Role of auditory non-verbal working memory in sentence repetition for bilingual children with primary language impairment

Assessment of Developmental Language Disorder in Multilingual Children: Results from an International Survey

INTRODUCTION

The Multilingual-Multicultural Affairs Committee of the International Association of Communication Disorders (IALP) conducted a survey of diagnostic criteria for developmental language disorder (DLD) in multilingual children to discover how clinicians apply terminology and diagnostic criteria to multilingual children in different parts of the world.

METHODS

An international web survey was used to survey 354 participants from 44 countries about their assessment practices, and clinical opinions about assessing multilingual children for DLD.

RESULTS

The findings show that most clinicians felt confident in assessing multilingual children, and they applied the DLD terminology and inclusionary criteria to multilingual children with difficulty learning language. Clinicians used different procedures to assess heritage and societal languages. Barriers to access to services included a lack of knowledge by parents and referral sources about services available and typical multilingual development, with additional reasons differing by geographical region.

DISCUSSION

Speech pathologists across the globe have many similarities in the way that they assess multilingual children. Differences may be attributed to clinical experience, professional education, the clinician's role, the system they work in, and the clinician's own language skills. This paper advances knowledge of current clinical practices, which can be used to evaluate frameworks in international and national contexts, with implications for policy and practice to improve access to clinical services.

A Nonword Repetition Task Discriminates Typically Developing Italian-German Bilingual Children From Bilingual Children With Developmental Language Disorder: The Role of Language-Specific and Language-Non-specific Nonwords

In bi- and monolingual children, nonword repetition tasks (NWRTs) differentiate between typically developing (TD) and children with Developmental Language Disorder (DLD). Language specificity is a crucial factor in nonword construction especially for multilingual children. While language-specific nonwords seem less artificial than non-specific nonwords, the application of language-specific phonemes may be less suitable for bilingual children who are exposed to the target language less than monolingual peers. This study evaluates the concurrent and predictive value of a novel, computerized NWRT implemented in the MuLiMi web-platform and its potential in the discrimination of bilingual children with and without DLD, investigating the role of nonwords' language specificity. Thirty-seven children (of whom 17 had an objective risk of phonological disorders) with at least one Italian-speaking parent, living and attending kindergartens in Germany were tested with the MuLiMi NWRT and German standardized language tests. Caregivers and kindergarten teachers filled in questionnaires. Fourteen of the children were re-tested after 8-12 months. The results suggest that the new test's concurrent and discriminative validity are good. Analysis of variance revealed highly significant differences between children with and without (an objective risk of) phonological disorders and a significant interaction between nonword specificity and risk group. Significant correlations of initial scores with follow-up scores collected after 8-12 months were also found, as well as correlations with improvements in language abilities. In conclusion, although both language-specific and language-non-specific nonword repetition can support DLD risk identification in bilingual children, language-specific stimuli appear to be particularly sensitive indicators. This is interpreted as confirming DLD children's reduced sensitivity to frequent, familiar characteristics of the linguistic stimuli. The test's discriminative and concurrent validity showed to be robust to various potentially influencing factors like patterns of language exposure.

Validation of a Greek Sentence Repetition Task with Typically Developing Monolingual and Bilingual Children

This study provides a preliminary validation of a Greek Sentence Repetition Task (SRT) with a sample of 110 monolingual and bilingual typically developing (TLD) children and examines the test's ability to distinguish between Greek monolingual children and age-matched Albanian-Greek bilinguals using a Receiver Operating Characteristics (ROC) analysis. This is the first study to report on the psychometric evaluation of a Greek SRT and its discriminatory ability with typical populations. Since most language assessments are standardized with monolinguals and bilingual children tend to underperform on these compared to monolinguals, it is essential to establish the level of bilingual TLD children's ability on the same tests before moving on to diagnose language impairment in bilinguals. Results showed that the Greek SRT had very high validity and reliability scores, with Accuracy measures being more reliable than Grammaticality measures. The school-age monolingual and bilingual TLD children reached different cut-off scores on this task.

Contribution of Nonverbal Cognitive Skills on Bilingual Children’s Grammatical Performance: Influence of Exposure, Task Type, and Language of Assessment

This study explores the contribution of nonverbal working memory and processing speed on bilingual children’s morphosyntactic knowledge, after controlling for language exposure. Participants include 307 Spanish–English bilinguals in Kindergarten, second, and fourth grade (mean age = 7;8, SD = 18 months). Morphosyntactic knowledge in English and Spanish was measured using two separate language tasks: a cloze task and a narrative language task. In a series of four hierarchical linear regressions predicting cloze and narrative performance in English and Spanish, we evaluate the proportion of variance explained after adding (a) English exposure, (b) processing speed and working memory, and (c) interaction terms to the model. The results reveal the differential contribution of nonverbal cognitive skills across English and Spanish. Cognition was not significantly related to performance on either grammatical cloze or narrative tasks in Spanish. Narrative tasks in English were significantly predicted by processing speed, after controlling for age and exposure. Grammatical cloze tasks in English posed an additional cognitive demand on working memory. The findings suggest that cognitive demands vary for bilinguals based on the language of assessment and the task.

