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

Beyond Language Scores: How Language Exposure Informs Assessment of Nonword Repetition, Vocabulary and Narrative Macrostructure in Bilingual Turkish/Swedish Children with and without Developmental Language Disorder

As in many other countries, baseline data concerning the linguistic development of bilingual children in Sweden are lacking, and suitable methods for identifying developmental language disorder (DLD) in bilinguals are lacking as well. This study presents reference data from 108 typically developing (TD) Turkish/Swedish-speaking children aged 4;0-8;1, for a range of language tasks developed specifically for the assessment of bilinguals (LITMUS test battery, COST Action IS0804). We report on different types of nonword repetition (NWR) tasks (language-specific and language-independent), receptive and expressive vocabulary (Cross-Linguistic Lexical Tasks, CLTs), and narrative macrostructure comprehension and production (Multilingual Assessment Instrument for Narratives, MAIN) in Turkish, the children's home language, and in Swedish, the language of schooling and society. Performance was investigated in relation to age, language exposure, type of task, and (for NWR and narratives) vocabulary size. There was a positive development with age for all tasks, but effects of language exposure and vocabulary size differed between tasks. Six bilingual Turkish/Swedish children with DLD were individually compared to the TD children. TD/DLD performance overlapped substantially, particularly for NWR, and more so for the production than the comprehension tasks. Surprisingly, the discriminatory potential was poor for both language-specific and language-independent NWR. DLD case studies underscored the importance of interpreting language scores in relation to exposure history, and the need for an increased emphasis on functional language skills as reported by parents and teachers when assessing and diagnosing DLD in bilinguals.

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.

Identifying developmental language disorder (DLD) in multilingual children: A case study tutorial

PURPOSE

A long-standing issue in identifying developmental language disorder (DLD) in multilingual children is differentiating between effects of language experience and genuine impairment when clinicians often lack suitable norm-referenced assessments. In this tutorial we demonstrate, via a case study, that it is feasible to identify DLD in a multilingual child using the CATALISE diagnostic criteria, Language Impairment Testing in Multilingual Settings (LITMUS) assessment tools, and telepractice.

METHOD

This tutorial features a case study of one 6-year-old Urdu-Cantonese multilingual ethnic minority child, and seven age- and grade-matched multilinguals. They were tested via Zoom using Urdu versions of the Multilingual Assessment Instrument for Narratives (LITMUS-MAIN), the Crosslinguistic Lexical Task (LITMUS-CLT), the Crosslinguistic Nonword Repetition Test (LITMUS-CL-NWR), and the Sentence Repetition Task (LITMUS-SRep).

RESULT

The child scored significantly lower in the LITMUS tests compared to her peers in her best/first language of Urdu. Together with the presence of negative functional impact and poor prognostic features, and absence of associated biomedical conditions, the findings suggest this participant could be identified as having DLD using the CATALISE diagnostic criteria.

CONCLUSION

The result demonstrates the promise of this approach to collect reference data and identify DLD in multilingual children. The online LITMUS battery has the potential to support identification of multilingual DLD in any target language.

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.

The Effect of Background Noise, Bilingualism, Socioeconomic Status, and Cognitive Functioning on Primary School Children's Narrative Listening Comprehension

PURPOSE

This study focuses on 7- to 9-year-old children attending primary school in Swedish areas of low socioeconomic status, where most children's school language is their second language. The aim was to better understand what factors influence these children's narrative listening comprehension both in an ideal listening condition (in quiet) and for the primary school classroom, a typical listening condition (with multitalker babble noise).

METHOD

A total of 86 typically developing 7- to 9-year-olds performed a narrative listening comprehension test (Lyssna, Förstå och Minnas [LFM]; English translation: Listen, Comprehend, and Remember) in two listening conditions: quiet and multitalker babble noise. They also performed the crosslinguistic nonword repetition test and a digit span backwards (DSB) test. A predictive statistical model including these factors, the children's degree of school language exposure, parental education level, and age was derived.

RESULTS

Listening condition had the strongest predictive value for LFM performance, followed by school language exposure and nonword repetition accuracy. Parental education level was also a significant predictor. There was a significant three-way interaction effect between listening condition, age, and DSB performance.

CONCLUSIONS

Multitalker babble noise has a negative effect on children's narrative listening comprehension. The effect of multitalker babble noise could be explained by age differences in the ability to allocate working memory capacity during the narrative listening comprehension task, suggesting that younger children may be more vulnerable for missing information when listening in background noise than their older peers.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25209248.

