Relations Among Speech, Language, and Reading Disorders

Predictive factors of reading in children with developmental language disorder

The current study aimed to fill the gap in research on factors predictive of word reading in French-speaking children with developmental language disorder (DLD) by finding out whether the same predictors of written word recognition evidenced in typically developing children would be retrieved in children with DLD or if some predictors could be specific to children with DLD, especially in the phonological domain. In total, 38 children with DLD and 44 control children were followed from 6 to 8 years in a longitudinal design including two time points: (1) just before explicit reading instruction, where potential predictors of reading were assessed (oral language skills and reading-related skills), and (2) after 2 years of learning to read, where isolated word reading and text reading were assessed in addition to the assessment of oral language skills and reading-related skills. The study mainly showed that the predictors of reading identified in typically developing children are retrieved in children with DLD except for phonemic awareness; the latter result was probably explained by a floor effect. Among the predictors in the phonological domain, phonological instability appeared as a promising predictor of reading irregular words. These results are consistent with the findings of many previous studies and tend to confirm the idea of a strong link between oral phonological skills and written word recognition skills; they also call for attention to specific features in the phonological development of children with DLD when learning to read, particularly phonological instability as a direction for future exploration.

Brain Laterality in Dyslexia Seen during Literacy Development and Early Training

During the period in which children learn to read and write, a gradual shift from right to left hemisphere dominance for language is typically seen. However, in children with dyslexia, a deviant pattern is described in the literature. As part of a larger longitudinal study (The Bergen Longitudinal Dyslexia Study), the present study aimed to assess this development from an early age before children learn to read and write. Dichotic listening (DL), which is a non-invasive test, was used to assess the development of brain laterality in a Typical group and a Dyslexia group. The participants received yearly sessions of evidence-based literacy training at ages 5 to 7. The Typical group showed increasing ear scores and a shift from no ear advantage in the Pre-literacy stage (age 6), indicative of no hemisphere dominance, to a right ear advantage, indicative of a left hemisphere dominance, in the Emergent literacy stage (age 8) and the Literacy stage (age 11). The Dyslexia group showed a different pattern, with a significant right ear advantage at age 6, indicative of a right hemisphere dominance, and increasing ear scores at ages 8 and 11; however, no ear dominance was observed in the Literacy stage. The results point to an effect of relevant, evidence-based training affecting both right and left hemispheres in dyslexia, which should form a basis for further research.

Whole Genome Analysis in Consanguineous Families Reveals New Loci for Speech Sound Disorder (SSD)

Speech is the most common means of communication in humans. Any defect in accurate speech production ability results in the development of speech sound disorder (SSD), a condition that can significantly impair an individual's academic performance, social interactions, and relationships with peers and adults. This study investigated the genetic basis of SSD in three Pakistani families. We performed family-based genome-wide parametric linkage analysis and homozygosity mapping in three consanguineous families with SSD from the Punjab province of Pakistan. The Test for Assessment of Articulation and Phonology in Urdu (TAAPU) was used to analyze the speech articulation data and determine the Percentage Correct Consonants (PCC) score. The PCC score defined the affected and unaffected individuals in each family. Parametric linkage analysis revealed a linkage to chromosome 5 (5q21.3-5q23.1) with a significant logarithm of the odds (LOD) score of 3.13 in a Pakistani family with specific language impairment-97 (PKSLI-97) under an autosomal recessive mode of inheritance. The other two families showed a suggestive linkage at 6p22.1, 14q12, and 16q12.1 under the recessive mode of inheritance. Interestingly, homozygosity mapping showed a loss of heterozygosity in the linkage region at 5q15-5q23.1, shared among seven affected (mostly in the younger generation) and one unaffected individual of PKSLI-97. Our analysis identified the 6p22 locus previously implicated in dyslexia, childhood apraxia of speech (CAS), and language impairment, confirming the role of KIAA0319 and DCDC2 in this locus. These findings provide statistical evidence for the genomic regions associated with articulation disorder and offer future opportunities to further the role of genes in speech production.

Joint exome and metabolome analysis in individuals with dyslexia: Evidence for associated dysregulations of olfactory perception and autoimmune functions

Dyslexia is a learning disability that negatively affects reading, writing, and spelling development at the word level in 5%-9% of children. The phenotype is variable and complex, involving several potential cognitive and physical concomitants such as sensory dysregulation and immunodeficiencies. The biological pathogenesis is not well-understood. Toward a better understanding of the biological drivers of dyslexia, we conducted the first joint exome and metabolome investigation in a pilot sample of 30 participants with dyslexia and 13 controls. In this analysis, eight metabolites of interest emerged (pyridoxine, kynurenic acid, citraconic acid, phosphocreatine, hippuric acid, xylitol, 2-deoxyuridine, and acetylcysteine). A metabolite-metabolite interaction analysis identified Krebs cycle intermediates that may be implicated in the development of dyslexia. Gene ontology analysis based on exome variants resulted in several pathways of interest, including the sensory perception of smell (olfactory) and immune system-related responses. In the joint exome and metabolite analysis, the olfactory transduction pathway emerged as the primary pathway of interest. Although the olfactory transduction and Krebs cycle pathways have not previously been described in dyslexia literature, these pathways have been implicated in other neurodevelopmental disorders including autism spectrum disorder and obsessive-compulsive disorder, suggesting the possibility of these pathways playing a role in dyslexia as well. Immune system response pathways, on the other hand, have been implicated in both dyslexia and other neurodevelopmental disorders.

Cortical Processing of Conspecific Vocalizations in Zebra Finches Depends on the Early Acoustical Environment

Sensory experience during development has lasting effects on perception and neural processing. Exposing animals to artificial stimuli early in life influences the tuning and functional organization of the auditory cortex, but less is known about how the rich acoustical environments experienced by vocal communicators affect the processing of complex vocalizations. Here, we show that in zebra finches (Taeniopygia guttata), a colonial-breeding songbird species, exposure to a naturalistic social-acoustical environment during development has a profound impact on cortical-level auditory responses to conspecific song. Compared to birds raised by pairs in acoustic isolation, birds raised in a breeding colony had higher average firing rates, selectivity, and discriminability, especially in the narrow-spiking, putatively inhibitory neurons of a higher-order auditory area, the caudomedial nidopallium (NCM). Neurons in colony-reared birds were also less correlated in their tuning and more efficient at encoding the spectrotemporal structure of conspecific song. These results suggest that the auditory cortex adapts to noisy, complex acoustical environments by strengthening inhibitory circuitry, functionally decoupling excitatory neurons while maintaining overall excitatory-inhibitory balance.

A systematic review of factors that impact reading comprehension in children with developmental language disorders

Children with developmental language disorder (DLD) have a high rate of co-occurring reading difficulties. The current study aims to (i) examine which factors within the Active View of Reading (AVR; Duke & Cartwright, 2021) apply to individuals with DLD and (ii) investigate other possible factors that relate to reading comprehension ability in individuals with DLD, outside the components in the AVR. Electronic database search and journal hand-search yielded 5058 studies published before March 2022 related to reading comprehension in children with DLD. 4802 articles were excluded during abstract screening, yielding 256 studies eligible for full-text review. Following full-text review, 44 studies were included and further coded for demographics, language of assessment, description of reported disabilities, behavioral assessment, and reading comprehension assessment. While the results aligned with the AVR model, three additional factors were identified as significantly relating to reading comprehension abilities in children with DLD: expressive language (oral and written), question types of reading assessment, and language disorder history. Specifically, expressive language was positively associated with reading comprehension ability, while resolved DLD showed higher reading comprehension abilities than persistent DLD. Furthermore, children with DLD may face additional difficulties in comprehending inference-based questions. This study provides factors for researchers, educators, and clinical professionals to consider when evaluating the reading comprehension of individuals with DLD. Future research should further explore the relative importance of factors of the AVR to reading comprehension outcomes throughout development.

