Understanding Word Reading Difficulties in Children With SLI

Caregivers' reports of the home literacy environments of children with developmental language disorder and typically developing peers during the COVID-19 pandemic

PURPOSE

Children with developmental language disorder (DLD) are at heightened risk for reading difficulty. We investigated the home literacy environments of kindergarten children with DLD and typically developing (TD) peers during the COVID-19 pandemic.

METHOD

We analysed scores from standardised assessments of oral language, nonverbal intelligence, and word reading in conjunction with home literacy questionnaire data at three time points.

RESULT

Frequency of engagement in home literacy activities did not differ by group during school closures or when schools reopened. Caregivers from both groups reported increased home literacy engagement during closures. Engagement returned to pre-pandemic levels when schools reopened. For the DLD group, the child's word reading ability and interest in literacy were positively associated with the home literacy environment. Family history of language and/or literacy difficulty was negatively associated with the home literacy environment. For the TD group, only the child's interest in literacy was positively associated with the home literacy environment.

CONCLUSION

These findings elucidate the need for further research related to home literacy and families of children with DLD, with a focus on identifying potential strengths and vulnerabilities related to child and caregiver factors.

We Have to Talk About Something: Why NOT Talk About the Curriculum? A Guide to Embedding Language Interventions in Curricular Content

PURPOSE

Children with developmental language disorder frequently have difficulty with both academic success and language learning and use. This clinical focus article describes core principles derived from a larger program of research (National Science Foundation 1748298) on language intervention combined with science instruction for preschoolers. It serves as an illustration of a model for integrating language intervention with curricular content delivery.

METHOD

We present a five-step model for a speech-language pathologist and other school professionals to follow to (a) understand the grade-level core curriculum objectives; (b) align intervention targets with the curriculum; (c) select a therapy approach that aligns with both goals and curricular content, and (d) methods for implementing the intervention; and (e) verify that both the intervention and the curriculum have been provided in accordance with best practices. We apply this model to the Next Generation Science Standards, a science curriculum popular in the United States, and to grammar and vocabulary interventions, two areas of difficulty for children with developmental language disorders, though it would be possible to extend the steps to other curricular areas and intervention targets.

CONCLUSIONS

We conclude by discussing the barriers and benefits to adopting this model. We recognize that both speech-language pathologists and teachers may have limited time to implement language intervention within a general education curriculum, but we suggest that the long-term benefits outweigh the barriers.

Developmental Language Disorder and Writing: A Scoping Review From Childhood to Adulthood

PURPOSE

The purpose of this study was to conduct a scoping review of literature focused on the effects of developmental language disorder (DLD) on writing skills across the life span to highlight gaps in our knowledge of how to support writing for this population.

METHOD

We adopted the five-step framework for conducting scoping reviews outlined by Arksey and O'Malley (2005) to identify literature focused on writing outcomes for individuals with DLD in childhood, adolescence, and adulthood.

RESULTS

Seventy-two studies from 1991 to 2022 met review criteria. Results indicated that spelling may be an area of relative weakness for individuals with DLD across the life span. Children and adolescents with DLD also may have relative difficulty with grammar, organization, cohesion, and length of written output. Research on the writing skills of adults with DLD is too sparse to draw broad conclusions about the writing skills of this subset of the population with DLD.

CONCLUSIONS

Overall, research into the writing skills of individuals with DLD is limited, and more information is needed to inform functional evidence-based approaches to assessment and intervention of writing for those with DLD from childhood through adulthood. Additionally, more focus on electronic writing in research is needed, as only two studies included in this review examined typed writing in any form. Results of this review also indicate a need for systematic, uniform approaches to defining and measuring writing skills for those who experience language difficulties.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23596797.

Phonological Awareness and Rapid Automatized Naming: The Mediating Effect of Word Reading and Spelling in Children with Developmental Dyslexia, Attention Deficit Hyperactivity Disorder, and Mild Intellectual Disability

INTRODUCTION

In learning to read, children learn to integrate orthographic, phonological, and semantic codes into highly specified and redundant lexical representations. The aim is to test a proposed model for the relationship between phonological awareness (PA) and rapid automatized naming (RAN) as mediated by word reading (WR) and spelling (SP) in children with developmental dyslexia (DD), attention deficit hyperactivity disorder (ADHD), and mild intellectual disability (ID).

