A comparison of working memory profiles in school-aged children with Specific Language Impairment, Attention Deficit/Hyperactivity Disorder, Comorbid SLI and ADHD and their typically developing peers

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.

Links Among Attention-Deficit/Hyperactivity Disorder Symptoms and Psycholinguistic Abilities Are Different for Children With and Without Developmental Language Disorder

PURPOSE

Both developmental language disorder (DLD) and attention-deficit/hyperactivity disorder (ADHD) represent relatively common and chronic neurodevelopmental conditions associated with increased risk for poor academic and interpersonal outcomes. Reports of common co-occurrence suggest these neurodevelopmental disruptions might also be linked. Most of the data available on the issue have been based on case-control studies vulnerable to ascertainment and other biases.

METHOD

Seventy-eight children, representing four neurodevelopmental profiles (DLD, ADHD, co-occurring ADHD + DLD, and neurotypical development), were administered a battery of psycholinguistic tests. Parents provided standardized ratings of the severity of their children's inattention, hyperactivity/impulsivity, and executive function symptoms. Examiners were blinded to children's clinical status. Group differences, correlations, and best subset regression analyses were used to examine potential impacts of children's ADHD symptoms on their psycholinguistic abilities.

RESULTS

For children with DLD, significant links between their ADHD symptoms and psycholinguistic abilities were limited to the contributions of elevated hyperactivity/impulsivity symptoms to lower pragmatic abilities. For children without DLD, inattention symptoms contributed to lower levels of performance in pragmatic, sentence recall, receptive vocabulary, and narrative abilities.

DISCUSSION

Links among children's ADHD symptoms and their psycholinguistic abilities were different for children with and without DLD. Implications for the provision of clinical services are discussed.

A Role for Visual Memory in Vocabulary Development: A Systematic Review and Meta-Analysis

Although attention and early associative learning in preverbal children is predominantly driven by rapid eye-movements in response to moving visual stimuli and sounds/words (e.g., associating the word "bottle" with the object), the literature examining the role of visual attention and memory in ongoing vocabulary development across childhood is limited. Thus, this systematic review and meta-analysis examined the association between visual memory and vocabulary development, including moderators such as age and task selection, in neurotypical children aged 2-to-12 years, from the brain-based perspective of cognitive neuroscience. Visual memory tasks were classified according to the visual characteristics of the stimuli and the neural networks known to preferentially process such information, including consideration of the distinction between the ventral visual stream (processing more static visuo-perceptual details, such as form or colour) and the more dynamic dorsal visual stream (processing spatial temporal action-driven information). Final classifications included spatio-temporal span tasks, visuo-perceptual or spatial concurrent array tasks, and executive judgment tasks. Visuo-perceptual concurrent array tasks, reliant on ventral stream processing, were moderately associated with vocabulary, while tasks measuring spatio-temporal spans, associated with dorsal stream processing, and executive judgment tasks (central executive), showed only weak correlations with vocabulary. These findings have important implications for health professionals and researchers interested in language, as they advocate for the development of more targeted language learning interventions that include specific and relevant aspects of visual processing and memory, such as ventral stream visuo-perceptual details (i.e., shape or colour).

Language abilities in children and adolescents with DLD and ADHD: A scoping review

PURPOSE

There is an emerging view that attention-deficit/hyperactivity disorder (ADHD) is marked by problems with language difficulties, an idea reinforced by the fact that ADHD is highly comorbid with developmental language disorder (DLD). This scoping review provides an overview of literature on language abilities in children with DLD and ADHD while highlighting similarities and differences.

METHOD

A comprehensive search was performed to examine the literature on language abilities in the two disorders, yielding a total of 18 articles that met the inclusion criteria for the present review. Qualitative summaries are provided based on the language domain assessed.

RESULTS

The current literature suggests children and adolescents with ADHD have better morphosyntax/grammar, general/core language abilities, receptive, and expressive abilities than those with DLD. Further, that performance is comparable on assessments of semantic and figurative language but varies by sample on assessments of phonological processing, syntax, narrative language, and vocabulary.

CONCLUSION

Evidence presented points to children and adolescents with DLD as having greater language difficulties compared to those with ADHD, but with some important caveats. Despite limitations related to the paucity of studies and inconsistencies in how the two types of disorders are identified, our review provides a necessary and vital step in better understanding the language profiles of these two highly prevalent childhood disorders. These findings are useful in optimizing language outcomes and treatment efficacy for children and adolescents with ADHD and DLD.

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.

Do Language-Related Cognitive Capacities Help Predict Adjustment in Children with Attention-Deficit/Hyperactivity Disorder?

The goal of this paper was to examine the role that language-related cognitive capacities (LRCC) might play in explaining adjustment of 7 to 12 year-old children (M_age = 9.24; SD_age = 0.91) with and without ADHD. The sample was comprised of 178 children with ADHD and 86 typically-developing children (77.3% male; 81.4% White; 9.5% Black; 1.9% Hispanic; 0.8% Asian; 5.7% multiracial; 0.8% did not report race/ethnicity). Using simultaneous regression, we examined whether LRCC accounted for unique variance in achievement, attention problems, oppositional problems, conduct problems, and internalizing, over and above what standard covariates and ADHD diagnostic status could explain. Finally, we examined LRCC as a mediator of the relation between ADHD diagnostic status and these adjustment measures. Results indicated that LRCC significantly predicted 6 of 7 and partially mediated 5 of 7 measures, suggesting that language-related constructs warrant greater attention in diagnosis and treatment of ADHD.