Factors affecting judgment accuracy when scoring children's responses to non-word repetition stimuli in real time

BACKGROUND

Non-word repetition (NWR) tests are an important way speech and language therapists (SaLTs) assess language development. NWR tests are often scored whilst participants make their responses (i.e., in real time) in clinical and research reports (documented here via a secondary analysis of a published systematic review).

AIMS

The main aim was to determine the extent to which real-time coding of NWR stimuli at the whole-item level (as correct/incorrect) was predicted by models that had varying levels of detail provided from phonemic transcriptions using several linear mixed method (LMM) models.

METHODS & PROCEDURES

Live scores and recordings of responses on the universal non-word repetition (UNWR) test were available for 146 children aged between 3 and 6 years where the sample included all children starting in five UK schools in one year or two consecutive years. Transcriptions were made of responses to two-syllable NWR stimuli for all children and these were checked for reliability within and between transcribers. Signal detection analysis showed that consonants were missed when judgments were made live. Statistical comparisons of the discrepancies between target stimuli and transcriptions of children's responses were then made and these were regressed against live score accuracy. Six LMM models (three normalized: 1a, 2a, 3a; and three non-normalized: 1b, 2b, 3b) were examined to identify which model(s) best captured the data variance. Errors on consonants for live scores were determined by comparison with the transcriptions in the following ways (the dependent variables for each pair of models): (1) consonants alone; (2) substitutions, deletions and insertions of consonants identified after automatic alignment of live and transcribed materials; and (3) as with (2) but where substitutions were coded further as place, manner and voicing errors.

OUTCOMES & RESULTS

The normalized model that coded consonants in non-words as 'incorrect' at the level of substitutions, deletions and insertions (2b) provided the best fit to the real-time coding responses in terms of marginal R2, Akaike's information criterion (AIC) and Bayesian information criterion (BIC) statistics.

CONCLUSIONS & IMPLICATIONS

Errors that occur on consonants when non-word stimuli are scored in real time are characterized solely by the substitution, deletion and insertion measure. It is important to know that such errors arise when real-time judgments are made because NWR tasks are used to assess and diagnose several cognitive-linguistic impairments. One broader implication of the results is that future work could automate the analysis procedures to provide the required information objectively and quickly without having to transcribe data.

WHAT THIS PAPER ADDS

What is already known on this subject Children and patients with a wide range of cognitive and language difficulties are less accurate relative to controls when they attempt to repeat non-words. Responses to non-words are often scored as correct or incorrect at the time the test is conducted. Limited assessments of this scoring procedure have been conducted to date. What this study adds to the existing knowledge Live NWR scores made by 146 children were available and the accuracy of these judgements was assessed here against ones based on phonemic transcriptions. Signal detection analyses showed that live scoring missed consonant errors in children's responses. Further analyses, using linear mixed effect models, showed that live judgments led to consonant substitution, deletion and insertion errors. What are the practical and clinical implications of this work? Improved and practicable NWR scoring procedures are required to provide SaLTs with better indications about children's language development (typical and atypical) and for clinical assessments of older people. The procedures currently used miss substitutions, deletions and insertions. Hence, procedures are required that provide the information currently only available when materials are transcribed manually. The possibility of training automatic speech recognizers to provide this level of detail is raised.

Whole exome sequencing and polygenic assessment of a Swedish cohort with severe developmental language disorder

Developmental language disorder (DLD) overlaps clinically, genetically, and pathologically with other neurodevelopmental disorders (NDD), corroborating the concept of the NDD continuum. There is a lack of studies to understand the whole genetic spectrum in individuals with DLD. Previously, we recruited 61 probands with severe DLD from 59 families and examined 59 of them and their families using microarray genotyping with a 6.8% diagnostic yield. Herein, we investigated 53 of those probands using whole exome sequencing (WES). Additionally, we used polygenic risk scores (PRS) to understand the within family enrichment of neurodevelopmental difficulties and examine the associations between the results of language-related tests in the probands and language-related PRS. We identified clinically significant variants in four probands, resulting in a 7.5% (4/53) molecular diagnostic yield. Those variants were in PAK2, MED13, PLCB4, and TNRC6B. We also prioritized additional variants for future studies for their role in DLD, including high-impact variants in PARD3 and DIP2C. PRS did not explain the aggregation of neurodevelopmental difficulties in these families. We did not detect significant associations between the language-related tests and language-related PRS. Our results support using WES as the first-tier genetic test for DLD as it can identify monogenic DLD forms. Large-scale sequencing studies for DLD are needed to identify new genes and investigate the polygenic contribution to the condition.

