Differences in the performance of children with specific language impairment and their typically developing peers on nonverbal cognitive tests: a meta-analysis

Caregivers' reports of the home literacy environments of children with developmental language disorder and typically developing peers during the COVID-19 pandemic

PURPOSE

Children with developmental language disorder (DLD) are at heightened risk for reading difficulty. We investigated the home literacy environments of kindergarten children with DLD and typically developing (TD) peers during the COVID-19 pandemic.

METHOD

We analysed scores from standardised assessments of oral language, nonverbal intelligence, and word reading in conjunction with home literacy questionnaire data at three time points.

RESULT

Frequency of engagement in home literacy activities did not differ by group during school closures or when schools reopened. Caregivers from both groups reported increased home literacy engagement during closures. Engagement returned to pre-pandemic levels when schools reopened. For the DLD group, the child's word reading ability and interest in literacy were positively associated with the home literacy environment. Family history of language and/or literacy difficulty was negatively associated with the home literacy environment. For the TD group, only the child's interest in literacy was positively associated with the home literacy environment.

CONCLUSION

These findings elucidate the need for further research related to home literacy and families of children with DLD, with a focus on identifying potential strengths and vulnerabilities related to child and caregiver factors.

Characteristics of Children and Youth Referred for Language Assessment at Different Ages

PURPOSE

Early detection of language delays is essential, as language is key for academic outcomes, well-being, and societal participation. Previous studies have focused on undetected delays in young children. Much less is known about referrals at older ages. In this study, we aimed to (a) establish how many children are referred at toddler age (2-3 years) and how many at lower elementary (4-7 years), upper elementary (8-12 years), and high school (13-16 years) age; (b) evaluate characteristics of the referred children and adolescents across age groups; and (c) assess whether the ensuing classification (no language disorder [LD], developmental LD, LD + additional problems) differed across age groups.

METHOD

We used the 2010-2014 database of the Dutch federation of speech and hearing centers, containing 18,894 cases with target ages. We established the number of referrals in each age group (Q1) and assessed the composition of the age groups in terms of speech, language, behavioral, and cognitive outcomes (Q2), as well as in terms of classification (Q3). To answer Q2 and Q3, we conducted chi-squared analyses with the toddler group as reference group.

RESULTS

Late-identified LDs exist: There were new referrals in all age groups. Compared to older age groups, the toddler group contained fewer girls and multilingual children. The toddler group also contained fewer children without an LD and more children with LD + additional problems.

CONCLUSIONS

Reassuringly, children with multiple language problems are referred earliest. However, late-identified LDs exist, even at high school age. Girls and multilingual children tend to be missed at younger ages. More work on awareness and identification of language delays is needed, requiring awareness, knowledge, and tools for educational professionals.

A Review of Screeners to Identify Risk of Developmental Language Disorder

PURPOSE

This review aims to comprehensively summarize, compare, and evaluate screeners used to identify risk for developmental language disorder (DLD), a common learning disability that is underidentified. Screening for DLD is a cost-effective way to identify children in need of further assessment and, in turn, provides much needed supports.

METHOD

We identified 15 commercially available English language DLD screeners in North America. We then characterized each screener on 27 aspects in three domains, including (a) accessibility information (acronym, subtest, website, cost, materials included, publish year, examiner qualification, age range, administration time, and administration format), (b) usability features (dialect compatibility, progress monitoring function, actionable follow-up instruction, group assessment capability, and online administration availability), and (c) technical standards (the availability of a technical manual, conceptual definition, the sample size used in classification accuracy calculation, sample distribution, year of sample collection, outcome measure, sample base rate, cutoff score, sensitivity, specificity, positive predictive value, and negative predictive value).

RESULTS

We obtained sufficient accessibility information from 14 out of 15 (93%) screeners. In contrast, none of the screeners (0%) included comprehensive usability features. Ten screeners (67%) included a range of classification accuracy (70%-100% sensitivity and 68%-90% specificity). We provided areas of strength and weakness for each screener as a quick reference for users and generated screener recommendations for five practical scenarios.

CONCLUSIONS

Our findings presented some DLD screeners that meet most standards and highlight numerous areas for improvement, including improving classification accuracy and clarifying follow-up instructions for children who are identified with DLD risk. Screening for DLD is critical to provide timely early identification, intervention, and classroom support, which in turn facilitates student outcomes.

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

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

Dynamic Assessment of Narrative Skills for Identifying Developmental Language Disorder in Monolingual and Bilingual French-Speaking Children

Purpose:

Typically developing (TD) bilingual children usually produce narratives with preserved macrostructure (i.e., narrative scheme) but with impaired microstructure (i.e., language complexity). As for monolingual and bilingual children with developmental language disorder (DLD), they usually produce narratives with both impaired macro- and microstructure. It is therefore difficult to differentiate TD from DLD, on the basis of narrative production, especially in bilingual children. In this study, we examine whether a dynamic assessment (DA) task of narratives, using a pretest–teaching–posttest design, can differentiate TD from DLD, without disadvantaging bilinguals over monolinguals.

Method:

We recruited 118 French-speaking children ( M age = 8;5 [years;months]), with one experimental condition in which children benefited from a teaching phase (30 TD, 18 monolinguals and 12 bilinguals; 30 DLD, 15 monolinguals and 15 bilinguals) and one control condition (58 TD, 31 monolinguals and 27 bilinguals), in which children participated in another activity. In the pre- and posttest, children were asked to tell a story based on a series of pictures. During the teaching phase, an examiner asked children 12 specific questions about the story, targeting macro- and microstructural elements. Scores were attributed to the number of macro- and microstructural elements correctly produced and to the number of specific trained elements (TE) that were produced as a result of training.

Results:

Scores improved on macrostructure and on the number of TE following teaching for all groups of the experimental condition (TD and DLD), whereas there was no progress in children of the control condition. TD participants and participants with DLD differed on all measures in both pre- and posttest, with no differences between monolinguals and bilinguals.

Conclusions:

Our dynamic task led to both improved narrative skills and TD/DLD differentiation, with bilinguals not being disadvantaged. Our study thus supports the existing literature indicating that DA can be used to diagnose narrative deficits in children with DLD.

Selective short-term memory impairment for verbalizable visual objects in children with Developmental Language Disorder

BACKGROUND

Developmental language disorder (DLD) affects the ability to acquire and make use of native language. Possible underlying cognitive mechanisms are related to memory functions.

AIMS

The aim was examination of the relationship between visual short-term memory of objects as well as audiovisual short-term memory, and particular nonverbal and language abilities.

METHODS AND PROCEDURES

The study included 7-9-year-old children with DLD and matched control group. Participants completed the Language Development Test, the Stanford-Binet IQ scale (SB5), and two short-term memory tasks: immediate recall of the visually presented pictograms and immediate recall of audiovisually presented sequences of syllables.

OUTCOMES AND RESULTS

The results revealed diminished levels of short-term visual memory for objects as well as audiovisual memory in children with DLD. However, there were no group differences in the control task of WM.

CONCLUSIONS AND IMPLICATIONS

Results supported the idea of diminished abilities in children with DLD to perform mental operations on verbalizable visual objects. Importantly non-verbal working memory ability, which cannot easily be supported by verbal representations, is at typical levels. This suggests that verbalization ability should be taken into account in the assessment of seemingly non-verbal cognitive functions among children with DLD.

