Family history interview of a broad phenotype in specific language impairment and matched controls

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

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

Listening and Processing Skills in Young School Children with a History of Developmental Phonological Disorder

There is a lack of longitudinal studies on the broad-based outcomes in children with Developmental Phonological Disorder (DPD). The aim of this study was to investigate listening and processing skills in a clinical sample of 7-to-10-year-old children diagnosed with DPD in their preschool years and compare these to same-aged typically developing (TD) children. The Evaluation of Children's Listening and Processing Skills (ECLiPS) was completed by parents of 115 children with DPD and by parents of 46 TD children. The total ECLiPS mean score, and the five subscale mean scores, the proportion of children with clinically significant difficulties (≤10th percentile), and the proportion of children with co-occurrence of clinically significant difficulties on more than one subscale, were calculated. Results showed that the ECLiPS mean scores did not differ between the groups. There was no difference between groups regarding language and literacy, but a higher proportion of children with DPD than TD had difficulties in the total score, speech, and auditory processing, environmental and auditory sensitivity, and pragmatic and social skills. In addition, 33.9% of children with DPD had clinically significant difficulties in two or more subscales compared to 10.9% of TD children.

An evaluation of a prescribed joint book reading intervention for preschool children with speech, language and communication needs

Purpose: The aims of the present study were twofold: first, to investigate reading and screen time habits in a large clinical sample of caregivers of children with speech, language and communication needs (SLCN) before and after an 8 week intervention focussed on daily joint book reading and, second, to capture the caregivers' experiences of the activity.Method: Preschool aged children with SLCN and their caregivers were consecutively recruited during their first visit to the department of Speech and Language Pathology, Gävle County Hospital, Sweden. They participated in a survey-based interview before and after receiving an intervention with recommendations of at least 10 minutes of daily book reading with an interactional focus, as an add-on to ordinary speech-language pathology services. The results were analysed using descriptive statistics of the answers to the questions in the interview, as well as a thematic analysis of free-text comments.Result: The 135 families who participated in the pre-intervention interview survey reported variable reading frequency and screen time. The post-intervention interview survey was completed by 107 families. The results demonstrated significant increases in reading frequency and reading time, and a significant decrease in screen time per day. Caregivers also reported positive experiences of the daily interactive book reading.Conclusion: The results of this study demonstrate that a speech-language pathologist-(SLP) managed, caregiver-led book reading intervention is feasible and might have a positive impact on reading, other factors related to reading, and screen time in families of children with SLCN.

Impacts of a shared book-reading intervention for Italian-speaking children with developmental language disorder

BACKGROUND

The regular practice of shared book reading (SBR) at home may play a key role in fostering the linguistic development of children with developmental language disorder (DLD). However, more evidence is needed of the benefits of home-based SBR interventions on the parents' conversational strategies and on the communicative and linguistic production of children with DLD.

AIMS

To examine the impacts of a parent-based SBR intervention on the parent's use of conversational strategies, and on the engagement, conversational participation and linguistic production of Italian-speaking children with DLD. The mothers trained in the use of SBR strategies were expected to increase their use of these strategies. The children were expected to show gains in their level of engagement and conversational participation during SBR; in turn, moderate increments of the indices of language production were expected.

METHODS & PROCEDURES

Thirty-two preschool children with DLD participated in the study; all were receiving speech language therapy. Using a non-randomized pre-post-test control trial, 20 mother-child dyads implemented an 8-week SBR programme (the SBR intervention group), while 12 dyads acted as a comparison group. Based on the 'dialogic reading' method, eight verbal and non-verbal SBR strategies were employed during individual and small-group parent training sessions. Speech-language therapists were involved in the individual parent training sessions to provide suggestions focused on the specific characteristics of each mother-child dyad. Measures of parents' intervention strategies, children's engagement, conversational participation and oral language were included.

