Developmental sentence scoring: a clinical procedure for estimating syntactic development in children's spontaneous speech

Transcription Decisions of Conjoined Independent Clauses Are Equitable Across Dialects but Impact Measurement Outcomes

PURPOSE

Transcription of conjoined independent clauses within language samples varies across professionals. Some transcribe these clauses as two separate utterances, whereas others conjoin them within a single utterance. As an inquiry into equitable practice, we examined rates of conjoined independent clauses produced by children and the impact of separating these clauses within utterances on measures of mean length of utterance (MLU) by a child's English dialect, clinical status, and age.

METHOD

The data were archival and included 246 language samples from children classified by their dialect (African American English or Southern White English) and clinical status (developmental language disorder [DLD] or typically developing [TD]), with those in the TD group further classified by their age (4 years [TD4] or 6 years [TD6]).

RESULTS

Rates of conjoined independent clauses and the impact of these clauses on MLU varied by clinical status (DLD < TD) and age (TD4 < TD6), but not by dialect. Correlations between the rate of conjoined clauses, MLU, and language test scores were also similar across the two dialects.

CONCLUSIONS

Transcription decisions regarding conjoined independent clauses within language samples lead to equitable measurement outcomes across dialects of English. Nevertheless, transcribing conjoined independent clauses as two separate utterances reduces one's ability to detect syntactic differences between children with and without DLD and document syntactic growth as children age.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25822675.

Studying Conversational Adjustments in Interaction: Beyond Acoustic Phonetic Changes

PURPOSE

We examined which measures of complexity are most informative when studying language produced in interaction. Specifically, using these measures, we explored whether native and nonnative speakers modified the higher level properties of their production beyond the acoustic-phonetic level based on the language background of their conversation partner.

METHOD

Using a subset of production data from the Wildcat Corpus that used Diapix, an interactive picture matching task, to elicit production, we compared English language production at the dyad and individual level across three different pair types: eight native pairs (English-English), eight mixed pairs (four English-Chinese and four English-Korean), and eight nonnative pairs (four Chinese-Chinese and four Korean-Korean).

RESULTS

At both the dyad and individual levels, native speakers produced longer and more clausally dense speech. They also produced fewer silent pauses and fewer linguistic mazes relative to nonnative speakers. Speakers did not modify their production based on the language background of their interlocutor.

CONCLUSIONS

The current study examines higher level properties of language production in true interaction. Our results suggest that speakers' productions were determined by their own language background and were independent of that of their interlocutor. Furthermore, these demonstrated promise for capturing syntactic characteristics of language produced in true dialogue.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24712956.

Language sample analysis of conversation samples from school-age children who stutter: The role of syntactic factors in stuttering

INTRODUCTION

The purpose of the study was to compare school-age children who stutter (CWS) and age-matched children who do not stutter (CWNS) in syntactic abilities and syntactic performance.

METHODS

Computerized Language Sample Analysis (LSA) was conducted on the conversation samples obtained from 46 school-age CWS and CWNS between 7 and 16 years (CWS, n = 23). Syntactic abilities were assessed using the Index of Productive Syntax (the IPsyn) and Developmental Sentence Scores (DSS) and mixed effects logistic regression analyses with participants as random effects were conducted to determine if the scores were predictive of group membership. Additionally, the groups were compared in the IPsyn subcategories to assess the use of syntactic structures. Syntactic performance was assessed by: (a) Categorizing the sentences from each conversation sample into high vs. low syntactic complexity categories based on DSS scores and comparing the sentence categories in % stuttered sentences (% SS); and (b) Comparing the groups in the proportion of phrase-level disfluencies (phrase repetitions vs. revisions) that are associated with syntactic planning.

RESULTS

In terms of syntactic abilities, the IPsyn scores interacted with the number of utterances (sample size) used to compute the scores in predicting group membership. In comparison to the CWNS, the CWS obtained higher scores in the IPsyn and the sentence structure subcategory of the IPsyn that were independent of sample size. In terms of syntactic performance: (a) Significantly more sentences were stuttered in the high compared to the low syntactic sentence category; (b) Compared to the CWNS who demonstrated significantly more phrase revisions, the CWS showed comparable and fewer phrase revisions and repetitions. Additionally, post-hoc analysis showed that the CWS used significantly elaborated noun phrases and a similar trend was evident for verb phrase elaborations. A significant association between verb phrase elaborations and%SS was also obtained.

CONCLUSIONS

Findings from the IPsyn and the use of elaborate noun phrases, and to some extent verb phrases, suggested that the CWS used more complex syntax even in shorter conversational samples. More stuttered sentences in the high DSS sentence category, the use of fewer phrase revisions, and the association between stuttering and elaborated verb phrases in the CWS are interpreted to suggest the effects of syntactic planning and reformulation demands on fluency during ongoing articulation.

A reconceptualization of sentence production in post-stroke agrammatic aphasia: the synergistic processing bottleneck model

The language production deficit in post-stroke agrammatic aphasia (PSA-G) tends to result from lesions to the left inferior frontal gyrus (LIFG) and is characterized by a triad of symptoms: fragmented sentences, errors in functional morphology, and a dearth of verbs. Despite decades of research, the mechanisms underlying production patterns in PSA-G have been difficult to characterize. Two major impediments to progress may have been the view that it is a purely morphosyntactic disorder and the (sometimes overzealous) application of linguistic theory without interceding psycholinguistic evidence. In this paper, empirical evidence is examined to present an integrated portrait of language production in PSA-G and to evaluate the assumption of a syntax-specific syndrome. In light of extant evidence, it is proposed that agrammatic language production results from a combination of morphosyntactic, phonomotor, and processing capacity limitations that cause a cumulative processing bottleneck at the point of articulatory planning. This proposed Synergistic Processing Bottleneck model of PSA-G presents a testable framework for future research. The paper ends with recommendations for future research on PSA-G.