Does the procedural deficit hypothesis of dyslexia account for the lack of automatization and the comorbidity among developmental disorders?

We critically examine the procedural deficit hypothesis (PDH) that proposes that a deficit in procedural (as opposed to declarative) learning underlies dyslexia and other developmental disorders. We first note that the existence of dissociated learning disorders (and multiple forms for each disorder) appears incompatible with a general deficit account. Moreover, the PDH formulation appears generally underspecified in terms of predictions to be tested. A particular focus is on the conceptualization of automatization. However, there are alternative views of automaticity, and comparing these different views helps frame the body of findings on the PDH. The insufficient PDH specification led to tasks touching on different skills and selecting target groups based on general diagnostic categories. Accordingly, several recent reviews and meta-analyses reported mixed patterns of findings and reached contradictory conclusions on the PDH. We propose avenues for future research to effectively examine the role of PDH in learning and other developmental disorders.

The reading-attention relationship: Variations in working memory network activity during single word decoding in children with and without dyslexia

This study utilized a neuroimaging task to assess working memory (WM) network recruitment during single word reading. Associations between WM and reading comprehension skills are well documented. Several converging models suggest WM may also contribute to foundational reading skills, but few studies have assessed this contribution directly. Two groups of children (77 developmental dyslexia (DD), 22 controls) completed a functional magnetic resonance imaging (fMRI) task to identify activation of a priori defined regions of the WM network. fMRI trials consisted of familiar word, pseudoword, and false font stimuli within a 1-back oddball task to assess how activation in the WM network differs in response to stimuli that can respectively be processed using word recognition, phonological decoding, or non-word strategies. Results showed children with DD recruited WM regions bilaterally in response to all stimulus types, whereas control children recruited left-lateralized WM regions during the pseudoword condition only. Group-level comparisons revealed activation differences in the defined WM network regions for false font and familiar word, but not pseudoword conditions. This effect was driven by increased activity in participants with DD in right hemisphere frontal, parietal, and motor regions despite poorer task performance. Findings suggest the WM network may contribute to inefficient decoding and word recognition strategies in children with DD.

Reading profiles in secondary school: concurrent language and cognitive abilities, and retrospective and prospective reading skills

Introduction

We examined the concurrent language and cognitive abilities in a group of Swedish students with different reading profiles in secondary school, and the retrospective (primary school) and prospective (upper-secondary school) reading skills of each reading profile.

Methods

Seventy-nine students participated in data collections in primary (grade 2: age 8), secondary (grade 8: age 14) and upper-secondary school (year 2: age 17). Independent variables included measures of word recognition, and vocabulary and text comprehension in secondary school. Dependent variables included measures of phonemic awareness, verbal fluency, listening comprehension, spelling, verbal working memory and nonverbal reasoning skills in secondary school, and word recognition and reading comprehension in primary and upper-secondary school.

Results

When exploring the concurrent language and cognitive abilities of the reading profiles in secondary school, spelling emerged as a weakness and listening comprehension as a strength for students with poor decoding. Students with poor comprehension experienced weaknesses in spelling, and non-verbal reasoning. Students with both poor decoding and comprehension displayed a multi-deficit profile in language and cognition. As regards the retrospective and prospective reading skills, the relative ranking of the reading profiles was rather consistent in both primary and upper-secondary school.

Discussion

The findings suggest that limitations in phonological awareness may not be a prominent feature of secondary school students with poor decoding in more transparent orthographies. From an educational perspective, spoken sources may support learning among students with poor decoding, whereas students with poor comprehension or combined difficulties in decoding and comprehension need support when learning from both spoken and written sources.

Assessment of Specific Learning Disabilities and Intellectual Disabilities

We review literature related to the assessment and identification of Specific Learning Disabilities (SLD) and Intellectual Disabilities (ID). SLD and ID are the only two disorders requiring psychometric test performance for identification within the group of neurodevelopmental disorders in Diagnostic and Statistical Manual - 5. SLD and ID are considered exclusionary of one another, but the processes for assessment and identification of each disorder vary. There is controversy about the identification and assessment methods for SLD, with little consensus. Unlike ID, SLD is weakly related to full-scale IQ, and there is insufficient evidence that the routine assessment of IQ or cognitive skills adds value to SLD identification and treatment. We have proposed a hybrid method based on the assessment of low achievement with norm-referenced tests, instructional response, and other disorders and contextual factors that may be comorbid or contraindicative of SLD. In contrast to SLD, there is strong consensus for a three-prong definition for the identification and assessment of ID: (a) significantly subaverage IQ, (b) adaptive behavior deficits that interfere with independent living in the community, and (c) age of onset in the developmental period. For both SLD and ID, we identify areas of controversy and best practices for identification and assessment.

Disentangling dyslexia from typical L2-learning in emergent literacy

The present paper assessed how dyslexia can be identified in school children with another language than their first language. Participants were school children with Norwegian as their second language (L2), and two groups of children with Norwegian as their first language (L1): a control group (L1-Con), and a dyslexia group (L1-Dys). All were 2nd and 3rd graders who had attended Norwegian schools from 1st grade on. None of the individuals in L1-Con or the L2 group were identified with any learning disability. However, slow literacy progress was seen in some L2-children. The children were tested individually within the symptomatic and cognitive levels. Results were analysed in two steps: (1) group comparisons; (2) L2 individual profiles and tentative L2 subgrouping. An unexpected L2 profile showed language scores below norm, coupled with some scores within and some scores above norm within the cognitive domain. Case assessment of the L2 group resulted in three subgroups: one comparable to L1-Con, one comparable to L1-Dys, and one with a result in between these two groups. Low linguistic scores cannot be considered valid markers of dyslexia in L2. Within the cognitive domain, a variety of low scores can indicate dyslexia, while high scores can be compensatory.

Understanding language processing in variable populations on their own terms: Towards a functionalist psycholinguistics of individual differences, development, and disorders

Classic psycholinguistics seeks universal language mechanisms for all people, emphasing the "modal" listener: hearing, neurotypical, monolingual, young adults. Applied psycholinguistics then characterizes differences in terms of their deviation from modal. This mirrors naturalist philosophies of health which presume a normal function, with illness as a deviation. In contrast, normative positions argue that illness is partially culturally derived. It occurs when a person cannot meet socio-culturally defined goals, separating differences in biology (disease) from socio-cultural function (illness). We synthesize this with mechanistic functionalist views in which language emerges from diverse lower level mechanisms with no one-to-one mapping to function (termed the functional mechanistic normative approach). This challenges primarily psychometric approaches-which are culturally defined-suggesting a process-based approach may yield more insight. We illustrate this with work on word recognition across multiple domains: cochlear implant users, children, language disorders, L2 learners, and aging. This work investigates each group's solutions to the problem of word recognition as interesting in its own right. Variation in process is value-neutral, and psychometric measures complement this, reflecting fit with cultural expectations (disease vs. illness). By examining variation in processing across people with a variety of skills and goals, we arrive at deeper insight into fundamental principles.