METHODS

The relation between PA and RAN was found to be mediated by WR and SP in children with DD, ADHD, and mild ID. Three groups of children were included: DD children (N = 70), ADHD children (N = 68), and ID children (N = 69). This is a quantitative correlational, cross-sectional study investigating the strength and direction of relationships among proposed variables.

RESULTS

The relation between PA and RAN was found to be mediated by WR and SP. Based on their correlation analysis, the researcher concluded that there are significant correlations between PA, RAN, WR, and SP. PA correlates positively with RAN and SP. RAN correlates positively with WR and SP.

CONCLUSION

The study extended our knowledge of the relationship between PA and RAN as mediated by WR and SP in children with DD, ADHD, and mild ID. In practice, this is conducive to promote the utilization of "PA" and "RAN" so as to improve the early literacy skills (WR and SP) among children with DD, ADHD, and mild ID.

Distinct neural correlates of poor decoding and poor comprehension in children with reading disability

Reading disability (RD) can manifest itself as a word decoding problem or a reading comprehension problem. In the current study, we identified 3 subtypes of RD: poor decoders (PD), poor comprehenders (PC), and poor-in-both (PB). We found that PD had greater deficits in meta-linguistic skills such as phonological awareness, orthographic skills, and morphological skills than PC, whereas PC had greater deficits in listening comprehension than PD. In the brain, we also found different patterns of deficits during an auditory rhyming judgment task using functional magnetic resonance imaging. PD showed less activation than PC and age controls in the left dorsal inferior frontal gyrus (IFG) and pre-supplementary motor area (SMA), brain activation of which was correlated with phonological awareness and working memory. In contrast, PC showed less activation in the left fusiform gyrus than PD and age controls, which was correlated with reading comprehension fluency and morphological skill. Last, PB showed both PD's and PC's deficits, as well as additional deficits in the bilateral lingual gyri. Our findings contribute to revealing different neural signatures of poor decoding and poor comprehension, which are distinct disorders but co-occur very often. These findings implicate possibility and necessity of precise diagnosis and individualized intervention.

Promoting Reading Achievement in Children With Developmental Language Disorders: What Can We Learn From Research on Specific Language Impairment and Dyslexia?

Purpose Specific language impairment (SLI; see also developmental language disorder) and dyslexia are separate, yet frequently co-occurring disorders that confer risks to reading comprehension and academic achievement. Until recently, most studies of one disorder had little consideration of the other, and each disorder was addressed by different practitioners. However, understanding how the two disorders relate to each other is important for advancing theories about each disorder and improving reading comprehension and academic achievement. The purpose of this clinical focus article is to integrate research on SLI and dyslexia as well as advocate for the consideration of comorbidities in future research and clinical practice. Method The first section reviews definitions as well as inclusionary and exclusionary criteria for SLI and dyslexia. The second section reviews research demonstrating that SLI and dyslexia are different disorders that often co-occur. Studies examining language, working memory, and academic achievement in children with separate versus co-occurring SLI and dyslexia are reviewed. The final section compares and contrasts school identification frameworks for children with SLI and dyslexia and considers the potential benefits of incorporating broad language skills into response to intervention (RTI) assessment frameworks. Conclusions Children with weak language skills are at a high risk of experiencing reading problems, but language difficulties are often hidden from view. Directly addressing language skills within school RTI frameworks can help improve the identification and treatment of children with SLI and dyslexia as well as support improved reading comprehension and academic achievement for all students. Presentation Video https://doi.org/10.23641/asha.13063793.

General Education Teachers' Contribution to the Identification of Children With Language Disorders

Purpose

The estimated prevalence of language disorders in early elementary school-age children is 7%–12%. Despite its prevalence, only 18% of children are identified and receive treatment. Children with language disorders who go unidentified and, consequently, untreated upon entry to kindergarten are at a cumulative risk for academic and social difficulties during their formative and later school years. Since there is no policy supporting universal screening for language impairment identification in public schools, vulnerabilities may exist in referral-based systems for language impairment identification. The primary purpose of this study was to examine the positive predictive value of general education teachers for language impairment identification.

Method

A record review of special education referrals across four elementary schools was conducted. A total of 177 referrals across all disabilities were examined. Forty-four of those language-based referrals became the focus of this study.

Results

Results showed, of the 44 referred for language impairment, general education teachers were the least correct of referral sources, with a positive predictive value of .35. Variables of teacher age, sex, years of teaching experience, and years of education did not predict general education teachers' ability to identify children with language impairment. The identification rate across the four schools was 1.38%.

