The language use inventory for young children: a parent-report measure of pragmatic language development for 18- to 47-month-old children

Exploratory Factor Analysis of the Social Communication Disorder Screener

Currently, there are no existing measures to screen for or diagnose Social (Pragmatic) Communication Disorder (SPCD). We conducted an exploratory factor analysis (EFA) of the Social Communication Disorder Screener (SCDS), a 14-item, parent-report measure based on the DSM-5 diagnostic criteria for SPCD. This EFA examined the internal consistency and factor structure of the SCDS for a sample of 500 parents of children, ages 5-18 years, representative of the U.S. census. Results yielded a correlated three-factor solution with good internal consistency reliability. Findings supported the presence of three subscale as well as the derivation of a total composite score reflecting overall verbal and non-verbal communication and limitations across contexts. Clinical and research implications are discussed.

Social Communication Delay in an Unbiased Sample of Preschoolers With the FMR1 Premutation

PURPOSE

The Fragile X Messenger Ribonucleoprotein-1 (FMR1) premutation (FXpm) is a genetic variant that is common in the general population and is associated with health symptoms and disease in adulthood. However, poor understanding of the clinical phenotype during childhood has hindered the development of clinical practice guidelines for screening and intervention. Given that social communication difficulties have been widely documented in adults with the FXpm and are linked with reduced psychosocial functioning, the present study aimed to characterize the communication profile of the FXpm during early childhood.

METHOD

Eighteen children with the FXpm who were identified through cascade testing (89%) or screening at birth (11%) were compared to 21 matched typically developing children, aged 2-4 years. Participants completed standardized assessments of language (Mullen Scales of Early Learning) and adaptive communication (Vineland Adaptive Behavior Scales-II). Social communication was rated from seminaturalistic interaction samples using the Brief Observation of Social Communication Change.

RESULTS

Children with the FXpm showed delayed social communication development, with the magnitude of group differences highlighting social communication as a feature that distinguishes children with the FXpm from their peers (p = .046, ηp2 = .12). The groups did not differ on the standardized language and adaptive communication measures (ps > .297, ηp2s < .03).

CONCLUSIONS

Early screening and treatment of social communication delays may be key to optimizing outcomes for children with the FXpm. Further research is needed to replicate findings in a larger sample, delineate the trajectory and consequences of social communication difficulties across the life span in the FXpm, and determine the potential epidemiological significance of FMR1 as a mediator of developmental communication differences within the general population.

Utility of the Language Use Inventory in Young Children at Elevated Likelihood of Autism

PURPOSE

The aims of this study were (a) to evaluate the convergent validity of the Language Use Inventory (LUI) with measures of autism spectrum disorder (ASD) symptoms, language, and social skills and (b) to assess discriminant validity of the LUI with measures of nonlanguage skills, including daily living skills and motor development.

METHOD

This study sample included participants from a longitudinal study (n = 239) of infant siblings with elevated familial likelihood of ASD and lower familial likelihood. Assessment measures completed at 36 months included the LUI, the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), the Mullen Scales of Early Learning, and the Vineland Adaptive Behavior Scales-Second Edition. Bivariate Pearson correlations were estimated between ADOS-2 comparison scores and four language and social skills measures. Additional correlations were estimated between LUI total scores and standard scores from nonlanguage measures. A series of Fisher's Z transformations were applied to evaluate whether bivariate correlations were significantly different.

RESULTS

All four language and social skill measures were moderately to strongly associated with each other and ASD symptom severity scores. The correlation between ADOS-2 comparison scores and LUI total scores was significantly stronger than ADOS-2 correlations with all other measures.

CONCLUSIONS

Our findings provide support for the LUI as a feasible, pragmatic language-targeted instrument for inclusion in early developmental evaluations prompted by language concerns. Administration of the LUI may accelerate earlier referral for a comprehensive assessment of ASD symptoms. Given the high correlation with ADOS-2 scores, an LUI total score in a clinical range of concern may encourage a clinician to refer families for a full diagnostic evaluation of ASD.

Evidence-Based Assessment of Developmental Disorders

Developmental disorders are diverse, common, and impairing; still, many clinicians lack comprehensive training in their assessment. This review presents thorough guidelines for the evaluation and diagnosis of common communication, sleeping, feeding, and elimination disorders that often onset in the early developmental period and that are commonly encountered in clinical practice. Thorough guidance on the evidence-based assessment of developmental disorders is critical, as they are prevalent, impairing, and commonly comorbid with other psychiatric disorders of childhood. This review is the first of its kind-providing critically needed, step-by-step guidance on the existing evidence-based methodologies and assessment tools available for diagnosis. This review also makes clear the dire need for further development and validation of relevant screening and diagnostic measure and calls for specific attention to the development of specific screening and diagnostic assessment measures for feeding disorders and elimination disorders in particular. Clinicians and researchers alike may find this article useful in guiding diagnostic, treatment, and research procedures.

Oral language skills and mental health in female prisoners: pragmatic skills are essential

Introduction

There are strong indications of an elevated incidence of both language problems and problems with mental health among prisoners. We also know that women in prison are a particularly vulnerable group who often face conditions that foremost accommodate the needs of men. In order to adapt prison conditions to women's needs and give better help, we need more information about their characteristics. In this study, we wanted to explore associations between oral language problems and mental health (depression and anxiety) in women in prison.

Method

Participants were 58 women, recruited from high and low security women's and mixed prisons. They completed a questionnaire covering demographic variables and several self-report measures. In the present study, the language measures were a Language Composite score (comprising articulation, impressive and expressive language, and pragmatics) and the La Trobe Communication Questionnaire (LCQ), measuring pragmatic skills specifically. Hopkins Symptom Checklist-10 (HSCL) was used as a measure of psychological distress. First, we assessed correlations between the language measures and mental health. Second, we performed group comparisons with groups defined as over or under cut-off on the Language Composite, LCQ total, and HSCL total scores.

Results

Results supported a clear connection between overall language and overall mental health. Pragmatic skills were the main driver of this effect. There was no difference in mental health between those scoring above and below cut-off for general language problems but the group with possible pragmatic impairment showed poorer mental health than those without. Conversely, there was no difference in general language skills between the groups scoring within and outside the range of psychological distress, but the first group evaluated their pragmatic skills as significantly poorer than the latter.

Discussion

We conclude that pragmatics seem to be core to the association between oral language skills and mental health among female prisoners. This should have implications for language services in prisons, as attending to these issues could positively affect prognosis and outcome.

Parental reports on language development in toddlers and preschoolers based on the Croatian version of Communicative Development Inventories III

Introduction

Previous studies have focused on understanding parental attempts to record language development in children, across many typologically different languages. However, many of these studies restricted their assessment to children up to the age of 3 years. The aim of this paper was to move this boundary by examining language development in typically language developed children older than 3 years.