Bioenvironmental Predictors of Childhood Reading and Speech Difficulties

PURPOSE

Reading and speech difficulties are common in childhood, yet it is not fully understood how much of their etiology is shared. This partly derives from methodological issues related to overlooking the potential co-occurrence between the two sets of difficulties. This study investigated the effects of five bioenvironmental predictors in a sample assessed for such co-occurrence.

METHOD

A combination of exploratory and confirmatory analyses was performed on longitudinal data from the National Child Development Study. Exploratory latent class analysis was performed on children's reading, speech, and language outcomes at ages 7 and 11 years. Membership in the obtained classes was modeled using a regression with sex and four early-life predictors: gestation period, socioeconomic status, maternal education, and the home reading environment.

RESULTS

The model yielded four latent classes that broadly reflected (1) average reading and speech, (2) excellent reading, (3) reading difficulties, and (4) speech difficulties. Early-life factors significantly predicted class membership. Male sex and preterm birth emerged as risk factors for both reading and speech difficulties. Protective effects against reading difficulties were identified for maternal education, and lower (but not higher) levels of socioeconomic status and the home reading environment.

CONCLUSIONS

Co-occurrence of reading and speech difficulties in the sample was low, and differential patterns of effect of the social environment were supported. Reading outcomes were under stronger malleable influence than speech outcomes.

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.

Distinct reinforcement learning profiles distinguish between language and attentional neurodevelopmental disorders

BACKGROUND

Theoretical models posit abnormalities in cortico-striatal pathways in two of the most common neurodevelopmental disorders (Developmental dyslexia, DD, and Attention deficit hyperactive disorder, ADHD), but it is still unclear what distinct cortico-striatal dysfunction might distinguish language disorders from others that exhibit very different symptomatology. Although impairments in tasks that depend on the cortico-striatal network, including reinforcement learning (RL), have been implicated in both disorders, there has been little attempt to dissociate between different types of RL or to compare learning processes in these two types of disorders. The present study builds upon prior research indicating the existence of two learning manifestations of RL and evaluates whether these processes can be differentiated in language and attention deficit disorders. We used a two-step RL task shown to dissociate model-based from model-free learning in human learners.

RESULTS

Our results show that, relative to neurotypicals, DD individuals showed an impairment in model-free but not in model-based learning, whereas in ADHD the ability to use both model-free and model-based learning strategies was significantly compromised.

CONCLUSIONS

Thus, learning impairments in DD may be linked to a selective deficit in the ability to form action-outcome associations based on previous history, whereas in ADHD some learning deficits may be related to an incapacity to pursue rewards based on the tasks' structure. Our results indicate how different patterns of learning deficits may underlie different disorders, and how computation-minded experimental approaches can differentiate between them.

Cognitive predictors of language abilities in primary school children: A cascaded developmental view

This study investigated the longitudinal relationship between children's domain-general cognitive constraints underlying phonological and sentence processing development in a big sample of typically developing children. 104 children were tested on non-linguistic processing speed, phonological skills (phonological short term memory, phonological knowledge, phonological working memory), and sentence processing abilities (sentence repetition and receptive grammar) in 1^st grade (aged 6 to 6.5) and one year later. A cross-lagged structural equation model showed that non-linguistic processing speed was a concurrent predictor of phonological skills, and that phonology had a powerful effect on the child's sentence processing abilities concurrently and longitudinally, providing clear evidence for the role of domain-general processes in the developmental pathway of language. These findings support a cascaded cognitive view of language development and pose important challenges for evaluation and intervention strategies in childhood.

How we measure language skills of children at scale: A call to move beyond domain-specific tests as a proxy for language

PURPOSE

The aim of this research note is to encourage child language researchers and clinicians to give careful consideration to the use of domain-specific tests as a proxy for language; particularly in the context of large-scale studies and for the identification of language disorder in clinical practice.

METHOD

We report on data leveraged through the prospective Raine Study cohort. Participants included 1626 children aged 10 years (n = 104 with developmental language disorder [DLD] and n = 1522 without DLD). We assessed the predictive utility of common language measures including subtests of a standardised omnibus language assessment, non-verbal intelligence, and a domain-specific receptive vocabulary test.

RESULT

Children with DLD performed within the average range on a measure of non-verbal intelligence (z = -0.86) and receptive vocabulary (z = -0.38), as well as two out of the six subtests on the omnibus language assessment (zs > -1.50). The magnitude of the predictive relationship between language assessments and the likelihood of a child meeting criteria for DLD at 10 years was assessed using a logistic regression model, which was significant: χ²(8) = 16.91, p = 0.031. Semantic Relationships (OR = 1.13, CI = 1.04 - 1.23, p = .004), Formulated Sentences (OR = 1.07, CI = 1.01 - 1.13, p = .028), Recalling Sentences (OR = 1.20, CI = 1.15 - 1.26, p < .001), and Sentence Assembly (OR = 1.17, CI = 1.07 - 1.30, p = .001) were significant predictors of DLD.

CONCLUSION

Domain-specific language assessments, particularly those testing receptive vocabulary, may overestimate the language ability of children with DLD. Caution is urged when using such tests by clinicians and researchers, especially those measuring language skills of children at scale. Future directions for measuring the functional impact of DLD are presented.

The effect of non-invasive vagus nerve stimulation on memory recall in reading: A pilot study

Expert reading acquisition is marked by fluent, effortless decoding, and adequate comprehension skills and is required for modern daily life. In spite of its importance, many individuals struggle with reading comprehension even when decoding skills are adequate. Unfortunately, effective reading comprehension interventions are limited, especially for adults. A growing body of research suggests that non-invasive transcutaneous stimulation of the auricular vagus nerve (taVNS) may drive neural plasticity for low-level reading skills such as speech sound perception and letter-sound learning, but it is unknown whether taVNS can improve higher level skills as well. Thus, the current pilot study was designed to evaluate the effect of taVNS paired with passage reading on reading comprehension performance. Twenty-four typically developing young adults were recruited and screened for baseline reading and working memory skills. Participants received either sham or active taVNS while reading short passages out loud. Immediately following each passage, participants answered a series of test questions that required either direct recall of passage details or more complete comprehension of the passage content. While taVNS did not improve the mechanics of reading (e.g., reading rate or accuracy), there was a significant effect of active taVNS on test performance. This effect was driven by significant improvement on accuracy for memory questions while there was no effect of taVNS on comprehension question accuracy. These findings suggest that taVNS may be beneficial for enhancing memory, but its efficacy may be limited in higher cognitive domains.

Investigation of the forkhead box protein P2 gene by the next-generation sequence analysis method in children diagnosed with specific learning disorder

OBJECTIVE

It was aimed to investigate the role of the forkhead box protein P2 (FOXP2) gene in the cause of specific learning disorder (SLD) with the next-generation sequencing method.

MATERIAL AND METHODS

The study included 52 children diagnosed with SLD and 46 children as control between the ages of 6-12 years. Interview Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifelong Version in Turkish, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-Based Screening and Evaluation Scale for Attention Deficit and Disruptive Behavior Disorders, Specific Learning Disability Test Battery were applied to all participants. The FOXP2 gene was screened by the next-generation sequencing (NGS) method in all participants.

RESULTS

A total of 17 variations were detected in the FOXP2 gene in participants. The number and diversity of variations were higher in the patient group. In the patient group, c.1914 + 8A>T heterozygous variation and three different types of heterozygous variation (13insT, 13delT and 4dup) in the c.1770 region were detected. It was found that the detected variations showed significant relationships with the reading phenotypes determined by the test battery.