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.

Morphosyntactic skills in Arabic-speaking children with autism spectrum disorder: Evidence from error patterns in the sentence repetition task

Background and aims

Although autism spectrum disorder (ASD) has not traditionally been associated with morphosyntactic impairments, some children with ASD manifest significant difficulties in this domain. Sentence Repetition (SRep) tasks are highly reliable tools for detecting morphosyntactic impairment in different languages and across various populations, including children with ASD. This study is among the first to evaluate morphosyntactic abilities of Palestinian-Arabic (PA) speaking children using a PA SRep task.

Methods

A total of 142 PA-speaking children, aged 5-11, participated in the study: 75 children with typical language development (TLD) and 67 children with ASD. The PA SRep task targeted morphosyntactic structures of varying complexity (simple subject-verb-object [SVO] sentences, biclausal sentences, wh-questions, relative clauses). Children's accuracy scores were assessed across these structures and error patterns encompassing morphosyntactic and pragmatic aspects were analyzed.

Results

Two subgroups of ASD emerged: 43% showed age-appropriate language skills (ASD  +  NL) pairing up with TLD peers, while 57% showed signs of morphosyntactic impairment (ASD  +  LI). Children in both groups exhibited a higher frequency of morphosyntactic errors than pragmatic ones. Children with ASD  +  LI showed difficulties with producing complex morphosyntactic structures, such as relative clauses and object wh-questions. Error analysis revealed that children in the ASD  +  LI group produced sentence fragments and simplified constructions when complex structures were targeted.

Conclusions

The current study extends the cross-linguistic evidence of the heterogeneity of morphosyntactic profiles in children with ASD to Arabic-speaking children. Error analysis indicates that poor morphosyntax, rather than pragmatics, challenges children's performance on the SRep task.

Implications

Our results emphasize the importance of comprehensive language assessment in children with ASD and underscore the need for tailored intervention plans targeting impaired morphosyntactic structures in some children with ASD.

A preliminary study of the effects of stimulant medications on estimates of psycholinguistic abilities for children with attention-deficit/hyperactivity disorder

Underlying deficits in inattention, hyperactivity, and/or impulsivity might contribute to suboptimal test-taking behaviours during language assessments that can lead to diagnostic errors. Considerations of potential medication effects on estimates of children's nonword repetition, sentence recall, tense-marking, and narrative abilities are warranted given long-standing enthusiasm for these indices to serve as clinical markers for developmental language disorder (DLD). A battery consisting of 1 nonverbal, 1 reading, and 6 verbal measures was administered twice to 26 children (6-9 years) with independently diagnosed combined-type attention-deficit/hyperactivity disorder (ADHD). All participants had been prescribed stimulant medications for the management of their ADHD symptoms and were assessed off- and on-medication, with order counter-balanced across participants. Half of the participants had concomitant DLD. Examiners were unaware of children's clinical status during assessments or when they were testing children who had received medication. Effect sizes were calculated for each measure. Significant score differences indicating a beneficial impact of stimulant medications on children's performances were observed on the recalling sentences subtest of the Clinical Evaluation of Language Fundamentals and the Picture Peabody Vocabulary Test. Adjustments may be needed when speech language pathologists use sentence recall or receptive vocabulary measures to make diagnostic decisions with children who have ADHD.

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.

Developmental patterns of non-word repetition by monolingual and bilingual school-aged children

PURPOSE

The present study examines cross-sectional trends in performance on a quasi-universal non-word repetition (NWR) task. It also considers whether NWR performance is dependent on levels of exposure to a language and compares the performance of bilingual children across their two languages.

METHOD

A cross-sectional design was employed. The English and French quasi-universal NWR tasks, featuring stimuli from two to five syllables in length, was administered to Canadian school-aged monolinguals and two groups of bilinguals: those who encountered their second language in early childhood and those who encountered their second language at school entry.