Receptive vocabulary, memory span, and speech articulation in Pakistani children with developmental language disorders

This study aimed to find the association of receptive vocabulary in the development of speech and language among school-going children (4-13 years) with language disorders. On the basis of non-verbal receptive vocabulary and percentage correct consonants (PCC) scores, children from public schools in Punjab, Pakistan with speech and language issues were separated into three groups; Speech sound disordered (SSD, N = 15), Language Impaired (LI) comorbid with SSD (N = 42) and typically developed (TD, N = 15). Urdu version of Peabody picture vocabulary test, fourth edition (U-PPVT-4), Digit memory test (DMT), and Test for assessment of articulation and phonology in Urdu (TAAPU) were used to assess non-verbal receptive vocabulary, Short-term memory (STM), Working memory (WM), and SSD. Correlation and regression analyses were performed to find the association of receptive vocabulary with other measures used. Receptive vocabulary, STM, WM, omission, substitution, and PCC scores were significantly different (p < 0.01) when compared among LI+SSD, SSD, and TD groups. Regression analysis showed that receptive vocabulary was significantly associated with STM and WM in the LI+SSD group. A positive correlation was found between the U-PPVT-4 standard score with STM and WM for LI+SSD and SSD groups. Our findings in Urdu-speaking children suggested that STM and WM were less developed in children with speech and language impairments. Moreover, children with speech and language deficits not only had weaker receptive vocabulary but also attention should be given to improving STM and WM that contribute to LI.

Language Problems and ADHD Behaviors: Unique and Interactive Associations with School Readiness in a Socioeconomically Disadvantaged Preschool Sample

This study examined the unique and interactive effects of receptive language ability and ADHD behaviors on six school readiness outcomes, over and above the effects of socioeconomic status, in 49 preschoolers (M_age = 3.98, SD_age = .58; 53.06% female) recruited from Head Start-affiliated classrooms. Hierarchical regression analyses revealed unique positive associations between receptive language ability and cognitive and mathematics readiness, and unique negative associations between ADHD behaviors and social-emotional, physical, cognitive, and literacy readiness. Moderation analyses indicated that at higher, but not lower, levels of ADHD behaviors, lower receptive language ability was associated with lower social-emotional readiness. Results highlight that, when considered together, children's receptive language ability and ADHD behaviors vary in how they predict school readiness. Further, results provide preliminary evidence for ADHD behaviors as a risk factor in the association between receptive language deficits and social-emotional school readiness. Educational and clinical practice implications are discussed.

The contribution of visual and linguistic cues to the production of passives in ADHD and DLD: evidence from thematic priming

This study investigated how thematic priming via visual and linguistic cues influences the choice of syntactic voice in healthy French-speaking adults and in French-speaking children with typical and atypical development. In particular, we focused on children with attention deficit hyperactivity disorder (ADHD) and developmental language disorder (DLD), two clinical groups with documented syntactic difficulties. Twenty adults (M= 24;7) and 60 children aged 6-11 (20 typically developing, 20 with DLD and 20 with ADHD) were presented with agent or patient cues that progressively increased in strength over three conditions: a no cue condition, a visual cue condition with two cue types (perceptual vs. referential) and a linguistic cue condition with two cue types (topicalization of the agent/patient with and without subsequent sentence initiation). Results showed that all participants produced more passives after having been presented with a patient cue, regardless of cue type (cue > no cue), but linguistic cues facilitated the production of passives significantly more than visual cues (linguistic cue > visual cue). We also found that children with DLD were more sensitive than children with ADHD to visual cues (DLD > ADHD), which were more implicit than the linguistic cues and may have required more attentional resources. The opposite pattern (ADHD > DLD) was true for the linguistic cues, which required syntactic processing. These findings highlight how the development of dynamic tools using cue modality and cue sensitivity might be useful for discriminating children with and without syntactic impairment.

The effect of anxiety on working memory and language abilities in elementary schoolchildren with and without Additional Health and Developmental Needs

Although excessive childhood anxiety is recognised as a significant public health, education and socioeconomic concern, the specific effects of such anxiety on language development and working memory, particularly visual working memory, are relatively unknown. Thus, this study aimed to examine parent-reported trait anxiety, parent-reported functional language (daily communication skills) and clinical measures of non-verbal intelligence, receptive and expressive vocabulary, phonological awareness, and visual and auditory-verbal short-term and working memory in elementary schoolchildren. The final sample included 41 children categorised as Additional Health and Developmental Needs (AHDN) due to medical, neurodevelopmental or educational concerns and 41 age- and IQ-matched neurotypical (NT) children, aged 5- to 9-years. Results showed that 26% of all children in our entire sample (AHDN and NT) experienced moderate, sub-clinical anxiety (as reported by parents), and that AHDN children were 10.5 times more likely to experience high anxiety than the NT group (odds ratio). Parents of AHDN children reported lower functional language in their children than parents of NT children. Cognitive testing indicated that the AHDN group also had poorer visual and auditory-verbal working memory than the NT group. Further, High Anxiety children (drawn from both AHDN and NT groups) showed poorer parent-reported functional language skills, and lower visual and auditory-verbal working memory capacities. Our findings are amongst the first to confirm that the presence of high parent-rated trait anxiety is associated with reduced visual working memory in children, which is consistent with biological and theoretical expectations of the impact of anxiety on visually driven, goal-directed attention and working memory. Our results regarding the high prevalence of sub-clinical anxiety in both ADHD and neurotypical children highlight the need for early assessment of anxiety in all schoolchildren, especially those classified as AHDN.