CONCLUSION

It was found that FOXP2 variations were seen more frequently in the patient group. Some of the detected variations might be related to the clinical phenotype of SLD and variations found in previous studies from different countries were not seen in Turkish population. Our study is the first to evaluate the role of FOXP2 gene variations in children with SLD in Turkish population, and novel variations in the related gene were detected.

Intact reading ability despite lacking a canonical visual word form area in an individual born without the left superior temporal lobe

The visual word form area (VWFA), a region canonically located within left ventral temporal cortex (VTC), is specialized for orthography in literate adults presumbly due to its connectivity with frontotemporal language regions. But is a typical, left-lateralized language network critical for the VWFA's emergence? We investigated this question in an individual (EG) born without the left superior temporal lobe but who has normal reading ability. EG showed canonical typical face-selectivity bilateraly but no wordselectivity either in right VWFA or in the spared left VWFA. Moreover, in contrast with the idea that the VWFA is simply part of the language network, no part of EG's VTC showed selectivity to higher-level linguistic processing. Interestingly, EG's VWFA showed reliable multivariate patterns that distinguished words from other categories. These results suggest that a typical left-hemisphere language network is necessary for acanonical VWFA, and that orthographic processing can otherwise be supported by a distributed neural code.

Rate of Stuttering and Factors Associated With Speech Fluency Characteristics in Adult Struggling Readers

Stuttering is a disorder that affects about 1% of the population and manifests as speech disfluencies. Reading difficulties and disabilities are commonly found in this population. Nonetheless, speech disfluencies have not been explored in adult struggling readers (ASRs). In the current study, we examined the rate of stuttering in ASRs as well as the relationships between their speech fluency and reading skills. A total of 120 participants were interviewed about their experiences with reading and administered standardized reading and reading-related assessments. Speech fluency and the criterion for stuttering were based on the interview. About 18.3% of the sample met the criterion for stuttering. ASRs who stutter (ASRs-S) and ASRs who do not stutter (ASRs-NS) did not differ in their reading and reading-related skills. ASRs-S had higher rates of negative correlations between reading and reading-related skills compared with ASRs-NS. Correlation patterns between performance on standardized assessments point to higher rates of uneven skills or dissociations in ASRs-S. These findings may have implications for the assessment and instruction for ASRs.

Association of Developmental Language Disorder With Comorbid Developmental Conditions Using Algorithmic Phenotyping

IMPORTANCE

Developmental language disorder (DLD) is a common (with up to 7% prevalence) yet underdiagnosed childhood disorder whose underlying biological profile and comorbidities are not fully understood, especially at the population level.

OBJECTIVE

To identify clinically relevant conditions that co-occur with DLD at the population level.

DESIGN, SETTING, AND PARTICIPANTS

This case-control study used an electronic health record (EHR)-based population-level approach to compare the prevalence of comorbid health phenotypes between DLD cases and matched controls. These cases were identified using the Automated Phenotyping Tool for Identifying Developmental Language Disorder algorithm of the Vanderbilt University Medical Center EHR, and a phenome enrichment analysis was used to identify comorbidities. An independent sample was selected from the Geisinger Health System EHR to test the replication of the phenome enrichment using the same phenotyping and analysis pipeline. Data from the Vanderbilt EHR were accessed between March 2019 and October 2020, while data from the Geisinger EHR were accessed between January and March 2022.

MAIN OUTCOMES AND MEASURES

Common and rare comorbidities of DLD at the population level were identified using EHRs and a phecode-based enrichment analysis.

RESULTS

Comorbidity analysis was conducted for 5273 DLD cases (mean [SD] age, 16.8 [7.2] years; 3748 males [71.1%]) and 26 353 matched controls (mean [SD] age, 14.6 [5.5] years; 18 729 males [71.1%]). Relevant phenotypes associated with DLD were found, including learning disorder, delayed milestones, disorders of the acoustic nerve, conduct disorders, attention-deficit/hyperactivity disorder, lack of coordination, and other motor deficits. Several other health phenotypes not previously associated with DLD were identified, such as dermatitis, conjunctivitis, and weight and nutrition, representing a new window into the clinical complexity of DLD.

CONCLUSIONS AND RELEVANCE

This study found both rare and common comorbidities of DLD. Comorbidity profiles may be leveraged to identify risk of additional health challenges, beyond language impairment, among children with DLD.

Socioeconomic dissociations in the neural and cognitive bases of reading disorders

Childhood socioeconomic status (SES) strongly predicts disparities in reading development, yet it is unknown whether early environments also moderate the cognitive and neurobiological bases of reading disorders (RD) such as dyslexia, the most prevalent learning disability. SES-diverse 6-9-year-old children (n = 155, half with RD) completed behavioral and functional magnetic resonance imaging (fMRI) tasks engaging phonological and orthographic processing, which revealed corresponding double-dissociations in neurocognitive deficits. At the higher end of the SES spectrum, RD was most strongly explained by differences in phonological skill and corresponding activation in left inferior frontal and temporoparietal regions during phonological processing-widely considered the "core deficit" of RD. However, at the lower end of the SES spectrum, RD was most strongly explained by differences in rapid naming skills and corresponding activation in left temporoparietal and fusiform regions during orthographic processing. Findings indicate that children's early environments systematically moderate the neurocognitive systems underlying RD, which has implications for assessment and treatment approaches to reduce SES disparities in RD outcomes. Further, results suggest that reliance on high-SES convenience samples may mask critical heterogeneity in the foundations of both typical and disordered reading development.

Cognitive Requirements of the Phonological Tests Affect Their Ability to Discriminate Children With and Without Developmental Dyslexia

PURPOSE

The main purpose of this study was to investigate whether the performance on each of seven phonological processing (PP) tests from the Russian Test of Phonological Processing (RuToPP), with their varying levels of linguistic complexity and composite phonological indices, are significant predictors of developmental dyslexia (DD) and can reliably differentiate children with and without reading impairment. Additionally, we examined the general contribution of phonological skills to text reading fluency in children with various levels of reading performance.

METHOD

A total of 173 Russian-speaking 7- to 11-year-old children participated in this study: 124 who were typically developing (TD) and 49 who had been diagnosed with DD. We assessed reading fluency with a standardized reading test and PP with the RuToPP. We investigated the potential of phonological skills to predict the presence or absence of a dyslexia diagnosis using multinomial logistic regression, receiver operating characteristic (ROC) curve analysis, and calculations of the sensitivity and specificity of each test and index. The contribution of phonological skills to reading fluency was also assessed in a mixed group of children.

RESULTS

Six of seven RuToPP tests were significant predictors of dyslexia. However, while the RuToPP correctly identified 93%-99% of TD children, for children with dyslexia, it ranged from 4% to 47% depending on the test. In a mixed group of children with and without dyslexia, performance in the more complex phonological tests was a stronger predictor of reading fluency.

CONCLUSIONS

Our findings are consistent with the literature on predictors of literacy skills and dyslexia while uniquely demonstrating the impact of the complexity level of the phonological tests on the classification outcome. PP is a significant and necessary predictor of reading skills, but it is not sufficient for diagnostic purposes.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20779294.

Trends in Dyslexia Research during the Period 1950 to 2020-Theories, Definitions, and Publications

INTRODUCTION

The focus of the present paper is on (1) how dyslexia research and hence definitions have developed during the period 1950-2020 and includes (2) a database search of scientific publications on dyslexia during the same period. The focus is on the definitions of dyslexia and the organization of the network search based on the causal four-level model by Morton and Frith.