A Role for Visual Memory in Vocabulary Development: A Systematic Review and Meta-Analysis

Although attention and early associative learning in preverbal children is predominantly driven by rapid eye-movements in response to moving visual stimuli and sounds/words (e.g., associating the word "bottle" with the object), the literature examining the role of visual attention and memory in ongoing vocabulary development across childhood is limited. Thus, this systematic review and meta-analysis examined the association between visual memory and vocabulary development, including moderators such as age and task selection, in neurotypical children aged 2-to-12 years, from the brain-based perspective of cognitive neuroscience. Visual memory tasks were classified according to the visual characteristics of the stimuli and the neural networks known to preferentially process such information, including consideration of the distinction between the ventral visual stream (processing more static visuo-perceptual details, such as form or colour) and the more dynamic dorsal visual stream (processing spatial temporal action-driven information). Final classifications included spatio-temporal span tasks, visuo-perceptual or spatial concurrent array tasks, and executive judgment tasks. Visuo-perceptual concurrent array tasks, reliant on ventral stream processing, were moderately associated with vocabulary, while tasks measuring spatio-temporal spans, associated with dorsal stream processing, and executive judgment tasks (central executive), showed only weak correlations with vocabulary. These findings have important implications for health professionals and researchers interested in language, as they advocate for the development of more targeted language learning interventions that include specific and relevant aspects of visual processing and memory, such as ventral stream visuo-perceptual details (i.e., shape or colour).

Children With Developmental Language Disorder Have Lower Quality of Life Than Children With Typical Development and Children With Cochlear Implants

PURPOSE

The purpose of this study was to examine quality of life (QOL) and its relation to language skills in children with developmental language disorder (DLD). This was examined by comparing QOL to a control group of children with typical development (TD), as well as children with cochlear implants (CIs), who potentially struggle with language for language, although for a different reason than children with DLD.

METHOD

Two groups of children, a group with TD (n = 29) and a group of children with CIs (n = 29), were matched to the DLD group (n = 29) on chronological age, gender, nonverbal IQ, and parental educational level through a propensity matching procedure. A third group consisting of children with CIs was also matched to the DLD group but additionally matched on language abilities. QOL scores were compared across groups, and the association between language skills and QOL was examined in the DLD group.

RESULT

The DLD group was reported by parents to have statistically significantly poorer QOL scores than peers with TD or CIs. When controlling for language skills, either statistically or through an additional CI group matched on language abilities, there were no statistically significant differences in QOL scores across groups. In the DLD group, language skills explained 16% of the variation in QOL.

CONCLUSION

DLD is associated with the children's overall QOL, and the degree of reduced QOL relates to the severity of the language impairment.

Nonverbal Executive Functioning in Relation to Vocabulary and Morphosyntax in Preschool Children With and Without Developmental Language Disorder

PURPOSE

Developmental language disorder (DLD) is characterized by persistent and unexplained difficulties in language development. Accumulating evidence shows that children with DLD also present with deficits in other cognitive domains, such as executive functioning (EF). There is an ongoing debate on whether exclusively verbal EF abilities are impaired in children with DLD or whether nonverbal EF is also impaired, and whether these EF impairments are related to their language difficulties. The aims of this study were to (a) compare nonverbal performance of preschoolers with DLD and typically developing (TD) peers, (b) examine how nonverbal EF and language abilities are related, and (c) investigate whether a diagnosis of DLD moderates the relationship between EF and language abilities.

METHOD

A total of 143 children (nDLD = 65, nTD = 78) participated. All children were between 3 and 6.5 years old and were monolingual Dutch. We assessed nonverbal EF with a visual selective attention task, a visuospatial short-term and working memory task, and a task gauging broad EF abilities. Vocabulary and morphosyntax were each measured with two standardized language tests. We created latent variables for EF, vocabulary, and morphosyntax.

RESULTS

Analyses showed that children with DLD were outperformed by their TD peers on all nonverbal EF tasks. Nonverbal EF abilities were related to morphosyntactic abilities in both groups, whereas a relationship between vocabulary and EF skills was found in the TD group only. These relationships were not significantly moderated by a diagnosis of DLD.

CONCLUSIONS

We found evidence for nonverbal EF impairments in preschool children with DLD. Moreover, nonverbal EF and morphosyntactic abilities were significantly related in these children. These findings may have implications for intervention and support the improvement of prognostic accuracy.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24121287.

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

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

Abilities and Disabilities Among Children With Developmental Language Disorder

PURPOSE

The aim of this study was to situate developmental language disorder (DLD) within the impairment and disability framework of the International Classification of Functioning, Disability, and Health (ICF); describe the functional strengths and weaknesses of a cohort of first-grade children with DLD and their peers; and explore the ways that language-related disabilities relate to language impairment, developmental risk, and receipt of language services.

METHOD

We queried the caregivers of 35 children with DLD and 44 peers with typical language development about their children's language-related functions, developmental risks, and language services using mixed quantitative and qualitative methods.

RESULTS

The children with DLD presented with weaknesses in domains that are highly dependent upon language skill, including communication, community function, interpersonal relationships, and academics. They presented with strengths in domestic and personal aspects of daily living, play and coping aspects of socialization, and gross motor function. Caregivers of children with DLD expressed pride in their children's agentive and prosocial qualities. Consistent with the ICF, what distinguished children with DLD who had functional weaknesses and disabilities from those who had healthy function was not the severity of language impairment as measured by decontextualized tests of language skill, but the presence of cumulative developmental risks. Compared to those with healthy function, a larger portion of children with weaknesses and disabilities were receiving language services; however, two girls who had disabilities despite mild levels of impairment were without services.

CONCLUSIONS

Children with DLD present with predictable strengths and weaknesses in everyday language-related functioning. For some children, the weaknesses are mild, but for others, they limit function to a greater extent and should be considered disabilities. The severity of language impairment is not a strong indicator of language-related function and, therefore, is not a good metric for determining service qualification.

Intellectual Profiles of Clinic-Referred Preschoolers

Intellectual impairments in preschoolers have been widely studied. A regularity that emerges is that children's intellectual impairments have an important impact on later adjustments in life. However, few studies have looked at the intellectual profiles of young psychiatric outpatients. This study aimed to describe the intelligence profile of preschoolers referred to psychiatry for various cognitive and behavioral problems in terms of verbal, nonverbal, and full-scale IQ and to examine their association with diagnoses. Three hundred four clinical records from young children aged under 7 years and 3 months who consulted at an outpatient psychiatric clinic and who had one intellectual assessment with a Wechsler Preschool and Primary Scale of Intelligence were reviewed. Verbal IQ (VIQ), Nonverbal IQ (NVIQ), and Full-scale IQ (FSIQ) were extracted. Hierarchical cluster analysis using Ward's method was employed to organize data into groups. The children had, on average, a FSIQ of 81, which is significantly lower than that expected in the general population. Four clusters were identified by the hierarchical clusters analysis. Three were characterized by low, average, and high intellectual ability. The last cluster was characterized by a verbal deficit. Findings also revealed that children's diagnoses were not related to any specific cluster, except for children with an intellectual disability with, as expected, low abilities. Children referred to an intellectual assessment in an early childhood mental health clinic showed an altered intellectual development, more specifically in the verbal domain.

