWS and 12 TFA completed two tasks. One was a picture naming task featuring High and Low Agreement object naming. Naming accuracy and reaction times (RT), and event-related potentials (ERPs) time-locked to picture onset, were recorded. Second was a flanker task featuring Congruent and Incongruent arrow arrays. Push-button accuracy and RTs, and ERPs time-locked to arrow array onset, were recorded.

RESULTS

Low Agreement pictures were named less accurately and slower than High Agreement pictures in both Groups. The magnitude of the Agreement effect on naming RTs was larger in AWS versus TFA. Delta-plot analysis revealed that the Agreement effect was positively correlated with individual differences in inhibition in TFA but not in AWS. Moreover, Low Agreement pictures elicited negative-going ERP activity relative to High Agreement pictures in both Groups. However, the scalp topography of this effect was markedly reduced in AWS versus TFA. For the Flanker task, Congruency affected push-button accuracy and RTs, and N2 amplitudes, similarly between groups.

CONCLUSIONS

Results point to a selective deficit in inhibitory control of lexical selection in AWS. Potential pathways between diminished inhibitory control of lexical selection, speech motor control and stuttering are discussed.

Do Children With Developmental Language Disorder (DLD) Have Difficulties With Interference Control, Visuospatial Working Memory, and Selective Attention? Developmental Patterns and the Role of Severity and Persistence of DLD

Purpose Many children with developmental language disorder (DLD) have weaknesses in executive functioning (EF), specifically in tasks testing interference control and working memory. It is unknown how EF develops in children with DLD, if EF abilities are related to DLD severity and persistence, and if EF weaknesses expand to selective attention. This study aimed to address these gaps. Method Data from 78 children with DLD and 39 typically developing (TD) children were collected at three times with 1-year intervals. At Time 1, the children were 5 or 6 years old. Flanker, Dot Matrix, and Sky Search tasks tested interference control, visuospatial working memory, and selective attention, respectively. DLD severity was based on children's language ability. DLD persistence was based on stability of the DLD diagnosis. Results Performance on all tasks improved in both groups. TD children outperformed children with DLD on interference control. No differences were found for visuospatial working memory and selective attention. An interference control gap between the DLD and TD groups emerged between Time 1 and Time 2. Severity and persistence of DLD were related to interference control and working memory; the impact on working memory was stronger. Selective attention was unrelated to DLD severity and persistence. Conclusions Age and DLD severity and persistence determine whether or not children with DLD show EF weaknesses. Interference control is most clearly impaired in children with DLD who are 6 years and older. Visuospatial working memory is impaired in children with severe and persistent DLD. Selective attention is spared.

Working Memory and Linguistic Performance of Dual Language Learners With and Without Developmental Language Disorders

Purpose This research note describes the use of working memory measures as potential indicators of developmental language disorders (DLD) in preschool-age dual language learners from Spanish-speaking backgrounds. This report is an extension of early work, completed by the same authors that described the diagnostic accuracy of a Spanish nonword repetition task. Method One hundred thirty Spanish-speaking families with preschool-age children participated; 37 children had DLD, and 93 were typically developing. Families were recruited from early childhood programs in three states in the western region of the United States. Working memory and linguistic measures were collected from the children; parents completed a vocabulary checklist and reported on their child's longest utterances. Results Nonverbal working memory was not associated with other measures, but verbal working memory was associated with linguistic measures. Although there were no group differences on nonverbal working memory, group differences (DLD vs. typical development) were detected on verbal working memory and linguistic measures. Verbal working memory combined with vocabulary scores resulted in 79% of cases correctly classified. Conclusions Working memory tasks yielded different results depending on the type of task (verbal vs. nonverbal). Outcomes from this study showed that a nonverbal working memory task (hand movement) was not useful in distinguishing preschool-age dual language children with DLD from typical peers, but a verbal working memory task (nonword repetition) may be useful if combined with other more robust linguistic measures.

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.

Do preschoolers born premature perform properly on lexical and verbal short-term memory abilities?

PURPOSE

To investigate lexical performance and verbal short-term memory ability in premature infants at preschool age and compare the results with their full-term peers.

METHODS

Forty preschool children aged between 4 and 5 years and 11 months participated on the study and were equally divided into two groups considering their gestational age: preterm and full-term. Groups did not differ on age, family income and maternal education. Participants were paired according to their chronological age and their socioeconomic status. Their performance was assessed using expressive vocabulary and verbal short-term memory tests. Inferential statistical analysis was performed using the Mann-Whitney and the Fisher exact test.

RESULTS

Group performance did not differ on vocabulary, but premature children showed an inferior performance on nonword repetition tasks.

CONCLUSION

These data indicates that preschoolers born premature performed statistically lower than their peers born full-term on nonword repetition task. Thus, premature birth was associated to vocabulary development on typically developing range, but also to verbal short-term memory impairments.