METHOD

(1) The definitions are presented in accordance with a historic review of dyslexia research from 1950 to 2020 and based on (2) Google Scholar counts of publications on dyslexia, on defining dyslexia, on dyslexia at the four levels (symptomatic, cognitive, biological, environmental), and by areas (sensorimotor, comorbidity). Finally, a percentage calculation shows the relative development within each level and area by decennium (1950-1960, 1960-1970, 1970-1980, 1990-2000, 2002-2010, 2010-2020).

RESULTS

(1) Of the seven definitions presented, only the definition by the BDA 2007 included the four levels of the causal model. (2) The number of publications increased substantially over the period. However, relatively few publications have defined dyslexia. An increase in publications from 1950 to 2020 was seen across the four levels and two areas-however, with an alteration in the thematic focus over this time span.

SUMMARY

Defining dyslexia has still not reached a consensus. This uncertainty may explain why only one of the seven definitions proved satisfactory according to the four-level model. Along with the general increase in research, publications on dyslexia have increased accordingly during the period 1950 to 2020. Although the symptomatic level has played a dominant role over the whole period, thematic shifts have been seen over these 70 years. In particular, a substantial thematic shift was seen by the turn of the millennium. There has been a relative increase in the focus on literacy at the symptomatic level, on phonological awareness at the cognitive level, in gender at the biological level, and second language learning as comorbidities. However, increases in counts are not alone a valid indication of scientific progress. In particular, the lack of definitional criteria as a basis for participant and method selection should attract much more focus in future studies. The present study underlines the multifactorial nature of dyslexia, as evidenced by a substantial increase in the number of publications on the subject. It is a challenge for future research to continuously use and possibly redefine dyslexia definitions in line with such standards.

Biolinguistics: A Scientometric Analysis of Research on (Children's) Molecular Genetics of Speech and Language (Disorders)

There are numerous children and adolescents throughout the world who are either diagnosed with speech and language disorders or manifest any of them as a result of another disorder. Meanwhile, since the emergence of language as an innate capability, the question of whether it constitutes a behaviour or an innate ability has been debated for decades. There have been several theories developed that support and demonstrate the biological foundations of human language. Molecular evidence of the biological basis of language came from the FOXP2 gene, also known as the language gene. Taking a closer look at both human language and biology, biolinguistics is at the core of these inquiries-attempting to understand the aetiologies of the genetics of speech and language disorders in children and adolescents. This paper presents empirical evidence based on both scientometrics and bibliometrics. We collected data between 1935 and 2022 from Scopus, WOS, and Lens. A total of 1570 documents were analysed from Scopus, 1440 from the WOS, and 5275 from Lens. Bibliometric analysis was performed using Excel based on generated reports from these three databases. CiteSpace 5.8.R3 and VOSviewer 1.6.18 were used to conduct the scientometric analysis. Eight bibliometric and eight scientometric indicators were used to measure the development of the field of biolinguistics, including but not limited to the production size of knowledge, the most examined topics, and the most frequent concepts and variables. A major finding of our study is identifying the most examined topics in the genetics of speech and language disorders. These included: gestural communication, structural design, cultural evolution, neural network, language tools, human language faculty, evolutionary biology, molecular biology, and theoretical perspective on language evolution.

Reading Skills in Children With Suspected Childhood Apraxia of Speech and Children With Reading Disorders: Same or Different?

PURPOSE

The primary aim of this study was to compare decoding and literacy-related skills of children with suspected childhood apraxia of speech (sCAS) to children with reading disorders (RD) and no history of speech sound disorder (RD-no SSD) to determine if the groups differ in decoding and the endophenotypes that contribute to RD. We also explored the association between language impairment (LI) and decoding and literacy-related skills within the participant group with sCAS.

METHOD

Participants were school-age children and adolescents, 8-14 years of age, with a diagnosis of sCAS (n = 13) or RD-no SSD (n = 16). The sCAS and RD-no SSD groups were compared on measures of single-word decoding, oral language, motor-speech skills, phonological processing, and speech-in-noise perception, employing t tests and analysis of covariance. The sCAS + LI and sCAS-only groups were compared on similar measures using t tests.

RESULTS

Compared to the RD-no SSD group, the sCAS group performed significantly worse on measures of phonological processing, multisyllable word repetition, diadochokinetic rate, and speech-in-noise perception. The groups did not differ on measures of single-word decoding, with mean scores for both groups falling below average. All participants with sCAS + LI demonstrated deficits in literacy and literacy-related skills compared to a smaller percentage of the sCAS-only group.

CONCLUSIONS

Children with sCAS and children with RD-no SSD demonstrate similar impairments in literacy. However, the endophenotypes underlying these difficulties can differ between the groups. Deficits in skills needed for literacy may require specifically tailored interventions to address reading difficulties for children with sCAS, especially for those with comorbid LI.

Supporting students with sex chromosome aneuploidies in educational settings: Results of a nationwide survey

Children with sex chromosome aneuploidies (SCAs) are at an increased risk for neurocognitive and behavioral disorders that may interfere with academic success, including early developmental delays, learning disabilities, executive function problems, and social communication deficits. The present national survey aimed to update and extend our understanding of school supports and educational outcomes for students with these increasingly common genetic diagnoses. Parents of children with a diagnosed SCA, birth to 21 years, living in the United States (N = 248), responded to an electronic survey with questions focused on school support plans, academic accommodations, educational therapies, school completion, and perceptions of educator awareness of SCAs. Results revealed high rates of delayed kindergarten, grade retention in primary years, and educational support plans (IEPs = 71%; Section 504 Plans = 26%). A majority (73%) of respondents with children over age 18 years (N = 41) reported their children successfully completed high school, and nearly half (46%) pursued post-secondary education opportunities. Many parents reported their children's educators had little to no knowledge of SCA conditions, justifying a need to train teachers and policy makers in the unique educational needs of children and adolescents with SCAs. School psychologists should be aware of the frequent need for accommodations and individualized support plans in this population so they can support children and families by advocating for early and comprehensive evaluations and intervention plans.

Brain Source Correlates of Speech Perception and Reading Processes in Children With and Without Reading Difficulties

Neural correlates in reading and speech processing have been addressed extensively in the literature. While reading skills and speech perception have been shown to be associated with each other, their relationship remains debatable. In this study, we investigated reading skills, speech perception, reading, and their correlates with brain source activity in auditory and visual modalities. We used high-density event-related potentials (ERPs), fixation-related potentials (FRPs), and the source reconstruction method. The analysis was conducted on 12–13-year-old schoolchildren who had different reading levels. Brain ERP source indices were computed from frequently repeated Finnish speech stimuli presented in an auditory oddball paradigm. Brain FRP source indices were also computed for words within sentences presented in a reading task. The results showed significant correlations between speech ERP sources and reading scores at the P100 (P1) time range in the left hemisphere and the N250 time range in both hemispheres, and a weaker correlation for visual word processing N170 FRP source(s) in the posterior occipital areas, in the vicinity of the visual word form areas (VWFA). Furthermore, significant brain-to-brain correlations were found between the two modalities, where the speech brain sources of the P1 and N250 responses correlated with the reading N170 response. The results suggest that speech processes are linked to reading fluency and that brain activations to speech are linked to visual brain processes of reading. These results indicate that a relationship between language and reading systems is present even after several years of exposure to print.