The contribution of theta and delta to feedback processing in children with developmental language disorder

PURPOSE

The study aimed at evaluating feedback processing at the electrophysiological level and its relation to learning in children with developmental language disorder (DLD) to further advance our understanding of the underlying neural mechanisms of feedback-based learning in children with this disorder.

METHOD

A feedback-based probabilistic learning task required children to classify novel cartoon animals into two categories that differ on five binary features, the probabilistic combination of which determined classification. The learning outcomes' variance in relation to time- and time-frequency measures of feedback processing were examined and compared between 20 children with developmental language disorder and 25 age-matched children with typical language development.

RESULTS

Children with developmental language disorder (DLD) performed poorer on the task when compared with their age-matched peers with typical language development (TD). The electrophysiological data in the time domain indicated no differences in the processing of positive and negative feedback among children with DLD. However, the time-frequency analysis revealed a strong theta activity in response to negative feedback in this group, suggesting an initial distinction between positive and negative feedback that was not captured by the ERP data. In the TD group, delta activity played a major role in shaping the FRN and P3a and was found to predict test performance. Delta did not contribute to the FRN and P3a in the DLD group. Additionally, theta and delta activities were not associated with the learning outcomes of children with DLD.

CONCLUSION

Theta activity, which is associated with the initial processing of feedback at the level of the anterior cingulate cortex, was detected in children with developmental language disorder (DLD) but was not associated with their learning outcomes. Delta activity, which is assumed to be generated by the striatum and to be linked to elaborate processing of outcomes and adjustment of future actions, contributed to processing and learning outcomes of children with typical language development but not of children with DLD. The results provide evidence for atypical striatum-based feedback processing in children with DLD.

The association of cognitive abilities with language disorder in 8-year-old children: A population-based clinical sample

BACKGROUND

Despite accumulated evidence that language development depends on basic cognitive processes, the balance in contributions of verbal and non-verbal cognitive skills to language abilities is still underexplored. Little is known about which cognitive measures best predict the degree of severity in children with language disorder (LD).

AIMS

To examine the association between verbal and non-verbal cognitive abilities with language abilities in typically developing and language impaired 8-year-old children, as well as which cognitive abilities are most effective in distinguishing LD severity levels.

METHODS & PROCEDURES

Children (N = 509) from the Language-8 Study, which oversampled probable cases of children with LD from a population-based cohort in Norway, were assessed at 8 years. Language skills were assessed using the Norwegian Clinical Evaluation of Language Fundamentals-4 (CELF-4). Children's verbal and non-verbal cognitive abilities were assessed via standardized cognitive measures. An exploratory factor analysis (EFA) was first conducted to uncover the underlying factor structure of the cognitive variables. Using a hierarchical multiple regression analysis, we then examined to what extent the non-verbal cognition factor explained language abilities above and beyond verbal cognition factors. Lastly, multinomial logistic regression was used to examine which cognitive measures best predicted the degree of severity in the children with LD.

OUTCOMES & RESULTS

The EFA resulted in three factors (Verbal Cognition, Processing Speed and Memory, and Non-Verbal Cognition). The hierarchical multiple regression analysis revealed that all three cognitive factors contributed significantly to individual variation in language abilities. Non-Verbal Cognition explained 5.4% variance in language abilities above and beyond that accounted for by Verbal Cognition and Processing Speed and Memory. Results from the multinomial logistic regression analysis indicated that cognitive subtests, including Familiar Sequences, WASI Vocabulary and WASI Similarities, not only distinguished LD from typically developing children, but were also efficient in distinguishing severity of LD symptoms.

CONCLUSIONS & IMPLICATIONS

This study confirms concurrent links between language and non-verbal cognitive skills above and beyond the contribution of verbal cognitive skills. The results provide further evidence that children with LD experience both language and cognitive problems in mid-childhood. Our findings suggest implications for LD intervention and diagnosis. The findings support the importance of measuring both verbal and non-verbal cognitive skills when making an LD diagnosis, and point to the potential of targeting underlying cognitive skills as one strategy to support language abilities.

WHAT THIS PAPER ADDS

What is already known on the subject Language development is dependent on basic cognitive processes. These include both verbal and non-verbal cognitive abilities. Children with LD often experience both language and cognitive problems. There is evidence that performance on cognitive tests may be associated with the degree of severity of LD. What this paper adds to existing knowledge The current results from a large population-based cohort establish that a number of verbal and non-verbal cognitive abilities are tightly linked to variation in language abilities and the degree of severity of LD. Our study confirms concurrent links between language and non-verbal cognitive abilities above and beyond the contribution of verbal cognitive abilities. We also identify specific verbal and non-verbal cognitive tests that distinguish between typical children and children with LD, as well as LD severity. What are the potential or actual clinical implications of this work? Our findings support the importance of measuring both verbal and non-verbal cognitive skills when making an LD diagnosis. Our findings also point to the potential of targeting underlying cognitive skills as one strategy to support language abilities. We suggest that future intervention studies focus on the impact of non-verbal cognitive skills on language development in children with LD.

Speech/Language Impairment or Specific Learning Disability? Examining the Usage of Educational Categories

PURPOSE

Developmental language disorder (DLD) is a lifelong condition that when impacting educational performance is identified and serviced through U.S. schools as outlined in the Individuals with Disabilities Education Act. A few examples of educational categories that refer to DLD are (a) speech or language impairment (S/LI) and (b) specific learning disability (SLD). In this research note, we aim to examine trends in how these categories are assigned.

METHOD

We analyzed publicly available data released by the U.S. Department of Education from six school years between 2010 and 2020. We examined the use of S/LI and SLD categories across students of different ages at the U.S. national and state levels.

RESULTS

We present a trend in which younger students tend to be identified with the S/LI category, whereas older students tend to be identified with the SLD category. This trend is evident in all 6 years of data analyzed at the national level, and in 49 of 50 states.

CONCLUSIONS

We discuss these findings in the context of research on language disorders to explain this trend. We highlight the potential damaging effects of using inconsistent terminology, including affecting the services for which students with DLD qualify and causing confusion for their parents and educators.

The significance of nonverbal performance in children with developmental language disorder

Nonverbal deficits are frequently reported in children with developmental language disorder (DLD). In the new diagnostic criteria of DLD, the previous requirement of normal nonverbal performance has been removed and children with below average and even weak nonverbal skills now fit under the DLD definition. However, the significance of the nonverbal cognitive level, and the connection between nonverbal and verbal skills in these children diagnosed according to the new DLD classification is unclear. In the present study, the significance of nonverbal cognitive level on verbal performance was investigated among preschool-aged children with remarkable deficits in language development. Verbal skills were compared between average, below average, and weak nonverbal cognitive level groups. The connection between nonverbal and verbal skills was evaluated with Pearson correlations, and the covariance structure of the subtests used was modeled with Structural Modelling. The connection between nonverbal cognitive level and verbal skills was clear; weaker nonverbal cognitive levels were associated with lower verbal skills. While receptive language skills and verbal short-term-memory (STM) were the most profound weaknesses, relative strengths emerged for each nonverbal cognitive level group in fluid intelligence, especially in nonverbal reasoning tasks without time limits. In addition, fluid intelligence was strongly linked to verbal understanding and reasoning. These results suggest that the relative strength in nonverbal fluid intelligence with specific weaknesses in receptive language, verbal understanding, and verbal STM could be used as basic factors differentiating children with DLD from those with intellectual disability.

