Diagnostic Accuracy of Sentence Repetition and Nonword Repetition for Developmental Language Disorder in Vietnamese

Nonword Repetition in Children With Developmental Language Disorder: Revisiting the Case of Cantonese

PURPOSE

Nonword repetition (NWR) has been described as a clinical marker of developmental language disorder (DLD), as NWR tasks consistently discriminate between DLD and typical development (TD) cross-linguistically, with Cantonese as the only reported exception. This study reexamines whether NWR is able to generate TD/DLD group differences in Cantonese-speaking children by reporting on a novel set of NWR stimuli that take into account factors known to affect NWR performance and group differentiation, including lexicality, sublexicality, length, and syllable complexity.

METHOD

Sixteen Cantonese-speaking children with DLD and 16 age-matched children with TD repeated two sets of high-lexicality nonwords, where all constituent syllables are morphemic in Cantonese but meaningless when combined, and one set of low-lexicality nonwords, where all constituent syllables are nonmorphemic. Low-lexicality nonwords were further classified on sublexicality in terms of consonant-vowel (CV) combination attestedness (whether or not CV combinations in nonword syllables occur in real Cantonese words).

RESULTS

Children with DLD scored significantly below their peers with TD. Effect sizes showed that high-lexicality nonwords and nonword syllables with attested CV combinations offered the greatest TD/DLD group differentiation. Nonword length and syllable complexity did not affect TD/DLD group differentiation.

CONCLUSIONS

NWR can capture TD/DLD group differences in Cantonese-speaking children. Lexicality and sublexicality effects must be considered in designing NWR stimuli for TD/DLD group differentiation. Future studies should replicate the present study on a larger sample size and a younger population as well as examine the diagnostic accuracy of this NWR test.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25529371.

Sentence Repetition as a Diagnostic Tool for Developmental Language Disorder: A Systematic Review and Meta-Analysis

PURPOSE

This systematic review and multilevel meta-analysis examines the accuracy of sentence repetition (SR) tasks in distinguishing between typically developing (TD) children and children with developmental language disorder (DLD). It explores variation in the way that SR tasks are administered and/or evaluated and examines whether variability in the reported ability of SR to detect DLD is related to these differences.

METHOD

Four databases were searched to identify studies that had used an SR task on groups of monolingual children with DLD and TD children. Searches produced 3,459 articles, of which, after screening, 66 were included in the systematic review. A multilevel meta-analysis was then conducted using 46 of these studies. Multiple preregistered subgroup analyses were conducted in order to explore the sources of heterogeneity.

RESULTS

The systematic review found a great deal of methodological variation, with studies spanning 19 languages, 39 SR tasks, and four main methods of production scoring. There was also variation in study design, with different sampling (clinical and population sampling) and matching (age and language matching) methods. The overall meta-analysis found that, on average, TD children outperformed children with DLD on the SR tasks by 2.08 SDs. Subgroup analyses found that effect size only varied as a function of the matching method and language of the task.

CONCLUSIONS

Our results indicate that SR tasks can distinguish children with DLD from both age- and language-matched samples of TD children. The usefulness of SR appears robust to most kinds of task and study variation.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25864405.

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

SUPPLEMENTAL MATERIAL

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

Exploring the role of singing, semantics, and amusia screening in speech-in-noise perception in musicians and non-musicians

Sentence repetition has been the focus of extensive psycholinguistic research. The notion that music training can bolster speech perception in adverse auditory conditions has been met with mixed results. In this work, we sought to gauge the effect of babble noise on immediate repetition of spoken and sung phrases of varying semantic content (expository, narrative, and anomalous), initially in 100 English-speaking monolinguals with and without music training. The two cohorts also completed some non-musical cognitive tests and the Montreal Battery of Evaluation of Amusia (MBEA). When disregarding MBEA results, musicians were found to significantly outperform non-musicians in terms of overall repetition accuracy. Sung targets were recalled significantly better than spoken ones across groups in the presence of babble noise. Sung expository targets were recalled better than spoken expository ones, and semantically anomalous content was recalled more poorly in noise. Rerunning the analysis after eliminating thirteen participants who were diagnosed with amusia showed no significant group differences. This suggests that the notion of enhanced speech perception-in noise or otherwise-in musicians needs to be evaluated with caution. Musicianship aside, this study showed for the first time that sung targets presented in babble noise seem to be recalled better than spoken ones. We discuss the present design and the methodological approach of screening for amusia as factors which may partially account for some of the mixed results in the field.

