CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children

Investigating Task Persistence in Preschool Children With Developmental Language Disorder

PURPOSE

The present study was designed to investigate persistence in preschool children with developmental language disorder (DLD) compared to similar-age peers with typical language (TL) on tasks designed to be moderately challenging, yet equivalent in difficulty for both groups.

METHOD

Sixteen preschool-age children with DLD were matched to 16 children with TL based on chronological age, biological sex, and maternal education. The children completed two play-based tasks that were designed to elicit some success but impossible to complete. Task persistence was measured by the total time spent attempting to complete each unachievable task.

RESULTS

Despite equivalent task difficulty for both groups, the children with DLD exhibited less persistence than the TL group. This reduced persistence behavior on the part of the DLD group was a generalized and not a task-specific response.

CONCLUSIONS

Despite experiencing the same degree of success on moderately challenging play-based tasks, the children in the DLD group exhibited reduced task persistence relative to the TL group. Potential implications for reduced persistence for children with DLD are discussed.

Dynamics of Motor Skill Learning in American and Israeli Toddlers With Varied Language Proficiency

PURPOSE

The aim of the present study was twofold: to determine if deficits in motor skill proficiency and learning were present in 2-year-old children identified with early expressive language delay compared to peers without the delay, and to distinguish how motor skill proficiency and learning behaviors may manifest differently across culturally and linguistically diverse backgrounds.

METHOD

The study involved 54 children (24-36 months of age), 23 of whom were identified as having an expressive language delay. Furthermore, 16 participants were American and English-speaking and 38 were Israeli and Hebrew-speaking. After motor and language skill proficiency was assessed using a variety of measures, each child and participating parent were introduced to a nonsymmetrical-shaped insertion task so that motor learning skills could be observed. This block insertion task was observed for each child at three time points and included a transfer task (same task, new nonsymmetrical shape).

RESULTS

Children with early expressive language delay were statistically significantly more likely to exhibit deficits in fine-motor proficiency than peers without language delay, regardless of country of origin or language spoken. Furthermore, participants with language delay demonstrated significantly higher error rates in transfer task completion compared with peers. Finally, participants in the U.S. sample indicated lower fine-motor skills and higher error rates than those in the Israeli sample.

CONCLUSION

Differences in motor skill proficiency were universally associated with language delay status, indicating support for the notion that language acquisition deficits may extend beyond the linguistic system even in young children identified as late talkers.

Early Oral Language and Cognitive Predictors of Emergent Literacy Skills in Arabic-Speaking Children: Evidence From Saudi Children With Developmental Language Disorder

PURPOSE

Although children with developmental language disorder (DLD) are known to have difficulties with emergent literacy skills, few available studies have examined emergent literacy skills in Arabic-speaking children with DLD. Even though Arabic language characteristics, such as diglossia and orthographic structure, influence the acquisition of literacy in Arabic-speaking children, research shows that oral language skills, such as vocabulary, and cognitive skills, such as verbal short-term memory (VSTM), predict literacy in Arabic-speaking children. Moreover, linguistic and memory abilities are impaired in children with DLD, including Arabic-speaking children. The current study examines the relationships between oral language, VSTM, and emergent literacy skills in Arabic-speaking typically developing (TD) children and children with DLD.

METHOD

Participants were 40 TD children (20 girls; aged 4;0-6;11 [years;months]) and 26 children with DLD (nine girls, aged 4;0-6;11). All participants were monolingual Arabic speakers and matched on age and socioeconomic status. A set of comprehensive Arabic language (vocabulary knowledge, morphosyntactic, and listening comprehension skills), VSTM, and emergent literacy (phonological awareness and letter knowledge skills) tests were administered.

RESULTS

The DLD group scored significantly lower than the TD group on language, VSTM, and emergent literacy measures. Results revealed that the contributions of oral language and VSTM to emergent literacy skills across TD and DLD groups were different. In the TD group, VSTM predicted emergent literacy skills, whereas in the DLD groups, both vocabulary knowledge and VSTM predicted emergent literacy skills.

CONCLUSIONS

This study represents an important first step in understanding emergent literacy skills and their relationships to language and memory in Arabic-speaking children with and without DLD. The implications of these findings for clinical and education provision are discussed.

Predictive Measures in Child Language Development: The Role of Familial History and Early Expressive Vocabulary

PURPOSE

Prediction of developmental language disorder in children under 3 years of age is challenging. Among early risk factors, research has focused on having a positive familial history (FH+) for language or literacy problems and on late language emergence, that is, late-talker (LT) status. The interaction between these two risk factors and their cumulative effect is still debated. Here, we (a) investigate the effect of FH+ on 24-month language development, (b) test for cumulative effects of FH+ status and early language delay on 36-month language outcomes, and (c) disentangle the direct and indirect effects of familial history (FH) on the language outcome.

METHOD

One hundred eighty-five Italian children were followed up longitudinally between 24 and 36 months of age (64 FH+ and 121 FH-) through parental questionnaires and direct child assessment.

RESULTS

At the age of 24 months, the FH+ group showed worse expressive vocabulary and higher prevalence of LT. At the age of 36 months, main effects of LT and FH were identified on lexical and phonological performances, respectively. Interestingly, significant interaction effects were identified on expressive vocabulary and phonological processing. Path analysis highlights that FH had a direct effect on later measures of phonology, whereas its effect on 36-month lexical abilities was indirect, via measures of expressive vocabulary at 24 months.

CONCLUSIONS

The study suggests specific predictive roles of FH and LT status on language development. Interestingly, FH+ seems to represent an additive risk for LT children. The use of cumulative risk measures is confirmed as a powerful approach to identify those children with the highest probability of developing persistent language difficulties.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26790580.

Exploring vowel errors produced in nonword repetition in children with speech and language disorders

BACKGROUND

Accurate nonword repetition (NWR) is contingent on many underlying skills, including encoding, memory and motor planning and programming. Though vowel errors are frequently associated with childhood apraxia of speech (CAS), several recent studies have found that children with developmental language disorder (DLD) produce high rates of vowel errors in NWR tasks.

AIMS

This retrospective analysis explored whether the overall frequency and types of vowel errors produced in NWR distinguish children with DLD, children with CAS, children with speech sound disorder (SSD) and children with typical development (TD).

METHODS AND PROCEDURE

We present data for 24 children (six per DLD, CAS, SSD and TD groups), ranging in age from 50-92 months. Children with DLD, CAS and SSD showed similar articulation scores and children with DLD and children with CAS showed similar expressive language scores. Total vowel errors, total monophthong errors, monophthong substitutions, diphthongization errors, total diphthong errors, diphthong substitutions and diphthong reduction errors were calculated by syllable length and group. Repeated measures analyses of variance were used to examine group differences.

OUTCOMES AND RESULTS

Children with DLD and children with CAS produced a higher frequency of total vowel errors compared to children with TD. Children with DLD produced more total monophthong errors than children with TD. Children with DLD and children with CAS produced more total diphthong errors than children with TD. For children with DLD, these were characterised by diphthong substitutions. For children with CAS, these were characterised by diphthong substitutions and diphthong reduction errors. For all measures, error rates in children with SSD did not significantly differ from any of the other three groups.

CONCLUSION

Preliminary evidence indicates that children with DLD and children with CAS both show high rates of vowel errors in NWR tasks and weaknesses in encoding and memory. For children with CAS, additional motor planning difficulties are associated with an increased likelihood to reduce diphthongs. Children with SSD show more mild processing difficulties than children with DLD and children with CAS, though they do not perform as well as TD peers. Future work should replicate and further specify the processing weaknesses that affect vowel accuracy in NWR tasks in a larger sample.