RESULT

When evaluated in English, the early-exposure bilinguals produced significantly fewer errors than the school-entry exposure bilinguals and the English monolingual groups. When evaluated in French, the early-exposure bilinguals and the French monolinguals produced significantly fewer errors than the school-entry exposure bilinguals. Compared across languages, the French monolinguals produced fewer errors on the French version of the NWR task than the English monolinguals did on the English version of the same task. In both languages and across all analyses, the youngest age group (7-8 years) produced more errors than the two older groups (9-10 years and 11-12 years).

CONCLUSION

The quasi-universal NWR task showed sensitivity to improvements from 7 to 11 years of age in English and up to 9 years of age in French. Better performance in French may be due to the relatively greater frequency of multisyllabic words in that language. The development and use of this particular NWR task with monolinguals and bilinguals-in both of their languages-contribute to a deeper understanding of quasi-universal NWR performance in typically developing children.

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.

The automated screening of speech motor development in children based on the sequential motion rate

BACKGROUND

Motor skills in children have traditionally been examined via challenging speech tasks such as syllable repetition, and calculating the syllabic rate using a stopwatch or by inspecting the oscillogram followed by a laborious comparison of the scores on a look-up table representing the typical performances of children of the given age and sex. As the commonly used performance tables are over-simplified to allow for manual scoring, we raise the question of whether a computational model of motor skills development could be more informative, and could allow for the automated screening of children to detect underdeveloped motor skills.

METHODS

We recruited a total of 275 children aged four to 15 years. All the participants were native Czech speakers with no history of hearing or neurological impairments. We recorded each child's performance of/pa/-/ta/-/ka/syllable repetition. Various parameters of diadochokinesis (DDK; DDK rate, DDK regularity, voice onset time [VOT] ratio, syllable, vowel and VOT duration) were investigated in the acoustic signals using supervised reference labels. Female and male participants were analyzed separately by comparing younger, middle, and older age groups of children via ANOVA. Finally, we implemented a fully automated model that estimated the developmental age of a child based on the acoustic signal, and evaluated its accuracy using Pearson's correlation coefficient and normalized root-mean-squared errors (RMSEs).

RESULTS

The DDK rate reflected the ages of the children proportionally (p < 0.001). Other DDK parameters also showed strong sensitivity to age (p < 0.001), with the exception of VOT duration, which had a smaller effect (p = 0.091). The effect of age was found to be sex specific for the syllable length (p < 0.001) and DDK rate (p = 0.003). We observed that females spoke more slowly and had a longer VOT at preschool age (p < 0.001). The DDK rate obtained via the automated algorithm was strongly correlated with the reference (p < 0.001, Pearson's correlation coefficient of 0.97), with a low normalized RMSE of 3.77%.

CONCLUSIONS

As children develop their motor skills, they are capable of shortening the vowels to increase the rate of syllabic repetitions. The nonlinear development in childhood and adolescence, with a steady state in adulthood, follows a logistic function for the DDK rate. This study demonstrates that the development of motor skills can be examined sensitively and more appropriately by a fully automated noninvasive procedure that also accounts for the dispersion of values within age brackets.

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.

A new dynamic word learning task to diagnose language disorder in French-speaking monolingual and bilingual children

Tools to effectively assess the language performance of bilingual children are lacking. Static tests assessing vocabulary knowledge (e.g., naming task) are not appropriate for testing bilingual children due to different types of bias. Alternative methods have been developed to diagnose bilingual children, including measuring language learning (e.g., word learning) through dynamic assessment. Research conducted with English-speaking children indicates that DA of word learning is effective in diagnosing language disorders in bilingual children. In this study, we examine whether a dynamic word learning task, using shared-storybook reading, can differentiate French-speaking (monolingual and bilingual) children with developmental language disorder (DLD) from those with typical development (TD). Sixty children (4-8 years), 43 with TD and 17 with DLD, participated: 30 were monolinguals and 25 were bilinguals. The dynamic word-learning task used a shared-storybook reading context. The children had to learn four non-words, paired with novel objects, as well as their semantic characteristics (a category and a definition) during the reading of a story. Post-tests assessed the recall of the phonological form and the semantic features of the objects. Phonological and semantic prompts were given if the child was unable to name or describe the objects. Results indicated that children with DLD performed less well than those with TD on phonological recall, leading to fair sensitivity and good specificity at delayed post-test for young children (4-6 years). Semantic production did not differentiate the two groups: all children performed well at this task. In sum, children with DLD have more difficulties encoding the phonological form of the word. Our findings suggest that a dynamic word learning task using shared-storybook reading is a promising approach for diagnosing lexical difficulties in young French-speaking, monolingual and bilingual, children.