The relationship between mean length of utterance (MLU), Persian developmental sentence score (PDSS), and photographic expressive Persian grammar test (PEGT) in typically developing children and those with developmental language disorder (DLD)

PURPOSE

This study investigated the relationship between three practical measures for evaluating Persian grammar expression skills, MLU, PDSS, and PEGT, in preschool children with developmental language disorder (DLD) and their typically developing (TD) peers.

METHOD

Secondary data were obtained by re-analyzing language samples collected in previous studies. Previously audiotaped language samples of 25 monolingual 5-7 years-old Persian children with DLD and 25 TD children were transcribed and reanalyzed to calculate MLU in words (MLU-w) and PDSS for comparison with the results of PEGT.

RESULTS

Children with DLD had lower scores in PEGT, PDSS, and MLU-w than TD children (p < 0.001). In addition, there was a strong correlation between PDSS and MLU-w in both DLD (r = 0.91) and TD groups (r = 0.79). There was a significant correlation between PEGT and MLU (r = 0.76) and PDSS (r = 0.78) in the DLD group, while these correlations were not significant in TD group.

CONCLUSIONS

Considering the positive and significant correlation between MLU, PDSS, and PEGT in children with DLD, the use of PEGT, as a valid, reliable, and accurate test of grammar, which can be implemented quickly and easily, is suggested for clinical purposes of identification and screening of Persian children with DLD.

Assessment and Therapy Goal Planning Using Free Computerized Language Analysis Software

Background

We discuss a free software system (Computerized Language Analysis [CLAN]) that can enable fast, thorough, and informative language sample analysis (LSA).

Method

We describe methods for eliciting, transcribing, analyzing, and interpreting language samples. Using a hypothetical child speaker, we illustrate use KidEval to generate a diagnostic report.

Results

Given LSA results suggestive of expressive language delay, we analyze further using CLAN's Developmental Sentence Score and Index of Productive Syntax routines, and outline the child's use of Brown's morphemes.

Discussion

This tutorial provides an introduction to the use of free CLAN software. We discuss how LSA results can be used to structure therapy goals that address specific aspects of grammatical structure that the child may not yet demonstrate in their spoken language. Finally, we provide answers to common questions, including user support.

Language Sample Analysis in Clinical Practice: Speech-Language Pathologists' Barriers, Facilitators, and Needs

Purpose Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, although they do regard LSA as highly informative for goal setting and evaluating grammatical therapy. The primary aim of this study was to identify facilitators, barriers, and needs related to performing LSA by Dutch SLPs working with children with DLD. The secondary aim was to investigate whether a training would change the actual performance of LSA. Method A focus group with 11 SLPs working in Dutch speech-language pathology practices was conducted. Barriers, facilitators, and needs were identified using thematic analysis and categorized using the theoretical domain framework. To address the barriers, a training was developed using software program CLAN. Changes in barriers and use of LSA were evaluated with a survey sent to participants before, directly after, and 3 months posttraining. Results The barriers reported in the focus group were SLPs' lack of knowledge and skills, time investment, negative beliefs about their capabilities, differences in beliefs about their professional role, and no reimbursement from health insurance companies. Posttraining survey results revealed that LSA was not performed more often in daily practice. Using CLAN was not the solution according to participating SLPs. Time investment remained a huge barrier. Conclusions A training in performing LSA did not resolve the time investment barrier experienced by SLPs. User-friendly software, developed in codesign with SLPs might provide a solution. For the short-term, shorter samples, preferably from narrative tasks, should be considered.

Tracking Child Language Development With Neural Network Language Models

Recent work on the application of neural networks to language modeling has shown that models based on certain neural architectures can capture syntactic information from utterances and sentences even when not given an explicitly syntactic objective. We examine whether a fully data-driven model of language development that uses a recurrent neural network encoder for utterances can track how child language utterances change over the course of language development in a way that is comparable to what is achieved using established language assessment metrics that use language-specific information carefully designed by experts. Given only transcripts of child language utterances from the CHILDES Database and no pre-specified information about language, our model captures not just the structural characteristics of child language utterances, but how these structures reflect language development over time. We establish an evaluation methodology with which we can examine how well our model tracks language development compared to three known approaches: Mean Length of Utterance, the Developmental Sentence Score, and the Index of Productive Syntax. We discuss the applicability of our model to data-driven assessment of child language development, including how a fully data-driven approach supports the possibility of increased research in multilingual and cross-lingual issues.

Strengths and challenges of the COSMIN tools in outcome measures appraisal: A case example for speech-language therapy

BACKGROUND

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) is an international initiative that offers standardized and validated tools to guide the appraisal of patient-reported outcome measures in healthcare.

AIMS

To explore the use of a new set of tools from the COSMIN to appraise studies on one outcome measure available to speech and language therapists (SLTs).

METHODS & PROCEDURES

We used the COSMIN tools to appraise seven studies and a user manual that reported the measurement properties of the Focus on the Outcomes of Children Under Six (FOCUS), a validated measure of pre-schoolers' communicative participation that is used in various contexts around the world.

