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Lüke C, Kauschke C, Dohmen A, Haid A, Leitinger C, Männel C, Penz T, Sachse S, Scharff Rethfeldt W, Spranger J, Vogt S, Niederberger M, Neumann K. Definition and terminology of developmental language disorders-Interdisciplinary consensus across German-speaking countries. PLoS One 2023; 18:e0293736. [PMID: 37943803 PMCID: PMC10635531 DOI: 10.1371/journal.pone.0293736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
In recent years, there have been intense international discussions about the definition and terminology of language disorders in childhood, such as those sparked by the publications of the CATALISE consortium. To address this ongoing debate, a Delphi study was conducted in German-speaking countries. This study consisted of three survey waves and involved over 400 experts from relevant disciplines. As a result, a far-reaching consensus was achieved on essential definition criteria and terminology, presented in 23 statements. The German term 'Sprachentwicklungsstörung' was endorsed to refer to children with significant deviations from typical language development that can negatively impact social interactions, educational progress, and/or social participation and do not occur together with a potentially contributing impairment. A significant deviation from typical language development was defined as a child's scores in standardized test procedures being ≥ 1.5 SD below the mean for children of the same age. The results of this Delphi study provide a proposal for a uniform use of terminology for language disorders in childhood in German-speaking countries.
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Affiliation(s)
- Carina Lüke
- Faculty of Human Sciences, Department of Special Education and Therapy in Language and Communication Disorders, University of Würzburg, Würzburg, Germany
| | - Christina Kauschke
- Department of German Linguistics, University of Marburg, Marburg, Germany
| | - Andrea Dohmen
- Department of Applied Health Sciences, Speech and Language Therapy, University of Applied Health Sciences (HS Gesundheit), Bochum, Germany
| | - Andrea Haid
- Swiss University of Speech and Language Sciences SHLR, Rorschach, Switzerland
| | - Christina Leitinger
- Logopädieaustria, Professional Association of Austrian Speech-Language Therapists, Vienna, Austria
| | - Claudia Männel
- Department of Audiology and Phoniatrics, Charité –Universitätsmedizin Berlin, Berlin, Germany
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Tanja Penz
- University Hospital for Hearing, Voice and Language Disorders, Innsbruck, Austria
| | - Steffi Sachse
- Institute of Psychology, University of Education Heidelberg, Heidelberg, Germany
| | | | - Julia Spranger
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Susanne Vogt
- Department of Health & Social Affairs, University of Applied Sciences Fresenius Frankfurt, Frankfurt, Germany
| | - Marlen Niederberger
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Katrin Neumann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, Münster, Germany
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Goffman L, Gerken L. A developmental account of the role of sequential dependencies in typical and atypical language learners. Cogn Neuropsychol 2023; 40:243-264. [PMID: 37963089 PMCID: PMC10939949 DOI: 10.1080/02643294.2023.2275837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023]
Abstract
The Gerken lab has shown that infants are able to learn sound patterns that obligate local sequential dependencies that are no longer readily accessible to adults. The Goffman lab has shown that children with developmental language disorder (DLD) exhibit deficits in learning sequential dependencies that influence the acquisition of words and grammar, as well as other types of domain general sequences. Thus, DLD appears to be an impaired ability to detect and deploy sequential dependencies over multiple domains. We meld these two lines of research to propose a novel account in which sequential dependency learning is required for many phonological and morphosyntactic patterns in natural language and is also central to the language and domain general deficits that are attested in DLD. However, patterns that are not dependent on sequential dependencies but rather on networks of stored forms are learnable by children with DLD as well as by adults.
