Deficits in Coordinative Bimanual Timing Precision in Children With Specific Language Impairment

Impaired motor skills and proprioceptive function in Mandarin-speaking children with developmental language disorder

This study examined proprioceptive acuity and its relationship with motor function in Mandarin-speaking children with and without developmental language disorder (DLD). Fifteen children aged 9-12 years with DLD and 15 age- and sex-matched typically developing (TD) children participated in this study. Children's motor function was assessed using the second edition of the Movement Assessment Battery for Children (MABC-2). Their proprioceptive acuity was measured based on the absolute error (i.e., proprioceptive bias) and variable error (i.e., proprioceptive precision) when performing joint position matching tasks. Compared with the TD group, the DLD group exhibited impaired motor function and poorer proprioceptive acuity, as evidenced by the lower scores on the MABC-2 and the higher rates of absolute and variable errors in the joint position matching tasks. A significant association between the proprioceptive bias (absolute error) and the MABC-2 total score was also observed in the combined cohort of children with and without DLD. We conclude that DLD is associated with proprioceptive dysfunction.

Children With Developmental Language Disorder Show Deficits in the Production of Musical Rhythmic Groupings

PURPOSE

Children with developmental language disorder (DLD) show evidence of domain-general deficits in sequentially patterned motor skills. This study focuses on the production of rhythmically grouped sequences drawn from a music task, with the hypothesis that children with DLD will show a sequential pattern learning deficit that crosses language and action domains.

METHOD

Fifty-seven 4- to 5-year-old children (36 with DLD) drummed and clapped a developmentally appropriate musical rhythmic sequence 24 times (clapped 12 times, drummed 12 times). The accuracy of rhythmic events (markings of claps, drums, and pauses in a target sequence) was assessed through a modification of classic speech and language transcription procedures. The variability and prosodic structure of the rhythmic groupings were also measured.

RESULTS

Children with DLD produced less accurate and more variable rhythmic groupings compared to their typically developing (TD) peers. While the final-position grouping of the sequence was especially vulnerable for all children, those with DLD included more co-occurring errors in initial and final groupings of the same rhythmic sequence. Both TD children and children with DLD were less accurate in the clapping than the drumming task. Neither rhythmic drumming nor clapping accuracy correlated with motor skill in either group of children.

CONCLUSIONS

This study provides novel evidence of a manual rhythmic grouping deficit in DLD, one that is motivated by language-not motor or speech-factors. Cognitive abilities necessary to organize rhythmic events into higher order groupings are impaired across music and language in children with DLD. Rhythmic organization and sequencing may serve an important role in diagnosis and intervention in this population.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24158745.

Manual Rhythmic Sequencing Skills in Children With Childhood Apraxia of Speech

PURPOSE

Rhythm is one procedural mechanism that underlies language and motor skill acquisition and has been implicated in children with childhood apraxia of speech (CAS). The purpose of this study is to investigate manual rhythmic sequencing skills in children with a history of or current CAS (hx/CAS) compared to children with typical development (TD).

METHOD

Thirty-eight children (18 with hx/CAS, 20 with TD), ages 5;0-12;8 (years;months), from across the United States participated in an online study. Participants imitated two rhythms in two different conditions, clapping and tapping. We assessed overall accuracy, mean number of beats, pause marking, and rhythmic sequence variability using the Mann-Whitney U test. Effect sizes were calculated to examine the influence of coordinative complexity on performance.

RESULTS

Compared to children with TD, children with hx/CAS marked fewer trials with a pause in both conditions of the easier rhythm and showed lower overall accuracy and more variable rhythmic sequences in both rhythms and conditions. The mean number of beats produced by children with hx/CAS and children with TD did not differ in three out of four rhythms/conditions. Unlike children with TD, children with hx/CAS showed little improvement from clapping to tapping across most dependent measures; reducing coordination demands did not improve performance in children with hx/CAS.

CONCLUSIONS

We found that children with hx/CAS show manual rhythmic deficits that are similar to the deficits they display in speech. These findings provide support for a domain-general cognitive mechanisms account of the rhythmic deficits observed across linguistic and nonlinguistic tasks in children with hx/CAS.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24052821.

