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

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

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

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.

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.

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

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

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.