The Relationship between Phonological Processing and Emergent Literacy Skills in Arabic-Speaking Kindergarten Children

INTRODUCTION

Children with weak emergent literacy skills are at risk for later reading problems. The majority of research on the relationship between phonological processing and emergent literacy has been conducted on children who speak English and European languages. The aim of the current study was to address the relationship between phonological processing and emergent literacy skills in Arabic-speaking Egyptian children.

METHODS

A cross-sectional correlational study was conducted on a sample of 50 typically developing kindergarten children in the age range from 4 years 6 months to 6 years 5 months. Children were subjected to assessment of both phonological processing and emergent literacy using a specially constructed test battery in Arabic.

RESULTS

A highly significant positive correlation was found between total scores of phonological processing and of emergent literacy tests. Both isolating final phonemes and rapid naming were the best predictors of emergent literacy.

CONCLUSIONS

Phonological processing skills are important prerequisites for the development of emergent literacy skills in Arabic-speaking children. The designed test battery proved to be both valid and reliable and can be used as a screening tool for the identification of children at risk of later reading problems.

Syntax and working memory in typically-developing children

A growing trend in developmental psycholinguistics is to relate linguistic development to the development of other cognitive systems. Jakubowicz (2005, 2011) in particular argued that the processing of a complex sentence requires considerable working memory (WM) resources and that these resources are limited in young children, which would explain their non-adult grammar. The present research aims to clarify the relationship between WM and complex syntax, in comprehension, repetition, and spontaneous production, in 48 typically-developing children aged 5 to 12. Our results demonstrate a strong age effect for all measures of WM and syntax. They also reveal strong correlations between scores on simple and complex spans and syntactic performance. Finally, we show the highly predictive value of WM capacities on the acquisition of syntactic skills in both comprehension and production. In particular, the complex-span task, measuring counting span, explains the largest part of the variance in the spontaneous production of embedded clauses.

Spoken Word Learning Differences Among Children With Dyslexia, Concomitant Dyslexia and Developmental Language Disorder, and Typical Development

Purpose The purpose of our study was to test the hypotheses (a) that children with dyslexia have spoken word learning deficits primarily related to phonology and (b) that children with dyslexia and concomitant developmental language disorder (DLD) have word learning deficits related to both phonology and semantic processing when compared to peers with typical development (TD). Method Second-graders with dyslexia (n = 82), concomitant dyslexia and DLD (dyslexia + DLD; n = 40), and TD (n = 167) learned names and semantic features for cartoon monsters in 5 carefully controlled word learning tasks that varied phonological and semantic demands. The computer-based tasks were played in 6 different word learning games. We analyzed results using Bayesian statistics. Results In general, the dyslexia + DLD group showed lower accuracy on tasks compared to the dyslexia and TD groups. As predicted, word learning tasks that taxed phonology revealed deficits in the dyslexia group, although there were some exceptions related to visual complexity. Word learning deficits in the dyslexia + DLD group were present in tasks that taxed phonology, semantic processing, or both. Conclusions The dyslexia + DLD group demonstrated word learning deficits across the range of word learning tasks that tapped phonology and semantic processing, whereas the dyslexia group primarily struggled with the phonological aspects of word learning. Supplemental Material https://doi.org/10.23641/asha.9807929.

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.

Including Nonlinguistic Processing Tasks in the Identification of Developmental Language Disorder

Purpose Accurate identification of developmental language disorder (DLD) remains challenging, particularly for children who speak different dialects, languages, or more than 1 language. Children with DLD, on average, have shown subtle deficits on nonlinguistic cognitive processing tasks, and performance on such tasks may be minimally influenced by language experience. This study explores whether nonlinguistic cognitive processing tasks can contribute to the identification of DLD in children from diverse linguistic backgrounds. Method Study 1 combined data from 4 U.S.-based investigations to yield a sample of 395 children, ages 6-10 years, who spoke only English or both Spanish and English. Study 2 consisted of an international sample of 55 kindergarten children living in Vietnam. Each study included children with DLD and children with typical development. Participants completed nonlinguistic cognitive tasks of processing speed, auditory working memory, and attentional control. Data analysis compared typically developing to DLD groups by age and language background. Then, we empirically derived cut-points to report diagnostic accuracy (sensitivity, specificity, and positive and negative likelihood ratios). Results For all 3 tasks, adequate sensitivity or specificity (but not both in most cases) was achieved in nearly all age groups. Likelihood ratios reached moderately to very informative levels in several instances. Diagnostic results were maintained when monolingual and bilingual samples were combined into a single group. Conclusions Nonlinguistic cognitive processing tasks may contribute to accurate identification of DLD in combination with other measures. Further research is needed to refine tasks, confirm cut-points established here, and extend findings to children from additional language backgrounds.