Conclusions

General education teachers were responsible for nearly half of the referrals made to special education but demonstrated the most difficulty in correctly identifying children with language impairment. As a result, identification rates were considerably lower than prevalence expectations. This is of particular concern as teachers play a primary role in the identification of this population under a referral-based format.

Predicting Dyslexia in Children With Developmental Language Disorder

Purpose In this study, we examine how well kindergarten letter identification and phonological awareness predict 2nd grade word reading and dyslexia in children with developmental language disorder (DLD) and their age- and grade-matched peers with typical language (TL). Method We employ (a) logistic regression to determine how letter identification and phonological awareness predict dyslexia, that is, dichotomous categorization of good or poor word reading, in children with DLD and TL and (b) quantile regression to determine how letter identification and phonological awareness are associated with word reading abilities on a continuum in these groups of children. Results Logistic regression revealed that letter identification was the only significant, unique kindergarten predictor of dyslexia in 2nd grade children with DLD, when compared to phonological awareness. In children with TL, both kindergarten letter identification and phonological awareness significantly predicted dyslexia in 2nd grade. Quantile regression revealed that kindergarten letter identification was a stronger predictor of 2nd grade word reading for average and lower achieving word readers with DLD and their peers with TL compared to higher performing readers. Phonological awareness was weakly associated with word reading across the full continuum of word reading abilities in children with DLD. Conclusion Letter identification is a more accurate predictor of poor word reading and dyslexia than phonological awareness in kindergarten children with DLD, which has important implications for recent U.S. legislation around early identification of dyslexia in all children.

Identifying Children at Risk for Developmental Language Disorder Using a Brief, Whole-Classroom Screen

Purpose The aim of this study was to determine whether parents of children with developmental language disorder (DLD) were aware of their children's language difficulties and whether a brief, classroom-based language screen can reliably identify children at risk for DLD, including those with both good and poor word reading skills. Method First- and second-grade students ( N = 97) completed a language screen and assessments of nonverbal intelligence, word reading, and language designed for linguistically diverse students. Their parents completed a questionnaire. Results Few parents of children with DLD reported that their child had ever received speech, language, reading, or other educational services. Parents of children with DLD with average word reading skills reported receiving services approximately half as often as children with DLD with poor word reading. Parents of children with DLD also reported few concerns about their children's speech, language, and academic development. The brief whole-classroom screen showed acceptable classification accuracy for identifying children with DLD overall, although sensitivity was lower for children with DLD with average word reading skills. Conclusion Based on reports of prior services and concerns, many parents of children with DLD appear to be unaware of their children's difficulty with oral language. Whole-classroom screens for language show potential for efficient identification of children who may benefit from comprehensive assessments for DLD without relying on their parents or teachers to raise concerns.

A Multiyear Population-Based Study of Kindergarten Language Screening Failure Rates Using the Rice Wexler Test of Early Grammatical Impairment

Purpose

The purpose of this study was to evaluate, over 2 separate school years, the school-district-wide failure rate of kindergartners on a screener of grammatical tense marking-the Rice Wexler Test of Early Grammatical Impairment (TEGI) Screening Test (Rice & Wexler, 2001)-composed of past tense (PT) and third-person singular (3S) probes.

Method

In the fall of 2 consecutive school years, consented and eligible kindergartners (n = 148 in Year 1, n = 126 in Year 2) in a rural southern school district were administered the TEGI Screening Test. Children who failed the screening test or either of the individual probes (PT or 3S) were administered the Primary Test of Nonverbal Intelligence. All children also completed the Test of Articulation Performance-Screen (Bryant & Bryant, 1983) and, in Year 2, the Get Ready to Read! emergent literacy screener (Whitehurst & Lonigan, 2001).

Results

The screening tool outcome most closely and consistently aligned with the recommended failure rate of approximately 30% (Oetting, Gregory, & Rivière, 2016; based on Tomblin et al., 1997) was the TEGI PT probe. TEGI Screening Test and 3S probe failure rates fell below the recommended level. Most children who failed the PT probe demonstrated nonverbal intelligence skills within the average range. In addition, most children who failed the PT probe would not have been readily identified on the basis of only the results of their articulation or emergent literacy screenings.

Conclusions

The TEGI PT probe is an efficient and reliable screener that identifies children for monitoring or additional language assessment. Children with language vulnerabilities are not necessarily identified by articulation or emergent literacy screenings at entry to kindergarten. To identify children at risk for language impairment, it is therefore necessary to directly screen oral language.