WHAT THIS PAPER ADDS

What is already known on the subject Nonword repetition (NWR) tasks are often included in diagnostic batteries to identify children with developmental language disorder (DLD). Poor performance on these tasks have historically been attributed to phonological working memory deficits in children with DLD. However, repeating nonwords relies on a number of underlying processing skills and many of these skills are affected to varying degrees in children with speech and language disorders. An in-depth analysis of vowel errors has the potential to reveal the shared as well as specific underlying processing weaknesses in children with DLD, children with childhood apraxia of speech (CAS) and children with speech sound disorder (SSD). What this paper adds to existing knowledge We found that children with DLD and children with CAS show low vowel competence compared to children with typical development. A nuanced examination of vowel error types further revealed that children with DLD and children with CAS show weaknesses in encoding and memory. Motor planning and programming weaknesses were unique to CAS. Children with SSD show more mild processing deficits and their performance did not significantly differ from any of the other three groups. What are the clinical implications of this work? Examining the types of vowel errors produced by children with DLD, children with CAS and children with SSD in NWR allows us to further specify the underlying processing weaknesses that differentiate these three groups. This research informs theoretical accounts of language processing in children with different types of speech and language disorders and has the potential to improve the diagnostic utility of NWR tasks.

A preliminary study of the effects of stimulant medications on estimates of psycholinguistic abilities for children with attention-deficit/hyperactivity disorder

Underlying deficits in inattention, hyperactivity, and/or impulsivity might contribute to suboptimal test-taking behaviours during language assessments that can lead to diagnostic errors. Considerations of potential medication effects on estimates of children's nonword repetition, sentence recall, tense-marking, and narrative abilities are warranted given long-standing enthusiasm for these indices to serve as clinical markers for developmental language disorder (DLD). A battery consisting of 1 nonverbal, 1 reading, and 6 verbal measures was administered twice to 26 children (6-9 years) with independently diagnosed combined-type attention-deficit/hyperactivity disorder (ADHD). All participants had been prescribed stimulant medications for the management of their ADHD symptoms and were assessed off- and on-medication, with order counter-balanced across participants. Half of the participants had concomitant DLD. Examiners were unaware of children's clinical status during assessments or when they were testing children who had received medication. Effect sizes were calculated for each measure. Significant score differences indicating a beneficial impact of stimulant medications on children's performances were observed on the recalling sentences subtest of the Clinical Evaluation of Language Fundamentals and the Picture Peabody Vocabulary Test. Adjustments may be needed when speech language pathologists use sentence recall or receptive vocabulary measures to make diagnostic decisions with children who have ADHD.

Revisiting nonword repetition as a clinical marker of developmental language disorder: Evidence from monolingual and bilingual L2 Cantonese

Cross-linguistically, nonword repetition (NWR) tasks have been found to differentiate between typically developing (TD) children and those with Developmental Language Disorder (DLD), even when second-language TD (L2-TD) children are considered. This study examined such group differences in Cantonese. Fifty-seven age-matched children (19 monolingual DLD (MonDLD); 19 monolingual TD (MonTD); and 19 L2-TD) repeated language-specific nonwords with varying lexicality levels and Cantonese-adapted quasi-universal nonwords. At whole-nonword level scoring, on the language-specific, High-Lexicality nonwords, MonDLD scored significantly below MonTD and L2-TD groups which did not differ significantly from each other. At syllable-level scoring, the same pattern of group differentiation was found on quasi-universal nonwords. These findings provide evidence from a typologically distinct and understudied language that NWR tasks can capture significant TD/DLD group differences, even for L2-Cantonese TD children with reduced language experience. Future studies should compare the performance of an L2-DLD group and evaluate the sensitivity and specificity of Cantonese NWR.

Factors affecting speech-language pathologists' language assessment procedures and tools - challenges and future directions in Sweden

Purpose: National surveys of speech-language pathologists' (SLP) practices play an important role in professional development, and previous research show that many challenges faced by the profession are similar across the globe. This study aims to describe Swedish SLP assessment practices, examine factors that may affect this practice, and discuss the results in the light of international studies. Methods: Data from 584 SLPs were collected through an online questionnaire with multiple choice and open-ended questions. A mixed-method design was deployed where a deductive qualitative analysis of free-text responses complemented quantitative data. Results: In line with previous results from English-speaking countries, both standardized discrete skill tests and contextualized assessments were used by the respondents but fewer used language sample analysis and dynamic assessment procedures, despite international recommendations. There were few differences based on experience, work setting, proportion of multilingual assessments and socio-economic status of the health catchment area. Main challenges reported were lack of time and difficulty prioritizing, and assessment and/or diagnosis of multilingual/L2 children, which is similar to challenges faced by SLPs in other countries. Swedish SLPs also reported lack of national clinical guidelines as a main challenge. Factors contributing to better assessments included experience, and the combination of many sources of information, including professional and interprofessional discussions. Conclusions: The accumulated evidence from this and previous studies show that to address challenges and build on strengths, changes on a systemic level are needed. This includes more time and resources for continuing education and implementation of recommended assessment methods, as well as professional and interprofessional collaborations.

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

PURPOSE

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

METHOD

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

RESULTS

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

DISCUSSION

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

Variability of theory of mind versus pragmatic ability in typical and atypical development

INTRODUCTION

Numerous studies have linked deficits in Theory of Mind (ToM) with language problems. We aimed to explore the similarities and differences between children's patterns of performance on a ToM task that requires minimal linguistic skill and a pragmatic inference task that relies on both ToM and language. We assessed variability in pragmatic inference skills and ToM across populations of children (8-14 years) displaying varying cognitive profiles. We further compared the sensitivity of ToM versus pragmatic ability to core language skills, memory and executive functioning (EF).

METHOD

ToM was tested using the Social Attribution Task (SAT-MC-II). Pragmatic ability was assessed in an implicature comprehension task. Receptive vocabulary, grammar comprehension, short-term and working memory (STM and WM) capacity and EF were measured using Hungarian adaptations of standard tasks and tests developed by the authors' lab. In addition to typically developing (TD) children (n = 33), we included children with neurodevelopmental disorders where ToM and/or language abilities are vulnerable: autism spectrum disorder (ASD, n = 26), attention deficit hyperactivity disorder (ADHD, n = 25) and developmental language disorder (DLD, n = 18).

RESULTS

Results revealed a significant but only moderate positive correlation between pragmatic inference and ToM indicating that the two abilities are related but distinct. The ASD group showed impairments in both ToM and pragmatic inference ability but no significant deficit was observed in ADHD or DLD relative to TD children in either skill. However, while SAT-MC-II results were only affected by verbal WM and vocabulary measures, pragmatic performance was associated with STM, verbal WM, EF, grammatical skills and vocabulary.

CONCLUSION

Our findings indicate that disentangling the contributions of different cognitive skills to ToM tasks may help clarify the role of ToM in language skills and identify distinct patterns of ToM and pragmatic skills in developmental disorders.

Introducing a self-managed early communication resource for parents - A mixed methods feasibility study of the Swedish "ComAlong online"

BACKGROUND

Web-based programmes offer parents of children with communication difficulties promising access to parent-mediated, early interventions. However, empirical evaluations of such programmes are limited. This study focused on parents and used mixed methods to examine the feasibility of ComAlong online.

METHODS

ComAlong online is a Swedish, self-managed web-resource teaching parents supportive strategies to promote child communication. Data of different types were collected from a total of 71 parents: ten individual parent interviews, 21 pre-questionnaires and 10 post-questionnaires, and finally 50 anonymous digital evaluation surveys. Descriptive statistics and deductive qualitative content analysis were used.