OUTCOMES & RESULTS

Using COSMIN guidelines, the FOCUS was categorized as a 'category A' tool because there was a sufficient level of evidence to support its content validity and internal consistency. According to the COSMIN guidelines, this means that the FOCUS can be recommended for use. The quality of evidence supporting measurement properties of the FOCUS received a rating of 'moderate', meaning users can have moderate confidence in its measurement properties. Since these ratings from the COSMIN tools may be unclear to users of the FOCUS, we have provided more specific recommendations.

CONCLUSIONS & IMPLICATIONS

The COSMIN tools offer detailed standards to support the appraisal of outcome measures available to SLTs. However, several limitations were observed, and recommendations to support the application of the COSMIN tools are provided. What this paper adds What is already known on the subject Collecting outcome data is essential to ensure speech and language therapy is effective. Until the development of COSMIN there was a lack of standards in the way the measurement properties of outcome measure instruments were appraised. What this paper adds to existing knowledge This paper used the FOCUS, a measure of pre-schoolers' communicative participation outcomes in speech and language therapy, as a case example to illustrate the applications of the COSMIN tools. In doing so, the strengths and limitations of the current COSMIN tools in appraising the quality of outcome measure instruments are emphasized. What are the potential or actual clinical implications of this work? The COSMIN tools offer a step-by-step, standardized approach to appraise various measurement properties in outcome instruments. Due to existing limitations of the COSMIN tools, appraisal should provide clear and specific recommendations so users of outcome measures (e.g., SLTs, researchers) can identify the appropriate uses of each instrument.

Clinical Characteristics Associated With Stuttering Persistence: A Meta-Analysis

Purpose The purpose of this meta-analytic study was to identify clinical characteristics, defined as child factors that can be assessed by a speech-language pathologist as part of a routine speech-language evaluation that may differentiate children who persist in stuttering from children who eventually recover from stuttering. Clinical characteristics explored included sex, age at onset, family history of stuttering, stuttering frequency and severity, speech-language skills, and temperament. Method Studies were identified through electronic databases, journals, and reference lists of relevant reports (e.g., research articles). Eligible studies followed young children who stutter (i.e., under 6 years old) for at least 24 months, assessed a potential clinical marker at study entry, and determined talker group classification (i.e., persistent or recovered) at study completion. Sex and family history differences were estimated using risk ratios; all other differences were estimated using Hedges's g. Heterogeneity and methodological differences among studies were evaluated. Results Eleven studies (41 reports) met eligibility criteria. Persistent children were older at stuttering onset and exhibited higher frequencies of stuttering-like disfluencies, lower speech sound accuracy, and lower expressive and receptive language skills than recovered children. Males and children with a family history of stuttering were also more likely to persist. Conclusions Clinical characteristics were identified that are associated with increased risk for stuttering persistence. Future studies have the potential to translate these clinical characteristics into prognostic markers for stuttering persistence risk.

Using narratives in differential diagnosis of neurodegenerative syndromes

PURPOSE

Language decline has been associated with healthy aging and with various neurodegenerative conditions, making it challenging to differentiate among these conditions. This study examined the utility of linguistic measures derived from a short narrative language sample for 1) identifying language characteristics and cut-off scores to differentiate between healthy aging, Primary Progressive Aphasia (PPA), Mild Cognitive Impairment (MCI), and Alzheimer's dementia (AD); and 2) differentiating among PPA variants in which language is the primary impairment.

METHOD

Participants were 25 neurologically healthy English speakers, 20 individuals with MCI, 20 with AD, and 26 with PPA (non-fluent/agrammatic N = 10, logopenic N = 9, semantic N = 7). Narrative language samples of the Cookie Theft Picture of persons with healthy aging, MCI and AD were retrospectively obtained from the DementiaBank database (https://talkbank.org/DementiaBank/) and PPA samples were obtained from an ongoing research study. The language samples were analyzed for fluency, word retrieval success, grammatical accuracy, and errors using automated and manual analysis methods. The sensitivity and specificity of various language measures was computed.

RESULTS

Participants with PPA scored lower than neurologically healthy and MCI groups on fluency (words per minute and disfluencies), word retrieval (Correct Information Units and number of errors), and sentence grammaticality. PPA and AD groups did not differ on language measures. Agrammatic PPA participants scored lower than logopenic and semantic PPA groups on several measures, while logopenic and semantic PPA did not differ on any measures.

CONCLUSION

Measures derived from brief language samples and analyzed using mostly automated methods are clinically useful in differentiating PPA from healthy aging and MCI, and agrammatic PPA from other variants. The sensitivity and specificity of these measures is modest and can be improved when coupled with clinical presentation.

Using Computerized Language Analysis to Evaluate Grammatical Skills

Purpose Conducting in-depth grammatical analyses based on language samples can be time consuming. Developmental Sentence Scoring (DSS) and the Index of Productive Syntax (IPSyn) analyses provide detailed information regarding the grammatical profiles of children and can be conducted using free computer-based software. Here, we provide a tutorial to support clinicians' use of computer-based analyses to aid diagnosis and develop and monitor treatment goals. Method We analyzed language samples of a 5-year-old with developmental language disorder and an adolescent with Down syndrome using computer-based software, Computerized Language Analysis. We focused on DSS and IPSyn analyses. The tutorial includes step-by-step procedures for conducting the analyses. We also illustrate how the analyses may be used to assist in diagnosis, develop treatment goals focused on grammatical targets, and monitor progress on these treatment goals. Conclusion Clinicians should consider using Computerized Language Analysis's IPSyn and DSS analyses to support grammatical language assessments used to aid diagnosis, develop treatment goals, and monitor progress on these treatment goals. Supplemental Material https://doi.org/10.23641/asha.12021141.