A First-Person Account of Developmental Language Disorder

PURPOSE

The aim of this study is to share the lived experiences of an adult with developmental language disorder (DLD) and relate her experience to the evidence base and issues in clinical practice.

METHOD

We co-wrote a first-person account grounded in the research literature. We organized the account into six main sections: (a) the early signs of DLD; (b) diagnosis; (c) treatment; (d) the impact of DLD on family relationships, social-emotional health, and academic performance; and (e) considerations for practicing speech-language pathologists. We close with (f) the first author's current perspective on life with DLD.

CONCLUSIONS

The first author was diagnosed with moderate-to-severe DLD in early childhood, and she continues to exhibit subtle and occasional symptoms of DLD as an adult. At specific points in development, her family relationships were disrupted and her social, emotional, and academic functions were disabled, particularly in the school context. Supportive adults, especially her mother and her speech-language pathologist, helped lessen these impacts. DLD and its consequences also positively influenced her worldview and professional choices. The precise nature of her DLD and her experiences around the disorder will not be true of everyone with DLD. Nevertheless, the broad themes that emerge from her narrative are reflected in the evidence base and thus are likely applicable to many individuals with DLD or other neurodevelopmental conditions.

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.

A developmental account of the role of sequential dependencies in typical and atypical language learners

The Gerken lab has shown that infants are able to learn sound patterns that obligate local sequential dependencies that are no longer readily accessible to adults. The Goffman lab has shown that children with developmental language disorder (DLD) exhibit deficits in learning sequential dependencies that influence the acquisition of words and grammar, as well as other types of domain general sequences. Thus, DLD appears to be an impaired ability to detect and deploy sequential dependencies over multiple domains. We meld these two lines of research to propose a novel account in which sequential dependency learning is required for many phonological and morphosyntactic patterns in natural language and is also central to the language and domain general deficits that are attested in DLD. However, patterns that are not dependent on sequential dependencies but rather on networks of stored forms are learnable by children with DLD as well as by adults.

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Using Motor Tempi to Understand Rhythm and Grammatical Skills in Developmental Language Disorder and Typical Language Development

Children with developmental language disorder (DLD) show relative weaknesses on rhythm tasks beyond their characteristic linguistic impairments. The current study compares preferred tempo and the width of an entrainment region for 5- to 7-year-old typically developing (TD) children and children with DLD and considers the associations with rhythm aptitude and expressive grammar skills in the two populations. Preferred tempo was measured with a spontaneous motor tempo task (tapping tempo at a comfortable speed), and the width (range) of an entrainment region was measured by the difference between the upper (slow) and lower (fast) limits of tapping a rhythm normalized by an individual's spontaneous motor tempo. Data from N = 16 children with DLD and N = 114 TD children showed that whereas entrainment-region width did not differ across the two groups, slowest motor tempo, the determinant of the upper (slow) limit of the entrainment region, was at a faster tempo in children with DLD vs. TD. In other words, the DLD group could not pace their slow tapping as slowly as the TD group. Entrainment-region width was positively associated with rhythm aptitude and receptive grammar even after taking into account potential confounding factors, whereas expressive grammar did not show an association with any of the tapping measures. Preferred tempo was not associated with any study variables after including covariates in the analyses. These results motivate future neuroscientific studies of low-frequency neural oscillatory mechanisms as the potential neural correlates of entrainment-region width and their associations with musical rhythm and spoken language processing in children with typical and atypical language development.

An Investigation of Developmental Coordination Disorder Characteristics in Children With Childhood Apraxia of Speech

PURPOSE

Children with childhood apraxia of speech (CAS) evidence a high rate of co-occurring fine and gross motor deficits. This clinical focus article reports a preliminary investigation of characteristics of developmental coordination disorder (DCD), a neurodevelopmental disorder categorized by poor motor proficiency and functional limitations, in this population.

METHOD

Children with CAS underwent a comprehensive motor evaluation using the Movement Assessment Battery for Children-Second Edition, the Developmental Coordination Disorder Questionnaire, and a developmental history questionnaire to determine if they met criteria for a DCD diagnosis as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

RESULTS

Six out of seven participants met DCD criteria based on the DSM-5 criteria. Four of these children had a co-occurring diagnosis of developmental language disorder, and all met criteria for DCD.