RESULTS

Findings indicate that parents perceived improved child communication and own competence after using the ComAlong online. The most valued parts included podcasts with experts and videos of parent-child interaction. Parents reported that the resource was easy to use, but they wanted to have gained access to the resource when the child was younger. Suggestions for changes included adding a chat function with experts, a parent net forum, and the possibility of creating personalised playlists of videos and podcasts. Evaluation of the research process revealed difficulties in recruiting parents from local child healthcare services and parents of children not yet with a diagnosis.

CONCLUSIONS

This study supports the potential for self-managed, web-based resources to disseminate evidence-based parent training for supporting early communication development. Importantly, parents lack individual guidance from experts and contact with other parents. Also, measures need to be made to disseminate the resources within local child healthcare services.

The Effect of Age of First Exposure on Vocabulary, Mean Length of Utterance, Morphosyntactic Accuracy, and Semantic and Sentence-Level Patterns in the First 2 Years of French Second-Language Learning by Preschool- to Adolescent-Age Mandarin Speakers

BACKGROUND

Bilingual assessment is particularly difficult in the very first period of children's second language (L2) exposure. This exploratory, longitudinal study examined L2 learning after 1 and 2 years of L2 exposure by young immigrants and how it is affected by their age at first exposure to the L2 (AoE).

METHOD

Participants were 18 immigrants ranging in age from 2;11 to 14;2 (years;months), all within their first year in Montreal at Time 1, enrolled in a French school or day care, and from a Mandarin first language background. Participants were tested again a year later. Measures included receptive and expressive French vocabulary tests and conversational language samples analyzed using traditional measures of mean length of utterance (MLU) and morphological accuracy as well as novel measures of semantic and sentence-level patterns.

RESULTS

Performance was relatively high already at Time 1 and increased significantly at Time 2 in both vocabulary and MLU. At Time 2, vocabulary scores were below normative values, whereas MLU was within expected values relative to monolingual and simultaneous bilinguals for the majority of the participants. However, higher MLUs were accompanied by more instances of both semantic errors and creative semantic strategies. French performance was strongly related to AoE; with amount of exposure equivalent, older participants outperformed the younger ones on MLU and vocabulary. Semantic errors and creative uses were strongly predicted by AoE; however, morphological accuracy and number of agrammatical utterances were not.

CONCLUSIONS

This initial period of French learning involved a rapid growth spurt for most of the participants. We argue that the pattern observed, particularly among the older children, constitutes an early stage of L2 learning characterized by long utterances that are also frequently hard to understand as speakers encounter challenges and use creative strategies in their attempt to convey meaning. Comparison with normative reference bases for monolinguals and bilinguals with greater cumulative L2 exposure who have similar MLUs should be done with much caution during this early period.

Speech sound development of young Dutch children with a developmental language disorder: A complex matter

BACKGROUND

Approximately 50% of all young children with a developmental language disorder (DLD) also have problems with speech production. Research on speech sound development and clinical diagnostics of speech production difficulties focuses mostly on accuracy; it relates children's phonological realizations to adult models. Contrarily to these relational analyses, independent analyses indicate the sounds and structures children produce irrespective of accuracy. Such analyses are likely to provide more insight into a child's phonological strengths and limitations, and may thus provide better leads for treatment.

AIMS

Ram (1) To contribute to a more comprehensive overview of the speech sound development of young Dutch children with DLD by including independent and relational analyses, (2) to develop an independent measure to assess these children's speech production capacities; and (3) to examine the relation between independent and relational speech production measures for children with DLD.

METHODS & PROCEDURES

We describe the syllable structures and sounds of words elicited in two picture-naming tasks of 82 children with DLD and speech production difficulties between ages 2;7 and 6;8. The children were divided into four age groups to examine developmental patterns in a cross-sectional manner. Overviews of the children's productions on both independent and relational measures are provided. We conducted a Spearman correlation analysis to examine the relation between accuracy and independent measures.

OUTCOMES & RESULTS

The overviews show these children are able to produce a greater variety of syllable structures and consonants irrespective of target positions than they can produce correctly in targets. This is especially true for children below the age of 4;5. The data indicate that children with DLD have difficulty with the production of clusters, fricatives, liquids and the velar nasal (/ŋ/). Based on existing literature and our results, we designed a Dutch version of an independent measure of word complexity, originally designed for English (word complexity measure-WCM) in which word productions receive points for specific word, syllable and sound characteristics, irrespective of accuracy. We found a strong positive correlation between accuracy scores and scores on this independent measure.

CONCLUSIONS & IMPLICATIONS

The results indicate that the use of independent measures, including the proposed WCM, complement traditional relational measures by indicating which sounds and syllable structures a child can produce (irrespective of correctness). Therefore, the proposed measure can be used to monitor the speech sound development of children with DLD and to better identify treatment goals, in combination with existing relational measures.

WHAT THIS PAPER ADDS

What is already known on the subject Speech production skills can be assessed in different ways: (1) using analyses indicating the structures and sounds a child produces irrespective of accuracy, that is, performance analyses; and (2) using analyses indicating how the productions of a child relate to the adult targets, that is, accuracy analyses. In scientific research as well as in clinical practice the focus is most often on accuracy analyses. As a consequence, we do not know if children who do not improve in accuracy scores, improve in other phonological aspects that are not captured in these analyses, but can be captured by performance analyses. What this study adds to the existing knowledge The overviews show these children are able to produce a greater variety of syllable structures and consonants irrespective of target positions than they can produce correctly in targets. Consequently, adding performance analyses to existing accuracy analyses provides a more complete picture of a child's speech sound development. What are the potential or actual clinical implications of this work? We propose a Dutch version of a WCM, originally designed for English, in which word productions receive points for word structures, syllable structures and sounds, irrespective of accuracy. This measure may be used by Dutch clinicians to monitor the speech sound development of children with DLD and to formulate better treatment goals, in addition to accuracy measures that are already used.

Predictors of language and reading outcomes in 12-year-old children born very preterm

AIM

To investigate predictors of language and reading outcomes in 12-year-old Swedish children born very preterm (<32 gestational weeks) in 2004-2007.

METHOD

Children born very preterm (n = 78, 43 girls), and term-born controls (n = 50, 32 girls), were examined on verbal IQ, semantic and phonemic fluency, sentence recall, reading fluency, word and phonological decoding at 12 years of age. The results were related to neonatal characteristics, language development, measured with Bayley-III, at 2.5 years corrected age, and concurrent non-verbal IQ.

RESULTS

Preterm children showed language and reading difficulties that were not completely accounted for by level of concurrent non-verbal IQ. Extremely preterm born children (<28 gestational weeks) demonstrated specific linguistic weaknesses. Administration of antenatal steroids, retinopathy of prematurity and persistent ductus arteriosus explained unique variance in language and reading outcomes. Language assessments at 2.5 years had low predictive value for language and reading outcomes at age 12.

CONCLUSION

Language and reading difficulties in 12-year-old children born preterm were not fully explained by concurrent non-verbal IQ, and were not reliably predicted by language assessments at 2.5 years. Renewed language assessments at school age are warranted for identifying children with persisting linguistic difficulties.

Caregivers' reports of the home literacy environments of children with developmental language disorder and typically developing peers during the COVID-19 pandemic

PURPOSE

Children with developmental language disorder (DLD) are at heightened risk for reading difficulty. We investigated the home literacy environments of kindergarten children with DLD and typically developing (TD) peers during the COVID-19 pandemic.