Methods

Using the Croatian version of the Communicative Development Inventories III (CDI-III-HR), we investigated the contribution of parental reports of a child's lexical, grammatical, and metalinguistic awareness abilities to general language abilities assessed by clinicians. Participants included the parents of 151 children between the ages of 30 to 48 months, who completed the CDI-III-HR and reported on their child's language abilities.

Results

Our results show that age is significantly associated with the lexical, grammatical, and metalinguistic awareness abilities of a child's language development. These findings confirm that all three abilities increase with age and that parents can perceive changes in a child's language development. The subsections of CDI-III-HR were moderately to strongly associated with each other, with the strongest association being between lexicon and grammar, suggesting that they remain closely related after the age of 30 months. Parental assessments of a child's language development are a better predictor of language production than language comprehension, with grammar making the most consistent and significant contribution.

Discussion

This study confirms that the development of grammatical abilities is the most prominent skill between the ages of 30 to 48 months and that parents can observe the transition in the child's language development through their usage of grammar in words to grammar in sentences. Based on the selected sample of children, we discovered different patterns of parental success in assessing the child's language ability. These findings indicate that parents can act as valuable sources of information regarding the child's language abilities, but clinical assessments of early language development should consider many other formal sources of information in addition to parental reports.

Assessing pragmatics in early childhood with the Language Use Inventory across seven languages

The Language Use Inventory (LUI) is a parent-report measure of the pragmatic functions of young children's language, standardized and norm-referenced in English (Canada) for children aged 18-47 months. The unique focus of the LUI, along with its appeal to parents, reliability and validity, and usefulness in both research and clinical contexts has prompted research teams globally to translate and adapt it to other languages. In this review, we describe the original LUI's key features and report on processes used by seven different research teams to translate and adapt it to Arabic, French, Italian, Mandarin, Norwegian, Polish, and Portuguese. We also review data from the studies of the seven translated versions, which indicate that all the LUI versions were reliable and sensitive to developmental changes. The review demonstrates that the LUI, informed by a social-cognitive and functional approach to language development, captures growth in children's language use across a range of linguistic and cultural contexts, and as such, can serve as a valuable tool for clinical and research purposes.

Narrative Abilities at Age 3 Are Associated Positively With Gesture Accuracy but Negatively With Gesture Rate

PURPOSE

Though the frequency of gesture use by infants has been related to the development of different language abilities in the initial stages of language acquisition, less is known about whether this frequency (or "gesture rate") continues to correlate with language measures in later stages of language acquisition, or whether the relation to language skills also depends on the accuracy with which such gestures are produced (or reproduced). This study sets out to explore whether preschoolers' narrative abilities are related to these two variables, namely, gesture rate and gesture accuracy.

METHOD

A total of 31 typically developing 3- to 4-year-old children participated in a multimodal imitation task, a context-based gesture elicitation task, and a narrative retelling task.

RESULTS

Results showed that there was a significant positive correlation between the children's narrative scores and their gesture accuracy scores, whereas higher rates of gesture use did not correlate with higher levels of narrative skill. Further multimodal regression analysis confirmed that gesture accuracy was a positive predictor of narrative performance, and moreover, showed that gesture rate was a negative predictor.

CONCLUSIONS

The fact that both gesture accuracy and gesture rate are strongly and differently linked to oral language abilities supports the claim that language and gesture are highly complex systems, and that complementary measures of gesture performance can help us assess with greater granularity the relationship between gesture and language development. These findings highlight the need to use gesture during clinical assessments as an informative indicator of language development and suggest that future research should further investigate the value of multimodal programs in the treatment of language and communication disorders.

Prevalence and functional impact of social (pragmatic) communication disorders

BACKGROUND

The aim of this study was to evaluate the Children's Communication Checklist-2 (CCC-2) for measuring social-pragmatic communication deficits and to ascertain their prevalence and functional impact in a community sample.

METHODS

We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for social (pragmatic) communication disorder (SPCD). We tested the prevalence of social-pragmatic deficits in a population-based sample of children (n = 386) aged 5-6 years old using CCC-2 algorithms. We also investigated the academic and behavioural profiles of children with broadly defined limitations in social-pragmatic competence on the CCC-2.

RESULTS

Regardless of the diagnostic algorithm used, the resulting prevalence rates for social-pragmatic deficits indicated that very few children had isolated social-communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this profile was associated with a range of adverse academic and behavioural outcomes.

CONCLUSIONS

A considerable proportion of children in the early years of primary school has social-pragmatic deficits that interfere with behaviour and scholastic activity; however, these rarely occur in isolation. Exclusionary criteria that include structural language may lead to underidentification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.

Exploring communicative competence in autistic children who are minimally verbal: The Low Verbal Investigatory Survey for Autism (LVIS)

LAY ABSTRACT

Approximately one in three autistic children is unable to communicate with language; this state is often described as minimally verbal. Despite the tremendous clinical implications, we cannot predict whether a minimally verbal child is simply delayed (but will eventually develop spoken language) or will continue to struggle with verbal language, and might therefore benefit from learning an alternative form of communication. This is important for clinicians to know, to be able to choose the most helpful interventions, such as alternative forms of communication. In addition, the field lacks a standard definition of "minimally verbal." Even when we do agree on what the term means (e.g. fewer than 20 words), describing a child based on their lack of words does not tell us whether that child is communicating in other ways or how they are using those 20 words. To address these concerns, we developed the Low Verbal Investigatory Survey (LVIS), a one-page parent-report measure designed to help us characterize how minimally verbal autistic children are communicating. Parents of 147 children (aged 1-8 years) completed the LVIS. Here, we ask (1) whether the survey measures what it was designed to measure, that is, communicative ability in children without much spoken language, and (2) how the LVIS relates to cognitive and language ability, and symptoms of autism. Results suggest that this survey, which takes only 5 min to complete, is a good estimate of the child's communication skills. Furthermore, LVIS survey scores are correlated with other measures of language and cognitive abilities as well as autism symptomatology. The LVIS has the potential to save time and money in both clinical and research efforts to assess communication skills in minimally verbal autistic children.