A Narrative Approach to Synthesizing Research on Vietnamese Bilingual and Monolingual Children

PURPOSE

This review article offers a narrativized synthesis of my research over the past 15+ years with Vietnamese-speaking children based on data collected from individual bilingual and monolingual children in preschool and elementary schools.

METHOD

I begin with a positionality narrative to describe who I am in relation to the research conducted. I provide an overview of the research program including tool building and how my research with bilinguals in the United States led me to international collaborations in Vietnam.

RESULTS

I present main findings from this body of work in three areas: typical bilingual development, reading performance in Vietnam, and characteristics of developmental language disorder in the Vietnamese language. Implications within each area are discussed in terms of clinical application and future research directions. Practitioners and researchers alike can freely access the Vietnamese assessment tools created and validated to date from our website, https://vietslp.sdsu.edu/.

CONCLUSIONS

This research overview aims to offer clinicians and researchers the sociocultural context for understanding the relevance of this body of research. It also serves as an invitation for new generations of scholars, particularly scholars of color, to see their own unique positionings and perspectives as valuable and necessary for scientific innovation and progress.

PRESENTATION VIDEO

https://doi.org/10.23641/asha.23929491.

Locus of nonword repetition impairments in Mandarin-speaking children with developmental language disorder

Current theories of nonword repetition (NWR) impairments for children with Developmental Language Disorder (DLD) are developed predominantly using data from Indo-European languages. Seldom have relevant theories been attested to the morph-syllabic language Mandarin Chinese. The present research aimed to explore the locus of NWR impairments for Mandarin children with DLD. 80 Mandarin-speaking children with typical development (TD) and 80 children with DLD were compared on nonword repetition accuracy and error types. It was a three-factor design with language groups (children with DLD vs. TD children) as the between-subjects factor, and components (onset, rhyme, and tone) and syllable numbers (one to four syllables) as the within-subjects factors. The analysis showed that both groups had less accuracy on the two phonological segments (onset and rhyme) relative to tone and showed more errors in multi-syllable nonwords. Children with DLD exhibited more noticeable errors in onsets and rhymes, although they did not display similar issues with tones compared to TD children. Repeated measures ANOVAs showed that children with DLD had pronounced errors in onsets, especially in repeating multi-syllable nonwords. Error type analysis revealed that children with DLD displayed more multiple than single errors in nonword repetition. The results support the "segment-to-frame association" theory, suggesting that Mandarin children with DLD are constrained in the concurrent mapping process between onsets, rhymes, and tones.

A Sentence Repetition Task in Spanish language: a valid tool for early language assessment

PURPOSE

Sentence Repetition Tasks (SRT) have been widely used to assess early language abilities in different languages and populations. In addition, it has been proved that performance in SRTs serve as a clinical marker to detect language difficulties. However, most of the research has been conducted in English language and with children older than 4 years of age. Despite this scarcity, [1] developed a SRT for monolingual Spanish-speaking children between 2 and 4 years of age. Initial findings showed that it is a useful tool for discriminating children with different linguistic levels. In addition, the task showed concurrent validity with a nonword repetition task. In the current study we want to explore the predictive validity of this task.

METHODS

We conducted a longitudinal study including 20 monolingual Spanish-Speaking children who were tested twice, at 33 months of age and six months later. In addition to the SRT, participants completed a nonword repetition task [2] and the Spanish version of the Merrill-Palmer-R Developmental Scales [3].

RESULTS

showed strong and positive relationships between the different tests when first assessed. We also found strong and predictive relationships between the SRT at time 1 and SRT and the Merrill-Palmer-R at time 2.

CONCLUSION

We conclude that the SRT developed [1] is a valid tool for examining early language abilities and its changes over time.

Psycholinguistic profiling of children with sluggish cognitive tempo

Language disorders are frequently comorbid with attention deficit/hyperactivity disorder (ADHD). Sluggish cognitive tempo (SCT), a second attention disorder, may potentially explain some of the links between language disorders and ADHD. In this study we examined the psycholinguistic abilities of 207 children (mean age 7;10) with and without clinically significant levels of SCT symptoms to determine the degree to which symptoms of language disorder co-occur in cases of SCT. Analyses of children's tense-marking, nonword repetition, and sentence recall indicated that deficits in these areas were not associated with SCT. Instead, SCT appears to be more closely aligned with features of social (pragmatic) communication disorder.