METHOD

We analysed scores from standardised assessments of oral language, nonverbal intelligence, and word reading in conjunction with home literacy questionnaire data at three time points.

RESULT

Frequency of engagement in home literacy activities did not differ by group during school closures or when schools reopened. Caregivers from both groups reported increased home literacy engagement during closures. Engagement returned to pre-pandemic levels when schools reopened. For the DLD group, the child's word reading ability and interest in literacy were positively associated with the home literacy environment. Family history of language and/or literacy difficulty was negatively associated with the home literacy environment. For the TD group, only the child's interest in literacy was positively associated with the home literacy environment.

CONCLUSION

These findings elucidate the need for further research related to home literacy and families of children with DLD, with a focus on identifying potential strengths and vulnerabilities related to child and caregiver factors.

Language ability in 5-12-year-old children with new-onset epilepsy

PURPOSE

This clinically based study aimed to explore and describe language ability in 5-12-year-old children with new-onset epilepsy.Participants and methods: Twenty-one consecutively recruited children (eleven boys, ten girls) with new-onset epilepsy, were assessed using Clinical Evaluation of Language Fundamentals, fourth edition (CELF-4) and additional tests for verbal fluency/word retrieval and phonology. In addition, caregivers rated their child's speech, language, and communication in everyday context. Based on available tests and clinical observation, an overall evaluation of language ability was made to distinguish children with language disorders and children with language difficulties from those with language abilities within the normal range. Language disorder was diagnosed following the ICD-10 criteria. The cutoff for language difficulties was set at 1 standard deviation below the normative mean on the CELF-4 Core Language Score and additional indices.

RESULTS

Out of twenty-one children, ten (47.5%) met the criteria for a language disorder diagnosis according to ICD-10. Another five (24%) had language difficulties but did not meet the criteria for a language disorder diagnosis according to ICD-10. Hence a total of fifteen (71.5%) children had an impaired language ability affecting different domains of language, including receptive language, language memory, and semantic processing. The remaining six (28.5%) children had average language ability.

CONCLUSION

In this group of children with new-onset epilepsy, a large over-representation of co-existing language disorder and language difficulties was found. The findings suggest that specific language assessments for children with new-onset epilepsy are needed, to ensure that adequate interventions and support can be offered.

Microstructural Properties of the Cerebellar Peduncles in Children With Developmental Language Disorder

Children with developmental language disorder (DLD) struggle to learn their native language for no apparent reason. While research on the neurobiological underpinnings of the disorder has focused on the role of corticostriatal systems, little is known about the role of the cerebellum in DLD. Corticocerebellar circuits might be involved in the disorder as they contribute to complex sensorimotor skill learning, including the acquisition of spoken language. Here, we used diffusion-weighted imaging data from 77 typically developing and 54 children with DLD and performed probabilistic tractography to identify the cerebellum's white matter tracts: the inferior, middle, and superior cerebellar peduncles. Children with DLD showed lower fractional anisotropy (FA) in the inferior cerebellar peduncles (ICP), fiber tracts that carry motor and sensory input via the inferior olive to the cerebellum. Lower FA in DLD was driven by lower axial diffusivity. Probing this further with more sophisticated modeling of diffusion data, we found higher orientation dispersion but no difference in neurite density in the ICP of children with DLD. Reduced FA is therefore unlikely to be reflecting microstructural differences in myelination, rather the organization of axons in these pathways is disrupted. ICP microstructure was not associated with language or motor coordination performance in our sample. We also found no differences in the middle and superior peduncles, the main pathways connecting the cerebellum with the cortex. To conclude, it is not corticocerebellar but atypical olivocerebellar white matter connections that characterize DLD and suggest the involvement of the olivocerebellar system in speech and language acquisition and development.

Exploring the Psychosocial Experiences of Individuals with Developmental Language Disorder During Childhood: A Qualitative Investigation

Children with Developmental Language Disorder (DLD) often experience co-occurring psychosocial difficulties, the developmental trajectories of which are still not fully understood. This study sought to explore the manifestation of such difficulties during childhood, through first-hand accounts of those with DLD and their close relatives. Individual semi-structured interviews were conducted with 11 mothers of children with DLD (aged 6-12 years old) and were analysed alongside the secondary data from interviews of five adults with DLD. Interviews were conducted online; all participants resided in Europe and were fluent in spoken and written English. A process of interpretive phenomenological analysis resulted in the development of five overall themes: experiencing anxiety, social frustrations, maintaining factors, childhood strengths and the parenting experience. Cognitive appraisals appeared particularly important during childhood in both escalating and maintaining anxiety, low self-esteem, emotion dysregulation and social frustrations. High levels of isolation and stress were experienced by all mothers. The findings suggest parents in the United Kingdom and Ireland require more support and guidance at the point of diagnosis than is currently provided. Emphasis was given to the link between children's experience of anxiety and social behaviours, such as withdrawal, as well as their intolerance of uncertainty. Internalising symptoms were a prioritisation for intervention during childhood by both parents and adults with DLD.

The grammaticality judgement of inflectional morphology in children with and without Developmental Language Disorder

To explore the clinical potential of grammaticality judgement tasks, this study investigated whether a Grammaticality Judgment Task (GJT) of inflectional morphology could differentiate between a clinically selected sample of children with DLD and children in mainstream (i.e. regular education) schools. We also explored the relationship between grammaticality judgement and measures of receptive vocabulary, receptive grammar, and nonword repetition. Children with DLD (n = 30; age range = 69-80 months) and mainstream children in Pre-primary, Year 1, and Year 2 (n = 89, age range = 61-96 months) were assessed on a GJT of regular past tense, third person singular, and possessive 's. The GJT was sensitive to developmental differences in mainstream children and differentiated children with DLD from Year 1 and 2 mainstream children, with DLD results consistent with a one-year delay in performance compared to controls. The GJT was the strongest discriminator of membership to a clinically selected sample of children with DLD (ROC curve analysis, area under the curve = 88%). Receptive grammar, receptive vocabulary, and nonword repetition were related to performance on the GJT. The grammaticality judgement of inflectional morphology shows promise as a reliable indicator of DLD and a measure sensitive to developmental differences in mainstream children. GJTs should continue to be explored for clinical application as a potential tool for both assessment and intervention.

LanguageScreen: The Development, Validation, and Standardization of an Automated Language Assessment App

PURPOSE

Oral language skills provide a critical foundation for formal education and especially for the development of children's literacy (reading and spelling) skills. It is therefore important for teachers to be able to assess children's language skills, especially if they are concerned about their learning. We report the development and standardization of a mobile app-LanguageScreen-that can be used by education professionals to assess children's language ability.

METHOD

The standardization sample included data from approximately 350,000 children aged 3;06 (years;months) to 8;11 who were screened for receptive and expressive language skills using LanguageScreen. Rasch scaling was used to select items of appropriate difficulty on a single unidimensional scale.

RESULTS

LanguageScreen has excellent psychometric properties, including high reliability, good fit to the Rasch model, and minimal differential item functioning across key student groups. Girls outperformed boys, and children with English as an additional language scored less well compared to monolingual English speakers.

CONCLUSIONS

LanguageScreen provides an easy-to-use, reliable, child-friendly means of identifying children with language difficulties. Its use in schools may serve to raise teachers' awareness of variations in language skills and their importance for educational practice.

A randomised controlled trial of the effectiveness of parent-based models of language intervention for 2- to 3-year-old children with speech, language and communication needs (SLCN) in areas of social disadvantage

BACKGROUND

Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self-perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing.