Developmental Language Disorder Is Associated With Slower Processing Across Domains: A Meta-Analysis of Time-Based Tasks

PURPOSE

Individuals with developmental language disorder (DLD) often exhibit slower processing on time-based tasks in comparison with age-matched peers. Processing speed has been linked to various linguistic skills and might serve as a global indicator of individual differences in language abilities. Despite an extensive literature on processing speed in DLD, it remains unclear whether slower processing is domain general or restricted to linguistic and/or auditory tasks.

METHOD

This meta-analysis used robust variance estimation to compare response/reaction times (RTs) of DLD and age-matched groups (N = 812 DLD, 870 neurotypical; M _age [DLD] = 8.9 years, range: 4.3-22.7 years). Moderators included task (simple RT, choice RT, naming, congruent/baseline conditions of interference control tasks), stimulus type (linguistic/nonlinguistic), stimulus modality (auditory/nonauditory), and response modality (verbal/nonverbal). Age and publication year were covariates.

RESULTS

The overall effect based on 46 studies and 144 estimates indicated longer mean RTs in DLD groups (g = .47, p < .001, 95% CI [.38, .55]). Moderator analyses indicated larger effects when tasks required verbal as opposed to nonverbal responses. No other moderators approached significance. All subgroup analyses were significant, indicating longer mean RTs in DLD groups across tasks, stimulus types, stimulus modalities, and response modalities.

CONCLUSIONS

Individuals with DLD exhibit longer RTs across verbal and nonverbal tasks, which may contribute to observed difficulties in language, motor skills, and executive functioning. Simple processing speed measures should be included in screening for language delays but may not be suitable for differential diagnosis, given that slower processing may occur across multiple disorders.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809355.

Comparison of the Wechsler Preschool and Primary Scale of Intelligence-Third Edition and the Leiter-R Intellectual Assessments for Clinic-Referred Children

A review of clinical records was conducted for children with developmental, emotional, and behavioral difficulties who were assessed with both the Wechsler preschool and primary scale of intelligence-third edition (WPPSI-IIICDN; Wechsler, 2004) and the Leiter international performance scale-revised (Leiter-R; Roid & Miller, 1997) within the same psychological evaluation. Forty children, ages 3-7, were included in this study. Pearson correlations showed that the IQ scores of the two instruments are strongly related (r > .70; p < .001). However, paired t-tests showed that overall Leiter-R scores (M = 99.03) were significantly higher than WPPSI-IIICDN scores (PIQ; M = 82.28, FSIQ; M = 75.24) (p < .001). The discrepancies between the instrument's scores were clinically important as the use of only one of the two instruments could result in misclassification of child intellectual ability. These results should prompt professionals working with this clinical population to be cautious when using results from a single instrument in a child's intellectual evaluation.

Understanding the nature and severity of reading difficulties among students with language and reading comprehension difficulties

This study investigated the presence of word reading difficulties in a sample of students in Grades 1-4 (n = 357) identified with language and reading comprehension difficulties. This study also examined whether distinct word reading and listening comprehension profiles emerged within this sample and the extent to which these groups varied in performance on cognitive and demographic variables. Findings showed that the majority of students (51%) with language and reading comprehension difficulties demonstrated significant risk in word reading (more than 1 SD below the mean), even though the participant screening procedures did not examine word reading directly. Three latent profiles emerged when students were classified into subgroups based on their performance in listening comprehension (LC) and word reading (WR): (1) severe difficulties in LC and moderate difficulties in WR (11%), (2) mild difficulties in both LC and WR (50%), and (3) moderate difficulties in LC and mild difficulties in WR (39%). Of note, even though students were identified for participation on the basis of poor oral language and reading comprehension abilities, all profiles demonstrated some degree of word reading difficulties. Findings revealed there were differences in age and performance on measures of working memory, nonverbal reasoning, and reading comprehension performance between profiles. Implications for educators providing instruction to students with or at risk for dyslexia and developmental language disorders were discussed.

The speech and language profile of a child with Turner Syndrome- a case study

BACKGROUND

Turner syndrome is a genetic disorder that affects only females. It has specific cognitive characteristics, but speech and language data are scarce.

METHODS AND PROCEDURES

Prospective case report; we report a girl aged seven's cognitive and speech and language profile.

RESULTS

Cognitive assessment shows higher performance IQ (PIQ), and atypical cognitive profile for Turner syndrome. Speech and language assessment show a significant difference between receptive and expressive language levels. Although the girl did comprehend most of the language structure, there was a lack of it in spontaneous speech. She demonstrated inconsistency in the use of language morphology and complex linguistic structures, primarily because of significant inconsistency in her sound production. Although she produced the majority of phonemes correctly in isolation, her spontaneous speech production was incomprehensible.

CONCLUSION

Case studies of speech and language development may reveal a specific characteristic in the cases with Turner syndrome to delineate genetic factors from individual developmental variabilities.

Working Memory Performance in Children With Developmental Language Disorder: The Role of Domain

PURPOSE

This study examined working memory in children with developmental language disorder (DLD). The overarching goal of this work was to integrate three primary processing-based hypotheses of DLD, (a) limited verbal working memory, (b) slowed processing speed, and (c) inefficient inhibition of interference, by using the serial-order-in-a-box-complex span (SOB-CS) computational model as our theoretical framework. We also examined the role of domain in working memory performance by varying the domain of interference and recall (i.e., verbal vs. nonverbal) task demands.

METHOD

Participants were 55 school-age children, 21 children with DLD and 34 age-matched typically developing (TD) peers (9-13 years old).

RESULTS

Findings indicated that verbal and nonverbal working memory performance was poorer in the DLD than TD group. There was a modest benefit of dispersing interference and recall task demands across domains relative to task demands being within one domain, yet verbal interference affected performance to a greater degree than nonverbal interference in the DLD group.

CONCLUSIONS

Overall findings supported a role for each of the processing-based hypotheses of DLD, albeit an incomplete role. In contrast, the SOB-CS model accounted for interrelationships among these processing-based factors and provided an explanation across patterns of findings. Thus, the SOB-CS model represents a useful step forward in explaining processing in children with DLD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19526179.

The Genetic and Molecular Basis of Developmental Language Disorder: A Review

Language disorders are highly heritable and are influenced by complex interactions between genetic and environmental factors. Despite more than twenty years of research, we still lack critical understanding of the biological underpinnings of language. This review provides an overview of the genetic landscape of developmental language disorders (DLD), with an emphasis on the importance of defining the specific features (the phenotype) of DLD to inform gene discovery. We review the specific phenotype of DLD in the genetic literature, and the influence of historic variation in diagnostic inclusion criteria on researchers' ability to compare and replicate genotype-phenotype studies. This review provides an overview of the recently identified gene pathways in populations with DLD and explores current state-of-the-art approaches to genetic analysis based on the hypothesised architecture of DLD. We will show how recent global efforts to unify diagnostic criteria have vastly increased sample size and allow for large multi-cohort metanalyses, leading the identification of a growing number of contributory loci. We emphasise the important role of estimating the genetic architecture of DLD to decipher underlying genetic associations. Finally, we explore the potential for epigenetics and environmental interactions to further unravel the biological basis of language disorders.