CONCLUSIONS

Consistent with previous research, the majority of participants demonstrated motor deficits and 85% met criteria for DCD. Despite this high rate of motor deficits, only 57% had previously undergone a physical/occupational therapy evaluation and intervention and only one had a previous diagnosis of DCD. These findings suggest that formal movement assessments are essential for children with a CAS diagnosis.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20540193.

Contributions of early motor deficits in predicting language outcomes among preschoolers with developmental language disorder

Purpose: We assessed the extent to which language, speech, and fine/gross motor skills in preschoolers with developmental language disorder (DLD; also referred to as specific language impairment) predicted language outcome two years later.Method: Participants with DLD (n = 15) and typical development (TD; n = 14) completed language, speech, and fine/gross motor assessments annually, beginning as 4- to 5-year-olds (Year 1 timepoint) and continuing through 6 to 7 years of age (Year 3 timepoint). We performed Pearson correlation and hierarchical regression analyses to examine the relative contributions of Year 1 language, speech, and motor skills to Year 3 language outcome in each group.Result: Among children with DLD, Year 1 fine/gross motor scores positively correlated with Year 3 language scores, uniquely explaining 40% of the variance in language outcomes. Neither Year 1 language, speech-sound, nor speech-motor scores predicted language outcome in this group. Among children with TD, only Year 1 language predicted language outcome.Conclusion: This small longitudinal study reveals that, among preschoolers with DLD, certain early fine/gross motor deficits predict persistent language impairment. Future research that includes larger sample sizes and motor tasks that incorporate complex sequencing will enhance the understanding of the relationship between language, speech, and motor skills; specifically, whether certain motor deficits simply co-occur with language deficits or whether they are tied to DLD through shared impairments in sequential learning mechanisms.

A longitudinal study of the phonological organisation of novel word forms in children with developmental language disorder

Purpose: Deficits in the production of novel words, such as in nonword repetition tasks, are one of the early hallmarks of developmental language disorder (DLD). In children with DLD, the production of novel nonwords is characterised by speech sound inaccuracy. The focus of the present study is on the stable organisation of phonological sequences. Specifically, we aimed to identify the persistence of deficits in accuracy and in variability in sound sequencing in novel word production from pre-school to the early school years.Method: Children with and without DLD produced a set of six nonwords 12 times each, initially collected when children were 4- to 5-years old. Children repeated this task over the course of two years. Analyses included phonetic accuracy as well as network science indices of sound sequence organisation.Result: Children with DLD were less accurate than their peers with typical language at each timepoint, and their productions were markedly variable, as revealed by network science metrics; these children never converged with their peers with typical language.Conclusion: The findings suggest a unique deficit in phonological sequence production that persists beyond the pre-school years. These results offer new theoretical and clinical insights into mechanisms that underlie deficits in novel word form learning.

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

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

Developmental Language Disorder and Uninhibited Primitive Reflexes in Young Children

Purpose Developmental language disorder (DLD) is a developmental disorder where children fail to acquire language in the absence of a clear cause. Many studies have reported general motor deficits in children with DLD, but no studies have uncovered a cure. The purpose of our study is to better understand the underlying motor deficits in DLD, starting from uninhibited primary reflexes-which are the most basic stage of motor development. Knowledge of this motor-language relationship should lead to earlier and more targeted interventions in young children with DLD. Method Children with DLD (n = 75, age range: 4-10 years) and 99 age-matched typically developing (TD) children completed a nonword repetition test to assess DLD and six other tests to assess primitive reflexes. Results Children with DLD demonstrated higher levels of persistent primitive reflexes compared to TD children. As the scores for neuromotor immaturity increased, nonword repetition test scores decreased (r = -.44, p < .01). Results indicated that TD children exhibited lower neuromotor immaturity (M = 7.63, SD = 3.75) compared to children with DLD (M = 13.51, SD = 4.47). All primitive reflexes (the Moro reflex, the symmetrical tonic neck reflex in flexion and in extension, the asymmetrical tonic neck reflex, the tonic labyrinthine reflex, and the Galant reflex) turned out to be statistically significantly different for the TD and DLD groups (p < .001). We also observed some differences between sexes. Conclusions Children with impaired language development underwent slower neuromotor development. However, further research is needed to determine whether motor intervention programs that inhibit primitive reflexes are helpful for children with DLD.