Use of Computerized Language Analysis to Assess Child Language

[Figure: see text].

Using Computer Programs for Language Sample Analysis

Purpose

Although language sample analysis is widely recommended for assessing children's expressive language, few school-based speech-language pathologists routinely use it, citing a lack of time, resources, and training ( Pavelko, Owens, Ireland, & Hahs-Vaughn, 2016 ). The purpose of this clinical tutorial is (a) to describe options for language sample analysis using computer programs and (b) to demonstrate a process of using language sample analysis focused on the assessment of 2 preschool children as case studies.

Method

We provide an overview of collecting and analyzing child language samples and describe 3 programs for language sample analysis: 2 dedicated software programs (Computerized Language Analysis [ MacWhinney, 2000 ] and Systematic Analysis of Language Transcripts [ Miller & Iglesias, 2015 ]) and 1 protocol for using word processing software to analyze language samples (Sampling Utterances and Grammatical Analysis Revised; Pavelko & Owens, 2017 ). We also present analysis results from each program for play-based language samples from 2 preschool children and detailed analysis of the samples with potential treatment goals.

Results

Each program offers different analyses, comparison databases, and sampling contexts. We present options for additional analysis, clinical interpretations, and potential treatment goals based on the 2 preschool cases.

Conclusion

Clinicians can use computer programs for language sample analysis as part of a process to make naturalistic language assessment more feasible.

Supplemental Material

https://doi.org/10.23641/asha.10093403

Expressive language abilities of boys with idiopathic autism spectrum disorder and boys with fragile X syndrome + autism spectrum disorder: Cross-context comparisons

BACKGROUND AND AIMS

Understanding the unique expressive language profiles of children with phenotypically similar, but distinct neurodevelopmental disorders, such as idiopathic autism spectrum disorder and fragile X syndrome with a co-diagnosis of autism spectrum disorder (fragile X syndrome + autism spectrum disorder), has both clinical and theoretical implications. However, comparative studies of these two clinical groups have been limited, and results have been inconsistent, partially as a result of different assessment methods being utilized. Thus, the current study compared the expressive language profiles of boys with idiopathic autism spectrum disorder and boys with fragile X syndrome + autism spectrum disorder and examined whether a similar linguistic profile emerged across different language sampling contexts: a semi-structured conversation and the Autism Diagnostic Observation Schedule.

METHODS

Eighteen boys with autism spectrum disorder (M_age  = 13.25 years) and 19 boys with fragile X syndrome + autism spectrum disorder (M_age  = 12.19 years), matched on autism spectrum disorder symptom severity and similar in terms of chronological age and mean length of utterance, participated in this study. Boys produced two language samples: one semi-structured conversation and one taken from the Autism Diagnostic Observation Schedule. Language samples were coded for talkativeness, lexical diversity, mean length of utterance, intelligibility, and repetitive or perseverative language.

RESULTS

Analyses revealed that boys with autism spectrum disorder produced language samples that were more lexically diverse and intelligible, and that included less topic perseveration compared to boys with fragile X syndrome + autism spectrum disorder. With regards to sampling context, boys in both groups were more talkative and produced longer and more intelligible utterances in their conversation sample compared to their Autism Diagnostic Observation Schedule sample. However, boys with autism spectrum disorder and fragile X syndrome + autism spectrum disorder used a higher proportion of topic perseveration during the conversation sample.

CONCLUSIONS

Overall, we found similarities as well as distinctions in the expressive language profiles of boys with fragile X syndrome + autism spectrum disorder and boys with idiopathic autism spectrum disorder. Moreover, the Autism Diagnostic Observation Schedule sample elicited a relatively different language profile than the conversation sample for boys in both groups.

IMPLICATIONS

These findings help to further elucidate the unique language phenotypes of boys with idiopathic autism spectrum disorder and boys with fragile X syndrome + autism spectrum disorder. Moreover, our findings indicate that multiple language samples may be needed to obtain a comprehensive account of a child's expressive language ability.

The emergence of clause construction in children who use speech generating devices

This study aimed to detect patterns in clause construction structural changes produced by four participants aged 9;5-13;7 (years;months) with motor speech disorders who used speech-generating devices. Sequences of adult-child interactions, drawn from the data of a larger study focused on enhancing vocabulary and grammar skills, were examined. This current study comprises a secondary analysis of a corpus of 29 conversations totalling 808.36 min, analysing clause structures by type, linguistic complexity, and intensity of adult prompts (number of turns). Results show that, over time, the participants' clause structure complexity increased through addition of phrase-internal elements such as inflections, articles, and prepositions. Use of specific grammatical elements followed the developmental stages observed in children with typical development. For all participants, the personal pronoun I (first-person singular) emerged before she, he (third-person singular), and we or they (plural). Participants with the highest number of adult-child co-constructed clauses also had the highest number of well-formed clauses. The intensity of adult prompts increased as clause structures became more complex and as participants needed more support. Implications for practice and theory are discussed.

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.

Current Practice of Child Grammar Intervention: A Survey of Speech-Language Pathologists

PURPOSE

The aim of this study was to better understand current grammatical intervention approaches. Despite grammatical language being a common weakness among children with language impairment, relatively little is known about current grammatical intervention practices of speech-language pathologists (SLPs). Such information is needed to guide the development and evaluation of grammatical interventions and to identify areas in which the current practice is not empirically supported.