Predictors of Speech Severity and Inconsistency Over Time in Children With Token-to-Token Inconsistency

PURPOSE

The aim of this study was to describe and explain changes in severity of speech sound disorder (SSD) and token-to-token inconsistency in children with high levels of inconsistency.

METHOD

Thirty-nine children (aged 4;6-7;11 [years;months]) with SSDs and high levels of token-to-token inconsistency were assessed every 6 months for 2 years (i.e., five assessment points). Growth modeling was used to assess relations among therapy support, receptive vocabulary, severity, and inconsistency over time.

RESULTS

Children with the most severe SSDs and highest levels of token-to-token inconsistency showed the smallest improvements in speech accuracy over time. Therapy support did not predict changes in speech accuracy or token-to-token inconsistency over time. Receptive vocabulary (measured at the outset of the study) was also a significant predictor of speech accuracy and inconsistency.

CONCLUSIONS

These findings suggest that an immediate start to intervention (rather than a wait-and-see approach) is recommended for children with inconsistent speech error patterns. The results also highlight the value of developing vocabulary knowledge in addition to improving speech accuracy for some children with inconsistent speech production.

Access to Speech and Language Services and Service Providers for Children With Speech and Language Disorders

OBJECTIVES

The purposes of this study were to (a) examine children's access to services for their speech and language disorders during their lifetimes; (b) identify any child, disorder, and family characteristics associated with access to services; and (c) describe the speech and language service providers among children who received care.

STUDY DESIGN

Data from the 2012 National Health Interview Survey were used for this retrospective cohort study. Our sample included 491 children (ages 3;0-17;11 [years;months]) with speech disorders and 333 children with language disorders. We measured the receipt of services for speech or language difficulties (main outcome) and the type of professional providing services (secondary outcome). We examined associations between services and child, disorder, and family characteristics.

RESULTS

Approximately 75% of children with speech and language disorders had ever received services for their difficulties. Privately insured children and children with co-occurring conditions were more likely to receive services than their peers who were uninsured (speech: 6.1 [1.7,21.3]; language: 6.6 [1.3,32.9]) and had no co-occurring conditions (speech: 2.1 [1.2,3.9]; language: 2.9 [1.5,5.5]). Speech-language pathologists (SLPs) were the most commonly reported provider of services (speech: 68%, language: 60%) followed by early interventionists.

CONCLUSIONS

Most children with speech and language disorders received services. However, disparities existed by race/ethnicity, health insurance type, co-occurring diagnoses, and disorder duration (speech only). Most children who received services were being provided with care by the experts of speech and language: SLPs. Updated population-based data and implementation studies are needed to document speech and language screening, referral, and access to services.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19799389.

Predicting Which Children Will Normalize Without Intervention for Speech Sound Disorders

PURPOSE

The speech of some children does not follow a typical normalization trajectory, and they develop speech sound disorders (SSD). This study investigated predictive correlates of speech sound normalization in children who were at risk of SSD.

METHOD

A prospective population cohort study of 845 Cantonese-speaking preschoolers was conducted over 2.5 years to examine (a) children who resolved nonadult realizations of consonants (normalized) and (b) those who had persisting speech sound difficulties (did not normalize). From these 845, a sample of 82 participants characterized as having SSD (1.25 SDs below the mean in a standardized speech assessment, with a delay in initial consonant acquisition or with one or more atypical errors) was followed for 2 years at 6-month intervals or until the completion of their initial consonant inventory. Data from 43 children who did not receive speech-language pathology services were analyzed with survival analysis to model time to normalization while controlling for covariates. The target event (outcome) was the completion of their initial consonant inventory.

RESULTS

Under the no-intervention condition, the estimated median time to normalization was 6.59 years of age. Children who were more likely to normalize or normalized in a shorter time were stimulable to all errors and more intelligible as rated by caregivers using the Intelligibility in Context Scale. Those who showed atypical error patterns did not necessarily take longer to normalize. Similarly, expressive language ability was not significantly associated with speech normalization.

CONCLUSIONS

Stimulability and intelligibility were more useful prognostic factors of speech normalization when compared to (a)typicality of error patterns and expressive language ability. Children with low intelligibility and poor stimulability should be prioritized for speech-language pathology services given that their speech errors are less likely to resolve naturally.

Language Difficulties in School-Age Children With Developmental Dyslexia

Developmental dyslexia (DD) is a common reading disability, affecting 5% to 11% of children in North America. Children classified as having DD often have a history of early language delay (ELD) or language impairments. Nevertheless, studies have reported conflicting results as to the association between DD-ELD and the extent of current language difficulties in children with DD. To examine these relationships, we queried the parents of school-age children with reading difficulties on their child's early and current language ability. Siblings were also examined. Children were directly assessed using quantitative tests of language and reading skills. To compare this study with the literature, we divided the sample (N = 674) into three groups: DD, intermediate readers (IR), and skilled readers (SR). We found a significant association between DD and ELD, with parents of children in the DD/IR groups reporting their children put words together later than the SR group. We also found a significant association between DD and language difficulties, with children with low reading skills having low expressive/receptive language abilities. Finally, we identified early language predicted current language, which predicted reading skills. These data contribute to research indicating that children with DD experience language difficulties, suggesting early recognition may help identify reading problems.

Children's vocabulary and friendships: A comparative study between children with and without Specific Learning Disorder and Attention Deficit Hyperactivity Disorder

Language skills are important in the formation and maintenance of friendships. Children with specific learning disorder (SLD) or attention-deficit/hyperactivity disorder (ADHD) experience difficulties with their relationships and have language-related problems. This study aims to examine how expressive and receptive vocabulary may relate to friendships of children with and without SLD or ADHD. Participants were 64 children with SLD, 64 children with ADHD, and 64 typically developing (TD) children, aged 8-12 years (M_age  = 9.77 years, SD = 1.22), attending Grades 3 to 6 in inclusive primary schools of Attica, Greece. The Greek versions of the Peabody Picture Vocabulary Test and the expressive vocabulary subscale of the WISC-III were administered along with the sociometric nominations of friends and the self-reports of best friendship duration. Results showed that children with SLD and ADHD reported best friendships of shorter duration and had significantly poorer receptive and expressive vocabulary. Children with ADHD had significantly fewer close and best friends than children with SLD, who in turn had significantly fewer close and best friends than the TD children. Children's vocabulary in all three groups was positively correlated with the duration of their best friendships and was found to moderately predict children's close friendships.

Evaluating the Effect of Rich Vocabulary Instruction and Retrieval Practice on the Classroom Vocabulary Skills of Children With (Developmental) Language Disorder

PURPOSE

Learning new vocabulary has been identified as a challenge for students with (developmental) language disorder ((D)LD). In this study, we evaluate the effects of two active learning methods, (a) retrieval practice (RP) and (b) rich vocabulary instruction (RVI), in a group of students with (D)LD in secondary school.

METHOD

A quasi-experimental counterbalanced within-subject design was used to compare and evaluate the effect of RP and RVI on learning Tier 2 vocabulary, with target and control words as dependent measures. Eleven students with (D)LD (M _age = 14.9 years) attending a language unit participated. RP and RVI were implemented in regular classroom activities during 16 lessons (eight lessons/instructional condition). Learning was assessed by comparing performance on a pretest session 1-2 weeks prior, with posttest performance 1 week after each instructional condition.