Not All Procedural Learning Tasks Are Difficult for Adults With Developmental Language Disorder

Purpose The experiment reported here compared two hypotheses for the poor statistical and artificial grammar learning often seen in children and adults with developmental language disorder (DLD; also known as specific language impairment). The procedural learning deficit hypothesis states that implicit learning of rule-based input is impaired, whereas the sequential pattern learning deficit hypothesis states that poor performance is only seen when learners must implicitly compute sequential dependencies. The current experiment tested learning of an artificial grammar that could be learned via feature activation, as observed in an associatively organized lexicon, without computing sequential dependencies and should therefore be learnable on the sequential pattern learning deficit hypothesis, but not on the procedural learning deficit hypothesis. Method Adults with DLD and adults with typical language development (TD) listened to consonant-vowel-consonant-vowel familiarization words from one of two artificial phonological grammars: Family Resemblance (two out of three features) and a control (exclusive OR, in which both consonants are voiced OR both consonants are voiceless) grammar in which no learning was predicted for either group. At test, all participants rated 32 test words as to whether or not they conformed to the pattern in the familiarization words. Results Adults with DLD and adults with TD showed equal and robust learning of the Family Resemblance grammar, accepting significantly more conforming than nonconforming test items. Both groups who were familiarized with the Family Resemblance grammar also outperformed those who were familiarized with the OR grammar, which, as predicted, was learned by neither group. Conclusion Although adults and children with DLD often underperform, compared to their peers with TD, on statistical and artificial grammar learning tasks, poor performance appears to be tied to the implicit computation of sequential dependencies, as predicted by the sequential pattern learning deficit hypothesis.

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

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

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

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

Diagnosis of Developmental Language Disorder in Research Studies

Purpose The aim of this study was to investigate the extent to which researchers in the field of developmental language disorder are utilizing validated methods to diagnose their research participants. Method We examined 90 research articles published from 2015 to 2019 that included English-speaking participants from the United States who were identified as having a developmental language disorder or specific language impairment. From these articles, we identified the tests and measures used to identify participants and classify them as healthy or impaired. We then consulted the test manuals and the literature to find information on sensitivity and specificity of the test and the evidence-based cut score that maximized identification accuracy. Results Of the 90 articles examined, 38 (42%) were found to reflect validated diagnostic methods, and 51 (58%) did not. Conclusion Our results illustrate that validated methods are used less than half of the time even by those who should have a high level of expertise and despite calls for increasing scientific rigor in research practices.

How Children with Autism Spectrum Disorder, Developmental Language Disorder, and Typical Language Learn to Produce Global and Local Semantic Features

A local processing bias, often considered a cognitive style unique to autism spectrum disorder (ASD), may influence the types of semantic features acquired by children with ASD and could contribute to weaknesses in word learning. Children with developmental language disorder (DLD) also struggle to learn semantic aspects of words, but this cognitive style has not been ascribed to children with DLD. The purpose of this study was to explore whether global–local processing differences influence the type of semantic features children with ASD, DLD, and their neurotypical peers learn to produce when learning new words. Novel word definitions produced by 36 school-aged children (12 with ASD, 12 with DLD, and 12 with typical language) who participated in an extended word-learning paradigm were used to extract newly learned semantic features. These semantic features were then coded for global and local attributes and analyzed to detect whether there were differences between groups. Results indicated that the children with ASD and DLD produced more global, rather than local, semantic features in their definitions than the children with typical language. An over-reliance on global, rather than local, features in children with ASD and DLD may reflect deficits in depth of word knowledge.

Is atypical rhythm a risk factor for developmental speech and language disorders?