What Children with Developmental Language Disorder Teach Us About Cross-Situational Word Learning

Children with developmental language disorder (DLD) served as a test case for determining the role of extant vocabulary knowledge, endogenous attention, and phonological working memory abilities in cross‐situational word learning. First‐graders (M_age = 7 years; 3 months), 44 with typical development (TD) and 28 with DLD, completed a cross‐situational word‐learning task comprised six cycles, followed by retention tests and independent assessments of attention, memory, and vocabulary. Children with DLD scored lower than those with TD on all measures of learning and retention, a performance gap that emerged in the first cycle of the cross‐situational protocol and that we attribute to weaknesses in initial encoding. Over cycles, children with DLD learned words at a similar rate as their TD peers but they were less flexible in their strategy use, demonstrating a propose‐but‐verify approach but never a statistical aggregation approach. Also, they drew upon different mechanisms to support their learning. Attention played a greater role for the children with DLD, whereas extant vocabulary size played a greater role for the children with TD. Children navigate the problem space of cross‐situational learning via varied routes. This conclusion is offered as motivation for theorists to capture all learners, not just the most typical ones.

Language Disorders Research on Bilingualism, School-Age, and Related Difficulties: A Scoping Review of Descriptive Studies

BACKGROUND

Developmental language disorder (DLD) often remains undetected until children shift from 'learning to read' to 'reading to learn,' around 9 years of age. Mono- and bilingual children with DLD frequently have co-occurring reading, attention, and related difficulties, compared to children with typical language development (TLD). Data for mono- and bilingual children with DLD and TLD would aid differentiation of language differences versus disorders in bilingual children.

OBJECTIVE

We conducted a scoping review of descriptive research on mono-and bilingual children < and >= 9 years old with DLD versus TLD, and related skills (auditory processing, attention, cognition, executive function, and reading).

DATA SOURCES

We searched PubMed for the terms "bilingual" and "language disorders" or "impairment" and "child[ren]" from August 1, 1979 through October 1, 2018.

CHARTING METHODS

Two abstracters charted all search results. Main exclusions were: secondary data/reviews, special populations, intervention studies, and case studies/series. Abstracted data included age, related skills measures', and four language groups of participants: monolingual DLD, monolingual TLD, bilingual DLD, and bilingual TLD.

RESULTS

Of 366 articles, 159 (43%) met inclusion criteria. Relatively few (14%, n = 22) included all 4 language groups, co-occurring difficulties other than nonverbal intelligence (n = 49, 31%) or reading (n = 51, 32%) or any 9-18 year-olds (31%, n = 48). Just 5 (3%) included only 9-18 year-olds. Among studies with any 9 to 18 year olds, just 4 (8%, 4/48) included 4 language groups.

CONCLUSIONS

Future research should include mono- and bilingual children with both DLD and TLD, beyond 8 years of age, along with data about their related skills.

The comparability of intelligence test results: Group- and individual-level comparisons of seven intelligence tests

A significant body of research has demonstrated that IQs obtained from different intelligence tests substantially correlate at the group level. Yet, there is minimal research investigating whether different intelligence tests yield comparable results for individuals. Examining this issue is paramount given that high-stakes decisions are based on individual test results. Consequently, we investigated whether seven current and widely used intelligence tests yielded comparable results for individuals between the ages of 4-20 years. Results mostly indicated substantial correlations between tests, although several significant mean differences at the group level were identified. Results associated with individual-level comparability indicated that the interpretation of exact IQ scores cannot be empirically supported, as the 95% confidence intervals could not be reliably replicated with different intelligence tests. Similar patterns also appeared for the individual-level comparability of nonverbal and verbal intelligence factor scores. Furthermore, the nominal level of intelligence systematically predicted IQ differences between tests, with above- and below-average IQ scores associated with larger differences as compared to average IQ scores. Analyses based on continuous data confirmed that differences appeared to increase toward the above-average IQ score range. These findings are critical as these are the ranges in which diagnostic questions most often arise in practice. Implications for test interpretation and test construction are discussed.

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.

Speech production factors and verbal working memory in children and adults with developmental language disorder

Verbal working memory (VWM) deficits are common in individuals with developmental language disorder (DLD) but are not well understood. This study evaluated how both memory and language production factors influence VWM performance in children and adults with DLD, focusing on the influence of serial position, phonological activation (PA), and lexical frequency. Participants were 30 children with DLD and 26 with typical language (TL), and 21 adults with DLD and 23 with TL. The participants completed a listening span task in which they were asked to recall the final words of sentences in sets of increasing size. Responses (dependent variable) were coded as correct, incorrect, or no response. Final words were coded for frequency, serial position within the set, and PA (number of occurrences of the initial phoneme, vowel, and whole word in the task). These variables, along with age and language status, were entered as predictors in mixed-effects multinomial regression models. Extreme serial position, greater PA, and higher frequency reduced incorrect and no responses. These effects were attenuated for the DLD group, and the effect of greater PA varied with set size. The findings suggest that for individuals with DLD, VWM performance is affected by more limited effective language experience and by the dynamic task demands.

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.

Perfil psicomotor y lenguaje en niños/as con Trastorno Específico del Lenguaje mixto escolarizados

El diagnóstico de trastorno específico del lenguaje (TEL) suele abordarse desde los saberes del profesional fonoaudiólogo con escaso aporte de otras disciplinas. Se ha demostrado que el desarrollo infantil es un proceso complejo influido por diferentes factores que se retroalimentan y participan en la evolución de habilidades, aptitudes y destrezas durante la niñez. Debido a la imbricación de distintas dimensiones, resulta de interés visualizar las interrelaciones que puedan darse entre la adquisición patológica del lenguaje y otras esferas del desarrollo. En este estudio se observaron los perfiles psicomotores de 22 niños/as diagnosticados con TEL mixto entre 5 y 7 años y 11 meses, que asistían a un establecimiento educacional gratuito de la Región Metropolitana de Chile. A continuación, se correlacionaron estos perfiles con algunas variables lingüísticas: vocabulario, gramática receptiva, gramática expresiva y fonología. Los resultados muestran que los niños/as con diagnóstico de TEL mixto presentan un perfil psicomotor normal o dispráxico, sin diferencias entre los tres rangos etarios estudiados. Todos los factores psicomotores correlacionan con al menos una variable lingüística, a excepción de lateralidad. El vocabulario fue la variable lingüística que correlacionó con más factores psicomotores. Los factores psicomotores que aparecieron más descendidos fueron noción de cuerpo, estructuración espaciotemporal y praxia fina.