Cognitive Mechanisms of Monolingual and Bilingual Children in Monoliterate Educational Settings: Evidence From Sentence Repetition

Sentence repetition (SR) tasks have been extensively employed to assess bilingual children’s linguistic and cognitive resources. The present study examined whether monoliterate bilingual children differ from their monolingual (and monoliterate) peers in SR accuracy and cognitive tasks, and investigated links between vocabulary, updating, verbal and visuospatial working memory and SR performance in the same children. Participants were two groups of 35 children, 8–12 years of age: one group consisted of Albanian-Greek monoliterate bilingual children and the other of Greek monolingual children attending a monolingual-Greek educational setting. The findings demonstrate that the two groups performed similarly in the grammaticality scores of the SR. However, monolinguals outperformed the monoliterate bilinguals in SR accuracy, as well as in the visuospatial working memory and updating tasks. The findings did not indicate any bilingual advantage in cognitive performance. The results also demonstrate that updating and visuospatial working memory significantly predicted monolingual children’s SR accuracy scores, whereas Greek vocabulary predicted the performance of our monoliterate bilingual children in the same task. We attribute this outcome to the fact that monoliterate bilingual children do not rely on their fluid cognitive resources to perform the task, but instead rely on language proficiency (indicated by expressive vocabulary) while performing the SR.

Working Memory and Linguistic Performance of Dual Language Learners With and Without Developmental Language Disorders

Purpose This research note describes the use of working memory measures as potential indicators of developmental language disorders (DLD) in preschool-age dual language learners from Spanish-speaking backgrounds. This report is an extension of early work, completed by the same authors that described the diagnostic accuracy of a Spanish nonword repetition task. Method One hundred thirty Spanish-speaking families with preschool-age children participated; 37 children had DLD, and 93 were typically developing. Families were recruited from early childhood programs in three states in the western region of the United States. Working memory and linguistic measures were collected from the children; parents completed a vocabulary checklist and reported on their child's longest utterances. Results Nonverbal working memory was not associated with other measures, but verbal working memory was associated with linguistic measures. Although there were no group differences on nonverbal working memory, group differences (DLD vs. typical development) were detected on verbal working memory and linguistic measures. Verbal working memory combined with vocabulary scores resulted in 79% of cases correctly classified. Conclusions Working memory tasks yielded different results depending on the type of task (verbal vs. nonverbal). Outcomes from this study showed that a nonverbal working memory task (hand movement) was not useful in distinguishing preschool-age dual language children with DLD from typical peers, but a verbal working memory task (nonword repetition) may be useful if combined with other more robust linguistic measures.

Which Measures Better Discriminate Language Minority Bilingual Children With and Without Developmental Language Disorder? A Study Testing a Combined Protocol of First and Second Language Assessment

Purpose This study aimed to assess a protocol for the evaluation of developmental language disorder (DLD) in language minority bilingual children (LMBC). The specific aims were (a) to test group differences, (b) to evaluate the discriminant validity of single measures included in the protocol, and (c) to define which model of combined variables had the best results in terms of efficacy and efficiency. Method Two groups of LMBC were involved, one with typical development (n = 35) selected from mainstream schools and one with DLD (n = 20). The study protocol included the collection of demographic information and linguistic history; a battery of standardized tests in their second language (Italian), including nonword repetition, morphosyntactic comprehension and production, and vocabulary and narrative skills; and direct (children's evaluation) and indirect (parents' questionnaire) assessment of linguistic skills in their first language. Results Results showed that the two groups differed in almost all linguistic measures. None of the single measures reached good specificity/sensitivity scores. A combined model that included direct and indirect assessment of first language skills, morphosyntactic comprehension and production, and nonword repetition reached good discriminant validity, with 94.5% of cases correctly classified. Discussion The study defines a complex picture of the linguistic profile in bilingual children with DLD, compared to typically developing bilingual peers. The results reinforce the idea that no single measure can be considered optimal in distinguishing children with DLD from typical peers. The study offers a concrete example of an effective and efficient protocol with which to discriminate LMBC with and without DLD.