Attention Control in Children With ADHD: An Investigation Using Functional Near Infrared Spectroscopy (fNIRS)

Attention problems are a predominant contributor to near- and far-term functional outcomes in attention-deficit/hyperactivity disorder (ADHD); however, most interventions focus on improving the alerting attentional network, which has failed to translate into improved learning for a majority of children with ADHD. Comparatively less is known regarding the executive attentional network and its overarching attention control process, which governs the ability to maintain relevant information in a highly active, interference-free state, and is intrinsic to a broad range of cognitive functions. This is the first study to compare attention control abilities in children with ADHD and typically developing (TD) children using the Visual Array Task (VAT) and to simultaneously measure hemodynamic functioning (oxyHb) using functional Near-Infrared Spectroscopy (fNIRS). Nineteen children with ADHD Combined type and 18 typically developing (TD) children aged 8 to 12 years were administered the VAT task while prefrontal activity was monitored using fNIRS. Results revealed that children with ADHD evinced large magnitude deficits in attention control and that oxyHb levels in the left dorsal lateral prefrontal cortex (dlPFC) were significantly greater in children with ADHD relative to TD children. These findings suggest that poor attention control abilities in children with ADHD may be related to increased left dlPFC activation in response to an underdeveloped and/or inefficient right dlPFC. The need to design interventions that target and strengthen attention control and its corresponding neural network is discussed based on the likelihood that attention control serves as the potential quaesitum for understanding a wide array of ADHD-related deficits.

Which 'Working' Components of Working Memory aren't Working in Youth with ADHD?

Despite replicated evidence for working memory deficits in youth with ADHD, no study has comprehensively assessed all three primary 'working' subcomponents of the working memory system in these children. Children ages 8-13 with (n = 45) and without (n = 41) ADHD (40% female; M_age = 10.5; 65% Caucasian/Non-Hispanic) completed a counterbalanced battery of nine tasks (three per construct) assessing working memory reordering (maintaining and rearranging information in mind), updating (active monitoring of incoming information and replacing outdated with relevant information), and dual-processing (maintaining information in mind while performing a secondary task). Detailed analytic plans were preregistered. Bayesian t-tests indicated that, at the group level, children with ADHD exhibited significant impairments in working memory reordering (BF₁₀ = 4.64 × 10⁵; d = 1.34) and updating (BF₁₀ = 9.49; d = 0.64), but not dual-processing (BF₀₁ = 1.33; d = 0.37). Overall, 67%-71% of youth with ADHD exhibited impairment in at least one central executive working memory domain. Reordering showed the most ADHD-related impairment, with 75% classified as below average or impaired, and none demonstrating strengths. The majority of children with ADHD (52%-57%) demonstrated average or better abilities in the remaining two domains, with a notable minority demonstrating strengths in updating (8%) and dual-processing (20%). Notably, impairments in domain-general central executive working memory, rather than individual subcomponents, predicted ADHD severity, suggesting that common rather than specific working memory mechanisms may be central to understanding ADHD symptoms. These impairment estimates extend prior work by providing initial evidence that children with ADHD not only exhibit heterogeneous profiles across cognitive domains but also exhibit significant heterogeneity within subcomponents of key cognitive processes.

Capacity of the CCC-2 to Discriminate ASD from Other Neurodevelopmental Disorders

The Children’s Communication Checklist (CCC-2) has demonstrated its usefulness as an instrument to assess discrepancies between the use of structural dimensions of language and the pragmatic and sociointeractive uses of language. The aims of the present paper are: (1) to test the capacity of the Galician adaptation of the CCC-2 to discriminate the linguistic profiles of children with different disorders and (2) to test whether the capacity of the CCC-2 to discriminate the linguistic abilities of children with different disorders is the same at different ages: earlier development and later development. The sample is of 117 children previously diagnosed with different disorders: autism spectrum disorder (ASD), developmental language disorder (DLD), attention deficit with hyperactivity disorder (ADHD), Down syndrome children (DS) and typically developing children (TD). The children were divided into two different age groups: from 4 to 6 and from 7 to 16 years of age. The results indicate that the Galician CCC-2 (1) accurately identified children with and without communicative impairments, (2) distinguished between profiles with a predominance of pragmatic (ASD and ADHD) and structural disorders (DS and DLD) and (3) distinguished between different profiles of pragmatic impairment. The CCC-2 equally identified these profiles at both earlier and later ages. The Galician CCC-2 seems to be a useful instrument for differentiating among different clinical groups and for assessing pragmatic disorders from an early age, which can be valuable for planning early intervention.