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Affiliation(s)
- Lisa Goffman
- Callier Center, Speech, Language, & Hearing, University of Texas at Dallas, Richardson, USA
| | - LouAnn Gerken
- Psychology & Cognitive Science, University of Arizona, Tucson, USA
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Goffman L, Factor L, Barna M, Cai F, Feld I. Phonological and Articulatory Deficits in the Production of Novel Signs in Children With Developmental Language Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1051-1067. [PMID: 36795546 PMCID: PMC10205102 DOI: 10.1044/2022_jslhr-22-00434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/30/2022] [Accepted: 11/23/2022] [Indexed: 05/25/2023]
Abstract
PURPOSE Sign language, like spoken language, incorporates phonological and articulatory (or motor) processing components. Thus, the learning of novel signs, like novel spoken word forms, may be problematic for children with developmental language disorder (DLD). In the present work, we hypothesize that phonological and articulatory deficits in novel sign repetition and learning would differentiate preschool-age children with DLD from their typical peers. METHOD Children with DLD (n = 34; aged 4-5 years) and their age-matched typical peers (n = 21) participated. Children were exposed to four novel signs, all iconic, but only two linked to a visual referent. Children imitatively produced these novel signs multiple times. We obtained measures of phonological accuracy and articulatory motion stability as well as of learning of the associated visual referent. RESULTS Children with DLD showed an increased number of phonological feature (i.e., handshape, path, and orientation of the hands) errors when compared with their typical peers. While articulatory variability did not overall differentiate children with DLD from typical peers, children with DLD showed instability in one novel sign that obligated bimanual oppositional movement. Semantic aspects of novel sign learning were unaffected in children with DLD. CONCLUSIONS Deficits that have been documented in phonological organization of spoken words in children with DLD are also evident in the manual domain. Analyses of hand motion variability suggest that children with DLD do not show a generalized motor deficit, but one that is restricted to the implementation of coordinated and sequential hand motion.
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Affiliation(s)
| | | | - Mitchell Barna
- Ann & Robert H. Lurie Children's Hospital of Chicago, IL
| | | | - Ilana Feld
- Department of Communication Sciences and Disorders, Elmhurst University, IL
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Krishnan S, Cler GJ, Smith HJ, Willis HE, Asaridou SS, Healy MP, Papp D, Watkins KE. Quantitative MRI reveals differences in striatal myelin in children with DLD. eLife 2022; 11:e74242. [PMID: 36164824 PMCID: PMC9514847 DOI: 10.7554/elife.74242] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 07/21/2022] [Indexed: 12/25/2022] Open
Abstract
Developmental language disorder (DLD) is a common neurodevelopmental disorder characterised by receptive or expressive language difficulties or both. While theoretical frameworks and empirical studies support the idea that there may be neural correlates of DLD in frontostriatal loops, findings are inconsistent across studies. Here, we use a novel semiquantitative imaging protocol - multi-parameter mapping (MPM) - to investigate microstructural neural differences in children with DLD. The MPM protocol allows us to reproducibly map specific indices of tissue microstructure. In 56 typically developing children and 33 children with DLD, we derived maps of (1) longitudinal relaxation rate R1 (1/T1), (2) transverse relaxation rate R2* (1/T2*), and (3) Magnetization Transfer saturation (MTsat). R1 and MTsat predominantly index myelin, while R2* is sensitive to iron content. Children with DLD showed reductions in MTsat values in the caudate nucleus bilaterally, as well as in the left ventral sensorimotor cortex and Heschl's gyrus. They also had globally lower R1 values. No group differences were noted in R2* maps. Differences in MTsat and R1 were coincident in the caudate nucleus bilaterally. These findings support our hypothesis of corticostriatal abnormalities in DLD and indicate abnormal levels of myelin in the dorsal striatum in children with DLD.