AIMS

To compare the impact of standard parent-based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations.

METHODS AND PROCEDURES

A multicentre clustered blind randomised controlled trial was used to compare the effect of parent-based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20-week period. Participants received one of two interventions: (1) Standard Care - indirect group PBI - (PBI) (2) Enhanced Care: indirect group enhanced PBI - (EPBI). Both standardised and non-standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure - Speech & Language Therapy (PAM-SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well-being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development.

OUTCOMES AND RESULTS

One hundred fifty-five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur-Bates Communicative Development Inventories Sentence Length, from pre-intervention to post-intervention and 6 months post-intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval -0.02 to 0.76), although wide variation was found.

CONCLUSIONS AND IMPLICATIONS

This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents.

WHAT THIS PAPER ADDS

What is already known on the subject Speech, language and communication needs (SLCN) have a knock-on effect on emotional well-being, school readiness, literacy and school attainment, putting children at increased risk of long-term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self-perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work? This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes.

Enhancing social-emotional functioning in adolescents with developmental language disorder or deaf or hard of hearing through a Theory of Mind intervention

BACKGROUND

This study examines the effect of a Theory of Mind (ToM) intervention on ToM abilities and social-emotional functioning in adolescents with developmental language disorder (DLD) or who are deaf/hard of hearing (D/HH). It emphasizes the importance of self-reflection and measurement for personal growth. The research design incorporates both subjective and objective measures to evaluate the intervention's efficacy.

AIMS

To investigate the impact of the ToM intervention on ToM abilities and social-emotional functioning in adolescents with DLD or who are D/HH. It hypothesizes that participants in the intervention groups will show improved ToM and social-emotional functioning compared with those in the control groups.

METHODS & PROCEDURES

Adolescents with DLD or who are D/HH were recruited through collaboration with educational institutions. The study utilized a pre-/post-test design, assigning participants to either the intervention or the control group. The ToM intervention involved targeted activities to enhance ToM abilities. ToM abilities and social-emotional functioning were assessed using standardized tests and self-report questionnaires. Statistical analyses compared outcomes between the intervention and no intervention groups.

OUTCOMES & RESULTS

The findings reveal subjective improvements in social-emotional functioning among the D/HH intervention group. However, no significant effects on objective ToM measures were observed. These results highlight the need for further investigation and refinement of interventions in these areas. Future research should focus on improving intervention strategies and exploring additional objective measures to gain a comprehensive understanding of the intervention's impact on ToM and social-emotional functioning in this population.

CONCLUSIONS & IMPLICATIONS

The ToM intervention shows subjective benefits in improving social-emotional functioning among D/HH adolescents. However, it does not yield significant effects on objective ToM measures. These findings emphasize the ongoing need to refine interventions targeting ToM abilities and social-emotional functioning in this population. Future studies should explore alternative strategies and incorporate additional objective measures to enhance understanding and outcomes.

WHAT THIS PAPER ADDS

What is already known on this subject Before this study, it was known that ToM interventions have the potential to enhance ToM abilities. However, the specific effects of such interventions on subjective and objective measures for ToM and social-emotional functioning in adolescents with DLD or who are D/HH remained unclear, necessitating further research. What this paper adds to the existing knowledge This study adds to the existing knowledge by demonstrating subjective improvements in social-emotional functioning among adolescents who are D/HH and underwent a ToM intervention. However, no significant effects on objective ToM measures were observed. These findings highlight the need for refining interventions and exploring additional measures to better understand the intervention's impact. What are the potential or actual clinical implications of this work? The subjective improvements in social-emotional functioning observed in this study have important clinical implications. They suggest that ToM interventions can positively impact the social well-being of adolescents who are D/HH. However, the lack of significant effects on objective ToM measures emphasizes the need for further research and intervention refinement to address specific areas of improvement in this population.

Measuring Vocal Fatigability in Teachers: The Vocal Fatigability Scale for Teachers (VFS-T)

OBJECTIVES

This study focuses on the distinction between vocal fatigability and vocal fatigue (VF), highlighting the importance of vocal fatigability when assessing teachers' quality of life. Vocal fatigability is more critical for quality of life than performance or perceived VF because it considers the accumulation and chronicity of fatigue over isolated tasks. The objectives are to develop and validate the Vocal Fatigability Scale for Teachers (VFS-T), to assess teachers' levels of vocal fatigability, and to analyze variations based on personal and occupational traits. The VFS-T construct encompasses items related to vocal sensations and performance, their connection to accumulated demanding vocal activity, descriptions of recovery strategies, necessary rest periods, and the impact of VF on daily activities.

STUDY DESIGN

A single cross-sectional study with an ex post facto design was conducted.

METHODS

The sample consisted of 184 active teachers with various vocal conditions. They completed the VFS-T questionnaire, provided personal and occupational data, and completed the VHI-10 questionnaire. The data collected were analyzed for item refinement, internal structure, reliability, validity, diagnostic capacity, cutoff values, and group differences.

RESULTS

The item refinement and internal structure analysis revealed a scale comprising 17 items grouped into two factors. The VFS-T shows good reliability and validity, with cutoffs at <15 for no fatigability, 15-27 for moderate fatigability, and >28 for high fatigability. Most teachers fall into the moderate fatigability range, with 72% experiencing vocal fatigability.

CONCLUSIONS

The VFS-T is a reliable tool for detecting vocal fatigability in teachers. This scale focuses on the construct of vocal fatigability, which is related to chronicity of VF and limitations in daily activities in teachers.

Cognitive vs. Linguistic Training in Children with Developmental Language Disorder: Exploring Their Effectiveness on Verbal Short-Term Memory and Verbal Working Memory

The present study explores comparatively the effectiveness of a cognitive (verbal short-term memory (vSTM), verbal working memory (vWM)) and of a linguistic training (10-week duration each) in the diffusion of gains in cognitive abilities (vSTM and vWM) of in school-aged Greek-speaking children with developmental language disorder (DLD). To this purpose, two computerized training programs i.e., a linguistic and a cognitive one, were developed and applied to three groups (A, B, and C) of children with DLD (N = 49, in total). There were three assessments with two vSTM tasks (non-word repetition and forward digit span) and a vWM task (backward digit span): pre-therapeutically (time 1), where no significant between-group differences were found, post-therapeutically I (time 2), and post-therapeutically II (time 3) and two training phases. In phase Ι, group A received meta-syntactic training, whereas group B vSTM/vWM training and group C received no training. In phase ΙΙ, a reversal of treatment was performed for groups A and B: group A received vSTM/vWM while group B meta-syntactic training. Again, group C received no training. Overall, the results indicated a significant performance improvement for the treatment groups and revealed beneficial far-transfer effects as language therapy can affect vSTM and vWM in addition to direct and near transfer effects. In addition, the intervention type order affected performance as follows: first, better performance on the vSTM task (non-word repetition) was shown when the linguistic treatment was delivered first; second, better performance on the vWM in Time 2 and Time 3 was shown by group B, for which the cognitive treatment was delivered first. Concluding, not only intervention type but also intervention type order can affect performance in DLD.