Executive Function, Working Memory, and Verbal Fluency in Relation to Non-Verbal Intelligence in Greek-Speaking School-Age Children with Developmental Language Disorder

Developmental Language Disorder (DLD) is often associated with impairments in working memory (WM), executive functions (EF), and verbal fluency. Moreover, increasing evidence shows poorer performance of children with DLD on non-verbal intelligence tests relative to their typically developing (TD) peers. Yet, the degree and generality of relevant difficulties remain unclear. The present study aimed at investigating WM capacity, key EFs and verbal fluency in relation to non-verbal intelligence in Greek-speaking school-age children with DLD, compared to TD peers (8–9 years). To our knowledge, the present study is the first to attempt a systematic relevant assessment with Greek-speaking school-age children, complementing previous studies mostly involving English-speaking participants. The results showed that children with DLD scored lower than TD peers on the non-verbal intelligence measure. Groups did not differ in the inhibition measures obtained (tapping resistance to either distractor or proactive interference), but children with DLD were outperformed by TD peers in the WM capacity, updating, monitoring (mixing cost), and verbal fluency (phonological and semantic) measures. The effects showed limited (in the case of backward digit recall) or no dependence on non-verbal intelligence. Findings are discussed in terms of their theoretical and practical implications as well as in relation to future lines of research.

Investigating the Role of Inattention and/or Hyperactivity/impulsivity in Language and Social Functioning Using a Dimensional Approach

The current study parsed out the distinct components of attention-deficit/hyperactivity disorder (ADHD) symptomatology to examine differential relations with language and social ability. Using a research domain criteria (RDoC) framework, we administered standardized tests and previously developed and validated questionnaires to assess levels of inattention and/or hyperactivity/impulsivity symptomatology, language, social responsivity and social competency in 98 young adults. Those with higher inattention and/or hyperactivity/impulsivity symptomatology had reduced language comprehension, social responsivity, and social competency. Inattention and hyperactivity/impulsivity both predicted language comprehension, but not language production. Interestingly, inattention uniquely contributed to social responsiveness and social competency, but hyperactivity/impulsivity did not. Findings suggest that inattention and/or hyperactivity/impulsivity symptoms, inattention in particular, may be especially important for social skills programs geared towards individuals with attention limitations.

Working, Declarative, and Procedural Memory in Children With Developmental Language Disorder

Purpose Previous research into the working, declarative, and procedural memory systems in children with developmental language disorder (DLD) has yielded inconsistent results. The purpose of this research was to profile these memory systems in children with DLD and their typically developing peers. Method One hundred four 5- to 8-year-old children participated in the study. Fifty had DLD, and 54 were typically developing. Aspects of the working memory system (verbal short-term memory, verbal working memory, and visual-spatial short-term memory) were assessed using a nonword repetition test and subtests from the Working Memory Test Battery for Children. Verbal and visual-spatial declarative memory were measured using the Children's Memory Scale, and an audiovisual serial reaction time task was used to evaluate procedural memory. Results The children with DLD demonstrated significant impairments in verbal short-term and working memory, visual-spatial short-term memory, verbal declarative memory, and procedural memory. However, verbal declarative memory and procedural memory were no longer impaired after controlling for working memory and nonverbal IQ. Declarative memory for visual-spatial information was unimpaired. Conclusions These findings indicate that children with DLD have deficits in the working memory system. While verbal declarative memory and procedural memory also appear to be impaired, these deficits could largely be accounted for by working memory skills. The results have implications for our understanding of the cognitive processes underlying language impairment in the DLD population; however, further investigation of the relationships between the memory systems is required using tasks that measure learning over long-term intervals. Supplemental Material https://doi.org/10.23641/asha.13250180.

Executive Functions and Morphosyntax: Distinguishing DLD From ADHD in French-Speaking Children

Attention deficit hyperactivity disorder (ADHD) is commonly associated with deficits in executive functions executive functions (EF), but children with this disorder frequently demonstrate co-occurring morphosyntactic impairment when assessed using standardized tests. On the other hand, children with developmental language disorder (DLD), a population defined by impaired linguistic functioning, are often diagnosed with comorbid EF deficits. We investigated EF and morphosyntax in 60 French-speaking children aged six to 12: 20 with typical development (TD), 20 with ADHD, and 20 with DLD. To obtain an EF profile for the different cognitive groups, we used standardized tests to assess lower-order EF skills, (i) selective attention and (ii) short-term memory capacity, and higher-order EF skills, (i) working memory capacity and (ii) attention shifting. To test morphosyntax, we used (i) a standardized omnibus test that elicited a variety of complex structures and (ii) a more fine-grained probe test that assessed the production of third person object clitic pronouns, a clinical marker of DLD in French. Children with ADHD and DLD were associated with different EF and morphosyntactic profiles: children in the ADHD group demonstrated higher-order EF weakness and difficulty on the omnibus morphosyntax task, whereas children with DLD showed both lower- and higher-order limitations and struggled with both morphosyntax tasks. Our findings indicate that deficits in morphosyntax are not characteristic of ADHD but that the performance of children with ADHD can mimic morphosyntactic impairment when all-encompassing omnibus tests evaluating various and unpredictable structures are used. If morphosyntax is tested using reliable markers of atypical language development and external cognitive-load factors are optimally reduced, there are significant discrepancies in the observed ADHD-DLD outcomes. Clinical implications that include perspectives for the differential diagnosis of ADHD and DLD are discussed.