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Affiliation(s)
- Saloni Krishnan
- Wellcome Centre for Integrative Neuroimaging, Dept of Experimental Psychology, University of OxfordOxfordUnited Kingdom
- Department of Psychology, Royal Holloway, University of London, Egham HillLondonUnited Kingdom
| | - Gabriel J Cler
- Wellcome Centre for Integrative Neuroimaging, Dept of Experimental Psychology, University of OxfordOxfordUnited Kingdom
- Department of Speech and Hearing Sciences, University of WashingtonSeattleUnited States
| | - Harriet J Smith
- Wellcome Centre for Integrative Neuroimaging, Dept of Experimental Psychology, University of OxfordOxfordUnited Kingdom
- MRC Cognition and Brain Sciences Unit, University of CambridgeCambridgeUnited Kingdom
| | - Hanna E Willis
- Wellcome Centre for Integrative Neuroimaging, Dept of Experimental Psychology, University of OxfordOxfordUnited Kingdom
- Nuffield Department of Clinical Neurosciences, John Radcliffe HospitalOxfordUnited Kingdom
| | - Salomi S Asaridou
- Wellcome Centre for Integrative Neuroimaging, Dept of Experimental Psychology, University of OxfordOxfordUnited Kingdom
| | - Máiréad P Healy
- Wellcome Centre for Integrative Neuroimaging, Dept of Experimental Psychology, University of OxfordOxfordUnited Kingdom
- Department of Psychology, University of CambridgeCambridgeUnited Kingdom
| | - Daniel Papp
- NeuroPoly Lab, Biomedical Engineering Department, Polytechnique MontrealMontrealCanada
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neuroscience, University of OxfordOxfordUnited Kingdom
| | - Kate E Watkins
- Wellcome Centre for Integrative Neuroimaging, Dept of Experimental Psychology, University of OxfordOxfordUnited Kingdom
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Iuzzini-Seigel J, Moorer L, Tamplain P. An Investigation of Developmental Coordination Disorder Characteristics in Children With Childhood Apraxia of Speech. Lang Speech Hear Serv Sch 2022; 53:1006-1021. [PMID: 36041512 DOI: 10.1044/2022_lshss-21-00163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Children with childhood apraxia of speech (CAS) evidence a high rate of co-occurring fine and gross motor deficits. This clinical focus article reports a preliminary investigation of characteristics of developmental coordination disorder (DCD), a neurodevelopmental disorder categorized by poor motor proficiency and functional limitations, in this population. METHOD Children with CAS underwent a comprehensive motor evaluation using the Movement Assessment Battery for Children-Second Edition, the Developmental Coordination Disorder Questionnaire, and a developmental history questionnaire to determine if they met criteria for a DCD diagnosis as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). RESULTS Six out of seven participants met DCD criteria based on the DSM-5 criteria. Four of these children had a co-occurring diagnosis of developmental language disorder, and all met criteria for DCD. CONCLUSIONS Consistent with previous research, the majority of participants demonstrated motor deficits and 85% met criteria for DCD. Despite this high rate of motor deficits, only 57% had previously undergone a physical/occupational therapy evaluation and intervention and only one had a previous diagnosis of DCD. These findings suggest that formal movement assessments are essential for children with a CAS diagnosis. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20540193.
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Sack L, Dollaghan C, Goffman L. Contributions of early motor deficits in predicting language outcomes among preschoolers with developmental language disorder. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:362-374. [PMID: 34793281 PMCID: PMC9881565 DOI: 10.1080/17549507.2021.1998629] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Purpose: We assessed the extent to which language, speech, and fine/gross motor skills in preschoolers with developmental language disorder (DLD; also referred to as specific language impairment) predicted language outcome two years later.Method: Participants with DLD (n = 15) and typical development (TD; n = 14) completed language, speech, and fine/gross motor assessments annually, beginning as 4- to 5-year-olds (Year 1 timepoint) and continuing through 6 to 7 years of age (Year 3 timepoint). We performed Pearson correlation and hierarchical regression analyses to examine the relative contributions of Year 1 language, speech, and motor skills to Year 3 language outcome in each group.Result: Among children with DLD, Year 1 fine/gross motor scores positively correlated with Year 3 language scores, uniquely explaining 40% of the variance in language outcomes. Neither Year 1 language, speech-sound, nor speech-motor scores predicted language outcome in this group. Among children with TD, only Year 1 language predicted language outcome.Conclusion: This small longitudinal study reveals that, among preschoolers with DLD, certain early fine/gross motor deficits predict persistent language impairment. Future research that includes larger sample sizes and motor tasks that incorporate complex sequencing will enhance the understanding of the relationship between language, speech, and motor skills; specifically, whether certain motor deficits simply co-occur with language deficits or whether they are tied to DLD through shared impairments in sequential learning mechanisms.