Tense Marking in the Kindergarten Population: Testing the Bimodal Distribution Hypothesis

Purpose The purpose of this study was to explore whether evidence for a bimodal distribution of tense marking, previously documented in clinically referred samples, exists in a population-based sample of kindergarten children from a rural county in Tennessee. Method A measure of tense marking, the Test of Early Grammatical Impairment (TEGI) Screening Test, was individually administered to consented kindergarten students (N = 153) across three elementary schools in a single school district. The consented children constituted 73% of kindergartners in the district. Cluster analysis was used to evaluate the number and composition of latent classes that best fit the distribution of the TEGI Screening Test scores. Results Analysis of the scores revealed a distribution that deviated significantly from normality. Cluster analyses (Ward's, k-means, single linkage) revealed a two-cluster solution as the best fitting model. The very large effect-size difference in mean TEGI Screening Test score between the two clusters (d = 4.77) provides validation of an identifiable boundary delineating typical from atypical tense marking in this sample of kindergartners. The difference in tense marking across the two clusters was not attributable to child chronological age. The percentage of the sample comprising the low-performing cluster aligns with specific language impairment and developmental language disorder prevalence estimates. Conclusion Additional demonstrations of a bimodal distribution of tense marking in future studies with carefully defined samples could strengthen the clinical marker evidence and utility of this linguistic feature.

The complexity of early diagnostic decision making: A follow-up study of young children with language difficulties

BACKGROUND & AIMS

Due to the complexity of early diagnostic decision making, we examined the predictive value of an early diagnostic classification and early abilities on later best estimate diagnosis for 22 clinically referred children with language difficulties.

METHODS AND PROCEDURES

Four years after initial evaluation (Time 1), the clinical files of these children were reviewed. A best-estimate (BE) diagnosis of language disorder (LD), intellectual disability (ID), or autism spectrum disorder (ASD) was established, with ASD being most common.

OUTCOMES AND RESULTS

Early clinical classifications were relatively unstable or difficult to establish at a young age. The magnitude of children's cognitive and receptive language delay was a significant predictor of a later BE diagnosis of ID and LD respectively. A BE diagnosis of ASD, by contrast, could not be predicted from children's early social communication problems nor the presence of restricted and repetitive behaviors and interests.

CONCLUSIONS

Taken together, the results of this study suggest that language difficulties can be an early marker of a neurodevelopmental disorder which is often not identified at the age of first referral.

IMPLICATIONS

Eligibility for treatment should, therefore, be based on biopsychosocial case formulation rather than DSM or ICD diagnostic classification.

WHAT THIS PAPER ADDS?

In this study a dimensional approach was used to characterize the abilities of young children referred with mild to profound receptive and/or expressive language difficulties. Later on, a categorical approach was adopted to establish best estimate diagnoses. Our clinical, broadly defined sample reflects the heterogeneous intake of young children referred for diagnostic assessment. Other studies on diagnostic stability often only focus on one diagnostic category (and are explicitly excluding children with specific other diagnoses), not taking into account the difficulties of early differential diagnostic decision making and stability across different categories over time. Investigations of differential diagnosis within a clinical group, instead of only differentiating children with a specific diagnosis from typically developing children, may be more informative for clinicians.

Promoting Reading Achievement in Children With Developmental Language Disorders: What Can We Learn From Research on Specific Language Impairment and Dyslexia?

Purpose Specific language impairment (SLI; see also developmental language disorder) and dyslexia are separate, yet frequently co-occurring disorders that confer risks to reading comprehension and academic achievement. Until recently, most studies of one disorder had little consideration of the other, and each disorder was addressed by different practitioners. However, understanding how the two disorders relate to each other is important for advancing theories about each disorder and improving reading comprehension and academic achievement. The purpose of this clinical focus article is to integrate research on SLI and dyslexia as well as advocate for the consideration of comorbidities in future research and clinical practice. Method The first section reviews definitions as well as inclusionary and exclusionary criteria for SLI and dyslexia. The second section reviews research demonstrating that SLI and dyslexia are different disorders that often co-occur. Studies examining language, working memory, and academic achievement in children with separate versus co-occurring SLI and dyslexia are reviewed. The final section compares and contrasts school identification frameworks for children with SLI and dyslexia and considers the potential benefits of incorporating broad language skills into response to intervention (RTI) assessment frameworks. Conclusions Children with weak language skills are at a high risk of experiencing reading problems, but language difficulties are often hidden from view. Directly addressing language skills within school RTI frameworks can help improve the identification and treatment of children with SLI and dyslexia as well as support improved reading comprehension and academic achievement for all students. Presentation Video https://doi.org/10.23641/asha.13063793.

The Fast-Mapping Abilities of Adults With Developmental Language Disorder

Purpose The aim of the study was to determine the integrity of fast mapping among adults with developmental language disorder (DLD). Method Forty-eight adults with DLD or typical language development (TD) were presented with 24 novel words and photos of their unfamiliar referents from the semantic categories of mammal, bird, fruit, or insect in two conditions. In the fast-mapping condition, 12 of the 24 unfamiliar referents were presented, one at a time alongside a familiar referent (e.g., a dog) and a question (e.g., Is the tail of the torato up?). In the explicit-encoding condition, the other 12 unfamiliar referents were presented alone, one at a time, with a label (e.g., This is a spimer). Immediately after exposure (T1) and again after a 1-day interval (T2), memory for the word-to-exemplar link was measured with a three-alternative forced-choice test, requiring the participant to match a spoken word to one of three pictured referents from the training set. At T2, memory for semantic category information was measured with a four-alternative forced-choice test, requiring the participant to match a spoken word to one of four prototypical silhouettes representing each of the semantic categories. Results Performance on word-to-exemplar link recognition was stronger for words learned in the explicit-encoding than the fast-mapping condition and stronger for the TD group than the DLD group. Time was not a significant factor as both groups maintained posttraining levels of performance after a 1-day retention interval. Performance on semantic category recognition was stronger for words learned in the explicit-encoding than the fast-mapping condition and stronger for the TD group than the DLD group. The lower category recognition performance of the DLD group was related to their lower nonverbal IQ scores. Conclusion Contexts that allow for explicit encoding yield better learning of word-to-referent links than contexts that allow for fast mapping in both stronger and weaker learners. Adults with DLD have difficulty learning the link between words and referents, whether trained via fast mapping or explicit encoding and whether tested with exemplar or category referents. Retention is a relative strength for adults with DLD. Supplemental Material https://doi.org/10.23641/asha.12765551.

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.

Is Adult Second Language Acquisition Defective?