Pragmatic Language Development: Analysis of Mapping Knowledge Domains on How Infants and Children Become Pragmatically Competent

New-borns are capable of recognising and producing sounds as they become phonologically competent. Following this, infants develop a system for connecting these sounds, which helps them become increasingly lexically competent over time. Their knowledge of these words grows as they develop, using words to form phrases, turning them into sentences, and ultimately becoming syntactically competent. By making sense of these linguistic elements, these three competencies are enhanced, and this is how infants become semantically competent. As infants continue to develop linguistic and non-linguistic communication behaviours, this miraculous language development becomes even more complex, enabling them to perfect their linguistic abilities while being pragmatically competent. In this study, a scientometric approach was used to examine past, present, and future trends in pragmatic language development (PLD). A total of 6455 documents were analysed from the Scopus, WOS, and Lens databases between 1950 and 2022. The analysis involved the visualisation and tabulation of eight bibliometric and eight scientometric indicators using CiteSpace 5.8.R3 and VOSviewer 1.6.18 software for data analysis. In this study, we highlight the major patterns and topics directing the research on PLD between 1950 and 2022. The themes and topics included (1) analysing PLD as a social behaviour through the lens of executive functions; (2) studying PLD as a social behaviour based on social understanding; (3) examining PLD as a social behaviour associated with autism spectrum disorder; (4) developing an understanding of PLD in academic settings through the examination of executive functions; (5) identifying pragmatic competence versus communicative competence as a social behaviour; (6) analysing pragmatic language skills in aphasic patients via epistemic stances (i.e., attitudes towards knowledge in interaction); (7) investigating PLD as a behavioural problem in the context of a foreign language; (8) assessing PLD as a behavioural problem in individuals with autism spectrum disorder; (9) assessing PLD in persons with traumatic brain injury and closed head injury as a behavioural problem; (10) identifying the role of the right hemisphere in executive functions as a cognitive substrate; (11) assessing the impact of pragmatic failure in speech acts on pragmatic competence; and (12) investigating the patterns of PLD among learning-disabled children.

Arabic Validation of the Pragmatic Language Skills Inventory to Assess Pragmatic Language Development in Preschoolers with and without Pragmatic Language Impairment

Objective: An individual’s articulation of pragmatic language development (PLD) signifies successful social interaction with others. Therefore, it is important to detect early pragmatic language impairment (PLI), whether as a primary disorder or as a symptom of other neurodevelopmental disorders. This study reports on validating the Arabic version of the Pragmatic Language Skills Inventory (A-PLSI). Methods: The PLSI was subjected to various validation stages before the A-PLSI was created. To assess PLD in preschoolers with and without psychiatric histories, 264 preschoolers were assessed in several cities in Saudi Arabia by their teachers and speech–language pathologists. Results: The results of this study included three key findings. First, the established psychometric features, including construct validity, criterion-related validity, and (confirmatory) factor analysis, all reported a high level of measurability to consider the A-PLSI a valid instrument for assessing PLD in school settings and diagnosing PLI in clinical settings. Second, the A-PLSI provided empirical evidence by identifying children with and without PLI, documenting their progress on pragmatic language ability, and distinguishing between preschool children in school and clinical settings. In addition, the A-PLSI approved the typical norm that the older the children, the higher their level of PLD: the data showed higher performance for children aged 6–7 compared to the lower PLD level of children aged 4–5. Conclusion: The present study contributes to the existing literature on PLD assessment in a school setting and PLI diagnosis in a clinical setting. More importantly, it adds a new validated tool to the few available instruments in Arabic to assess PLD and diagnose PLI in Arabian contexts.

Reliability, validity and developmental sensitivity of the Language Use Inventory (LUI) in the Chinese context

BACKGROUND

Pragmatics has generally been defined as the ability to use language in social situations, it is commonly regarded as the third major component of language ability. To date, there is no tool for assessing early pragmatic development of Chinese-speaking children.

AIMS

To describe the translation of the Language Use Inventory (LUI) from English to Mandarin Chinese and to report findings on the Chinese version's reliability, validity and developmental sensitivity.

METHODS & PROCEDURES

The original English version of the LUI was translated into Mandarin Chinese. Parents of 177 typically developing (TD) toddlers and preschool children completed the inventory to examine its internal reliability and construct validity and how scores differed across ages and sexes. A total of 31 parents out of the 177 completed the LUI-Mandarin, again within 4 weeks, to assess test-retest reliability. To examine discriminative validity, 43 parents of age- and sex-matched TD children and children with autism spectrum disorder (ASD) recruited from Nanjing Brain Hospital affiliated with Nanjing Medical University completed the LUI-Mandarin.

OUTCOMES & RESULTS

Cronbach's alpha values for the LUI-Mandarin's three parts and for 11 of 12 LUI-Mandarin subscales were 0.707-0.992, with most values in the 0.825-0.992 range. Test-retest reliability ranged from 0.66 to 0.95, indicating good to excellent reliability. Factor analysis of the LUI-Mandarin revealed two different factors, and the total variance explained was 74.38%. The LUI-Mandarin total scores and subscale scores increased with age for both boys and girls, providing evidence of the inventory's developmental sensitivity. Girls, however, had higher total scores than boys at earlier ages (18-23 months). The results of the discriminant validity study revealed that performance was significantly lower in the ASD group than in the TD group with respect to LUI total scores and subscale scores (except for subscale A).

CONCLUSIONS & IMPLICATIONS

The LUI-Mandarin is the first and only questionnaire available in China that evaluates the pragmatic language skills of children aged between 18 and 47 months. The results of the study show that the LUI-Mandarin is a valid and reliable tool for Chinese toddlers and preschool children.

WHAT THIS PAPER ADDS

What is already known on this subject The LUI is a parent-report questionnaire that can provide comprehensive information about very young children's communicative competence. It is widely used both for assessment and to guide intervention. Additionally, it has been translated into French, Italian, Polish, Arabic, Portuguese and Norwegian and it shows good reliability and validity. What this paper adds to existing knowledge In the present study we describe the translation of the LUI from English to Mandarin Chinese and report findings on the Chinese version's reliability, validity and developmental sensitivity. What are the potential or actual clinical implications of this work? The LUI-Mandarin is the first and only questionnaire available in China that can evaluate pragmatic language skills of children aged between 18 and 47 months. The results show that the LUI-Mandarin is a valid and reliable tool for use with Chinese toddlers and preschool children.

Screening for Language Difficulties in Disadvantaged Populations on Entry to Early Years Education: Challenges and Opportunities

Children aged 3-4 years (n = 876) were recruited from deprived areas in England, and a significant minority of the sample were second language learners. Oral language ability was assessed using child administered standardized measures, and parents reported on children's language. We adapted the Language Use Inventory [LUI; (1)] to capture carer's reports of the children's structural language in the language of instruction and their home language (where appropriate). The final measure included six subscales from the original: use of simple words, requests for help, gaining attention, talking about activities/actions, interactions with others, and building sentences. Children's language abilities and non-verbal abilities were below norms on all standardized tests administered except non-word repetition. Factor analysis indicated that all the six scales of the adapted parent completed measure loaded on one language factor. The revised total scale score correlated significantly (p < 0.0005) with child assessed language measures, specifically expressive vocabulary and grammar. Different patterns across gender, language status and parental education were examined. Sensitivity and specificity of the scale to identify children with the greatest delays were evaluated. These preliminary data indicated that parent-reported information on children's language skills at 3 years of age has the potential to provide a reliable indicator to inform pedagogy and practice at the start of nursery school. Study limitations are examined and avenues for future development explored.