Although a growing literature points to substantial variation in speech/language abilities related to individual differences in musical abilities, mainstream models of communication sciences and disorders have not yet incorporated these individual differences into childhood speech/language development. This article reviews three sources of evidence in a comprehensive body of research aligning with three main themes: (a) associations between musical rhythm and speech/language processing, (b) musical rhythm in children with developmental speech/language disorders and common comorbid attentional and motor disorders, and (c) individual differences in mechanisms underlying rhythm processing in infants and their relationship with later speech/language development. In light of converging evidence on associations between musical rhythm and speech/language processing, we propose the Atypical Rhythm Risk Hypothesis, which posits that individuals with atypical rhythm are at higher risk for developmental speech/language disorders. The hypothesis is framed within the larger epidemiological literature in which recent methodological advances allow for large-scale testing of shared underlying biology across clinically distinct disorders. A series of predictions for future work testing the Atypical Rhythm Risk Hypothesis are outlined. We suggest that if a significant body of evidence is found to support this hypothesis, we can envision new risk factor models that incorporate atypical rhythm to predict the risk of developing speech/language disorders. Given the high prevalence of speech/language disorders in the population and the negative long-term social and economic consequences of gaps in identifying children at-risk, these new lines of research could potentially positively impact access to early identification and treatment. This article is categorized under: Linguistics > Language in Mind and Brain Neuroscience > Development Linguistics > Language Acquisition.

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.

Motor Performance in Children With Childhood Apraxia of Speech and Speech Sound Disorders

Purpose This study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development (TD) would perform differently on a standardized motor assessment and (b) whether comorbid language impairment would impact group differences. Method Speech, language, and motor abilities were assessed in children with CAS (n = 10), SSD (n = 16), and TD (n = 14) between the ages of 43 and 105 months. Motor skills were evaluated using the Movement Assessment Battery for Children-Second Edition (Henderson, Sugden, & Barnett, 2007), a behavioral assessment that is sensitive in identifying fine/gross motor impairments in children with a range of motor and learning abilities. Data were reanalyzed after reclassifying children by language ability. Results The CAS group performed below the normal limit on all components of the motor assessment and more poorly than the TD and SSD groups on Aiming and Catching and Balance. When children were reclassified by language ability, the comorbid CAS + language impairment group performed worse than the SSD-only and TD groups on Manual Dexterity and Balance and worse than the TD group on Aiming and Catching; all 7 children with CAS + language impairment evidenced performance in the disordered range compared to 1 of 3 children in the CAS-only group and 2 of 6 children in the SSD + language impairment group. Conclusions Children with CAS + language impairment appear to be at an increased risk for motor impairments, which may negatively impact social, academic, and vocational outcomes; referrals for motor screenings/assessments should be considered. Findings may suggest a higher order deficit that mediates cognitive-linguistic and motor impairments in this population.

Language Skill Mediates the Relationship Between Language Load and Articulatory Variability in Children With Language and Speech Sound Disorders

PURPOSE

The aim of the study was to investigate the relationship between language load and articulatory variability in children with language and speech sound disorders, including childhood apraxia of speech.

METHOD

Forty-six children, ages 48-92 months, participated in the current study, including children with speech sound disorder, developmental language disorder (aka specific language impairment), childhood apraxia of speech, and typical development. Children imitated (low language load task) then retrieved (high language load task) agent + action phrases. Articulatory variability was quantified using speech kinematics. We assessed language status and speech status (typical vs. impaired) in relation to articulatory variability.

RESULTS

All children showed increased articulatory variability in the retrieval task compared with the imitation task. However, only children with language impairment showed a disproportionate increase in articulatory variability in the retrieval task relative to peers with typical language skills.

CONCLUSION

Higher-level language processes affect lower-level speech motor control processes, and this relationship appears to be more strongly mediated by language than speech skill.

Children with specific language impairment are more likely to reach motor milestones late

BACKGROUND

Delayed language development without an obvious cause is considered an isolated developmental disorder and is called specific language impairment (SLI). SLI is probably the most prevalent developmental disorder in childhood with a generally cited prevalence of 7%. This study aimed to investigate whether SLI is always an isolated disorder or if children with SLI also have delayed motor development.

METHODS

We used data of an earlier study with a prospective nested case-control design in which developmental data were collected from child health care files. Cases were children (4-11 years) with diagnosed SLI. They were matched by sex and date of birth with control children attending mainstream education. Data of both groups on seven gross and six fine motor milestones which had been registered in the Dutch Developmental Instrument between the ages of 15-36 months were retrieved from child health care files. McNemar tests were performed to test for differences in reaching motor milestones at the age norm between the case and control group.