Low-Level Auditory Processing Correlates With Language Abilities: An ERP Study Investigating Sequence Learning and Auditory Processing in School-Aged Children

Auditory processing and procedural learning deficits have been associated with language learning difficulties. We investigated the relationship of these skills and school-age language abilities in children with and without a history of late talking using auditory event related potentials (ERPs). Late talking (i.e., slow early language development) increases the risk of persistent language difficulties, but its causes remain unknown. Participants in this study were children with varying language abilities (n = 60). Half of the participants (n = 30) had a history of late talking. We measured procedural learning by manipulating the predictability of sine tone stimuli in a passive auditory ERP paradigm. Auditory processing was tested by examining how the presence of noise (increasing perceptual demands) affected the ERPs. Contrary to our hypotheses on auditory processing and language development, the effect of noise on ERPs did not correlate with school-age language abilities in children with or without a history of late talking. Our paradigm failed to reveal interpretable effects of predictability leaving us unable to assess the effects of procedural learning. However, better language abilities were related to weaker responses in a 75-175 ms time window, and stronger responses in a 150-250 ms time window. We suggest that the weak early responses in children with better language ability reflect efficient processing of low-level auditory information, allowing deeper processing of later, high-level auditory information. We assume that these differences reflect variation in brain maturation between individuals with varying language abilities.

Zoti's Social Toolkit: Developing and piloting novel animated tasks to assess emotional understanding and conflict resolution skills in childhood

Current methods used to investigate emotional inference and conflict resolution knowledge are limited in their suitability for use with children with language disorders due to a reliance on language processing. This is problematic, as nearly 8% of the population are estimated to have developmental language disorder (DLD). In this paper, we present 'Zoti's Social Toolkit', a set of animated scenarios that can be used to assess emotion inferencing and conflict resolution knowledge. All animated scenarios contain interpersonal situations centred around a gender-neutral alien named Zoti. Four studies investigated the face and construct validity of the stimuli. The final stimulus set can be used with children, who may or may not have language difficulties and is openly available for use in research.

A higher proportion of children aged 4 years were referred to speech and language therapists after the introduction of a new language screening tool

AIM

Language difficulties in children can have enduring impacts on their academic and emotional well-being. Consequently, early identification and intervention are critical. This study aimed to investigate the impact of introducing Språkfyran, a language screening tool, on the identification and referral rates for speech and language assessment compared to the previous method.

METHODS

An observational study was conducted in Gotland, Sweden, using the medical records of 3537 children (53% boys) who were 3-4 years of age. The study period lasted between 5 January 2016 and 29 April 2022, encompassing data collection both before and after the introduction of Språkfyran.

RESULTS

Following the introduction of Språkfyran, 15% failed the screening, compared to 20% with the previous speech test. However, referrals for assessment increased significantly with Språkfyran, rising to 7% compared to 3% with the speech test.

CONCLUSION

The proportion of children who failed the Språkfyran screening was consistent with findings from previous studies. Children who failed the screening were more likely to be referred for speech and language assessment after the introduction of Språkfyran. This indicates that Språkfyran is a clinically relevant tool that promotes children's language development through increased referral rates.

Verb Vocabulary Supports Event Probability Use in Developmental Language Disorder

PURPOSE

Children with developmental language disorder (DLD) tend to interpret noncanonical sentences like passives using event probability (EP) information regardless of structure (e.g., by interpreting "The dog was chased by the squirrel" as "The dog chased the squirrel"). Verbs are a major source of EP information in adults and children with typical development (TD), who know that "chase" implies an unequal relationship among participants. Individuals with DLD have poor verb knowledge and verb-based sentence processing. Yet, they also appear to rely more on EP information than their peers. This paradox raises two questions: (a) How do children with DLD use verb-based EP information alongside other information in online passive sentence interpretation? (b) How does verb vocabulary knowledge support EP information use?

METHOD

We created novel EP biases by showing animations of agents with consistent action tendencies (e.g., clumsy vs. helpful actions). We then used eye tracking to examine how this EP information was used during online passive sentence processing. Participants were 4- to 5-year-old children with DLD (n = 20) and same-age peers with TD (n = 20).

RESULTS

In Experiment 1, children with DLD quickly integrated verb-based EP information with morphosyntax close to the verb but failed to do so with distant morphosyntax. In Experiment 2, the quality of children's sentence-specific verb vocabulary knowledge was positively associated with the use of EP information in both groups.

CONCLUSION

Depending on the morphosyntactic context, children with DLD and TD used EP information differently, but verb vocabulary knowledge aided its use.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25491805.

Testing the Continuum/Spectrum Model in Russian-Speaking Children With and Without Developmental Language Disorder

PURPOSE

Previously, Lancaster and Camarata (2019) showed that the continuum/spectrum model of the developmental language disorder (DLD) best explained the high heterogeneity of symptoms in children with DLD. We hypothesize that the continuum/spectrum approach can include not only children with DLD but also typically developing (TD) children with different timelines and patterns of language acquisition. This model can explain individual language profiles and deficits in children.

METHOD

We assessed language abilities in a group of Russian-speaking children with DLD aged 4-7 years (n = 53) and their age- and gender-matched peers without speech and language diagnoses (n = 53, TD). We evaluated the children's performance at four language levels in production and comprehension domains, using 11 subtests of the standardized language assessment for Russian: Russian Child Language Assessment Battery (RuCLAB). Using the k-means cluster method and RuCLAB scores, we obtained two clusters of children and analyzed their language performance in individual subtests.

RESULTS

The analysis revealed that the two clusters of children both included DLD and TD participants: Group 1, with higher test scores (TD = 45, DLD = 24 children), and Group 2, with lower scores (TD = 8, DLD = 29). Children from Group 1 mostly had lower scores at one of the language levels, whereas those from Group 2 struggled at several language levels. Furthermore, children with DLD from both groups tended to be more sensitive to linguistic features such as word length, noun case, and sentence reversibility compared to TD children.

CONCLUSIONS

The presence of two mixed groups shows that children with diagnosed DLD could perform on par with TD children, whereas some younger TD children could perform similarly to children with DLD. Our findings support the continuum/spectrum model: Linguistic skills in preschool children are a continuum, varying from high to poor skills at all language levels in comprehension and production. To describe a child's language profile, the tasks assessing all language levels should be used.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25521400.

Exploring the Views, Perspectives, and Current Practices of Educational Speech-Language Pathologists and Psychologists in Canada: How Childhood Developmental Language Disorders Are Identified and Diagnosed

PURPOSE

Across Canada, speech-language pathologists (SLPs) and educational psychologists (EPs) work in schools to identify and diagnose childhood learning difficulties, including language disorders; however, both professional groups use different terms to identify and diagnose them. Using the term developmental language disorder (DLD), developed by the CATALISE consortium, would provide consistency across fields. To effectively implement the use of DLD, it is crucial to understand how EPs and SLPs currently identify childhood language disorders and to investigate the potential impact of a practice change in this area.

METHOD

The study conducted 13 moderated focus groups and one one-on-one semistructured interview across six Canadian provinces in English and French.

RESULTS

We found some social and structural barriers that impact SLPs' and EPs' current practice of identifying and diagnosing language disorders generally (e.g., the belief that children should not be labeled "too early," institutions that prioritize certain professional diagnoses over others, board policies that do not allocate funds for language disorders, professionals' reticence to convey difficult information such as a diagnosis to collaborators) and DLD specifically (e.g., different professional taxonomies, lack of familiarity with or uncertainty about the label, not recognized as a condition in schools that may or may not even identify language disorder as a category of exceptionality). Nevertheless, the focus groups also revealed the extent to which DLD could be useful in their current practice.

CONCLUSION

Both EPs and SLPs acknowledged the importance of working together; therefore, DLD could inspire more collaborative practice between SLPs and EPs around language disorders.