Exploring the Linguistic, Cognitive, and Social Skills Underlying Lexical Processing Efficiency as Measured by the Looking-while-Listening Paradigm

The looking-while-listening (LWL) paradigm is frequently used to measure toddlers' lexical processing efficiency (LPE). Children's LPE is associated with vocabulary size, yet other linguistic, cognitive, or social skills contributing to LPE are not well understood. It also remains unclear whether LPE measures from two types of LWL trials (target-initial versus distractor-initial trials) are differentially associated with the abovementioned potential correlates of LPE. We tested 18- to 24-month-olds and found that children's word learning on a fast-mapping task was associated with LPE measures from all trials and distractor-initial trials but not target-initial trials. Children's vocabulary and pragmatic skills were both associated with their fast-mapping performance. Executive functions and pragmatic skills were associated with LPE measures from distractor-initial but not target-initial trials. Hence, LPE as measured by the LWL paradigm may reflect a constellation of skills important to language development. Methodological implications for future studies using the LWL paradigm are discussed.

The Early Social Cognition Inventory (ESCI): An examination of its psychometric properties from birth to 47 months

Social cognition refers to a broad range of cognitive processes and skills that allow individuals to interact with and understand others, including a variety of skills from infancy through preschool and beyond, e.g., joint attention, imitation, and belief understanding. However, no measures examine socio-cognitive development from birth through preschool. Current test batteries and parent-report measures focus either on infancy, or toddlerhood through preschool (and beyond). We report six studies in which we developed and tested a new 21-item parent-report measure of social cognition targeting 0–47 months: the Early Social Cognition Inventory (ESCI). Study 1 (N = 295) revealed the ESCI has excellent internal reliability, and a two-factor structure capturing social cognition and age. Study 2 (N = 605) also showed excellent internal reliability and confirmed the two-factor structure. Study 3 (N = 84) found a medium correlation between the ESCI and a researcher-administered social cognition task battery. Study 4 (N = 46) found strong 1-month test–retest reliability. Study 5 found longitudinal stability (6 months: N = 140; 12 months: N = 39), and inter-observer reliability between parents (N = 36) was good, and children’s scores increased significantly over 6 and 12 months. Study 6 showed the ESCI was internally reliable within countries (Australia, Canada, United Kingdom, United States, Trinidad and Tobago); parent ethnicity; parent education; and age groups from 4–39 months. ESCI scores positively correlated with household income (UK); children with siblings had higher scores; and Australian parents reported lower scores than American, British, and Canadian parents.

Comparing Early Pragmatics in Typically Developing Children and Children with Neurodevelopmental Disorders

This study examined the early pragmatic language skills in typically developing (TD) preschool-age children, children with language impairment (LI) and children with autism spectrum disorder (ASD). Two hundred and sixty-two TD children, 73 children with LI, and 16 children with ASD were compared on early pragmatics through direct assessment (DA). Post hoc analysis revealed that children in two clinical groups displayed significant pragmatic language deficits. Children in the ASD group who were older exhibited comparable degree of impairments as their LI peers, suggesting a relatively stagnant development of pragmatic language skills in children with ASD. Findings also supported the use of DA in identifying pragmatic language deficits, which have implications for the adoption of this assessment approach in clinical settings.

The Assessment of Early Pragmatic Development: A Study of the Reliability and Validity of the Language Use Inventory-Italian

Purpose Pragmatics is receiving much attention in both the fields of developmental and clinical psychology; however, there is a dearth of instruments to assess pragmatic abilities specifically among young toddler-age children. The aim of the current study was to test the psychometric properties of the Italian version of the Language Use Inventory (LUI), named the LUI-Italian, a parent report measure assessing pragmatic language development in children 18-47 months of age. Method Parents of Italian-speaking children who ranged in age between 18 and 47 months completed the LUI-Italian at T1 (N = 389) and 1 week later (N = 53). At T1, children were also administered the First Language Test (Test del Primo Linguaggio [TPL]), a direct measure of pragmatics, vocabulary, and syntax. Results Cronbach's alpha values were at or above acceptable levels. Factor analysis and test-retest confirmed the strong structure and reliability of the LUI-Italian. Some evidence for concurrent validity was found, as shown by associations between the LUI-Italian and the TPL. Conclusions The LUI-Italian demonstrated good psychometric properties relating to reliability, thus providing a sound basis for proceeding to a standardization study, and supporting cross-cultural comparison of pragmatic development and further exploration of profiles of pragmatic competence for children displaying language impairments or delay. Future studies need to further test concurrent, divergent, and predictive validity of the LUI-Italian.

Reproducibility and validity of the Functional Communication Classification System for young children with cerebral palsy

AIM

To examine interrater agreement and validity of the Functional Communication Classification System (FCCS) for young children with cerebral palsy (CP) aged 2 or 3 years.

METHOD

Speech-language pathologist (SLP) and parent FCCS ratings for 31 children with CP (aged 2y, n=16; aged 3y, n=15; 18 males, 13 females) were examined for interrater agreement using a weighted Cohen's kappa statistic. Relationships between FCCS (SLP) ratings and: (1) concurrent validity with the Language Use Inventory, a standardized pragmatic assessment for children aged 18 to 47 months, (2) gross motor and fine motor function, (3) associated impairments (visual and intellectual), and (4) primary expressive communication mode were examined using Spearman's correlation coefficients.

RESULTS

Almost perfect interrater agreement between SLP and parent FCCS ratings were found (k_w =0.94). Correlations with FCCS (SLP) were excellent for pragmatic function (r_s =-0.83, p<0.001), intellectual function (r_s =0.89, p<0.001), and primary expressive communication mode (r_s =0.92, p<0.001). Correlations were good for gross motor function (r_s =0.72, p<0.001) and visual impairment (r_s =0.70, p<0.001) and fair for fine motor function (r_s =0.53, p<0.002). Analysis was unwarranted for epilepsy (n=1 out of 31) and hearing-associated impairments (n=0 out of 31).