There is a large literature showing that adult L2 learners, in contrast to children, often fail to acquire native-like competence in the second language. Because of such age effects, adult L2 learning is often viewed as "fundamentally different" from child acquisition and defective in some way. However, adult L2 learners do not always do worse than child learners. Several studies (e.g., Sasaki, 1997; Dąbrowska and Street, 2006; Street, 2017; Dąbrowska, 2019) found considerable overlap between L1 and L2 speakers' performance on tasks tapping morphosyntactic knowledge. Crucially, these studies used grammatical comprehension tasks (e.g., picture selection) to test mastery of "functional" grammar (i.e., grammatical contrasts which correspond to a clear difference in meaning, such as the assignment of agent and patient roles in sentences with noncanonical word order and quantifier scope). In contrast, most ultimate attainment studies (e.g., Johnson and Newport, 1989; Flege et al., 1999; DeKeyser, 2000; DeKeyser et al., 2010) used a grammaticality judgment task (GST) which assessed mastery of "decorative" grammar, i.e., grammatical morphemes such as tense and agreement markers which make relatively little contribution to the meaning conveyed by a sentence. In this study, we directly compared native speakers, late immersion learners, and classroom foreign language learners on tasks assessing both aspects of grammar. As in earlier studies, we found significant differences between native speakers and both non-native groups in performance on "decorative" grammar, particularly when performance was assessed using spoken rather than written stimuli. However, the differences in performance on the "functional" grammar task were much smaller and statistically non-significant. Furthermore, even in the "decorative" grammar task, there was more overlap between native speakers and late L2 learners than reported in earlier research. We argue that this is because earlier studies underestimated the amount of variation found in native speakers.

Developmental Language Disorder: Applications for Advocacy, Research, and Clinical Service

Purpose

The CATALISE group (Bishop, Snowling, Thompson, Greenhalgh, & CATALISE Consortium, 2016; Bishop, Snowling, Thompson, Greenhalgh, & CATALISE-2 Consortium, 2017) recommended that the termdevelopmental language disorder(DLD) be used to refer to neurodevelopmental language deficit. In this tutorial, we explain the appropriate application of the term and present advantages in adhering to the CATALISE recommendations.

Conclusion

Both specific language impairment and DLD refer to a neurodevelopmental condition that impairs spoken language, is long-standing and, is not associated with any known causal condition. The applications of the termsspecific language impairmentandDLDdiffer in breadth and the extent to which identification depends upon functional impact. Use of the termDLDwould link advocacy efforts in the United States to those in other English-speaking countries. The criteria for identifying DLD presented in the CATALISE consensus offer opportunities for scientific progress while aligning well with practice in U.S. public schools.

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

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

You have the right to remain silent: The ability of adolescents with developmental language disorder to understand their legal rights

PURPOSE

This study compared Miranda Rights comprehension of adolescents with developmental language disorder (DLD) and their typically developing (TD) peers.

METHOD

Instruments for Assessing Understanding and Appreciation of Miranda Rights (Grisso, 1998) was administered to 20 adolescents with DLD and 20 age-matched TD peers.

RESULTS

The DLD group exhibited significantly greater difficulty in understanding and appreciating Miranda Rights than their TD peers. Adolescents with DLD were 7 times more likely to be at risk of failing to sufficiently understand the Miranda warnings than adolescents in the TD group.

DISCUSSION

Adolescents with DLD are particularly vulnerable to failing to understand Miranda Rights and the consequences of waiving them. Future work should determine if there is a link between difficulty comprehending legal rights and the high prevalence of adolescents with language disorder in juvenile detention facilities.

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.

Not All Nonverbal Tasks Are Equally Nonverbal: Comparing Two Tasks in Bilingual Kindergartners With and Without Developmental Language Disorder

Purpose This study investigates the interaction of language ability status, cultural experience, and nonverbal cognitive skill performance in Spanish-English bilinguals with typical development (TD) and developmental language disorder (DLD). Method One hundred sixty-nine Spanish-English bilingual kindergartener's scores on the Symbolic Memory and Cube Design subtests from the Universal Nonverbal Intelligence Test (Bracken & McCallum, 1998) were analyzed by language ability (TD vs. DLD). Results t tests and analysis of variance showed bilingual children with TD and DLD performed comparably to the Universal Nonverbal Intelligence Test norming sample on the cube design task, while children with DLD had significantly lower performance on the symbolic memory task. Conclusion These results suggest that cultural experience minimally impacted performance for bilingual children with typically developing language. Bilingual children with DLD were differentially impacted on symbolic memory, a task that is verbally mediated despite nonverbal administration and performance. Findings are discussed within the Cattell-Horn-Carroll theory of cognitive abilities.

Exploring the speech and language of individuals with non-syndromic submucous cleft palate: a preliminary report

BACKGROUND

Submucous cleft palate (SMCP) has a heterogeneous presentation and is often identified late or misdiagnosed. Diagnosis is prompted by speech, resonance or feeding symptoms associated with velopharyngeal insufficiency. However, the broader impacts of SMCP on communication have rarely been examined and therefore are poorly understood.

AIM

To describe the communicative profile of individuals with non-syndromic SMCP by examining speech, language and pragmatics (social language).

METHODS & PROCEDURES

Fifteen participants with SMCP aged 5;1-12;8, without a genetic diagnosis, participated in the study. Participants completed standardized assessments examining language, resonance, speech and non-verbal intellect. Parents also completed the Children's Communication Checklist (CCC-2), which provided a measure of overall communicative ability, including pragmatic skills. Formal language outcomes were compared with two cohorts: 36 individuals with overt non-syndromic clefts and 129 individuals with no history of clefting.

OUTCOMES & RESULTS

Speech intelligibility was reduced secondary to hypernasality, disordered articulation and/or impaired phonology (n = 7) in children with SMCP. Poorer overall language outcomes were observed for children with SMCP compared with both those with overt clefts and no history of clefting (p < 0.001). Language scores for children with SMCP ranged from impaired (n = 6) to above the standardized mean (n = 4). Receptive and expressive language performance were independently correlated with non-verbal IQ (p < 0.01). Those with severe language impairment (n = 4) also had borderline or impaired non-verbal IQ. Parents reported that speech and semantics were the most affected sub-domains of communication, while scores were the highest for the initiation domain. Speech and language skills were correlated strongly with pragmatics (r = 0.877, p < 0.01).

CONCLUSIONS & IMPLICATIONS

Overall, performance was variable within the SMCP group across speech, language and pragmatic assessments. In addition to well-documented speech difficulties, children with SMCP may have language or pragmatic impairments, suggesting that further neurodevelopmental influences may be at play. As such, for individuals with SMCP, additional clinical screening of language and pragmatic abilities may be required to ensure accurate diagnosis and guide both cleft and non-cleft related therapy programmes.

Prevalence of Publication Bias Tests in Speech, Language, and Hearing Research

PURPOSE

The purpose of this research note is to systematically document the extent that researchers who publish in American Speech-Language-Hearing Association (ASHA) journals search for and include unpublished literature in their meta-analyses and test for publication bias.

METHOD

This research note searched all ASHA peer-reviewed journals for published meta-analyses and reviewed all qualifying articles for characteristics related to the acknowledgment and assessment of publication bias.

RESULTS

Of meta-analyses published in ASHA journals, 75% discuss publication in some form; however, less than 50% test for publication bias. Further, only 38% (n = 11) interpreted the findings of these tests.

CONCLUSION

Findings reveal that more attention is needed to the presence and impact of publication bias. This research note concludes with 5 recommendations for addressing publication bias.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.7268648.

Children with mixed developmental language disorder have more insecure patterns of attachment

Background

Developmental Language disorders (DLD) are developmental disorders that can affect both expressive and receptive language. When severe and persistent, they are often associated with psychiatric comorbidities and poor social outcome. The development of language involves early parent-infant interactions. The quality of these interactions is reflected in the quality of the child’s attachment patterns.