Working Toward Recommended Terminology in the Canadian Preschool Speech-Language Pathology Context

PURPOSE

This quality improvement project aimed to address the inconsistent use of clinical labels across a preschool speech and language program in Ontario, Canada. The study investigated whether a multicomponent knowledge translation (KT) intervention could increase speech-language pathologists' (SLPs') knowledge about the recommended clinical labels, motivate their intentions to use the labels, and facilitate practice change during a 3-month pilot period.

METHOD

The diffusion of innovations theory was utilized to identify and address known and suspected barriers and facilitators that could influence the adoption of consistent terminology. The intervention was evaluated using a pre-experimental study design (with pre, post, and follow-up testing) and included two phases: Phase 1 involved the pretraining survey, KT intervention, and posttraining survey, and Phase 2 included an exit survey after a 3-month pilot period.

RESULTS

Five hundred twenty-nine SLPs in Phase 1 and 387 SLPs in Phase 2 participated. Following the web-based intervention, SLPs demonstrated improved knowledge about the recommended labels with most indicating intentions to communicate the labels going forward. SLPs also reported increased comfort using labels and positive views on their importance and value. After the 3-month pilot period, SLPs' reported use of most recommended labels decreased, as did ratings of comfort, value, and importance. However, most SLPs reported intentions to use the labels going forward.

CONCLUSIONS

Despite having intentions to adopt the recommended labels, the lack of implementation by SLPs suggests the presence of additional barriers impacting their use of the recommended clinical labels in practice. Future work should investigate clinician-identified barriers to inform future implementation efforts.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25254940.

Identifying and describing developmental language disorder in children

BACKGROUND

In 2016-17 an important consensus was established regarding the use of the diagnostic label 'developmental language disorder' (DLD) to describe children with a persistent language problem having a functional impact on communication or learning and in the absence of any other biomedical condition. Despite this consensus, past research has revealed ongoing uncertainty regarding when to use the DLD label among speech-language pathologists (SLPs).

AIMS

In response to this uncertainty, a survey of SLPs was conducted aimed at investigating which types of clinical language profiles, and specific assessment results, were viewed as warranting the diagnostic label DLD.

METHODS & PROCEDURES

SLPs were presented with 10 childhood language profiles and assessment results. Participants reviewed each case and described if they felt a diagnosis of DLD was warranted, which presented symptoms were consistent/inconsistent with DLD and if further information/testing was desired. Additionally, participants provided details regarding their personal diagnostic processes.

OUTCOMES & RESULTS

Results indicated a general consensus among SLPs as to when the DLD label should be applied. However, free-text responses demonstrated considerable variation between clinicians regarding symptoms of importance, points of contention/confusion in language profiles and minimal assessment results viewed as necessary in the diagnostic process.

CONCLUSIONS & IMPLICATIONS

This detailed look at the assessment/diagnostic process for DLD provides valuable insight into how to build further practice consistency in the provision of the diagnostic label DLD, especially in cases of complex language profiles and assessment results.

WHAT THIS PAPER ADDS

What is already known on this subject The label DLD should be used as a diagnostic label to describe children with persistent language problems having a functional impact on communication or learning and in the absence of any biomedical condition. However, in current clinical practice, actual use of the label is inconsistent and SLPs face a number of challenges in diagnosing DLD. What this paper adds to the existing knowledge This investigation provides clarity regarding which complexities in paediatric language profiles are most challenging for SLPs when determining if a child does/does not have DLD. Additionally, details regarding current assessment beliefs and practices are explored. What are the practical and clinical implications of this work? By providing a detailed look at the diagnostic processes of practising SLPs, valuable insight is provided into how to build further practice consistency and confidence in the provision of the diagnostic label DLD, especially in cases of complex language profiles and assessment results.

Exploring Spanish writing abilities of children with developmental language disorder in expository texts

Introduction

Numerous studies have shown that children with developmental language disorder (DLD), in addition to oral language difficulties, exhibit impaired writing abilities. Their texts contain problems in grammar, organization, cohesion, and length of written output. However, most of these studies have been conducted with English speakers. English is characterized by complex phonological structure, opaque orthography, poor morphology and strict word order. The aim of this research is to observe the writing abilities of children with DLD in a language with simple phonological structure, transparent orthography, rich morphology and flexible word order like Spanish in the production of expository texts.

Methods

Twenty-six children with DLD (mean age in months = 128.85) and 26 age-and sex-matched typically developing (TD) children (mean age in months = 124.61) wrote an expository text about their favorite animal.

Results

In order to analyze how the two groups plan and encode written texts, we looked at word frequency and sentence structure, grammatical complexity and lexical density, and omissions and errors. Compared to the TD group, the children with DLD omitted more content words; made more errors with functional words, verb conjugation and inflectional morphemes, and made a large number of spelling errors. Moreover, they wrote fewer words, fewer sentences, and less structurally and lexically complex texts.

Discussion

These results show that children with DLD who speak a transparent orthography language such as Spanish also have difficulties in most language areas when producing written texts. Our findings should be considered when planning and designing interventions.

A comparison of learning and retention of a syntactic construction between Cantonese-speaking children with and without DLD in a priming task

Procedural circuit Deficit Hypothesis (PDH) of Developmental Language Disorder (DLD) predicts problems with learning and retention of grammar. Twenty 7- to 9-year-old Cantonese-speaking children with DLD and their typically developing (TD) age peers participated in a syntactic priming task that was given in two sessions one week apart. Production of Indirect Object Relative Clause (IORC) was tested using a probe test before and after the priming task, and one week later. The study involved two cycles of learning and retention, and two levels of prior knowledge. Bayesian linear mixed effects modelling was used for data analysis. Children with DLD learned, and possibly retained, IORC less well than TD children after age, working memory and general grammatical knowledge were controlled for. No interaction effects were significant, meaning that cycle and prior knowledge affected both groups similarly in learning and retention. Results were discussed in relation to PDH and the Complementary Learning Systems Theory.

A maturational frequency discrimination deficit may explain developmental language disorder

Auditory perceptual deficits are widely observed among children with developmental language disorder (DLD). Yet, the nature of these deficits and the extent to which they explain speech and language problems remain controversial. In this study, we hypothesize that disruption to the maturation of the basilar membrane may impede the optimization of the auditory pathway from brainstem to cortex, curtailing high-resolution frequency sensitivity and the efficient spectral decomposition and encoding of natural speech. A series of computational simulations involving deep convolutional neural networks that were trained to encode, recognize, and retrieve naturalistic speech are presented to demonstrate the strength of this account. These neural networks were built on top of biologically truthful inner ear models developed to model human cochlea function, which-in the key innovation of the present study-were scheduled to mature at different rates over time. Delaying cochlea maturation qualitatively replicated the linguistic behavior and neurophysiology of individuals with language learning difficulties in a number of ways, resulting in (a) delayed language acquisition profiles, (b) lower spoken word recognition accuracy, (c) word finding and retrieval difficulties, (d) "fuzzy" and intersecting speech encodings and signatures of immature neural optimization, and (e) emergent working memory and attentional deficits. These simulations illustrate many negative cascading effects that a primary maturational frequency discrimination deficit may have on early language development and generate precise and testable hypotheses for future research into the nature and cost of auditory processing deficits in children with language learning difficulties. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Social media use by young people with language disorders: a scoping review

PURPOSE

Social media are widely used by young people (YP), but how YP with language disorders use social media for social interaction remains insufficiently studied. This article provides an overview of the research on social media use by YP with language disorders.

MATERIALS AND METHODS

A scoping review was conducted, guided by a five-stage framework. Ten databases were searched (CENTRAL, CINAHL, ERIC, LLBA, Medline, PsychINFO, Scopus, speechBITE, Web of Science, ProQuest Dissertations & Theses Global). Chaining searches of papers identified for inclusion were conducted.