INTERPRETATION

The FCCS has excellent interrater agreement and validity for communication classification of children with CP aged 2 or 3 years and is highly suitable for surveillance and research purposes. What this paper adds The Functional Communication Classification System (FCCS) is a valid instrument for children with cerebral palsy (CP) aged 2 or 3 years. Excellent agreement exists between speech-language pathologist and parent FCCS ratings. The FCCS has excellent correlation with intelligence, pragmatic function, and primary expressive mode. Stronger correlations with the Gross Motor Function Classification System and vision exist for children aged 2 or 3 years. Weaker correlations with manual ability exist when compared to older children with CP.

Screening for language development of preterm infants: relationship between two assessment instruments

ABSTRACT Purpose: to associate two screening instruments used to assess global and language development of preterm infants. Methods: a study including 69 children aged 0-24 months of corrected age, premature at birth, who were admitted to the Neonatal Intensive Care Unit (NICU). Researchers used an anamnesis and two protocols: Early Language Milestone Scale (ELM) and Observation and Monitoring Guide for Children from 0-48 months of age. According to the categorical and numerical variables, the protocols were associated with each other through descriptive percentages and non-parametric statistical tests, such as the Chi-square, Spearman's rank correlation coefficient and Mann-Whitney U, Kruskal-Wallis test and multiple correspondences (p<0.05). Results: a significant relationship was found between the Guide and the ELM, since the “not expected for the age” classification was associated with delayed/pathological classification in the Guide, while “expected” results were related to “adequate”. There was also a relationship between the percentile of both instruments, as the higher the Guide value, the higher the ELM values (ELM-R=0.564; p=0.000), suggesting that both protocols complement each other in the evaluation results. Conclusion: the protocols for the assessment of language acquisition in children showed to be complementary, providing a complete assessment and relevant data on the development of preterm infants.

Instruments to assess children’s language and speech translated and adapted into Brazilian Portuguese: an integrative literature review

ABSTRACT Purpose: to analyze the content and translation guidelines of instruments meant to assess language, speech sound production, and communicative skills of children, adapted to Brazilian Portuguese. Methods: a search was conducted in national and international databases to select articles on the assessment of language, speech, and communicative skills in children, considering the descriptors “translation”, “adaptation”, “cultural adaptation”, “cross-cultural adaptation”, “language”, “speech”, and “pragmatic”. The search was conducted in the SciELO, Virtual Health Library, PubMed/MEDLINE, and Latin American and Caribbean Health Sciences Literature. Results: eight assessment instruments compatible with the inclusion criteria were found. Conclusion: of the instruments found, four approached specific investigations, such as syntax, narrative, pragmatic skills, and speech sound organization, while the other four had a more encompassing profile, verifying form, content, and/or use (pragmatics). Concerning the guidelines, the most recurrent stages between the translation proposals were translation, conciliation of the previous stage or synthesis version, back-translation, reviewing committee, pretest, and final version. The conceptual, item and operational equivalences were frequently cited for verification.

Brief Report: Learning Language Through Overhearing in Children with ASD

We explored whether children with autism spectrum disorder (ASD) learn new nouns from overheard speech. Thirteen children (4-5 years) with ASD participated in an Addressed condition, in which they were directly taught a novel label (e.g., toma) for one of three novel objects, and an Overheard condition, in which the objects and label were presented in a conversation between two adults. In both conditions, children were then asked to identify the labeled object (e.g., "find the toma"). Children selected the target novel object at rates above chance in the Addressed condition, and of critical importance, they also did so in the Overheard condition. This suggests that, like TD children, children with ASD may learn from language that is not directed to them.

Relations between Everyday Executive Functioning and Language in Youth with Down Syndrome and Youth with Autism Spectrum Disorder

Language and executive functioning are major impairments in many neurodevelopmental disorders, but little is known about the relations between these constructs, particularly using parent-report. Thus, the current research sought to examine relations between executive function and language in two groups - Down syndrome (DS; n=41; Mage = 11.2) and autism spectrum disorder (ASD; n=91; Mage = 7.7). Results were as follows: in DS, executive function predicted pragmatic, but not structural language after covarying for age, sex, and social functioning; in ASD, executive function predicted both. Findings highlight the interrelatedness of language and executive functioning and may have implications for intervention development.

The Pragmatic Language Skills of Severely Neglected 42-Month-Old Children: Results of the ELLAN Study

The goals of this study were twofold: (1) to compare the pragmatic language skills (i.e., social communication skills) of 42-month-old neglected children with those of same-aged non-neglected children and (2) to measure the prevalence of pragmatic difficulties among the neglected children. The study sample was composed of 45 neglected and 95 non-neglected 42-month-old French-speaking children. The Language Use Inventory: French (LUI-French) was completed with all parents. This measure, comprised of 159 scored items divided into 10 subscales, was used to assess the children's pragmatic skills. The 10th percentile on the LUI-French (95% confidence interval ) was used to identify children with pragmatic difficulties. The neglected children had lower scores than the non-neglected children on all 10 dimensions of pragmatics evaluated (p < .01), as well as lower LUI-French Total Scores (p < .001). The effect sizes of these differences varied between 0.84 and 2.78. Forty-four percent of the neglected children presented significant pragmatic difficulties compared to 4.2% of their non-neglected peers (p < .001). It can be concluded that exposure to neglect significantly compromises children's pragmatic skills. These results support the need for interventions geared toward neglected children and their families to support the early development of their pragmatic skills.

Ratunku! or Just Tunku! Evidence for the Reliability and Concurrent Validity of the Language Use Inventory-Polish

Purpose To date, there is no tool for assessing early pragmatic development of Polish-speaking children. This study aimed to adapt to Polish a standardized parent report measure, the Language Use Inventory (LUI; O'Neill, 2009, in order to enable cross-cultural comparisons and to use the LUI-Polish to screen for pragmatic development in children 18-47 months of age. We concentrated on the sociocultural and functional adaptation of LUI and aimed to demonstrate its reliability, developmental sensitivity, and concurrent validity. Method Parents completed an online version of LUI-Polish, longitudinally at 3 time points (when the child was 20, 32, and 44 months old). In addition, parents completed the Polish adaptations of the Questionnaire for Communication and Early Language at 22 months and the Language Development Survey at 24 months. Children's spontaneous speech was assessed at 24 months, and their expressive and receptive vocabulary was assessed at 36 months. Results All 3 parts of the LUI-Polish (Gestures, Words, and Sentences) showed very good levels of internal consistency at each time point. Significant correlations were observed between all parts of the LUI-Polish at all 3 measurement time points. The expected developmental trajectory was observed for boys and girls providing evidence of its developmental sensitivity for children between the ages of 2 and 4 years: an increase with age in the total score (due to an increase in Words and Sentences) and a decrease in Gestures. Supporting concurrent validity, significant correlations were found between children's performance on (a) the LUI-Polish at 20 months and the Questionnaire for Communication and Early Language at 22 months as well as the Language Development Survey and spontaneous speech measures at 24 months and (b) the LUI-Polish at 32 months and the 2 measures of vocabulary comprehension and production at 36 months. Conclusion The Polish adaptation of the LUI demonstrated good psychometric properties that provide a sound basis for cross-cultural comparisons and further research toward norming of the LUI-Polish. Moreover, the expected developmental trajectory in the pragmatic development of Polish children was observed.