METHOD

Participants included 338 SLPs working primarily with children. Participants completed an online survey regarding their implementation of nine different grammatical intervention components, including goals, procedures, dosage, agents, contexts, goal attack strategies, service delivery models, activities, and outcome measurements. Participants also indicated how they would alter the intervention setting and dosage if resources were unlimited.

RESULTS

We grouped participants based on the ages of children that represent the largest percentage of their caseload resulting in an early education group (n = 114) and an elementary group (n = 224). We aggregated responses from each question to gain an estimate of current implementation practices associated with each intervention component queried.

CONCLUSIONS

This study provides general guidelines of current clinical practices to help guide research on grammatical interventions for children and to promote successful translation and implementations of evidence-based treatment approaches. Results may also help clinicians and researchers better understand misalignments between empirically supported intervention approaches and current approaches for treating grammatical weaknesses.

Eliciting the Language Sample for Developmental Sentence Scoring: A Comparison of Play With Toys and Elicited Picture Description

PURPOSE

This study investigated whether language samples elicited during play and description of pictured events would yield the same results for developmental sentence scoring (DSS).

METHOD

Two language samples were elicited from 58 three-year-olds. One sample was elicited during play with a parent, and the other sample was elicited by an examiner asking children to talk about pictured events in response to elicitation questions.

RESULTS

DSS scores were not significantly different between the play and event description samples. However, sentence points were significantly higher for the play sample than for the event description sample. Although there was a correlation between sample types for both DSS and sentence points, the correlation for DSS (r = .52) was below an acceptable level, and the correlation for sentence points (r = .71) was at a minimally acceptable level. Agreement between sample types for pass-fail decisions on the DSS scores using the 10th percentile cutoff recommended by Lee (1974) was only moderate (78%).

CONCLUSION

The current study shows that type of language samples could affect DSS and sentence point scores of 3-year-olds and, hence, the passing and failing decisions for their performance on DSS.

Assessing the impact of conversational overlap in content on child language growth

When engaged in conversation, both parents and children tend to re-use words that their partner has just said. This study explored whether proportions of maternal and/or child utterances that overlapped in content with what their partner had just said contributed to growth in mean length of utterance (MLU), developmental sentence score, and vocabulary diversity over time. We analyzed the New England longitudinal corpus from the CHILDES database, comprising transcripts of mother-child conversations at 14, 20, and 32 months, using the CHIP command to compute proportions of utterances with overlapping content. Rates of maternal overlap, but not child overlap, at earlier time-points predicted child language outcomes at later time-points, after controlling for earlier child MLU. We suggest that maternal overlap plays a formative role in child language development by providing content that is immediately relevant to what the child has in mind.

Preliminary Evidence That Growth in Productive Language Differentiates Childhood Stuttering Persistence and Recovery

Purpose

Childhood stuttering is common but is often outgrown. Children whose stuttering persists experience significant life impacts, calling for a better understanding of what factors may underlie eventual recovery. In previous research, language ability has been shown to differentiate children who stutter (CWS) from children who do not stutter, yet there is an active debate in the field regarding what, if any, language measures may mark eventual recovery versus persistence. In this study, we examined whether growth in productive language performance may better predict the probability of recovery compared to static profiles taken from a single time point.

Method

Productive syntax and vocabulary diversity growth rates were calculated for 50 CWS using random coefficient models. Logistic regression models were then used to determine whether growth rates uniquely predict likelihood of recovery, as well as if these rates were predictive over and above currently identified correlates of stuttering onset and recovery.

Results

Different linguistic profiles emerged between children who went on to recover versus those who persisted. Children who had steeper productive syntactic growth, but not vocabulary diversity growth, were more likely to recover by study end. Moreover, this effect held after controlling for initial language ability at study onset as well as demographic covariates.

Conclusions

Results are discussed in terms of how growth estimates can be incorporated in recommendations for fostering productive language skills among CWS. The need for additional research on language in early stuttering and recovery is suggested.

Investigating the origin of nonfluency in aphasia: A path modeling approach to neuropsychology

A major challenge in understanding the origin of clinical symptoms in neuropsychological impairments is capturing the complexity of the underlying cognitive structure. This paper presents a practical guide to path modeling, a statistical approach that is well-suited for modeling multivariate outcomes with a multi-factorial origin. We discuss a step-by-step application of such a model to the problem of nonfluency in aphasia. Individuals with aphasia are often classified into fluent and nonfluent groups for both clinical and research purposes, but despite a large body of research on the topic, the origin of nonfluency remains obscure. We propose a model of nonfluency inspired by the psycholinguistic approach to sentence production, review several bodies of work that have independently suggested a relationship between fluency and various elements in this model, and implement it using path modeling on data from 112 individuals with aphasia from the AphasiaBank. The results show that word production, comprehension, and working memory deficits all contribute to nonfluency, in addition to syntactic impairment which has a strong and direct impact on fluency. More generally, we demonstrate that a path model is an excellent tool for exploring complex neuropsychological symptoms such as nonfluency.

The Influence of Play Material on Discourse During Play

The present study examined the effect that selected play materials have on certain aspects of children's conversational behavior. Thirty-six children, ranging in age from 48-59 months, served as subjects within eighteen same-sex dyads. Each dyad engaged in three separate ten-minute play sessions. The dyads played with a different material during each of the three sessions. The materials used were Playdoh, a Fisher-Price farm set, and a set of four animal puppets. The conversations occurring during each play session were transcribed. Each utterance was then categorized as a Topic Initiation, Topic Extension, Topic Maintenance, or Topic Extension-Tangential. Results indicate that each toy elicited the same amount of talking. However, there were differences in discourse structure attributable to the different play materials. The discourse of boys and girls was similar. However, boys did tend to initiate more topics during play than did girls.