Diagnostic Accuracy of Sentence Repetition and Nonword Repetition for Developmental Language Disorder in Vietnamese

Purpose Sentence repetition and nonword repetition assess different aspects of the linguistic system, but both have been proposed as potential tools to identify children with developmental language disorder (DLD). Cross-linguistic investigation of diagnostic tools for DLD contributes to an understanding of the core features of the disorder. This study evaluated the effectiveness of these tools for the Vietnamese language. Method A total of 104 kindergartners (aged 5;2-6;2 [years;months]) living in Vietnam participated, of which 94 were classified as typically developing and 10 with DLD. Vietnamese sentence repetition and nonword repetition tasks were administered and scored using multiple scoring systems. Sensitivity, specificity, and likelihood ratios were calculated to assess the ability of these tasks to identify DLD. Results All scoring systems on both tasks achieved adequate to excellent sensitivity or specificity, but not both. Binary scoring of sentence repetition achieved a perfect negative likelihood ratio, and binary scoring of nonword repetition approached a highly informative positive likelihood ratio. More detailed scoring systems for both tasks achieved moderately informative values for both negative and positive likelihood ratios. Conclusions Both sentence repetition and nonword repetition are valuable tools for identifying DLD in monolingual speakers of Vietnamese. Scoring systems that consider number of errors and are relatively simple (i.e., error scoring of sentence repetition and syllables scoring of nonword repetition) may be the most efficient and effective for identifying DLD. Further work to develop and refine these tasks can contribute to cross-linguistic knowledge of DLD as well as to clinical practice.

Impact of epilepsy on language and discourse: Two self-limited focal epileptic syndromes of childhood

Self-limited focal epilepsy with centro-temporal spikes, also known as Rolandic epilepsy (RE), is a well-established focal epilepsy of childhood, characterized with language impairment. To investigate the relationship between language deficits and clinical parameters of self-limited focal epilepsies of childhood (SFEC), 21 patients with RE, 10 patients with childhood occipital epilepsy of Gastaut type (COE-G) (another SFEC that is not typically associated with language impairment), and 31 healthy controls were recruited. A broad panel of language tests also including narration sample was administered, and clinical features were documented. The language was significantly impaired in both RE and COE-G. Patients with COE-G showed worse scores than patients with RE in subtests measuring semantic functions. Clinical parameters were not associated with impaired language domains. Language impairment is experienced in different types of SFEC, emphasizing the broad representation of the language network. In SFEC, recent activity of epilepsy does not affect the severity of language dysfunction.

Preposition accuracy on a sentence repetition task in school age Spanish-English bilinguals

Preposition knowledge is important for academic success. The goal of this project was to examine how different variables such as English input and output, Spanish preposition score, mother education level, and age of English exposure (AoEE) may have played a role in children's preposition knowledge in English. 148 Spanish-English children between 7;0 and 9;11 produced prepositions in English and Spanish on a sentence repetition task from an experimental version of the Bilingual English Spanish Assessment Middle Extension (Peña, Bedore, Gutierrez-Clellen, Iglesias & Goldstein, in development). English input and output accounted for most of the variance in English preposition score. The importance of language-specific experiences in the development of prepositions is discussed. Competition for selection of appropriate prepositions in English and Spanish is discussed as potentially influencing low overall preposition scores in English and Spanish.

Nonverbal auditory working memory: Can music indicate the capacity?

Different working memory (WM) mechanisms that underlie words, tones, and timbres have been proposed in previous studies. In this regard, the present study developed a WM test with nonverbal sounds and compared it to the conventional verbal WM test. A total of twenty-five, non-music major, right-handed college students were presented with four different types of sounds (words, syllables, pitches, timbres) that varied from two to eight digits in length. Both accuracy and oxygenated hemoglobin (oxyHb) were measured. The results showed significant effects of number of targets on accuracy and sound type on oxyHb. A further analysis showed prefrontal asymmetry with pitch being processed by the right hemisphere (RH) and timbre by the left hemisphere (LH). These findings suggest a potential for employing musical sounds (i.e., pitch and timbre) as a complementary stimuli for conventional nonverbal WM tests, which can additionally examine its asymmetrical roles in the prefrontal regions.

Sentence Recall by Children With SLI Across Two Nonmainstream Dialects of English

PURPOSE

The inability to accurately recall sentences has proven to be a clinical marker of specific language impairment (SLI); this task yields moderate-to-high levels of sensitivity and specificity. However, it is not yet known if these results hold for speakers of dialects whose nonmainstream grammatical productions overlap with those that are produced at high rates by children with SLI.

METHOD

Using matched groups of 70 African American English speakers and 36 Southern White English speakers and dialect-strategic scoring, we examined children's sentence recall abilities as a function of their dialect and clinical status (SLI vs. typically developing [TD]).

RESULTS

For both dialects, the SLI group earned lower sentence recall scores than the TD group with sensitivity and specificity values ranging from .80 to .94, depending on the analysis. Children with SLI, as compared with TD controls, manifested lower levels of verbatim recall, more ungrammatical recalls when the recall was not exact, and higher levels of error on targeted functional categories, especially those marking tense.

CONCLUSION

When matched groups are examined and dialect-strategic scoring is used, sentence recall yields moderate-to-high levels of diagnostic accuracy to identify SLI within speakers of nonmainstream dialects of English.