RESULTS

Data from 253 children in each group were available. A significant difference was found between both groups in the proportion failing to reach three of the seven investigated gross motor milestones at the age norm (p < 0.05). The proportion of children not reaching the motor milestone at the age norm was significantly higher for five of the six fine motor milestones in children with SLI compared with control children (p < 0.05).

CONCLUSIONS

More children with SLI are late in reaching motor milestones than children without SLI. This means that it is debatable whether SLI can be regarded as a "specific" impairment, which is not associated with other developmental problems. A broader developmental assessment is therefore indicated when diagnosing SLI.

An Application of Network Science to Phonological Sequence Learning in Children With Developmental Language Disorder

PURPOSE

Network science has been a valuable tool in language research for investigating relationships between complex linguistic elements but has not yet been applied to sound sequencing in production. In the present work, we used standard error-based accuracy and articulatory kinematic approaches as well as novel measures from network science to evaluate variability and sequencing errors in speech production in children with developmental language disorder (DLD; aka specific language impairment).

METHOD

Twelve preschoolers with DLD and 12 age-matched controls participated in a 3-day novel word learning study. Transcription and articulatory movement data were collected to measure accuracy and variability of productions, and networks of speech productions were generated to analyze syllable co-occurrence patterns.

RESULTS

Results indicated that children with DLD were less accurate than children with typical language at the segmental level. Crucially, these findings did not align with performance at the articulatory level, where there were no differences in movement variability between children with DLD and those with typical language. Network analyses revealed characteristics that were not captured by standard measures of phonetic accuracy, including a larger inventory of syllable forms, more connections between the forms, and less consistent production patterns.

CONCLUSIONS

Network science provides significant insights into phonological learning trajectories in children with DLD and their typically developing peers. Importantly, errors in word production by children with DLD do not surface as a result of weakness in articulatory control. Instead, results suggest that speech errors in DLD may relate to deficits in sound sequencing.

Influence of Language Load on Speech Motor Skill in Children With Specific Language Impairment

Purpose

Children with specific language impairment (SLI) show particular deficits in the generation of sequenced action: the quintessential procedural task. Practiced imitation of a sequence may become rote and require reduced procedural memory. This study explored whether speech motor deficits in children with SLI occur generally or only in conditions of high linguistic load, whether speech motor deficits diminish with practice, and whether it is beneficial to incorporate conditions of high load to understand speech production.

Method

Children with SLI and typical development participated in a syntactic priming task during which they generated sentences (high linguistic load) and, then, practiced repeating a sentence (low load) across 3 sessions. We assessed phonetic accuracy, speech movement variability, and duration.

Results

Children with SLI produced more variable articulatory movements than peers with typical development in the high load condition. The groups converged in the low load condition. Children with SLI continued to show increased articulatory stability over 3 practice sessions. Both groups produced generated sentences with increased duration and variability compared with repeated sentences.

Conclusions

Linguistic demands influence speech motor production. Children with SLI show reduced speech motor performance in tasks that require language generation but not when task demands are reduced in rote practice.

Exemplar Variability Facilitates Retention of Word Learning by Children With Specific Language Impairment

Purpose

Variability in the input plays an important role in language learning. The current study examined the role of object variability for new word learning by preschoolers with specific language impairment (SLI).

Method

Eighteen 4- and 5-year-old children with SLI were taught 8 new words in 3 short activities over the course of 3 sessions. Half of the children saw 3 identical objects corresponding to each new word during training (No Variability group); the other half of the children saw 3 different objects corresponding to each new word during training (High Variability group). Children completed vocabulary learning tests for objects seen during training and for new within-category objects that were never seen during training as a test of category generalization. Learning was assessed the day after each training activity, and retention was assessed 3 weeks after the last training session.

Results

There were no group differences on trained or generalization items immediately following training sessions. However, children in the High Variability group demonstrated significantly better retention 3 weeks after experimental training.

Conclusion

These findings demonstrate that object variability facilitates retention of new word learning by children with SLI.

Supplemental Material

https://doi.org/10.23641/asha.5583979.