AphasiaBank as BigData

AphasiaBank has used a standardized protocol to collect narrative, procedural, personal, and descriptive discourse from 290 persons with aphasia, as well as 190 control participants. These data have been transcribed in the Codes for the Human Analysis of Transcripts (CHAT) format for analysis by the Computerized Language Analysis (CLAN) programs. Here, we review results from 45 studies based on these data that investigate aphasic productions in terms of these eight areas: discourse, grammar, lexicon, gesture, fluency, syndrome classification, social factors, and treatment effects. For each area, we also indicate how use of the CLAN programs has facilitated the analysis. We conclude with an examination of ways in which the size of the database could be increased through on-site recordings and data from teletherapy.

Hierarchical phrase-based grammatical analysis of language samples from Cantonese-speaking children with and without autism

The present study made a reference to Zhu Dexi's phrase-based grammar approach to analyse Cantonese utterances hierarchically into 14 syntactic structures (SS). A total of 68 speech samples from Cantonese-speaking children with and without Autism Spectrum Disorder (ASD) were collected. The mean length of utterance in words (MLUw), the number of syntactic structures (NOSS), the number of different syntactic structures (NODSS) and the flexibility of syntactic structures (FSS) of the samples were calculated. Comparisons among four groups of typically developing (TD) children revealed that all the indexes show developmental changes across age stages. Comparisons between ASD subjects and their age-matched (AM) and MLUw-matched (MM) normal peers were done. MLUw, NOSS and NODSS and FSS could be used to distinguish autistic children from their AM normal peers, but only FSS could be used to distinguish ASD from MM groups qualitatively and quantitatively. The lack of production of SP, V1O/SV2 and Coord1Coord2 with low FSS may be one of the factors that will affect ASD children's further syntactic development.

Validation of the Focus on the Outcomes of Communication under Six outcome measure

AIM

The aim of this study was to establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS(©) ),a tool designed to measure changes in communication skills in preschool children.

METHOD

Participating families' children (n=97; 68 males, 29 females; mean age 2y 8mo; SD 1.04y, range 10mo-4y 11mo) were recruited through eight Canadian organizations. The children were on a waiting list for speech and language intervention. Parents completed the Ages and Stages Questionnaire - Social/Emotional (ASQ-SE) and the FOCUS three times: at assessment and at the start and end of treatment. A second sample (n=28; 16 males 12 females) was recruited from another organization to correlate the FOCUS scores with speech, intelligibility and language measures. Second sample participants ranged in age from 3 years 1 month to 4 years 9 months (mean 3y 11mo; SD 0.41y). At the start and end of treatment, children were videotaped to obtain speech and language samples. Parents and speech-language pathologists (SLPs) independently completed the FOCUS tool. SLPs who were blind to the pre/post order of the videotapes analysed the samples.

RESULTS

The FOCUS measured significantly more change (p<0.01) during treatment than during the waiting list period. It demonstrated both convergent and discriminant validity against the ASQ-SE. The FOCUS change corresponded to change measured by a combination of clinical speech and language measures (κ=0.31, p<0.05).

CONCLUSION

The FOCUS shows strong construct validity as a change-detecting instrument.

Past tense marking in the spontaneous speech of preschool children who do and do not stutter

PURPOSE

The aim of this study was to identify whether different patterns of errors exist in irregular past-tense verbs in children who stutter (CWS) and children who do not stutter (CWNS).

METHOD

Spontaneous language samples of thirty-one age- and gender-matched pairs of children (total N=62) between the ages of 24 months and 59 months were analyzed.

RESULTS

Results indicated that children who do and do not stutter over-regularize irregular past-tense verbs (i.e., saying runned for ran) with comparable frequency. However, two nonsignificant trends which suggest possible intra-group differences were noted. First, irregular past tense verbs represented a greater portion of total verbs for CWS than for CWNS. Second, CWS appeared to double-mark (i.e., say ranned for ran) more often than CWNS. Results are discussed in light of theories about the acquisition of the irregular past-tense and about differences in language skills between CWS and CWNS.

EDUCATIONAL OBJECTIVES

After reading this article, the reader will be able to: (a) summarize previous findings about connections between stuttering and language in CWS and CWNS; (b) describe similarities and differences between irregular past-tense verb use and errors in CWS and CWNS; (c) discuss possible connections between the declarative-procedural model and stuttering.

Influence of Context on the Production of Complex Sentences by Typically Developing Children

Purpose

This study was designed to identify types of complex-sentence meanings (i.e., content ) produced in selected elicitation contexts by typically developing children within 3 different age groups. The research was motivated by the need for additional evidence-based assessments and interventions for children with language disorders.

Method

Participants included 3 groups of typically developing children, mean ages 2;8 (years;months; Cohort 1), 3;4 (Cohort 2), and 4;7 (Cohort 3). Four elicitation contexts distinguished on the basis of degree of spontaneity and the potential for eliciting complex sentences were used: free-play, script-play, elicited description, and story retelling. Tasks within these contexts were presented to each child over two 1-hr sessions.

Results

Significant differences were found among the cohorts for proportion of complex-sentence productions overall, across contexts, and across content categories. Significant relationships were found between content and contexts and between adult model and content of the child’s following utterance.