We hypothesized that children with DLD are at greater risk of insecure attachment, making them more vulnerable to psychiatric comorbidities. Therefore, we investigated the patterns of attachment of children with expressive and mixed expressive- receptive DLD.

Methods

Forty-six participants, from 4 years 6 months to 7 years 5 months old, 12 with expressive Specific Language Impairment (DLD), and 35 with mixed DLD, were recruited through our learning disorder clinic, and compared to 23 normally developing children aged 3 years and a half. The quality of attachment was measured using the Attachment Stories Completion Task (ASCT) developed by Bretherton.

Results

Children with developmental mixed language disorders were significantly less secure and more disorganized than normally developing children.

Conclusions

Investigating the quality of attachment in children with DLD in the early stages could be important to adapt therapeutic strategies and to improve their social and psychiatric outcomes later in life.

Associations Between Manual Dexterity and Language Ability in School-Age Children

Purpose

We aimed to determine whether individual differences in manual dexterity are associated with specific language skills (nonword repetition, receptive vocabulary, and receptive grammar) after controlling for nonverbal abilities (visual–spatial working memory and intelligence).

Method

We assessed manual dexterity using the pegboard task and examined relationships with verbal and nonverbal abilities in a diverse community sample of children ( N = 63, mean age = 8;2 [year;months], range: 6;0–10;8) varying in language ability (Comprehensive Evaluation of Language Fundamentals–Fourth Edition core language score M = 105, range: 62–126; Semel, Wiig, & Secord, 2003).

Results

Correlational analyses indicated significant relationships between manual dexterity and performance on tests of nonword repetition, receptive vocabulary, receptive grammar, and nonverbal intelligence, after controlling for multiple comparisons. In regression analyses, manual dexterity remained a significant predictor of nonword repetition after controlling for nonverbal abilities and age. In contrast, manual dexterity was no longer significant in predicting receptive vocabulary or grammar when nonverbal intelligence was included as a factor in the model.

Conclusions

These findings build on prior work implicating poor fine motor control in child language disorders by identifying a robust relationship between manual dexterity and nonword repetition. Relationships between manual dexterity and receptive language abilities appear to be indirect and mediated by nonword repetition. For clinicians, the results underscore the importance of screening children with poor fine motor control for concomitant language impairments.

Receptive and expressive language characteristics of school-aged children with non-syndromic cleft lip and/or palate

BACKGROUND

Research investigating language skills in school-aged children with non-syndromic cleft lip and/or palate is sparse. Past studies focus on younger populations, lack key comparisons to demographically matched control cohorts or explore language as a component of broader academic skills. Trends of existing studies suggest that affected children may perform at a lower level compared with typically developing peers.

AIMS

To examine the receptive and expressive language skills of middle-school-aged children with non-syndromic cleft lip and palate (CLP) and cleft palate only (CP). Additionally, to explore the language skills of children with clefts compared with a non-cleft control group.

METHODS & PROCEDURES

Thirty-seven participants with orofacial clefts (aged 7;1-14;1 years) participated in the study: 19 with CLP (10 males; 9 females) and 18 with CP (8 males; 10 females). A non-cleft comparison group consisted of 129 individuals matched on age, sex and maternal education level. Participants completed formal language (Clinical Evaluation of Language Fundamentals, Fourth Edition) and non-verbal intellectual measurements (Wechsler Abbreviated Scale of Intelligence-WASI). Demographic and developmental information was obtained via parental interview. Further clinical details (e.g., surgery; hearing status) were extracted from patient medical files. Cleft and non-cleft language and non-verbal IQ outcomes were reported separately. Language outcomes were then compared between groups.

OUTCOMES & RESULTS

Participants with clefts achieved core (mean = 103.31, standard deviation (SD) = 10.31), receptive (mean = 102.51, SD = 11.60) and expressive (mean = 102.89, SD = 12.17) language index scores within the normative average range. A total of 14.1% and 17.8% of the cleft and non-cleft groups respectively had impairment (i.e., ≥ 1.25 SD below the mean) in one or more language domains. No significant differences were found in the three language index scores between cleft and non-cleft groups.

CONCLUSIONS & IMPLICATIONS

This study is the first formally to examine language skills alongside non-verbal IQ in school-aged children with clefts compared with a large matched non-cleft population. Results suggest that health professionals should evaluate each child as they present and not assume that a child with non-syndromic CLP or CP will also have co-occurring language difficulties. Where language falls in the average range, these skills can be harnessed to support areas of difficulty often associated with orofacial clefting, such as speech.

Family aggregation of language impairment in an isolated Chilean population from Robinson Crusoe Island

BACKGROUND

It has been reported that the inhabitants of the Chilean Robinson Crusoe Island have an increased frequency of specific language impairment (SLI) or developmental language disorder (DLD).

AIMS

To explore the familial aggregation of DLD in this community.

METHODS & PROCEDURES

We assessed the frequency of DLD amongst colonial children between the ages of 3 and 8;11 years (50 individuals from 45 nuclear families). Familial aggregation rates of language disorder were calculated by assessing all available first-degree relatives (n = 107, 77 parents, 25 siblings, five half-siblings) of the probands.

OUTCOMES & RESULTS

We found that 71% of the child population performed significantly below expected in measures of phonological production or expressive and receptive morphology. The majority of these children presented with severe expressive and/or receptive language difficulties. One-quarter of language-disordered probands primarily had phonological difficulties. Family members of affected probands experienced a higher risk of language disorder than those of typically developing probands. This increased risk was apparent regardless of non-verbal IQ.

CONCLUSIONS & IMPLICATIONS

The study substantiates the existence of a familial form of speech and language disorder on Robinson Crusoe Island. Furthermore, we find that the familiarity is stable regardless of non-verbal IQ, supporting the recent movement to reduce the importance of non-verbal IQ criterion in DLD diagnoses.

An Initial Investigation of the Neural Correlates of Word Processing in Preschoolers With Specific Language Impairment

Purpose

Previous behavioral studies have found deficits in lexical-semantic abilities in children with specific language impairment (SLI), including reduced depth and breadth of word knowledge. This study explored the neural correlates of early emerging familiar word processing in preschoolers with SLI and typical development.

Method

Fifteen preschoolers with typical development and 15 preschoolers with SLI were presented with pictures followed after a brief delay by an auditory label that did or did not match. Event-related brain potentials were time locked to the onset of the auditory labels. Children provided verbal judgments of whether the label matched the picture.

Results

There were no group differences in the accuracy of identifying when pictures and labels matched or mismatched. Event-related brain potential data revealed that mismatch trials elicited a robust N400 in both groups, with no group differences in mean amplitude or peak latency. However, the typically developing group demonstrated a more robust late positive component, elicited by mismatch trials.

Conclusions

These initial findings indicate that lexical-semantic access of early acquired words, indexed by the N400, does not differ between preschoolers with SLI and typical development when highly familiar words are presented in isolation. However, the typically developing group demonstrated a more mature profile of postlexical reanalysis and integration, indexed by an emerging late positive component. The findings lay the necessary groundwork for better understanding processing of newly learned words in children with SLI.

A Narrative Evaluation of Mandarin-Speaking Children With Language Impairment

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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