Assessing phonological short-term memory in Greek: Reliability and validity of a non-word repetition test

This study explores the reliability and validity of a NWR task in a large cohort of 387 TD Greek-speaking children aged 7-13 years attending elementary (Grades 2-6) and secondary school (Grade 1), divided into six age groups. Further, the relationship between NWR and reading fluency skills as well as the predictive value of the NWR on reading fluency skills in TD children are examined. To investigate the external reliability of the NWR task, test-retest reliability was performed, and excellent test-retest reliability was found. Internal reliability was explored with Cronbach's alpha coefficient and good reliability was found. To explore convergent validity, correlation analysis between NWR and reading fluency was conducted and significant and strong correlations were found for all age groups excepted 2 (ages 9-10 and 12-13). To examine predictive validity, regression analysis was conducted between these two variables and showed that performance on NWR contributed significantly to reading fluency skills, suggesting that NWR skills are a good predictor of reading skills. Finally, it was explored whether the relevant scores increase as a function of age and found significant differences between groups that differed in 2 years or more, while this difference was no longer significant after 10 years. This finding suggests that phonological STM increases in capacity along with age, but only until the age of 10, where it seems to reach a ceiling. In addition, linear regression analysis showed that age contributed significantly to performance on NWR test. To sum up, the present study provides normative data of a NWR test for a wide age range, which does not exist in the Greek language (particularly for ages over 9 years) and it can be concluded that the present NWR test can be successfully used as a reliable and valid measure of phonological STM in the age range that was examined in this study.

Development and psychometric evaluation of the Persian Grammar-Phonology Screening Test: A preliminary study

This study aimed to develop a screening test for children suspected of developmental language disorders (DLD). The study was conducted in six steps. In the first two steps, we collected 34 sentences for the sentence repetition (SR) subtest, and 40 non-words for the non-word repetition (NWR) subtest, respectively. Experts determined the content validity in the third step and 19 sentences and 19 non-words were selected. In the fourth step, we draw simple pictures for the SR subtest. In the fifth step, two pilot studies were conducted on 30 and 35 Persian-speaking children aged 4.5-5.5 years, respectively. After calculating the discrimination index of the items, we removed items with the discrimination index less than 0.3. Nineteen sentences and 14 non-words remained in this step. In the sixth step, 92 typically developing (TD) children aged 4.5-5.5 and 10 children suspected of DLD were recruited. Then, we removed some items and evaluated the construct validity and reliability of the final form of the Persian Grammar-Phonology Screening Test (PGPST).The final form of the PGPST consisted of 16 sentences, and 11 non-words were developed. The correlation between the two subtests was 0.29. Children suspected of DLD in SR (p = .001) and NWR (p = .007) performed significantly worse than the TD children. The correlation between the two administrations of the test was 0.74 and 0.71, respectively, for SR and NWR. Cronbach's alpha was also 0.84 and 0.86 for the SR and NWR subtests, respectively. The PGPST is a quick and brief screening test with acceptable validity and reliability.

Sentence Repetition as a Clinical Marker for Mandarin-Speaking Preschoolers With Developmental Language Disorder

PURPOSE

Sentence repetition (SR) is believed to be a clinical marker for developmental language disorder (DLD) across many languages. This study explored the potential of a self-designed Mandarin SR task (MSRT) to reflect Mandarin-speaking preschoolers' language ability and to differentiate children with and without DLD in this population. Furthermore, we aimed to compare five scoring systems for evaluating children's MSRT performance.

METHOD

In Study 1, the MSRT was administered to 59 typically developing (TD) children aged 3;6 (years;months) to 6;5 in China. The task was examined regarding its ability to correlate with language indices derived from children's narrative samples. In Study 2, both a TD and a DLD group were recruited to investigate the task's sensitivity, specificity, and likelihood ratios to distinguish between children with and without DLD.

RESULTS

Study 1 showed that, using four of the five scoring methods, TD children's performance on the MSRT significantly correlated with all the language measures derived from narratives. Study 2 showed that the MSRT was able to differentiate children with and without DLD.