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Affiliation(s)
- Leah Sack
- Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Christine Dollaghan
- Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Lisa Goffman
- Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
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Factor L, Goffman L. Phonological characteristics of novel gesture production in children with developmental language disorder: Longitudinal findings. APPLIED PSYCHOLINGUISTICS 2022; 43:333-362. [PMID: 35342208 PMCID: PMC8955622 DOI: 10.1017/s0142716421000540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Children with developmental language disorder (DLD; aka specific language impairment) are characterized based on deficits in language, especially morphosyntax, in the absence of other explanatory conditions. However, deficits in speech production, as well as fine and gross motor skill, have also been observed, implicating both the linguistic and motor systems. Situated at the intersection of these domains, and providing insight into both, is manual gesture. In the current work, we asked whether children with DLD showed phonological deficits in the production of novel gestures and whether gesture production at 4 years of age is related to language and motor outcomes two years later. Twenty-eight children (14 with DLD) participated in a two-year longitudinal novel gesture production study. At the first and final time points, language and fine motor skills were measured and gestures were analyzed for phonological feature accuracy, including handshape, path, and orientation. Results indicated that, while early deficits in phonological accuracy did not persist for children with DLD, all children struggled with orientation while handshape was the most accurate. Early handshape and orientation accuracy were also predictive of later language skill, but only for the children with DLD. Theoretical and clinical implications of these findings are discussed.
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Narayanan S, Vijayan K, Vastare Guruprasad M, Prabhu P P, Barman A. Oral and Verbal Praxis in Impaired Language Learners. Percept Mot Skills 2021; 129:33-46. [PMID: 34749545 DOI: 10.1177/00315125211056421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the context of language descriptions, the terms oral and verbal praxis refer to volitional movements for performing oral gestures and movements for speech. These movements involve programming articulators and rapid sequences of muscle firings that are required for speech sound productions. A growing body of research has highlighted the links between oral motor kinematics and language production skills in both typically developing (TD) children and children with developmental language disorders, including Specific Language Impairment (SLI). Yet, there have been limited attempts to assess the link between non-linguistic and linguistic development. In the present study, we investigated oral and verbal praxis behaviors in children with SLI. Fifteen children with SLI formed a clinical group and 15 children with typical development who were matched to the clinical group for chronological age, gender, and socio-economic status formed the TD group. We assessed participants in both groups for their language abilities with age-appropriate standardized language tests. To investigate oral and verbal praxis behaviors, we administered the Assessment Protocol for Oral Motor, Oral Praxis and Verbal Praxis Skills to the two groups. We used the non-parametric Mann-Whitney U test to compare the two groups with respect to oral and verbal praxis measures; and we found a significant difference between isolated and sequential movements in the oral praxis section in two age subgroups of these groups (p ≤ .05). Spearman's correlations revealed a strong correlation between core language scores and sequential movements in the younger children with SLI and in TD children. These results showed co-morbidity between SLI and poor oral motor skills, suggesting that SLI is not just a language disorder, but a group of co-morbid conditions that include oral motor and verbal praxis difficulties.