Conclusions

Findings suggest that children’s complex-sentence production changes with development and is sensitive to features of linguistic and nonlinguistic contexts. These data provide evidence for the types of complex-sentence content that may be expected in specified contexts, thus serving as a basis for planning assessment and intervention for children with language disorders.

Narrative content as described by individuals with Down syndrome and typically developing children

Narratives of the wordless picture story, Frog, Where Are You?, by 33 individuals with Down syndrome and typically developing children (33 matched for mental age, 33 for syntax comprehension, 33 for mean length of utterance) were analyzed for expression of plot line, story theme, and the protagonists' misadventures in the story. Despite their restricted expressive syntax and vocabulary, the group with Down syndrome expressed more plot line and thematic content and more of one of the protagonists' misadventures than the MLU controls; they most resembled the syntax comprehension control participants. We conclude that the group with Down syndrome had a conceptual understanding of the picture story similar to that of the TACL-R group and a strategy for expressing that understanding despite expressive lexical and syntactic limitations; this resulted in the expression of more narrative content than formal measures of expressive language would predict. We propose that the higher syntactic comprehension skills of the group with Down syndrome, combined with their experience with story content (listening to stories), may have contributed to their developing higher-level story schemas than would be expected given their MLUs.

Third person pronoun errors by children with and without language impairment

Research findings have been mixed about pronoun case problems in the language-learning profile of children with specific language impairment (SLI). This study (N= 36) extended previous findings and located a number of error patterns using detailed error analyses. Results indicated that the children with expressive SLI produced more errors with third person singular (3Psg) pronouns than did their age-level peers, but they did not make more errors than their MLU-matched peers. Error patterns were similar in the children with SLI and their language-level peers. The most frequent type of error was the substitution of the objective case for the nominative case. More errors were made on the feminine pronoun, she, than on the masculine pronoun, he. Implications for theories and clinical practice were explored.

EDUCATIONAL OBJECTIVES

As a result of this activity, the reader will (1) learn how children with SLI compare to their peers in producing third person pronouns, (2) learn the most common types of pronoun errors made by the children matched for mean length of utterance (MLU), and (3) evaluate how the findings relate to two current theories: one from typical language development and one from the area of SLI.

Predicting language production in children and adolescents with Down syndrome: the role of comprehension

Predictors of language production skills in 12-minute narratives are investigated cross-sectionally in 48 children and adolescents with Down syndrome (trisomy 21), aged 5 to 20 years, in comparison to 48 control children aged 2 to 6 years matched statistically for nonverbal mental age and mother's years of education. Two models were evaluated by hierarchical regression analyses using predictors drawn from the domains of group membership, chronological age, cognition, socioeconomic status, and hearing screening status (Model I) and, additionally, comprehension performance (Model II). Results showed that Model II was more successful. In the DS group, it explained 68% of the variability in number of different words, 80% in MLU, and 32% in intelligibility. Corresponding percentages for the control group were 72%, 71%, and 26%. A mechanism linking comprehension of input to early stages of production practice through activation of the early speech motor area is proposed.

Language Sample Analysis in Spanish-Speaking Children

The purposes of this article are (a) to discuss issues related to the selection and development of language assessment procedures for children who speak Spanish and English based on spontaneous language samples and (b) to show how available procedures can be applied to research and clinical aims with these children. Sociolinguistic influences in the language performance of Spanish-speaking children, including patterns of language shift, differences in the amount of exposure to each of a bilingual's languages, and contextual effects of different language-learning environments, are discussed. Methodological issues and effects of codeswitching and dialect are examined concerning use of the Developmental Assessment of Spanish Grammar (DASG), mean length of response in words (MLR-w), mean length of terminable unit (MLTU), and mean length of utterance in morphemes (MLU-m). Measures of Spanish grammar with diagnostic potential are proposed. Clinical suggestions for the language assessment of Spanish-speaking children with different levels of English proficiency and research implications are discussed.

Syntax PAL: a system to improve the written syntax of language-impaired users

In our work with children who have difficulty with spelling or with the physical action of writing, we have found a number of children who also have difficulty with written grammar. As an extension of PAL, an existing predictive spelling and typing aid, we have developed a writing aid to help these children with sentence construction. The enhanced system uses the syntax of the initial part of a sentence to enhance the position in the prediction list of syntactically correct words. It was postulated that this would discourage the use of incorrect syntax and encourage the use of correct syntax. In two case studies, the use of Syntax PAL significantly improved the quality and quantity of one child's written output, but had little effect on the other child's work.

Conversations with autistic children: contingent relationships between features of adult input and children's response adequacy

The relationship between certain features of adult speech and autistic children's response adequacy was examined within the context of unstructured, dyadic conversations. On separate sessions, four verbal, nonecholalic children were observed talking with their mothers and teachers. Analysis of conversational turns showed that as the number of facilitating features contained in adults' eliciting utterances increased, the proportion of adequate replies from the children increased. In this analysis, facilitating features included the use of Yes/No questions, questions that were conceptually simple, and questions that were semantically contingent on the child's topic. In a further analysis, it was found that adults tended to modify their use of these features in response to child feedback, although this tendency was relatively small and observed only in a minority of the sequences evaluated. The findings are discussed in terms of pragmatic deficits associated with autism and implications for intervention with this population.