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.

Left hemisphere enhancement of auditory activation in language impaired children

Specific language impairment (SLI) is a developmental disorder linked to deficient auditory processing. In this magnetoencephalography (MEG) study we investigated a specific prolonged auditory response (N250m) that has been reported predominantly in children and is associated with level of language skills. We recorded auditory responses evoked by sine-wave tones presented alternately to the right and left ear of 9-10-year-old children with SLI (n = 10) and children with typical language development (n = 10). Source analysis was used to isolate the N250m response in the left and right hemisphere. In children with language impairment left-hemisphere N250m responses were enhanced compared to those of controls, while no group difference was found in the right hemisphere. Consequently, language impaired children lacked the typical right-ward asymmetry that was found in control children. Furthermore, left but not right hemisphere N250m responses correlated positively with performance on a phonological processing task in the SLI group exclusively, possibly signifying a compensatory mechanism for delayed maturation of language processing. These results suggest that enhanced left-hemisphere auditory activation reflects a core neurophysiological manifestation of developmental language disorders, and emphasize the relevance of this developmentally specific activation pattern for competent language development.

Fast mapping short and long words: Examining the influence of phonological short-term memory and receptive vocabulary in children with developmental language disorder

PURPOSE

To investigate factors that influence word learning in children with developmental language disorder (DLD).

METHOD

The participants were 23 children with DLD and 26 typically developing (TD) children, aged five. Participants completed a fast mapping task (assessed using a production measure), as well as tests of nonword repetition and receptive vocabulary. We explored the effect of word length on nonword repetition and fast mapping abilities while controlling for receptive vocabulary skills.

RESULTS

The results indicate that children with DLD demonstrate significant difficulties accurately repeating nonwords of all lengths relative to their TD peers. Children with DLD also exhibited significant difficulties with fast mapping, especially when learning longer novel words.

CONCLUSIONS

Our findings indicate that children with DLD demonstrate an impaired capacity to encode phonological information; however, this differentially impacts their nonword repetition and fast mapping abilities. TD children may more effectively take advantage of receptive vocabulary to support performance on these tasks.

LEARNING OUTCOMES

Readers will understand how phonological short-term memory and receptive vocabulary contribute to fast mapping in children with DLD and in TD children.

Effects of the Narrative Intervention Program for Preschool Portuguese Children

OBJECTIVE

This article analyzes the contribution of a narrative intervention program in linguistic performance (measured by the percentage of correct consonants [PCC], mean length of utterance [MLU], and auditory memory [AM]) of children.

PATIENTS AND METHODS

A group of 14 children with primary language impairments participated in this study. The children were divided into two groups (seven children in each): the narrative intervention group (experimental group) and the control group. All children were treated by the same speech-language therapist. The narrative intervention program consisted of eight weekly group sessions. Outcome measures of PCC, MLU, and AM (of pseudowords, words, sentences, and orders) were taken before and after intervention. A qualitative assessment of the intervention effects from the perspective of the children's parents was also included.

RESULTS

The results suggest improvements in PCC and MLU but no support for intervention effectiveness on these measures. In AM, the results indicate a significant intervention effect on words and orders. Parents reported intervention to be favorable/very favorable.

CONCLUSION

The narrative intervention program was effective in enhancing children's AM. However, further investigation is required to provide clinical evidence for speech and language therapists to employ this program for children with primary language impairments.

Measuring working memory capacity in children using adaptive tasks: Example validation of an adaptive complex span

Working memory tasks designed for children usually present trials in order of ascending difficulty, with testing discontinued when the child fails a particular level. Unfortunately, this procedure comes with a number of issues, such as decreased engagement from high-ability children, vulnerability of the scores to temporary mind-wandering, and large between-subjects variations in number of trials, testing time, and proactive interference. To circumvent these problems, the goal of the present study was to demonstrate the feasibility of assessing working memory using an adaptive testing procedure. The principle of adaptive testing is to dynamically adjust the level of difficulty as the task progresses to match the participant's ability. We used this method to develop an adaptive complex span task (the ACCES) comprising verbal and visuo-spatial subtests. The task presents a fixed number of trials to all participants, allows for partial credit scoring, and can be used with children regardless of ability level. The ACCES demonstrated satisfying psychometric properties in a sample of 268 children aged 8-13 years, confirming the feasibility of using adaptive tasks to measure working memory capacity in children. A free-to-use implementation of the ACCES is provided.