RESULTS

The learning gain for RP was superior to that for RVI, both with respect to the Bayesian probabilistic estimations for target words relative to control words and in direct comparison with RVI. Only weak evidence was found for RVI with respect to the Bayesian probabilistic estimations for target words relative to control words.

CONCLUSIONS

All participants showed positive learning gains following RP, whereas the outcome for RVI was more diverse. This initial work suggests that RP promotes larger learning gains relative to RVI and promotes learning across language profiles. This study extends previous studies by exploring the implementation of RP in regular classroom activities and by using more complex to-be-learned material (Tier 2 words).

Visual Implicit Learning Abilities in Infants at Familial Risk for Language and Learning Impairments

The ability of infants to track transitional probabilities (Statistical Learning—SL) and to extract and generalize high-order rules (Rule Learning—RL) from sequences of items have been proposed as being pivotal for the acquisition of language and reading skills. Although there is ample evidence of specific associations between SL and RL abilities and, respectively, vocabulary and grammar skills, research exploring SL and RL as early markers of language and learning (dis)abilities is still scarce. Here we investigated the efficiency of visual SL and RL skills in typically developing (TD) seven-month-old infants and in seven-month-old infants at high risk (HR) for language learning impairment. Infants were tested in two visual-habituation tasks aimed to measure their ability to extract transitional probabilities (SL task) or high-order, repetition-based rules (RL task) from sequences of visual shapes. Post-habituation looking time preferences revealed that both TD and HR infants succeeded in learning the statistical structure (SL task), while only TD infants, but not HR infants, were able to learn and generalize the high-order rule (RL task). These findings suggest that SL and RL may contribute differently to the emergence of language learning impairment and support the hypothesis that a mechanism linked to the extraction of grammar structures may contribute to the disorder.

A comparison of two phonological screening tools for French-speaking children

Purpose: To examine two screening tools for phonological production, the Evaluation Sommaire de la Phonologie chez l'enfant d'âge préscolaire (ESPP) and the Test de Phonologie du Français Canadien-Dépistage (TPFC-D), developed according to differing theoretical perspectives. The TPFC-D, designed according to nonlinear phonology, includes more words and contains a greater variety of segments across word structure as compared to the ESPP, which was guided by a linear phonological framework. The greater response rate to test items, time of administration, and phonological complexity were expected on the TPFC-D.Method: Each screening tool was administered to 14 4-year-old French-speaking children living in Central Canada. Paired samples t-tests compared children's responses on the two tasks with regards to (a) response rate and time of administration, (b) an overall percentage of consonants correct (PCC) and percentage of vowel correct (PVC), and (c) complexity of productions (i.e. PCC and PVC in relation to word structure, Word Shape Match, Whole Word Match, Phonological Mean Length of Utterance (pMLU) and Proportion of Whole-Word Proximity).Result: Item response rates were higher for the TPFC-D whereas time of administration, PCC and PVC were similar for both the ESPP and TPFC-D. Complexity measures showed a higher proportion of deletions in clusters and higher pMLUs on the TPFC-D compared to the ESPP.Conclusion: Both screening measures are appropriate for speech-language pathologists who want to assess quickly pre-school-aged children. Since the TPFC-D is phonologically more complex, it is recommended for clinicians needing to screen children who likely present with multiple speech sound errors across their phonological system.

Quality of life in Chinese children with developmental dyslexia: a cross-sectional study

OBJECTIVES

Our study aimed to compare the quality of life (QoL) between Chinese developmental dyslexia (DD) and healthy children.

DESIGN

A cross-sectional study.

SETTING

The participants were recruited from grades 3-6 in six primary schools in Tianmen, a city of Hubei Province, China.

PARTICIPANTS

A total of 5679 students were recruited. After excluding children with visual and auditory dysfunction or psychiatric diseases or with a response rate on the scales or questionnaires of less than 90%, 5352 children were finally included in the analysis. DD children were diagnosed according to their clinical symptoms, which were mainly assessed by the Dyslexia Checklist for Chinese Children and the Pupil Rating Scale Revised Screening for Learning Disabilities.

OUTCOME MEASURES

The QoL for DD and healthy children was appraised by the Quality of Life Scale for Children and Adolescents (QLSCA). Outcome measures included its four domain scores (psychosocial function, physiological and mental health, living environment and satisfaction with QoL) and total score.

RESULTS

A total of 186 children were diagnosed with DD. The distribution of DD children in five levels of QoL was statistically different from that of healthy children (χ²=57.63, p<0.001). Compared with healthy children, the proportion of poor or worse QoL in DD was higher, and the proportion of moderate, better or good QoL was lower. The total QLSCA score in DD children was 3.475 lower than that in healthy children (B=-3.475, p=0.006). Psychosocial function, physiological and mental health, living environment and satisfaction with QoL of DD children were also inferior to those of healthy children.

CONCLUSION

The QoL of DD was significantly lower than that of healthy children, prompting more public efforts to improve DD QoL.

Language Learning Under Varied Conditions: Neural Indices of Speech Perception in Bilingual Turkish-German Children and in Monolingual Children With Developmental Language Disorder (DLD)

Lateral temporal measures of the auditory evoked potential (AEP) including the T-complex (positive Ta and negative Tb), as well as an earlier negative peak (Na) index maturation of auditory/speech processing. Previous studies have shown that these measures distinguish neural processing in children with typical language development (TD) from those with disorders and monolingual from bilingual children. In this study, bilingual children with Turkish as L1 and German as L2 were compared with monolingual German-speaking children with developmental language disorder (DLD) and monolingual German-speaking children with TD in order to disentangle effects of limited language input vs. reduced perceptual abilities in the processing of speech and non-speech stimuli. Sensory processing reflected by the T-complex (or from lateral temporal electrode sites) was compared in response to a German vowel and a sine-wave tone in the three groups of children, ages 5 through 6 years. Stimuli were presented while children watched a muted video. Auditory evoked potentials (AEPs) were time-locked to the vowels and tones. AEPs to the frequent (standard) stimuli within an oddball paradigm were analyzed at the left (T7) and right (T8) temporal electrode sites.The results revealed language status (monolingual, bilingual, and DLD), stimulus (vowel and tone), and language test measures (receptive and expressive) all influenced the T-complex amplitudes. Particularly, the peak amplitude of Ta was modulated by language status and stimulus type. Bilingual children had significantly more negative Ta responses than the monolingual children with TD for both vowels and tones while DLD children differed from TD children only for the vowel stimulus. The amplitude of the T-complex was overall more negative at the left than at the right site. The Na peak latency was longer for the bilingual group than that observed for the two monolingual groups. The Tb latency was shorter for DLD and bilingual groups than that for TD children in the vowel condition, but no such latency difference between DLD and bilingual children was found. We suggest that the attenuated T-complex for bilingual children indicates continued plasticity of the auditory cortex to allow for learning of novel, second-language speech sounds.

Language Disorders Research on Bilingualism, School-Age, and Related Difficulties: A Scoping Review of Descriptive Studies

BACKGROUND

Developmental language disorder (DLD) often remains undetected until children shift from 'learning to read' to 'reading to learn,' around 9 years of age. Mono- and bilingual children with DLD frequently have co-occurring reading, attention, and related difficulties, compared to children with typical language development (TLD). Data for mono- and bilingual children with DLD and TLD would aid differentiation of language differences versus disorders in bilingual children.

OBJECTIVE

We conducted a scoping review of descriptive research on mono-and bilingual children < and >= 9 years old with DLD versus TLD, and related skills (auditory processing, attention, cognition, executive function, and reading).