Assessing Pragmatic Skills Using Checklists with Children who are Deaf and Hard of Hearing: A Systematic Review

This paper investigates the use of checklists to assess pragmatics in children and adolescents who are deaf and hard of hearing. A systematic literature review was undertaken to identify all of the published research articles between 1979 and 2018 on the topic of the assessment of pragmatics for this population of children and adolescents. The 67 papers identified in this review were analyzed and all papers that utilized a checklist to assess pragmatic skills were identified. Across the 18 different published papers on the use of pragmatic skills among children who are deaf and hard of hearing, nine checklists were identified. These nine checklists were then compared and contrasted on six key features including identification of a theoretical framework or model; the type of pragmatic skills measured; the age range of the child assessed; the information/outputs generated; the primary informant for the assessment; and reliability, validity, and normative data. The resulting analysis provides a comprehensive guide to aid clinicians, educators, and researchers in selecting an appropriate checklist to assess pragmatic skills for children and adolescents who are deaf and hard of hearing.

Translation of the Parental Inventory “Language Use Inventory” into Brazilian Portuguese

ABSTRACT Purpose To translate and adapt the assessment tool Language Use Inventory from English to Brazilian Portuguese. Methods The study was carried out in two stages. Once the publisher’s authorization was given, the process of translation and back-translation of the protocol was initiated, adapting it to sociocultural aspects, such as expressions, names, and adequate examples in Brazilian Portuguese. In order to investigate the internal reliability of the translation process, the Cronbach’s alpha coefficient was used. The second stage was a pilot study, in which the questionnaire was applied to 43 parents of children from 24 to 47 months old from a city in the State of São Paulo, Brazil. The results were analyzed according to the total score and to the subscales of the questionnaire. The variables age range and parental level of education were also analyzed. Results The analysis using the Cronbach’s alpha coefficient showed high internal consistency (α>0,98) in almost all the subscales which means that the instrument adapted to Brazilian Portuguese can be used. In the pilot study, an age effect was found in the total score and in the LUI subscale scores, i.e., the older the children, the fewer gestures they used, with more words and syntactic constructions. Conclusion The Brazilian-Portuguese version of the LUI questionnaire seems to be a reliable translation of the original and a reliable instrument to evaluate preschoolers’ language pragmatics. After future detailed analyses, it will allow early diagnosis and intervention in children with language disorders.

Metapragmatic Explicitation and Social Attribution in Social Communication Disorder and Developmental Language Disorder: A Comparative Study

PURPOSE

The purposes of this study are to investigate metapragmatic (MP) ability in 6-11-year-old children with social communication disorder (SCD), developmental language disorder (DLD), and typical language development and to explore factors associated with MP explicitation and social understanding (SU).

METHOD

In this cross-sectional study, all participants (N = 82) completed an experimental task, the Assessment of Metapragmatics (Collins et al., 2014), in which pragmatic errors are identified in filmed interactions. Responses were scored for complexity/type of explicitation (MP score) and attribution of social characteristics to the films' characters (SU score).

RESULTS

Groups with SCD and DLD had significantly lower MP scores and less sophisticated explicitation than the group with typical language development. After controlling for language and age, the group with SCD had significantly lower SU scores than the group with DLD. Significant correlations were found between MP scores and age/language ability but not with pragmatic impairment.

CONCLUSIONS

Children with SCD or DLD performed poorly on an MP task compared with children who are typically developing but do not differ from each other in ability to reflect verbally on pragmatic features in interactions. MP ability appears to be closely related to structural language ability. The limited ability of children with SCD to attribute social/psychological states to interlocutors may indicate additional social attribution limitations.

Length of Utterance, in Morphemes or in Words?: MLU3-w, a Reliable Measure of Language Development in Early Basque

The mean length of utterace (MLU), which was proposed by Brown (1973) as a better index for language development in children than age, has been regularly reported in case studies as well as in cross-sectional studies on early spontaneous language production. Despite the reliability of MLU as a measure of (morpho-)syntactic development having been called into question, its extensive use in language acquisition studies highlights its utility not only for intra- and inter-individual comparison in monolingual language acquisition, but also for cross-linguistic assessment and comparison of bilinguals' early language development (Müller, 1993; Yip and Matthews, 2006; Meisel, 2011). An additional issue concerns whether MLU should be measured in words (MLU-w) or morphemes (MLU-m), the latter option being the most difficult to gauge, since new challenges have arisen regarding how to count zero morphemes, suppletive and fused morphemes. The different criteria have consequences, especially when comparing development in languages with diverging morphological complexity. A variant of MLU, the MLU3, which is calculated out of the three longest sentences produced (MLU3-w and MLU3-m), is included among the subscales of expressive language development in CDI parental reports (Fenson et al., 1993, 2007). The aim of the study is to investigate the consistency and utility of MLU3-w and MLU3-m as a measure for (morpho-)syntactic development in Basque, an agglutinative language. To that end, cross-sectional data were obtained using either the Basque CDI-2 instrument (16- to 30-month-olds) or the Basque CDI-3 (30- to 50-month-olds). The results of analyzing reports on over 1,200 children show three main findings. First, MLU3-w and MLU3-m can report equally well on very young children's development. Second, the strong correlations found between MLU3 and expressive vocabulary in the Basque CDI-2 and CDI-3 instruments, as well as between MLU3 and both nominal and verbal morphology scales, confirm the consistency not only of MLU3 but also of the two Basque CDI instruments. Finally, both MLU3-w and MLU3-m subscales appear sensitive to input after age 2, which emphasizes their utility for identifying developmental patterns in Basque bilinguals.

An exploratory longitudinal study of social and language outcomes in children with autism in bilingual home environments

Little is known about outcomes of early intervention for children with autism spectrum disorder reared in bilingual homes. There are concerns that social communication deficits among children with autism spectrum disorder may reduce the developmental benefits of early intervention for children with autism spectrum disorder raised in bilingual environments. We conducted an exploratory analysis of cross-sectional and longitudinal data from a larger study to explore associations between home language environment and language ability and social skills in response to early autism spectrum disorder intervention. Participants, aged 12-26 months when recruited, were a subset of a larger 2-year, randomized intervention trial (ClinicalTrials.gov identifier: NCT00698997). Children from bilingual homes ( n = 13) began intervention with lower gesture use but otherwise demonstrated equal baseline language and social abilities as compared with age and nonverbal IQ-matched children from monolingual homes ( n = 24). Significant language growth was exhibited by children from both language groups and there was no moderating effect of home language environment. The bilingual home group demonstrated increased gesture use over the course of intervention as compared with the monolingual home group. Preliminary data revealed no basis for concerns regarding negative impact of a bilingual home environment on language or social development in young children with autism spectrum disorder.