Cognitive, Noncognitive, and Home Environment Correlates of Reading Difficulties in Primary-Grade Students With Language Impairment

Purpose This article first aimed to examine the cognitive (rapid automatized naming, phonological awareness, working memory, nonverbal cognition, and language) correlates of reading difficulty in children with language impairment (LI). Second, we considered whether noncognitive (effortful control, social competence, and behavior problems) correlates offered any explanatory value above that of cognitive factors. Third, we examined whether home environment (specifically household organization and home learning environment) would offer an additional explanatory value. Method The sample included 165 children in kindergarten and Grade 1 who were receiving intervention for LI in public schools. Standardized measures along with parent interviews/questionnaires were administered at the end of the school year. Results Logistic regression models indicated the noncognitive factors added discriminatory value to that of cognitive factors in predicting reading difficulties, whereas household factors did not. In the final model using all 11 predictors, prediction accuracy was 88.7% for the typical reading group and 54.2% for the reading difficulty group, with an overall accuracy of 76.4%. Only phonological awareness and working memory significantly contributed to predicting reading group membership when measured in kindergarten and Grade 1. Conclusions For this sample of children with LI, the most important predictors of reading were cognitive. The child's behavior and social competence improved prediction to a limited but statistically significant degree, whereas home environment did not. Overall classification was low, as only half of the children with reading difficulties were correctly predicted. Important factors differentiating good and poor emergent readers with LI were not captured in this study. Supplemental Material https://doi.org/10.23641/asha.12462428.

Working Memory Profiles of Children With Dyslexia, Developmental Language Disorder, or Both

Purpose Compared to children with typical development, children with dyslexia, developmental language disorder (DLD), or both often demonstrate working memory deficits. It is unclear how pervasive the deficits are or whether the deficits align with diagnostic category. The purpose of this study was to determine whether different working memory profiles would emerge on a comprehensive battery of central executive, phonological, visuospatial, and binding working memory tasks and whether these profiles were associated with group membership. Method Three hundred two 2nd graders with typical development, dyslexia, DLD, or dyslexia/DLD completed 13 tasks from the Comprehensive Assessment Battery for Children-Working Memory ( Gray, Alt, Hogan, Green, & Cowan, n.d. ) that assessed central executive, phonological, and visuospatial/attention components of working memory. Results Latent class analyses yielded 4 distinct latent classes: low overall (21%), average with high number updating (30%), average with low number updating (12%), and high overall (37%). Children from each disability group and children from the typically developing group were present in each class. Discussion Findings highlight the importance of knowing an individual child's working memory profile because working memory profiles are not synonymous with learning disabilities diagnosis. Thus, working memory assessments could contribute important information about children's cognitive function over and above typical psychoeducational measures.

Inhibitory Control and Information Processing in ADHD: Comparing the Dual Task and Performance Adjustment Hypotheses

Inhibition is a key neurocognitive domain in ADHD that is commonly assessed with the stop-signal task. The stop-signal involves both "go" and "stop" trials; previous research indicates that response times are reliably slower to "go" trials during tasks with vs. without intermittent "stop" trials. However, it is unclear whether this pattern reflects deliberate slowing to maximize inhibitory success (performance adjustment hypothesis) and/or disrupted bottom-up information processing due to increased cognitive demands (dual-task hypothesis). Given the centrality of "go" responding for estimating children's inhibitory speed, finding that children with ADHD slow differently -or for different reasons- has the potential to inform cognitive and self-regulatory theories of ADHD. The current study used a carefully-controlled experimental design to assess the mechanisms underlying stop signal-related slowing in ADHD. Children ages 8-13 with (n = 81) and without ADHD (n = 63) completed the stop-signal task and a control task that differed only in the presence/absence of "stop" trials. Using drift-diffusion modeling, Bayesian repeated-measures ANOVAs revealed a pattern consistent with the performance adjustment hypothesis, such that children adopted more cautious response strategies (BF10 = 6221.78; d = 0.38) but did not show changes in processing speed (BF01 = 3.08; d = 0.12) or encoding/motor speed (BF01 = 5.73; d = 0.07) when inhibition demands were introduced. Importantly, the ADHD/Non-ADHD groups showed equivalent effects of intermittent "stop" trials (BF01 = 4.30-5.56). These findings suggest intact self-regulation/performance monitoring in the context of adapting to increased inhibitory demands in ADHD, which has important implications for the continued isolation of potential mechanisms associated with ADHD symptoms and impairment.

Specific conditions for a selective deficit in memory for order in children with dyslexia

Short-term memory (STM) models distinguish between item and order memorization. The present study aims to explore how item and order STM are affected by the nature of the stimuli, the sequential versus simultaneous mode of presentation, the visual versus auditory presentation modality, the possibility of verbal recoding. A total of 20 children with dyslexia were matched one-by-one with 20 typically reading children on sex, age (8-14 years), and grade. Computerized STM tasks were administered while manipulating type (item vs. order), stimuli (letters vs. colors), sequentiality, input and output modality, as well as the presence/absence of articulatory suppression and distractors. General Linear Model analyses were conducted on accuracy scores for item and order STM. Both item and order recall scores were lower for children with dyslexia. Although order STM in the visual input condition turned out to be more impaired than item STM in the dyslexic group, both item and order memory impairments become evident when verbal recoding is prevented through articulatory suppression. Moreover, dyslexic children, unlike typical readers, were not facilitated by the linguistic nature of the stimuli to be remembered. The present findings suggest that the often-reported selective impairment of serial memory in dyslexia is restricted to stimuli that are verbal in nature or can be verbally recoded, whereas both item and order memory impairments become evident when verbal recoding is prevented through articulatory suppression. The presence of distractors is particularly detrimental to STM in the dyslexic group. The sensitivity to distractors, suppression, and stimuli in STM is predictive of reading performance.