Working memory training in children with developmental language disorder: Effects on complex syntax in narratives

This study assesses the impact of a working memory training program on the syntactic complexity of the spontaneous speech of French-speaking children with Developmental Language Disorder (DLD). Thirty-nine 6- to 12-year-old children with DLD were allocated to a WM training (DLD^MM, N = 20) or an active control group (DLD^SQULA, N = 19). The computerized training sessions took place three times a week, yielding 12 training hours per participant. Syntactic complexity was assessed in storytelling, measuring mean length of utterances, use of embedded clauses and rate of errors in complex utterances. The performance of participants with DLD was first compared to previous spontaneous data of 40 typically-developing (TD) children of the same age. Then, intragroup (pre- vs. post-test) and intergroup (DLD^MM vs. DLD^SQULA) comparisons were made to assess the impact of the working memory training on the language measures. Global results confirmed syntactic impairment in children with DLD, as opposed to TD children, with large differences for the use of embedded clauses. Findings also suggested gains in the mastery of embedded clauses in children who participated in the WM training, whereas no gains were observed in the DLD control group. These findings confirm deficits in complex syntax in children with DLD, in particular in embedded clauses, and may encourage the clinical use of language sample analysis, which provides an ecological account of children's language performance. While our results should be replicated on a larger scale, they also suggest positive transfer effects of working memory training on the capacity of participants with DLD to produce embedded clauses, in line with previous studies showing a positive effect of WM training on tasks of expressive syntax. It thus seems that working memory training can yield benefits for language, which leaves open the door to new therapeutic approaches for children with DLD.

Identifying the risk of dyslexia in bilingual children: The potential of language-dependent and language-independent tasks

This study investigates the linguistic processing and non-linguistic cognitive abilities of monolingual and bilingual children with and without reading difficulties and examines the relationship between these skills and reading. There were 72 Italian-speaking children: 18 monolingual good readers (MONO-GR, M_age = 10;4), 19 monolingual poor readers (MONO-PR, M_age = 10;3), 21 bilingual good readers (BI-GR, M_age = 10;6), and 16 bilingual poor readers (BI-PR, M_age = 10;6). All bilingual children spoke Italian as their L2. Children completed a battery of standardized Italian reading tests, language-dependent tasks: nonword repetition (NWR), sentence repetition (SR), and phonological awareness (PA), and language-independent tasks: timing anticipation, beat synchronization, inhibition control, auditory reaction time, and rapid automatized naming (RAN). Poor readers scored below good readers on the language-dependent tasks, including NWR, PA, and SR. Beat synchronization was the only language-independent task sensitive to reading ability, with poor readers showing greater variability than good readers in tapping to fast rhythms. SR was the only task influenced by language experience as bilinguals underperformed monolinguals on the task. Moreover, there were weak to moderate correlations between performance on some language-dependent tasks (NWR, PA), language-independent tasks (inhibition control, RAN), and reading measures. Performance on the experimental tasks (except for RAN) was not associated with the length of exposure to Italian. The results highlight the potential of NWR, PA, SR, and beat synchronization tasks in identifying the risk of dyslexia in bilingual populations. Future research is needed to validate these findings and to establish the tasks' diagnostic accuracy.

Adversity effects on nonword repetition skills: A proxy measure of language and reading ability

BACKGROUND

Children exposed to adversity are at increased risk for underachievement in reading; however, how early that risk appears and the mechanisms underlying that risk are unclear.

OBJECTIVE

Identify whether individual variation in nonword repetition-a clinical indicator of language and reading ability-can be captured in early childhood (three- to five-years-old) and how various features of adversity exposure (e.g., dosage, severity) are associated with performance.

PARTICIPANTS AND SETTING

Community-based sample of children between the ages of three- and five-years-old who were exposed to significant adversity (n = 92) and living in a major Midwestern metropolitan area.

METHODS

Participants completed a nonword repetition task, and their parent completed a comprehensive adversity questionnaire to report on the child's cumulative lifetime adversity exposure.

RESULTS

Over a third of the participants (34.78 %) did not meet age expectations on the nonword repetition task; however, nonword repetition performance did not significantly associate with the features of the adverse experience (i.e., dosage, severity, frequency, chronicity).