Screening Bilingual Preschoolers for Language Difficulties: Utility of Teacher and Parent Reports

PURPOSE

The utility of parent and teacher reports for screening 3 types of bilingual preschoolers (English-first language [L1]/Mandarin-second language[L2], Mandarin-L1/English-L2, or Malay-L1/English-L2) for language difficulty was investigated in Singapore with reference to measures of reliability, validity, sensitivity, and specificity in an English-medium kindergarten setting.

METHOD

The index tests were teachers' ratings of the English language ability of 5-year-olds (N = 85) on the Bilingual Language Assessment Battery (BLAB): Preschool Teacher Report (Pua, Lee, & Rickard Liow, 2013) and parents' ratings of their child's home language ability (N = 78 English-L1, Mandarin-L1, or Malay-L1) on the BLAB: Preschool Parent Report (Pua, Lee, & Rickard Liow, 2013). The reference standards were objective measures of single-word receptive vocabulary (80 items) and expressive vocabulary (140 items) in the child's L1 and L2, as proxies for language ability.

RESULTS

BLAB Teacher Reports for the English receptive and expressive subscales showed concurrent validity for all 3 bilingual groups, as well as generally high sensitivity and specificity. In contrast, BLAB Parent Reports for L1 receptive ability failed to show significant correlations with the objective measures of receptive vocabulary.

CONCLUSION

Subjective teacher ratings may be an effective method of screening bilingual preschoolers for language difficulty, thereby prompting referral to clinicians.

Mother-Child Communication: The Influence of ADHD Symptomatology and Executive Functioning on Paralinguistic Style

Paralinguistic style, involving features of speech such as pitch and volume, is an important aspect of one's communicative competence. However, little is known about the behavioral traits and cognitive skills that relate to these aspects of speech. This study examined the extent to which ADHD traits and executive functioning (EF) related to the paralinguistic styles of 8- to 12-year-old children and their mothers. Data was collected via parent report (ADHD traits), independent laboratory tasks of EF (working memory, inhibitory control, and cognitive flexibility), and an interactive problem-solving task (completed by mothers and children jointly) which was coded for paralinguistic speech elements (i.e., pitch level/variability; volume level/variability). Dyadic data analyses revealed that elevated ADHD traits in children were associated with a more exaggerated paralinguistic style (i.e., elevated and more variable pitch/volume) for both mothers and children. Mothers' paralinguistic style was additionally predicted by an interaction of mothers' and children's ADHD traits, such that mothers with elevated ADHD traits showed exaggerated paralinguistic styles particularly when their children also had elevated ADHD traits. Highlighting a cognitive mechanism, children with weaker inhibitory control showed more exaggerated paralinguistic styles.

Social (pragmatic) communication disorders and autism spectrum disorder

Changes have been made to the diagnostic criteria for autism spectrum disorder (ASD) in the recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and similar changes are likely in the WHO International Classification of Diseases (ICD-11) due in 2017. In light of these changes, a new clinical disorder, social (pragmatic) communication disorder (SPCD), was added to the neurodevelopmental disorders section of DSM-5. This article describes the key features of ASD, SPCD and the draft ICD-11 approach to pragmatic language impairment, highlighting points of overlap between the disorders and criteria for differential diagnosis.

CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children

Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting 'agree' or 'strongly agree') was at least 80 percent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.

The Swedish Communicative Development Inventory III: Parent reports on language in preschool children

A revised form of MacArthur-Bates Communicative Development Inventory III (SCDI-III) was presented designed for Swedish speaking children aged 2 years 6 months–4 years 0 months with the objective to give a proxy measure of their language competence. The instrument contains a vocabulary checklist with 100 words, mainly predicates, from four areas; Food words, Body words, Mental words and Emotion words. Two sections assess the child’s grammar skills and a final section appraises the child’s metalinguistic awareness. Assessments from 1,134 parents are reported. Scales with adequate psychometric properties were formed for each section. Monthly median values and spread of score distributions are presented for each scale. Girls scored higher than boys on all scales. The revision, sampling procedures, demographic variables and issues of reliability and validity, are discussed. The general structure of the instrument can well be integrated in similar instruments designed for other languages and cultures.

Social Communication is Predicted by Inhibitory Ability and ADHD Traits in Preschool-Aged Children: A Mediation Model

OBJECTIVE

Given the role inhibitory control plays in both ADHD and communication, this study examined whether inattentive and hyperactive-impulsive traits mediate the impact of weak inhibitory ability upon the knowledge and application of pragmatic rules early in development.

METHOD

Participants were 36 typically developing preschoolers and their caregivers. ADHD traits were assessed per caregiver report. Inhibition was assessed in children using a distraction task. Pragmatic language was assessed by asking children about hypothetical social situations (knowledge) and by asking caregivers to report on children's actual communicative behaviors (application).

RESULTS

Individual differences in inhibition predicted both facets of pragmatic language development. Hyperactive-impulsive behaviors were a significant mediator of this relationship-but only with regard to children's ability to effectively apply pragmatic rules in everyday life.

CONCLUSION

Our findings suggest that social communication difficulties in some young children are a downstream consequence of hyperactive-impulsive behaviors that arise from poorly developed inhibitory control.

Measuring pragmatic skills: early detection of infants at risk for communication problems

BACKGROUND

For the early detection of children who are at risk of communication problems, we need appropriate assessment instruments. Two Dutch-language standardised screening instruments are available: the Dutch version of the Non Speech Test (NNST) and the Dutch version of the MacArthur Communicative Development Inventories (N-CDIs). These instruments gauge the precursors of language development, early vocabulary and early morphosyntactic skills. However, they do not adequately assess pragmatic skills.

AIMS

To develop a norm-referenced instrument to examine the pragmatic skills of Dutch-speaking infants that is translatable into other languages.

METHODS & PROCEDURES

The instrument 'Lists for the Evaluation of Pragmatic Skills in Infants' is based on 'The Pragmatics Profile of Everyday Communication Skills in Children' Dewart and Summers (1995). We translated the instrument into Dutch and transformed the structured interview format into a parent questionnaire. The parent questionnaire-Evaluatie van Pragmatische Vaardigheden (EPV)-was created following extensive research on item selection, norm table development, and reliability and validity studies. The EPV1 is applicable to children 6-15 months old; EPV2 is applicable to children 16-30 months old.