Applying an Integrative Framework of Executive Function to Preschoolers With Specific Language Impairment

Purpose

The first goal of this research was to compare verbal and nonverbal executive function abilities between preschoolers with and without specific language impairment (SLI). The second goal was to assess the group differences on 4 executive function components in order to determine if the components may be hierarchically related as suggested within a developmental integrative framework of executive function.

Method

This study included 26 4- and 5-year-olds diagnosed with SLI and 26 typically developing age- and sex-matched peers. Participants were tested on verbal and nonverbal measures of sustained selective attention, working memory, inhibition, and shifting.

Results

The SLI group performed worse compared with typically developing children on both verbal and nonverbal measures of sustained selective attention and working memory, the verbal inhibition task, and the nonverbal shifting task. Comparisons of standardized group differences between executive function measures revealed a linear increase with the following order: working memory, inhibition, shifting, and sustained selective attention.

Conclusion

The pattern of results suggests that preschoolers with SLI have deficits in executive functioning compared with typical peers, and deficits are not limited to verbal tasks. A significant linear relationship between group differences across executive function components supports the possibility of a hierarchical relationship between executive function skills.

Research Review: Language problems in children with Attention-Deficit Hyperactivity Disorder - a systematic meta-analytic review

BACKGROUND

Children with Attention-Deficit Hyperactivity Disorder (ADHD) appear to have a higher risk of language problems compared with typically developing children, although the types of language problems experienced are less clear. This review aims to establish the types of language problems experienced by children with ADHD according to systematically reviewed literature and determine the empirical evidence for language problems in children with ADHD compared with non-ADHD controls.

METHODS

A standardized search protocol was used on databases: CINAHL, Medline, and PsychINFO. We identified studies with the following inclusion criteria: (a) confirmed ADHD status at the time of the study, (b) inclusion of a non-ADHD control group, (c) use of a validated language measure, and (d) age ≤ 18. t-Tests, Pearson's r, and Hedges g effect sizes (ES) were calculated using summary statistics. Random effects meta-analyses were conducted for the language domain suitable for analysis. Publication bias was investigated using both the trim and fill and p-curve techniques.

RESULTS

Twenty-one studies were included in the systematic review (ADHD = 1,209; Control = 1,101), within which 60 of 68 separate analyses found significant differences between the ADHD and control group on the language measures (p < .05). Follow-up meta-analyses found evidence for large deficits in the ADHD groups overall (10/11 studies met p < .05; weighted mean ES [WMES]: 1.04); expressive (10/10 met p < .05; WMES: 1.23); receptive (12/14 met p < .05; WMES: 0.97), and pragmatic language (4/4 studies met p < .05; WMES: 0.98) compared with controls.

CONCLUSIONS

This study demonstrates that children with ADHD have poorer performance on measures of overall, expressive, receptive, and pragmatic language compared with controls. A screening of language functioning may be a valuable addition to the assessment of ADHD.

Language Delay in 3-Year-Old Children With ADHD Symptoms

OBJECTIVE

Little is known about cognition in preschoolers with ADHD and language delay (LD). The objective was to investigate cognitive functions in preschoolers with ADHD symptoms and LD compared with children with ADHD symptoms only and to estimate the frequency of children with ADHD symptoms, co-occurring language delay, and delays on cognitive measures.

METHOD

Participants were recruited from the Norwegian Mother and Child Cohort Study. The teacher report of expressive language and the cognitive tests from 119 3-year-old children with parent reported ADHD symptoms and LD were compared with those of 258 children with ADHD symptoms only.

RESULTS

The ADHD + LD group performed significantly worse than the ADHD group on most language-related measures. There were no differences between the groups on most nonverbal measures. Single measures had a limited potential of differentiating between the groups.

CONCLUSION

ADHD symptoms and co-occurring LD in preschoolers were characterized by cognitive deficits associated with both disorders, not with global neurodevelopmental delay.

Short-Term Memory Performance in 7- and 8-Year-Old Children: The Relationship Between Phonological and Pitch Processing

PURPOSE

The relationship between short-term memory for phonology and pitch was explored by examining accuracy scores for typically developing children for 5 experimental tasks: immediate nonword repetition (NWR), nonword repetition with an 8-s silent interference (NWRS), pitch discrimination (PD), pitch discrimination with an 8-s silent interference (PDS), and pitch matching (PM).

METHOD

Thirty-six 7- and 8-year-old children (21 girls, 15 boys) with normal hearing, language, and cognition were asked to listen to and repeat nonsense words (NWR, NWRS), make a same versus different decision between 2 tones (PD, PDS), and listen to and then vocally reproduce a tone (PM).

RESULTS

Results showed no significant correlations between tasks of phonological memory and tests of pitch memory, that participants scored significantly better on nonword repetition tasks than PD and PM tasks, and that participants performed significantly better on tasks with no silent interference.

DISCUSSION

These findings suggest that, for typically developing children, pitch may be stored and rehearsed in a separate location than phonological information. Because of fundamental task differences, further research is needed to corroborate these data and determine the presence of developmental effects and neuroanatomical locations where a potential language/music overlap is occurring in children.