CONCLUSION

The MSRT is a promising tool to reflect language abilities and identify DLD in Mandarin-speaking preschoolers. Based on the current evidence, we recommend that researchers and clinicians select the number of errors in the syllable method or the binary method when scoring responses to meet their specific needs.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19386257.

Sentence Repetition as a Clinical Marker of Developmental Language Disorder: Evidence From Arabic

PURPOSE

Research on the typical and impaired grammatical acquisition of Arabic is limited. This study systematically examined the morphosyntactic abilities of Arabic-speaking children with and without developmental language disorder (DLD) using a novel sentence repetition task. The usefulness of the task as an indicator of DLD in Arabic was determined.

METHOD

A LITMUS (Language Impairment Testing in Multilingual Settings) sentence repetition task was developed in Palestinian Arabic (LITMUS-SR-PA-72) and administered to 30 children with DLD (M = 61.50 months, SD = 11.27) and 60 age-matched typically developing (TD) children (M = 63.85 months, SD = 10.16). The task targeted grammatical structures known to be problematic for Arabic-speaking children with DLD (language specific) and children with DLD across languages (language independent). Responses were scored using binary, error, and structural scoring methods.

RESULTS

Children with DLD scored below TD children on the LITMUS-SR-PA-72, in general, and in the repetition of language-specific and language-independent structures. The frequency of morphosyntactic errors was higher in the DLD group relative to the TD group. Despite the large similarity of the type of morphosyntactic errors between the two groups, some atypical errors were exclusively produced by the DLD group. The three scoring methods showed good diagnostic power in the discrimination between children with DLD and children without DLD.

CONCLUSIONS

Sentence repetition was an area of difficulty for Palestinian Arabic-speaking children with DLD. The DLD group demonstrated difficulties with language-specific and language-independent structures, particularly complex sentences with noncanonical word order. Most grammatical errors made by the DLD group resembled those of the TD group and were mostly omissions or substitutions of grammatical affixes or omissions of function words. SR appears to hold promise as a good indicator for the presence or absence of DLD in Arabic. Further validation of these findings using population-based studies is warranted. Supplemental Material https://doi.org/10.23641/asha.16968043.

Using Nonword Repetition to Identify Developmental Language Disorder in Monolingual and Bilingual Children: A Systematic Review and Meta-Analysis

Purpose A wealth of studies has assessed the diagnostic value of the nonword repetition task (NWRT) for the detection of developmental language disorder (DLD) in the clinical context of speech and language therapy, first in monolingual children and, more recently, in bilingual children. This review article reviews this literature systematically and conducts a meta-analysis on the discriminative power of this type of task in both populations. Method Three databases were used to select articles based on keyword combinations, which were then reviewed for relevance and methodological rigor based on internationally recognized checklists. From an initial pool of 488 studies, 46 studies were selected for inclusion in the systematic review, and 35 of these studies could be included in a meta-analysis. Results Most of the articles report significant discrimination between children with and without DLD in both monolingual and bilingual contexts, and the meta-analysis shows a large mean effect size. Three factors (age of the child, linguistic status, and language specificity of the task) yielded enough quantitative data for further exploration. Subgroups analysis shows variance in effect sizes, but none of the three factors, neither their interactions, were significant in a metaregression. We discuss how other, less explored factors (e.g., nature of the stimuli, scoring methods) could also contribute to differences in results. Sensitivity and specificity analyses reported in 33 studies confirmed that, despite possible effect size differences, the diagnostic accuracy of the NWRT is generally near thresholds considered to be discriminatory. It generally increases when it is combined with other tasks (e.g., parental questionnaire). Conclusions This review indicates that the NWRT is a promising diagnostic tool to identify children with DLD in monolingual and bilingual contexts with a large mean effect size. However, it seems necessary to choose the precise NWRT materials based on the children's language background and to complement the assessment sessions with other tools in order to ensure diagnosis and to obtain complete language profile of the child. Supplemental Material https://doi.org/10.23641/asha.15152370.