Behind the Scenes of Developmental Language Disorder: Time to Call Neuropsychology Back on Stage

Although the Developmental Language Disorder (DLD), also known as Specific Language Impairment in children has been the focus of unceasing scientific attention for decades, the nature and mechanisms of this disorder remain unclear. Most importantly, we still cannot reliably identify children requiring urgent intervention among other ‘late talkers’ at an early age and understand the high prevalence of comorbidity with psychiatric phenomena such as Autism Spectrum Disorder. One of the main reasons for this is the traditional ‘diagnosis-by-exclusion,’ resulting in heterogeneity of the DLD population. This paper proposes an alternative approach to the diagnosis, treatment and research of DLD, claiming that it is these children’s multiple deficits in neuropsychological development, which impede the spontaneous acquisition of their first language. Specifically, this review of the state-of-the-art in DLD research demonstrates deep and systematic interconnections between the speech and other higher cognitive functions developing in early childhood, including perception, attention and executive functions. In the proposed framework, speech is, therefore, considered as one of neuropsychological abilities, and the delay in its development is explained by other neuropsychological deficits, resulting in highly individual clinical profiles. By considering DLD as a complex neuropsychological syndrome, whose successful treatment depends on a holistic approach to diagnosis and intervention, we may significantly increase the efficacy of speech therapy, and also better understand the flexibility of the developing brain, its compensatory mechanisms and hence the comorbidity of DLD with psychiatric symptoms. Implications for using this paradigm in future scientific research are discussed.

Reconceptualizing developmental language disorder as a spectrum disorder: issues and evidence

BACKGROUND

There is considerable variability in the presentation of developmental language disorder (DLD). Disagreement amongst professionals about how to characterize and interpret the variability complicates both the research on understanding the nature of DLD and the best clinical framework for diagnosing and treating children with DLD. We describe and statistically examine three primary possible models for characterizing the variability in presentation in DLD: predictable subtypes; individual differences; and continuum/spectrum.

AIMS

To test these three models of DLD in a population-based sample using two distinct types of cluster analyses.

METHODS & PROCEDURES

This study included children with DLD (n = 505) from the US Epidemiological Study of Language Impairment database. All available language and cognitive measures were included. Two cluster methods were used: Ward's method and K-means. Optimal cluster sizes were selected using Bayesian information criteria (BIC). Bootstrapping and permutation methods were used to evaluate randomness of clustering.

OUTCOMES & RESULTS

Both clustering analyses yielded more than 10 clusters, and the clusters did not have spatial distinction: many of these clusters were not clinically interpretable. However, tests of random clustering revealed that the cluster solutions obtained did not arise from random aggregation.

CONCLUSIONS & IMPLICATIONS

Non-random clustering coupled with a large number of non-interpretable subtypes provides empirical support for the continuum/spectrum and individual differences models. Although there was substantial support for the continuum/spectrum model and weaker support for the individual differences model, additional research testing these models should be completed. Based on these results, clinicians working with children with DLD should focus on creating treatment plans that address the severity of functioning rather than seeking to identify and treat distinct subtypes. Additional consideration should be given to reconceptualizing DLD as a spectrum condition.

Mathematical thinking in children with developmental language disorder: The roles of pattern skills and verbal working memory

Previous research suggests that children with language disorders often have difficulties in mathematical tasks. In the current study, we investigated two relevant factors - working memory and pattern skills - that may underlie children's poor mathematics performance. Children with developmental language disorder (DLD, n = 18, ages 6-13) and age-matched typically-developing children (n = 18) completed three math tasks that tapped calculation skill and knowledge of concepts. Children also completed a visual pattern extension task and a verbal working memory task. There were four key findings: (1) children with DLD exhibited poorer mathematical knowledge than typically-developing children, both in calculation and on key math concepts, (2) children with DLD performed similarly to typically-developing children on the visual pattern extension task, (3) children with DLD had lower verbal working memory scores than typically-developing children, and these differences in working memory accounted in part for their poorer calculation performance, and (4) children's pattern extension scores predicted their arithmetic calculation scores, but not their concept scores.

Parent-rating vs performance-based working memory measures: Association with spoken language measures in school-age children

Working memory (WM) assessment is often part of cognitive-linguistic test batteries. The author examined the relationship between parent rating of WM functioning and children's performance-based WM, and the relationship of each with receptive and expressive spoken language measures. Study participants were eighty-three 7- to 11-year-old children. The sample represented a broad range of cognitive abilities. No participating child had frank neurological or intellectual disabilities, autism, fluency disorder, or hearing loss. Parents completed a standardized executive function rating scale that included a WM subscale. Children completed a standardized WM task and an experimental WM task. Children also completed six standardized language measures. Results showed that there was no correlation between parent rating and either of the performance-based WM tasks as well as the composite WM performance score. Parent rating of WM functioning was not related to any of the language scores whereas the composite WM performance score showed significant links with language abilities. Although parent rating and performance-based WM measures are designed to reflect the same cognitive construct, they are not correlated. Potential reasons for the findings and implications of using parent-rating and performance-based WM measures in school-age children are discussed.