OUTCOMES & RESULTS

We developed norm tables for the number of pragmatic skills achieved by the child and also for how and to what extent the skills are exhibited. For the norming study of EPV1 and EPV2 we included 390 and 534 infants respectively. The reliability scores are high for both lists. Concept validity and criterion validity studies demonstrate adequate results for the overall lists, the subscale components and specific items.

CONCLUSIONS & IMPLICATIONS

The parent questionnaire is a valuable tool that specifically targets pragmatic skills in infants. The instrument can detect communication delays in infants. It is translatable into other languages and avoids having the infant examined directly by a stranger.

Early pragmatic language difficulties in siblings of children with autism: implications for DSM-5 social communication disorder?

BACKGROUND

We evaluated early pragmatic language skills in preschool-age siblings of children with autism spectrum disorder (ASD), and examined correspondence between pragmatic language impairments and general language difficulties, autism symptomatology, and clinical outcomes.

METHODS

Participants were younger siblings of children with ASD (high-risk, n = 188) or typical development (low-risk, n = 119) who were part of a prospective study of infants at risk for ASD; siblings without ASD outcomes were included in analyses. Pragmatic language skills were measured via the Language Use Inventory (LUI).

RESULTS

At 36 months, the high-risk group had significantly lower parent-rated pragmatic language scores than the low-risk group. When defining pragmatic language impairment (PLI) as scores below the 10(th) percentile on the LUI, 35% of the high-risk group was identified with PLI versus 10% of the low-risk group. Children with PLI had higher rates of general language impairment (16%), defined as scores below the 10(th) percentile on the Receptive or Expressive Language subscales of the Mullen Scales of Early Learning, relative to those without PLI (3%), but most did not evidence general language impairments. Children with PLI had significantly higher ADOS scores than those without PLI and had higher rates of clinician-rated atypical clinical best estimate outcomes (49%) relative to those without PLI (15%).

CONCLUSIONS

Pragmatic language problems are present in some siblings of children with ASD as early as 36 months of age. As the new DSM-5 diagnosis of Social (Pragmatic) Communication Disorder (SCD) is thought to occur more frequently in family members of individuals with ASD, it is possible that some of these siblings will meet criteria for SCD as they get older. Close monitoring of early pragmatic language development in young children at familial risk for ASD is warranted.

Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category

Social (pragmatic) communication disorder (SCD) is a new diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The purpose of this review is to describe and synthesize the relevant literature from language and autism spectrum disorder (ASD) research relating to pragmatic language impairment and other previously used terms that relate to SCD. The long-standing debate regarding how social communication/pragmatic impairments overlap and/or differ from language impairments, ASD, and other neurodevelopmental disorders is examined. The possible impact of the addition of SCD diagnostic category and directions for future research are also discussed.

Adaptação do Inventário Parental "Language Use Inventory (LUI)" para crianças entre 18 e 47 meses para o Português Europeu: Estudo Piloto

OBJETIVO: A aquisição e o desenvolvimento da linguagem resultam da interação da criança com o meio ambiente. As interações sociais cotidianas com as pessoas e a comunicação com outros permitem que a criança adquira linguagem, sendo a pragmática o sistema de regras que suporta o uso comunicativo da linguagem. A identificação e a avaliação de crianças em risco de desenvolverem transtornos de linguagem são cruciais, tendo em vista a intervenção precoce eficaz. Tendo em vista a relevância da pragmática como componente da linguagem e a escassez, em Portugal, de instrumentos de avaliação da linguagem validados para idades precoces, a finalidade deste estudo consistiu na tradução, adaptação e validação do instrumento Language Use Inventory (LUI), para o português europeu. O LUI é um inventário parental que avalia o desenvolvimento da pragmática entre os 18 e os 47 meses. MÉTODOS: Foram adotados todos os procedimentos recomendados pelas diretrizes internacionais sobre a adaptação de testes, culminando em estudo piloto com uma amostra de 120 inventários, respondidos pelos pais/cuidadores de crianças portuguesas da referida faixa etária. RESULTADOS: Os coeficientes de consistência interna (Alfa de Cronbach) para a versão portuguesa do LUI situaram-se em 0,97 para a escala total e entre 0,71 e 0,96 para as subescalas. CONCLUSÃO: Os resultados preliminares da adaptação do LUI-Pt para crianças portuguesas sugerem a validade interna dessa escala.

Assessing the minimally verbal school-aged child with autism spectrum disorder

This paper addresses the issue of assessing communication, language, and associated cognitive and behavioral abilities of minimally verbal children with autism spectrum disorder (ASD), presenting a summary of a year-long series of meetings held by a group of experts in the field of ASD and National Institutes of Health staff. In this paper, our goals were to first define the population and then present general guidelines for optimizing assessment sessions for this challenging population. We then summarize the available measures that can be used across a variety of behavioral domains that are most directly relevant to developing language skills, including oral motor skills, vocal repertoire, receptive and expressive language, imitation, intentional communication, play, social behavior, repetitive and sensory behaviors, and nonverbal cognition. We conclude with a discussion of some of the limitations in the available measures and highlight recommendations for future research in this area.

Investigating the interchangeability and diagnostic utility of the PPVT-III and PPVT-IV for children with and without SLI

The receptive vocabulary performance of pre-school children with specific language impairment (SLI) and typically-developing (TD) controls was compared on the Peabody Picture Vocabulary Test third and fourth edition (PPVT-III and PPVT-IV) to determine consistency in performance and the effect of test revision on identification of impairment. Participants included 40 pre-school children with SLI and 40 controls. Tests were administered in counterbalanced order. Despite a strong relationship between performance on these two tests (p < 0.001), 35% of children performed differently between the two test versions. Children with SLI performed significantly worse than TD children on both tests (p < 0.001). Discriminate analyses identified an optimal standard score cut-off of 103 for both tests. Using this cut-off, sensitivity remained consistent at 80% (95% CI = 0.64-0.90), while specificity was 75% (95% CI = 0.59-0.87) on the PPVT-III and 70% (95% CI = 0.53-0.83) on the PPVT-IV. The results suggest that the two tests do not appear to be interchangeable for more than 1/3rd of children. The findings also highlight the misperception that newer test versions are superior to older in identifying presence or absence of language impairment. Children with SLI are unlikely to score low on these commonly used receptive vocabulary tests, despite known deficits of children with SLI in the area of vocabulary acquisition. Possible explanations for why children with SLI score well on these types of tests will be discussed.