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Affiliation(s)
- Swapna Narayanan
- Associate Professor of Speech Pathology, 58893All India Institute of Speech and Hearing, Mysuru, India
| | - Kavya Vijayan
- Research Associate, Department of Audiology, 58893All India Institute of Speech and Hearing, Mysuru, India
| | - Mekhala Vastare Guruprasad
- Research Associate, Department of Audiology, 58893All India Institute of Speech and Hearing, Mysuru, India
| | - Prashanth Prabhu P
- Assistant Professor in Audiology, 58893All India Institute of Speech and Hearing, Mysuru, India
| | - Animesh Barman
- Professor in Audiology, 58893All India Institute of Speech and Hearing, Mysuru, India
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Park J, Miller CA, Sanjeevan T, Van Hell JG, Weiss DJ, Mainela-Arnold E. Non-linguistic cognitive measures as predictors of functionally defined developmental language disorder in monolingual and bilingual children. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:858-872. [PMID: 34137124 DOI: 10.1111/1460-6984.12632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 04/01/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND & AIMS Given that standardized language measures alone are inadequate for identifying functionally defined developmental language disorder (fDLD), this study investigated whether non-linguistic cognitive abilities (procedural learning, motor functions, executive attention, processing speed) can increase the prediction accuracy of fDLD in children in linguistically diverse settings. METHODS & PROCEDURES We examined non-linguistic cognitive abilities in mono- and bilingual school-aged children (ages 8-12) with and without fDLD. Typically developing (TD) children (14 monolinguals, 12 bilinguals) and children with fDLD (28 monolinguals, 12 bilinguals) completed tasks measuring motor functions, procedural learning, executive attention and processing speed. Children were assigned as fDLD based on parental or professional concerns regarding children's daily language functioning. If no concerns were present, children were assigned as TD. Standardized English scores, non-verbal IQ scores and years of maternal education were also obtained. Likelihood ratios were used to examine how well each measure separated the fDLD versus TD groups. A binary logistic regression was used to test whether combined measures enhanced the prediction of identifying fDLD status. OUTCOMES & RESULTS A combination of linguistic and non-linguistic measures provided the best distinction between fDLD and TD for both mono- and bilingual groups. For monolingual children, the combined measures include English language scores, functional motor abilities and processing speed, whereas for bilinguals, the combined measures include English language scores and procedural learning. CONCLUSIONS & IMPLICATIONS A combination of non-linguistic and linguistic measures significantly improved the distinction between fDLD and TD for both mono- and bilingual groups. This study supports the possibility of using non-linguistic cognitive measures to identify fDLD in linguistically diverse settings. WHAT THIS PAPER ADDS What is already known on the subject Given that standardized English language measures may fail to identify functional language disorder, we examined whether supplementing English language measures with non-linguistic cognitive tasks could resolve the problem. Our study is based on the hypothesis that non-linguistic cognitive abilities contribute to language processing and learning. This is further supported by previous findings that children with language disorder exhibit non-linguistic cognitive deficits. What this paper adds to existing knowledge The results indicated that a combination of linguistic and non-linguistic cognitive abilities increased the prediction of functional language disorder in both mono- and bilingual children. What are the potential or actual clinical implications of this work? This study supports the possibility of using non-linguistic cognitive measures to identify the risk of language disorder in linguistically diverse settings.
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Affiliation(s)
- Jisook Park
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Carol A Miller
- Department of Communication Sciences and Disorders, Pennsylvania State University, University Park, PA, USA
| | - Teenu Sanjeevan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Janet G Van Hell
- Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | - Daniel J Weiss
- Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | - Elina Mainela-Arnold
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Department of Psychology and Speech and Language Pathology, University of Turku, Turku, Finland
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Nitido H, Plante E. Diagnosis of Developmental Language Disorder in Research Studies. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2777-2788. [PMID: 32692602 DOI: 10.1044/2020_jslhr-20-00091] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The aim of this study was to investigate the extent to which researchers in the field of developmental language disorder are utilizing validated methods to diagnose their research participants. Method We examined 90 research articles published from 2015 to 2019 that included English-speaking participants from the United States who were identified as having a developmental language disorder or specific language impairment. From these articles, we identified the tests and measures used to identify participants and classify them as healthy or impaired. We then consulted the test manuals and the literature to find information on sensitivity and specificity of the test and the evidence-based cut score that maximized identification accuracy. Results Of the 90 articles examined, 38 (42%) were found to reflect validated diagnostic methods, and 51 (58%) did not. Conclusion Our results illustrate that validated methods are used less than half of the time even by those who should have a high level of expertise and despite calls for increasing scientific rigor in research practices.
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Affiliation(s)
- Hallie Nitido
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Elena Plante
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
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