DATA SOURCES

We searched PubMed for the terms "bilingual" and "language disorders" or "impairment" and "child[ren]" from August 1, 1979 through October 1, 2018.

CHARTING METHODS

Two abstracters charted all search results. Main exclusions were: secondary data/reviews, special populations, intervention studies, and case studies/series. Abstracted data included age, related skills measures', and four language groups of participants: monolingual DLD, monolingual TLD, bilingual DLD, and bilingual TLD.

RESULTS

Of 366 articles, 159 (43%) met inclusion criteria. Relatively few (14%, n = 22) included all 4 language groups, co-occurring difficulties other than nonverbal intelligence (n = 49, 31%) or reading (n = 51, 32%) or any 9-18 year-olds (31%, n = 48). Just 5 (3%) included only 9-18 year-olds. Among studies with any 9 to 18 year olds, just 4 (8%, 4/48) included 4 language groups.

CONCLUSIONS

Future research should include mono- and bilingual children with both DLD and TLD, beyond 8 years of age, along with data about their related skills.

Developing Preschool Language Surveillance Models - Cumulative and Clustering Patterns of Early Life Factors in the Early Language in Victoria Study Cohort

BACKGROUND

Screening and surveillance of development are integral to ensuring effective early identification and intervention strategies for children with vulnerabilities. However, not all developmental skills have reliable screening processes, such as early language ability.

METHOD

We describe how a set of early life factors used in a large, prospective community cohort from Australia are associated with language abilities across the preschool years, and determine if either an accumulation of risk factors or a clustering of risk factors provide a feasible approach to surveillance of language development in preschool children.

RESULTS

There were 1,208 children with a 7-year language outcome. The accumulation of early life factors increased the likelihood of children having low language skills at 7-years. Over a third of children with typical language skills (36.6%) had ≤ two risks and half of the children with low language (50%) had six or more risks. As the number of factors increases the risk of having low language at 7-years increases, for example, children with six or more risks had 17 times greater risk, compared to those with ≤ two risks. Data collected from 1,910 children at 8- to 12-months were used in the latent class modeling. Four profile classes (or groups) were identified. The largest group was developmentally enabled with a supportive home learning environment (56.2%, n = 1,073). The second group was vulnerable, both developmentally and in their home learning environment (31.2%, n = 596); the third group was socially disadvantaged with a vulnerable home learning environment (7.4%, n = 142); the final group featured maternal mental health problems and vulnerable child socio-emotional adjustment (5.2%, n = 99). Compared to developmentally enabled children, the risk of low language at 7-years was greater for children in the three other groups.

CONCLUSION

The cumulative and cluster risk analyses demonstrate the potential to use developmental surveillance to identify children within the first years of life who are at risk of language difficulties. Importantly, parent-child interaction and the home learning environment emerged as a consistent cluster. We recommend they be adopted as the common focus for early intervention and universal language promotion programs.

Socioeconomic Status, Culture, and Reading Comprehension in Immigrant Students

Research on reading comprehension in immigrant students is heterogeneous and conflicting. Differences in socioeconomic status and cultural origins are very likely confounds in determining whether differences to native pupils can be attributed to immigrant status. We collected data on 312 Spanish students of Native, of Hispanic origin–therefore with the same family language as native students- and Non-Hispanic origin, while controlling for socioeconomic status, non-verbal reasoning and school membership. We measured reading comprehension, knowledge of syntax, sentence comprehension monitoring, and vocabulary. Differences among groups appeared only in vocabulary and syntax (with poorer performance in the non-Hispanic group), with no differences in reading comprehension. However, regression analyses showed that most of the variability in reading comprehension was predicted by age, socioeconomic status, non-verbal reasoning, and comprehension monitoring. Group membership did not significantly contribute to explain reading comprehension variability. The present study supports the idea that socioeconomically disadvantaged students, both native and immigrants from diverse cultural backgrounds, irrespective of the language of origin, are probably equally at risk of poor reading comprehension.

Reading intervention and neuroplasticity: A systematic review and meta-analysis of brain changes associated with reading intervention

Behavioral research supports the efficacy of intervention for reading disability, but the brain mechanisms underlying improvement in reading are not well understood. Here, we review 39 neuroimaging studies of reading intervention to characterize links between reading improvement and changes in the brain. We report evidence of changes in activation, connectivity, and structure within the reading network, and right hemisphere, frontal and sub-cortical regions. Our meta-analysis of changes in brain activation from pre- to post- reading intervention in eight studies did not yield any significant effects. Methodological heterogeneity among studies may contribute to the lack of significant meta-analytic findings. Based on our qualitative synthesis, we propose that brain changes in response to intervention should be considered in terms of interactions among distributed cognitive, linguistic and sensory systems, rather than via a "normalized" vs. "compensatory" dichotomy. Further empirical research is needed to identify effects of moderating factors such as features of intervention programs, neuroimaging tasks, and individual differences among participants.

Theory-driven classification of reading difficulties from fMRI data using Bayesian latent-mixture models

Decades of research have led to several competing theories regarding the neural contributors to impaired reading. But how can we know which theory (or theories) identifies the types of markers that indeed differentiate between individuals with reading disabilities (RD) and their typically developing (TD) peers? To answer this question, we propose a new analytical tool for theory evaluation and comparison, grounded in the Bayesian latent-mixture modeling framework. We start by constructing a series of latent-mixture classification models, each reflecting one existing theoretical claim regarding the neurofunctional markers of RD (highlighting network-level differences in either mean activation, inter-subject heterogeneity, inter-region variability, or connectivity). Then, we run each model on fMRI data alone (i.e., while models are blind to participants' behavioral status), which enables us to interpret the fit between a model's classification of participants and their behavioral (known) RD/TD status as an estimate of its explanatory power. Results from n=127 adolescents and young adults (RD: n=59; TD: n=68) show that models based on network-level differences in mean activation and heterogeneity failed to differentiate between TD and RD individuals. In contrast, classifications based on variability and connectivity were significantly associated with participants' behavioral status. These findings suggest that differences in inter-region variability and connectivity may be better network-level markers of RD than mean activation or heterogeneity (at least in some populations and tasks). More broadly, the results demonstrate the promise of latent-mixture modeling as a theory-driven tool for evaluating different theoretical claims regarding neural contributors to language disorders and other cognitive traits.

K-2 principal knowledge (not leadership) matters for dyslexia intervention

Kindergarten through second-grade elementary schools that best serve students with dyslexia have principals who are knowledgeable about dyslexia and understand the best practices for providing intervention for students with dyslexia. In this study, three styles of leadership were examined to understand the implication that leadership has on intervention for dyslexia: transformational, instructional, and integrated leadership. However, many students in elementary schools have difficulty learning to read despite good leadership by the principal, with 5-20% of students being diagnosed with dyslexia. While these students need phonetic, multisensory intervention to build necessary reading skills, this study found that many principals lack knowledge of this specialized instruction. The purpose of this research was to explore variables that determine the school-based level of appropriate intervention for students with dyslexia. A questionnaire assessing leadership skills, knowledge, and beliefs about dyslexia, preparation in reading disorders and/or dyslexia received from degree programs and professional development, and services provided to students with dyslexia was given to K-2 principals serving in schools across the United States. Results indicated that regardless of leadership style, principals who have greater knowledge and more correct beliefs about dyslexia provide more appropriate school-based services for students with dyslexia. Eight detailed K-2 principal/practitioner recommendations are included based upon this key finding.