Psychosoziale Belastungen bei Sprachentwicklungsstörungen

Zusammenfassung. Die umschriebenen Entwicklungsstörungen des Sprechens und der Sprache gehören zu den häufigsten Entwicklungsstörungen. Aufgrund der zentralen Bedeutung sprachlicher Kompetenzen für verschiedene Lebensbereiche beeinträchtigen Sprachentwicklungsstörungen nicht nur die schulische, sondern auch die soziale und emotionale Entwicklung eines Kindes und wirken bis ins Jugend- und Erwachsenenalter hinein. Es folgt eine Übersicht über die psychosozialen Belastungen bei betroffenen Kindern und Jugendlichen sowie ihren Angehörigen. Kinder mit Sprachentwicklungsstörungen tragen ein erhöhtes Risiko für komorbide internalisierende und externalisierende Störungen sowie für Schwierigkeiten mit Gleichaltrigen, die im Jugendalter zunehmend an Bedeutung gewinnen. Eltern von Kindern mit Sprachentwicklungsstörungen weisen im Vergleich zur Allgemeinbevölkerung höhere Stress- und Depressionswerte auf, die insbesondere durch die mangelnde Akzeptanz und Unterstützung durch das soziale Umfeld beeinflusst werden. Es existieren zu wenig therapeutische Angebote, die auf die besondere Situation der Betroffenen angepasst sind. Die Implikationen für Forschung und klinische Praxis werden diskutiert.

Temporal Attention as a Scaffold for Language Development

Language is one of the most fascinating abilities that humans possess. Infants demonstrate an amazing repertoire of linguistic abilities from very early on and reach an adult-like form incredibly fast. However, language is not acquired all at once but in an incremental fashion. In this article we propose that the attentional system may be one of the sources for this developmental trajectory in language acquisition. At birth, infants are endowed with an attentional system fully driven by salient stimuli in their environment, such as prosodic information (e.g., rhythm or pitch). Early stages of language acquisition could benefit from this readily available, stimulus-driven attention to simplify the complex speech input and allow word segmentation. At later stages of development, infants are progressively able to selectively attend to specific elements while disregarding others. This attentional ability could allow them to learn distant non-adjacent rules needed for morphosyntactic acquisition. Because non-adjacent dependencies occur at distant moments in time, learning these dependencies may require correctly orienting attention in the temporal domain. Here, we gather evidence uncovering the intimate relationship between the development of attention and language. We aim to provide a novel approach to human development, bridging together temporal attention and language acquisition.

Kognitive Kompetenzen und Sprachentwicklung bei Kindern im Alter zwischen vier und fünf Jahren

Zusammenfassung. Ziel der vorliegenden Studie ist es den Zusammenhang von verschiedenen kognitiven Basiskompetenzen und sprachlichen Fähigkeiten bei Vorschülern zu untersuchen. Verglichen werden die kognitiven Kompetenzen von Kindern mit niedrigen Leistungen im Wortschatz und/oder in der Grammatik (n = 69) und einer sprachlich unbeeinträchtigten Vergleichsgruppe (n = 69). Weiter wird eine multiple hierarchische Regressionsanalyse gerechnet um die Bedeutung von kognitiven Basiskompetenzen für die Pragmatik zu untersuchen. Insgesamt zeigt sich, dass die Vergleichsgruppe über bessere kognitive Fähigkeiten verfügt als die Risikogruppe, insbesondere in der Verarbeitungsgeschwindigkeit. Im Bereich Pragmatik konnte das Arbeitsgedächtnis als wichtiger Prädiktor identifiziert werden. Anhand der Analysen wird deutlich, dass kognitive Basiskompetenzen für verschiedene sprachliche Bereiche von Bedeutung sind.

The role of age and executive function in auditory category learning

Auditory categorization is a natural and adaptive process that allows for the organization of high-dimensional, continuous acoustic information into discrete representations. Studies in the visual domain have identified a rule-based learning system that learns and reasons via a hypothesis-testing process that requires working memory and executive attention. The rule-based learning system in vision shows a protracted development, reflecting the influence of maturing prefrontal function on visual categorization. The aim of the current study was twofold: (a) to examine the developmental trajectory of rule-based auditory category learning from childhood through adolescence and into early adulthood and (b) to examine the extent to which individual differences in rule-based category learning relate to individual differences in executive function. A sample of 60 participants with normal hearing-20 children (age range=7-12years), 21 adolescents (age range=13-19years), and 19 young adults (age range=20-23years)-learned to categorize novel dynamic "ripple" sounds using trial-by-trial feedback. The spectrotemporally modulated ripple sounds are considered the auditory equivalent of the well-studied "Gabor" patches in the visual domain. Results reveal that auditory categorization accuracy improved with age, with young adults outperforming children and adolescents. Computational modeling analyses indicated that the use of the task-optimal strategy (i.e., a conjunctive rule-based learning strategy) improved with age. Notably, individual differences in executive flexibility significantly predicted auditory category learning success. The current findings demonstrate a protracted development of rule-based auditory categorization. The results further suggest that executive flexibility coupled with perceptual processes play important roles in successful rule-based auditory category learning.

Executive functioning in preschoolers with specific language impairment

The pathogenesis of Specific Language Impairment (SLI) is still largely beyond our understanding. In this review, a neuropsychological perspective on language impairments in SLI is taken, focusing specifically on executive functioning (EF) in preschoolers (age range: 2.6-6.1 years) with SLI. Based on the studies described in this review, it can be concluded that similar to school-aged children with SLI, preschoolers with SLI show difficulties in working memory, inhibition and shifting, as revealed by both performance based measures and behavioral ratings. It seems plausible that a complex, reciprocal relationship exists between language and EF throughout development. Future research is needed to examine if, and if yes how, language and EF interact in SLI. Broad neuropsychological assessment in which both language and EF are taken into account may contribute to early detection of SLI. This in turn can lead to early and tailored treatment of children with (suspected) SLI aimed not only at stimulating language development but also at strengthening EF.