Nonword Repetition Performance of Arabic-Speaking Children With and Without Developmental Language Disorder: A Study on Diagnostic Accuracy

Purpose This study evaluates the effectiveness of a nonword repetition (NWR) task in discriminating between Palestinian Arabic-speaking children with developmental language disorder (DLD) and age-matched typically developing (TD) children. Method Participants were 30 children with DLD aged between 4;0 and 6;10 (years;months) and 60 TD children aged between 4;0 and 6;8 matched on chronological age. The Arabic version of a Quasi-Universal NWR task was administered. The task comprises 30 nonwords that vary in length, presence of consonant clusters (CCs) and wordlikeness ratings. Responses were scored using an item-level scoring method to assess the diagnostic accuracy of the task. Receiver operating characteristic curve analysis was conducted to determine the best cutoff point with the highest sensitivity and specificity values, and likelihood ratios were calculated. Results Children with DLD scored significantly lower on the NWR task than their age-matched TD peers. Only the DLD group was influenced by the phonological complexity of the nonwords, with nonwords with two CC being more difficult than nonwords with no or only one CC. For both groups, three-syllable nonwords were repeated less accurately than two- and one-syllable nonwords. Also, high word-like nonwords were repeated more accurately than nonwords with low wordlikeness ratings. The best cutoff score had sensitivity and specificity of 93% and highly informative likelihood ratios. Conclusions NWR was an area of difficulty for Palestinian Arabic-speaking children with DLD. NWR showed excellent discriminatory power in differentiating Arabic-speaking children diagnosed with DLD from their age-matched TD peers. NWR appears to hold promise for clinical use as it is a useful indicator of DLD in Arabic. These results need to be further validated using population-based studies. Supplemental Material https://doi.org/10.23641/asha.14880360.

Profiles of Linguistic Multicompetence in Vietnamese-English Speakers

Purpose Speech-language pathologists work with increasing numbers of multilingual speakers; however, even when the same languages are spoken, multilingual speakers are not homogeneous. Linguistic multicompetence (aka multi-competence) considers competency across all languages and is associated with multiple demographic, migration, linguistic, and cultural factors. Method This article examines the linguistic multicompetence of adults with Vietnamese heritage living in Australia (n = 271) and factors associated with varying profiles of multilingualism. Participants completed a self-report questionnaire (available in English and Vietnamese) regarding their language proficiency and associated factors. Results Participants were largely (76.6%) first-generation migrants to Australia. Three distinct profiles of linguistic multicompetence were statistically identified using a cluster analysis: (a) Vietnamese proficient (n = 81, 31%), (b) similar proficiency (n = 135, 52%), and (c) English proficient (n = 43, 17%); that is, half were proficient in both languages. Multinomial logistic regression analyses compared participants profiled as having similar proficiency with those who were more dominant in one language. Factors associated with the Vietnamese proficient group (compared with the similar proficiency group) were that the participants used Vietnamese much more than English with different people across different situations, were more likely to believe that maintaining Vietnamese helped them communicate in English, and earned less. Participants in the English proficient group used English more than Vietnamese with different people across different situations, were more likely to have lived in English-speaking countries longer, were younger in age, and were less likely to believe that maintaining Vietnamese helped improve academic study than those with similar proficiency. Conclusion Undertaking a comprehensive language profile is an important component of any multilingual assessment to enable speech-language pathologists to develop an understanding of different presentations of linguistic multicompetence, engage in culturally responsive practice, and acknowledge that high levels of competence can be achieved across multiple languages. Supplemental Material https://doi.org/10.23641/asha.14781984.

Sentence Repetition Tasks to Detect and Prevent Language Difficulties: A Scoping Review

Sentence repetition tasks (SRTs) have been widely used in language development research for decades. In recent years, there has been increasing interest in studying performance in SRTs as a clinical marker for language impairment. What are the characteristics of SRTs? For what purposes have SRTs been used? To what extent have they been used with young children, in different languages, and with different clinical populations? In order to answer these and other questions, we conducted a scoping review. Peer reviewed studies published in indexed scientific journals (2010–2021) were analyzed. A search in different databases yielded 258 studies. Research published in languages other than English or Spanish, adult samples, dissertations, case studies, artificial models, and theoretical publications were excluded. After this exclusion, 203 studies were analyzed. Our results show that most research using SRT were conducted with English monolingual speakers older than 5 years of age; studies with bilingual participants have mostly been published since 2016; and SRTs have been used with several non-typical populations. Research suggests that they are a reliable tool for identifying language difficulties and are specifically suitable for detecting developmental language disorder.

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

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