CONCLUSIONS

Risk for underachievement in reading appears early in the preschool years for children exposed to adversity; however, the underlying mechanisms remain unclear since the features of the children's adverse experiences did not associate with their performance. Implications for prevention and early identification within the learning context are discussed.

Multiple Mechanisms of Word Learning in Late-Talking Children: A Longitudinal Study

PURPOSE

The aim of this study was to identify variability in word-learning mechanisms used by late-talking children using a longitudinal study design, which may explain variability in late-talking children's outcomes.

METHOD

A cohort of typically developing children (n = 40) and children who were classified as late-talking children at age 2;0 (years;months; ≤ 10th percentile on expressive vocabulary, n = 21) were followed up at ages 3;0 and 3;6. We tested the cohort across tasks designed to isolate different mechanisms involved in word learning: encoding and producing spoken forms of words (using a nonword repetition task), identifying referents for words (using a fast mapping task), and learning associations between words and referents (using a cross-situational word-learning task).

RESULTS

Late-talking children had lower accuracy on nonword repetition than typically developing children, despite most of the sample reaching typical ranges for expressive vocabulary at age 3;6. There were no between-groups differences in fast mapping and retention accuracy; however, both were predicted by concurrent expressive vocabulary. Late-talking children performed less accurately than typically developing children on cross-situational word-learning retention trials, despite showing no between-groups differences during training trials. Combining performance across all three tasks predicted approximately 45% of the variance in vocabulary outcomes at the last time point.

CONCLUSIONS

Late-talking children continue to have deficits in phonological representation that impact their word-learning ability and expressive language abilities but do not show difficulties in fast mapping novel words. Late-talking children may also struggle to retain associative information about word-referent mappings. Late-talking children thus use some, but not all, word-learning mechanisms differently than typically developing children.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20405856.

Detecting Developmental Language Disorder in Monolingual and Bilingual Children: Comparison of Language-Specific and Crosslinguistic Nonword Repetition Tasks in French and Portuguese

PURPOSE

Over the last decades, many studies have documented the clinical potential of nonword repetition (NWR) tasks for detecting developmental language disorder in mono- (MON) and bilingual (BIL) children by unveiling their difficulties in short-term memory and phonological accuracy. However, the precise nature of the nonwords to be used and the best scoring methods remain under debate. Some authors (e.g., Gutiérrez-Clellen & Simon-Cereijido, 2010) support the use of "language-specific" nonwords designed for a given test language in standardized tests. Other authors (e.g., Chiat, 2015) advocate the use of "crosslinguistic" stimuli, thus allowing assessment independently of the languages spoken by the child.

METHOD

This research note compares two language-specific tasks (French vs. Portuguese) and a crosslinguistic NWR task in a population of 5- to 7-year-old MON and BIL children. Group comparisons (children with vs. without developmental language disorder; MON vs. BIL children), an error analysis, sensitivity and specificity calculations (assessed according to the recommendations of Plante and Vance, 1994, and Youden, 1950) are reported.

RESULTS

All three tasks significantly differentiate children with and without developmental language disorder with large effect sizes but did not show an effect for bilingualism, which is encouraging for the BIL assessment. As expected, an influence of children's age and length and complexity of the stimuli was also found. The language-specific French task was found to be the most sensitive (max. 88%) and specific (max. 92%); the crosslinguistic task also reached good accuracy percentages for the BIL group (max. 82% sensitivity and 84% specificity).

CONCLUSION

This research note adds to the evidence that NWR tasks are promising tolls for the identification of MON and BIL children with developmental language disorder.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19111628.

Linguistic aspects of stuttering: research updates on the language-fluency interface

PURPOSE

Although commonly defined as a speech disorder, stuttering interacts with the language production system in important ways. Our purpose is to summarize research findings on linguistic variables that influence stuttering assessment and treatment.

METHOD AND RESULTS

Numerous topics are summarized. First, we review research that has examined linguistic features that increase stuttering frequency and influence where it occurs. Second, we tackle the question of whether or not persons who stutter exhibit subtle language differences or deficits. Next, we explore language factors that appear to influence recovery from early stuttering in children. The final topic discusses the unique challenges inherent in differentially diagnosing stuttering in bilingual children. Clinical implications for each topic are discussed.

DISCUSSION

The article concludes with a discussion of the unique differences in the integration of language and speech demands by people who stutter, when compared to people who are typically fluent, and their clinical ramifications.