A morphemic measure of early language development: data from modern Hebrew

Given the nature of Hebrew as a highly synthetic language with rich bound morphology, an attempt was made to establish a measure corresponding to the MLU for a language such as English. The method of calculating MPU (morpheme-per-utterance) which is described here was tried out on 38 Hebrew-speaking children aged 2;0 to 3;0, and measured for internal consistency against different types of elicitation procedures, and for validity by comparison with the subjects' performance on a specially-devised measure of syntactic–semantic development. The results clearly indicate that the MPU is a useful developmental index of the linguistic proficiency of two- to three-year-old Hebrew speakers. Implications of this finding for intra-linguistic and cross-linguistic evaluation are then discussed.

Language functioning and speech development of six children receiving tracheotomy in infancy

Language functioning and speech development were assessed in six preschool boys who had undergone tracheotomy during infancy and had tracheal tubes in place for varying periods of time (from 11 to 44 mo). Results indicated that neonatal tracheotomy did not produce long-term effects on language development. Children with subnormal intelligence showed aberrant language functioning, characteristic of language-disordered children who had not had tracheotomies. Children with average intelligence exhibited grossly normal expressive language and verbal comprehension. All children learned to produce some verbalizations, if only through pops, lip movements, and breath sounds; or through esophageal speech. One child who did not vocalize until his cannula was removed at 21 mo was able to develop age-appropriate expressive language, despite lack of previous opportunity to produce speech sounds.

A comprehensive approach to assessment and treatment of severe developmental speech and language disorders

A comprehensive approach to assessment and treatment of severe developmental speech and language disorders is discussed based on clinical experience with 69 children between 2 1/2 and 7 years of age. Assessment involves the integration of many variables, including differentiation between linguistic competence versus performance, diagnosis, familial and environmental factors, and pragmatics. A framework is presented that distinguishes therapy goals from therapy styles. The three possible goals are elimination or alleviation of causal factors, increase of interpersonal language interaction, and treatment of specific linguistic problems. These goals can be achieved within the context of three possible therapy styles: structured formal therapy, directed stimulation in play, and free play. The decision regarding choice of goals and styles is based on an integrative assessment, with the result that the treatment plan is appropriately designed for each individual.

Use of radiotelemetry to obtain expressive language samples

Expressive language samples were obtained from normal and language-disordered children through standard interview procedures and through wireless radiotelemetry. Comparisons of these samples using Developmental Sentence Scoring (DSS), mean length of utterance (MLU), and inflectional scoring indicated significant differences between the groups of children, and among the interview-telemetry samples. Telemetry samples yielded different overall scores from those obtained with the interview samples, and there were significant differences in the types of language performance within the samples. Reliable telemetry scores across days were obtained. Difficulties in using the equipment are described and the procedures are compared.

Differences between scorers on selected language measures

Differences in scores assigned by five speech-language pathologists were determined for 96 language samples utilizing assessments of total words, total sentences, words per sentence, syntax quotient (usage and endings), syntax quotient (structures), and an abstract-concrete scale. Results of the study showed statistically significant interscorer differences for words per sentence, syntax quotient (usage and endings), and the abstract-concrete scale. Although the mean differences between scorers for total words, total sentences, and syntax quotient (structures) were not statistically significant, substantial absolute differences between scorers were found on all six measurement procedures.

Pediatric speech intelligibility test. I. Generation of test materials

Normal children between 3 and 7 years of age generated word and sentence messages for use in a new speech intelligibility test. Word materials did not differ as a function of chronological age, vocabulary skills, or receptive language ability. Sentence materials, however, did reflect differences in chronological age, vocabulary skills, and receptive language skills. Older children, approximately 5-10 years, responded with complete, adult-like sentences. Younger children, approximately 3-10 years, responded with either a proform substituted for the noun phrase subject of a sentence or by omitting the auxiliary verb "be" in forming the present progressive verb tense of the sentence. To represent the differences in the children's responses, two different types of test sentences were formed. In one construction, the test sentence is composed of (noun phrase/verb-ing/noun phrase), preceded by the carrier phrase "show me", e.g., "Show me a bear brushing his teeth". In the other construction, the test sentence is composed of (noun phrase/auxiliary verb-ing/noun phrase), e.g., "A bear is brushing his teeth". The two different sentence forms are proposed as a means of equating differences in normal language development among children.

Effect of elicitation variables on analysis of language samples for normal and language-disordered children

To evaluate the effect of elicitation stimuli and situations, expressive language samples were obtained from 10 normal children and 10 language-disordered children in four location-stimulus combinations and from wireless radio telemetry. These language samples were analyzed using the procedures of Developmental Sentence Scoring, Mean Length of Utterance, and inflectional scoring. No differences existed between the locations of home and clinic, but significant differences were noted among samples elicited using pictures as oppossed to open-ended questions as compared to telemetry samples. Normal and language-disordered children responded differently to these elicitation variables. Open-ended questions and telemetry yielded the highest performances on Developmental Sentence Scoring and inflectional scoring. Telemetry samples yielded the shortest response lengths. The two groups of children also responded differently in the specific scoring categories.

Effects of Delay Interval and Pictorial Cues on a Sentence Imitation Task

40 preschool children performed a sentence imitation task under four conditions (10 subjects in each condition): immediate imitation of auditorily presented stimuli, delayed imitation of auditorily presented stimuli, immediate imitation of auditorily and pictorially presented stimuli, and delayed imitation of auditorily and pictorially presented stimuli. The subjects in the immediate imitation conditions produced fewer total errors and more verbatim responses than the subjects in the delay interval conditions. These findings are discussed in relation to prior findings.