OUTCOMES & RESULTS

At post-test, mothers in the SBR intervention group used three of the eight SBR strategies-Shared Book Handling, Captivating Talking, and Utterances with a familiar topic-significantly more than the comparison group. Children whose mothers implemented the intervention showed significant gains in terms of time spent in engagement and amount of verbal production during shared reading. No effects were found for the children's communicative initiatives and answers, or for indices of language complexity and diversity.

CONCLUSIONS & IMPLICATIONS

The present parent-based SBR intervention for Italian-speaking preschoolers with DLD showed effects, albeit modest, on both maternal and child communicative behaviours. The results suggest that extralinguistic strategies may be implemented successfully by parents and may be effective in enhancing children's engagement and language production in the short term. Further investigations are needed that provide a longer intervention period and examine the joint impact of therapist- and parent-based intervention for children with DLD.

Language and traits of autism spectrum conditions: evidence of limited phenotypic and etiological overlap

Language difficulties have historically been viewed as integral to autism spectrum conditions (ASC), leading molecular genetic studies to consider whether ASC and language difficulties have overlapping genetic bases. The extent of genetic, and also environmental, overlap between ASC and language is, however, unclear. We hence conducted a twin study of the concurrent association between autistic traits and receptive language abilities. Internet-based language tests were completed by ~3,000 pairs of twins, while autistic traits were assessed via parent ratings. Twin model fitting explored the association between these measures in the full sample, while DeFries-Fulker analysis tested these associations at the extremes of the sample. Phenotypic associations between language ability and autistic traits were modest and negative. The degree of genetic overlap was also negative, indicating that genetic influences on autistic traits lowered language scores in the full sample (mean genetic correlation = -0.13). Genetic overlap was also low at the extremes of the sample (mean genetic correlation = 0.14), indicating that genetic influences on quantitatively defined language difficulties were largely distinct from those on extreme autistic traits. Variation in language ability and autistic traits were also associated with largely different nonshared environmental influences. Language and autistic traits are influenced by largely distinct etiological factors. This has implications for molecular genetic studies of ASC and understanding the etiology of ASC. Additionally, these findings lend support to forthcoming DSM-5 changes to ASC diagnostic criteria that will see language difficulties separated from the core ASC communication symptoms, and instead listed as a clinical specifier.

Nonword repetition--a clinical marker for specific language impairment in Swedish associated with parents' language-related problems

First, we explore the performance of nonword repetition (NWR) in children with specific language impairment (SLI) and typically developing children (TD) in order to investigate the accuracy of NWR as a clinical marker for SLI in Swedish-speaking school-age children. Second, we examine the relationship between NWR, family aggregation, and parental level of education in children with SLI. A sample of 61 children with SLI, and 86 children with TD, aged 8-12 years, were administered an NWR test. Family aggregation, measured as the prevalence of language and/or literacy problems (LLP) in parents of the children with SLI, was based on family history interviews. The sensitivity and specificity of nonword repetition was analyzed in a binary logistic regression, cut-off values were established with ROC curves, and positive and negative likelihood ratios reported. Results from the present study show that NWR distinguishes well between Swedish-speaking school-children with and without SLI. We found 90.2% sensitivity and 97.7% specificity at a cut-off level of -2 standard deviations for binary scoring of nonwords. Differences between the SLI and TD groups showed large effect sizes for the two scoring measures binary (d = 2.11) and percent correct consonants (PCC) (d = 1.79). The children with SLI were split into two subgroups: those with no parents affected with LLP (n = 12), and those with one or both parents affected (n = 49). The subgroup consisting of affected parents had a significantly lower score on NWR binary (p = .037), and there was a great difference between the subgroups (d = 0.7). When compared to the TD group, the difference from the subgroup with affected parents was almost one standard deviation larger (d = 2.47) than the difference from the TD to the subgroup consisting of non-affected parents (d = 1.57). Our study calls for further exploration of the complex interaction between family aggregation, language input, and phenotypes of SLI.