Executive Function in SLI: Recent Advances and Future Directions

This paper provides a review of recent research on executive function abilities in children with specific language impairment (SLI). Across several studies, children with SLI are reported to perform worse than typically developing peers on measures of sustained attention, working memory, inhibition, and attention shifting. However, few studies have considered multiple executive function components simultaneously and even fewer have examined the underlying relationship between executive function deficits and impaired language acquisition. We argue that in order to fully understand the nature of executive function deficits in SLI, the field must move past simply identifying weaknesses to instead test models of executive function development and explore the nature of the relationship between executive function and language. Future research directions are recommended in order to achieve these goals.

Sentence imitation as a marker of SLI in Czech: disproportionate impairment of verbs and clitics

PURPOSE

The authors examined sentence imitation as a potential clinical marker of specific language impairment (SLI) in Czech and its use to identify grammatical markers of SLI.

METHOD

Children with SLI and the age- and language-matched control groups (total N = 57) were presented with a sentence imitation task, a receptive vocabulary task, and digit span and nonword repetition tasks. Sentence imitations were scored for accuracy and error types. A separate count of inaccuracies for individual part-of-speech categories was performed.

RESULTS

Children with SLI had substantially more inaccurate imitations than the control groups. The differences in the memory measures could not account for the differences between children with SLI and the control groups in imitation accuracy, even though they accounted for the differences between the language-matched and age-matched control groups. The proportion of grammatical errors was larger in children with SLI than in the control groups. The categories that were most affected in imitations of children with SLI were verbs and clitics.

CONCLUSION

Sentence imitation is a sensitive marker of SLI. Verbs and clitics are the most vulnerable categories in Czech SLI. The pattern of errors suggests that impaired syntactic representations are the most likely source of difficulties in children with SLI.

Visuospatial working memory in specific language impairment: a meta-analysis

We conducted a meta-analysis of the data from studies comparing visuospatial working memory (WM) in children with specific language impairment (SLI) and typically developing (TD) children. The effect sizes of 21 studies (including 32 visuospatial storage tasks and 9 visuospatial central executive (CE) tasks) were identified via computerized database searches and the reference sections of the identified studies. Meta-analyses and moderator analyses were conducted to examine the magnitude of the differences in visuospatial storage and CE, and their relation to the inclusion criteria used for SLI and the age of the children. The results showed significant effect sizes for visuospatial storage (d=0.49) and visuospatial CE (d=0.63), indicating deficits in both components of visuospatial WM in children with SLI. The moderator analyses showed that greater impairment in visuospatial storage was associated with more pervasive language impairment, whereas age was not significant associated with visuospatial WM. The finding of deficits in visuospatial WM suggests domain-general impairments in children with SLI. It raises questions about the language-specificity of a diagnosis of SLI. Careful attention should thus be paid to both verbal and visuospatial WM in clinical practice, and especially in those children with pervasive language impairments.

The impacts of language background and language-related disorders in auditory processing assessment

PURPOSE

To examine the impact of language background and language-related disorders (LRDs--dyslexia and/or language impairment) on performance in English speech and nonspeech tests of auditory processing (AP) commonly used in the clinic.

METHOD

A clinical database concerning 133 multilingual children (mostly with English as an additional language) and 71 monolingual children (7- to 12-year-old native English speakers) with listening concerns was analyzed retrospectively.

RESULTS

Language background had no significant effect on the 3 nonspeech AP tests, but the multilingual group performed worse in most of the speech tests. Children with LRDs generally performed more poorly than those without, except for the masking level difference.

CONCLUSIONS

Although language background affects performance in AP tasks that use speech, the effect of LRDs appears to be more wide-ranging insofar as the majority of the AP tests--speech and nonspeech--were significantly affected by their presence. The effects of language background are probably mediated directly through the effects of language expertise, whereas those associated with LRDs appear to arise from associated deficits in memory and attention. The vast majority of so-called AP tests tap abilities far beyond those typically thought of as specifically auditory; thus, they are poor measures of an AP disorder.

Children with specific language impairment and resolved late talkers: working memory profiles at 5 years

PURPOSE

The evidence of a deficit in working memory in specific language impairment (SLI) is of sufficient magnitude to suggest a primary role in developmental language disorder. However, little research has investigated memory in late talkers who recover from their early delay. Drawing on a longitudinal, community sample, this study compared the memory profiles of 3 groups of 5-year-olds: children with SLI who had been identified as late talkers, resolved late talkers (RLTs), and children with typical language development (TLD).

METHOD

Participants were 25 children with SLI, 45 RLTs, and 32 children with TLD. Subtests from the Working Memory Test Battery for Children and the Children's Memory Scale plus recalling sentences and nonword repetition tasks were administered to test the components of Baddeley's working memory model.

RESULTS

The SLI group showed significantly poorer performance than the RLT and TLD groups on measures of the phonological loop and episodic buffer. The RLT and TLD groups scored similarly on all memory measures.

CONCLUSIONS

The results support previous findings that sentence recall and nonword repetition are markers of SLI. Although residual effects of late-talking status may emerge over time, RLTs do not necessarily show memory deficits at 5 years of age despite delayed early vocabulary development.