RESULTS

After screening 199 unique papers, 44 were included. Findings revealed that YP with language disorders use social media less compared to typically developing peers; their profile of communication difficulties may impact the types of social media with which they engage. Although intervention studies are limited, the results offer encouraging findings regarding the positive impact of support for use of social media. Barriers and facilitators for social media use are identified.

CONCLUSIONS

YP with language disorders use social media for social purposes. However, co-designed research into what YP with language disorders perceive their social media needs to be is urgently needed. How to support YP with language disorders to use social media is subject to future investigation.

A Word-Learning Intervention Pilot Study Utilizing Principles of Retrieval- and Criterion-Based Learning for Children With Developmental Language Disorder

PURPOSE

Vocabulary knowledge at school entry provides an essential foundation for academic and literacy learning. Thus, school entry is an important timepoint to support word learning by children with developmental language disorder (DLD). Retrieval-based training strategies support both learning and retention of words for individuals with DLD in lab-based research. Additionally, lab-based research with adults with typical development demonstrates that pairing retrieval- and criterion-based training strategies supports learning efficiency. Currently, it is unclear if retrieval- and criterion-based training in word-learning interventions is feasible and effective for children with DLD.

METHOD

In this pilot study, we taught preschool- and kindergarten-age children with DLD (N = 7) words in an intervention format. We implemented retrieval-based training in that children were asked to retrieve and produce the forms and meanings of words. We also implemented a criterion-based approach. Words were targeted until the child retrieved the form and meaning of a word at the beginning of two sessions. We assessed learning at the end of training and retention after 2- and 8-week post-training delays.

RESULTS

The retrieval- and criterion-based approach was effective to support word learning for six of the seven children. Children demonstrated better learning and retention of forms than meanings. Additionally, achieving criterion with a word during training was positively related to post-training retention.

CONCLUSIONS

A retrieval- and criterion-based approach is likely to support word learning during interventions for children with DLD. We include suggestions for future research to improve the effective and efficient implementation of these approaches.

Exploring clinical reasoning in child language assessment through decoloniality

PURPOSE

Clinical reasoning has been taught, practised, and researched under Western epistemologies, which have been fallible in addressing the complexity of clinical reasoning within Indigenous cultures and societies. We explored how speech-language pathologists in Sri Lanka negotiate and value Indigenous and Western perspectives in clinical reasoning within a decolonial framework.

METHOD

This study used participatory research methodology within the decolonised qualitative research paradigm to produce data collaboratively with eight Sri Lankan speech-language pathologists. Oral history narratives and object-based textual reflections generated the necessary data for the study. Systematic visual-textual analysis and reflexive thematic analysis were carried out iteratively, and the data analysis and interpretation were undertaken collaboratively with the participants.

RESULT

We generated four key themes about professional education, individuality in practice, holistic thinking, and balancing interests and priorities. The results demonstrate that social, political, and economic forces impact practitioners' clinical reasoning.

CONCLUSION

Practising science in its original form within Indigenous contexts is challenging. Colonial roots and imperialism impact the delivery of appropriate services in socially and politically marginalised communities. Practitioners' self-awareness about authentic identities and practical wisdom can develop culturally relevant knowledge for equitable practice.

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

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

Genetic outcomes in children with developmental language disorder: a systematic review

Introduction

Developmental language disorder (DLD) is a common childhood condition negatively influencing communication and psychosocial development. An increasing number of pathogenic variants or chromosomal anomalies possibly related to DLD have been identified. To provide a base for accurate clinical genetic diagnostic work-up for DLD patients, understanding the specific genetic background is crucial. This study aims to give a systematic literature overview of pathogenic variants or chromosomal anomalies causative for DLD in children.

Methods

We conducted a systematic search in PubMed and Embase on available literature related to the genetic background of diagnosed DLD in children. Included papers were critically appraised before data extraction. An additional search in OMIM was performed to see if the described DLD genes are associated with a broader clinical spectrum.

Results

The search resulted in 15,842 papers. After assessing eligibility, 47 studies remained, of which 25 studies related to sex chromosome aneuploidies and 15 papers concerned other chromosomal anomalies (SCAs) and/or Copy Number Variants (CNVs), including del15q13.1-13.3 and del16p11.2. The remaining 7 studies displayed a variety of gene variants. 45 (candidate) genes related to language development, including FOXP2, GRIN2A, ERC1, and ATP2C2. After an additional search in the OMIM database, 22 of these genes were associated with a genetic disorder with a broader clinical spectrum, including intellectual disability, epilepsy, and/or autism.

Conclusion

Our study illustrates that DLD can be related to SCAs and specific CNV's. The reported (candidate) genes (n = 45) in the latter category reflect the genetic heterogeneity and support DLD without any comorbidities and syndromic language disorder have an overlapping genetic etiology.

Eligibility Determinations for Speech and Language Services in U.S. Public Schools: Experiences and Tensions

PURPOSE

The purpose of this study was to examine school speech-language pathologists' (SLPs) experiences regarding students' eligibility for services in public schools within the United States.

METHOD

Fifteen school SLPs participated in online focus groups to examine the complex nature of SLPs' participation within decision-making teams and describe practice experiences in U.S. schools. SLPs worked in one to 10+ schools serving students from pre-K through 12th grade. Data were analyzed using Cultural-Historical Activity Theory (CHAT; Engeström, 2015).

RESULTS

School SLPs' practice is impacted by rules, community, and division of labor in schools. Participants discussed the following: culture of the work setting, interaction between team members, desire to assist families and children, knowledge of regulations, evaluation practices, and the impact of poverty, and cultural and linguistic differences. Nine major tensions were identified: need for greater SLP empowerment and advocacy, documentation of educational impact, complexities of students learning English as an additional language, concerns about evaluation data for decision making, SLPs' concerns regarding outcomes of eligibility decision making, overuse of speech-language impairment for students who do not qualify, parents' involvement in decision making, disagreement between team members, and administrations' adherence to rules.

CONCLUSIONS

Within the schools, the CHAT framework was useful to identify tensions and opportunities for change at the individual and institutional levels, impacting team decision making for eligibility, SLPs' provision of services, and student outcomes. Acknowledgment of tensions and opportunities for change regarding students' eligibility for services may guide public policy; preservice training; and individual, local, and national advocacy.

Communication in Daily Life of Children With Developmental Language Disorder: Parents' and Teachers' Perspectives

PURPOSE

This study explores limitations in communication in daily life of children with developmental language disorder (DLD) from their parents' perspective as well as communicative abilities and social functioning in the classroom from their teacher's perspective. Furthermore, differences between children with mixed receptive-expressive disorder and children with expressive-only disorder in communication in daily life and social functioning are studied.

METHOD

Data were collected through questionnaires completed by parents and teachers of children (5-6 years old) who attended schools for special education for DLD. Language test scores were retrieved from school records. Parents of 60 children answered open-ended questions about situations and circumstances in which their child was most troubled by language difficulties. Teachers of 83 children rated communicative abilities, social competence, and student-teacher relationship.

RESULTS

Parents reported communication with strangers as most troublesome and mentioned the influence of the mental state of their child. Parents considered limitations in expressing oneself and being understood and not being intelligible as core difficulties. Teachers rated the children's communicative abilities in the school context as inadequate, but their scores concerning social competence and the quality of teacher-child relationships fell within the normal range. Children with receptive-expressive disorder experienced limitations in communication in almost all situations, whereas those with expressive disorder faced limitations in specific situations. Children with receptive-expressive disorder were also significantly more limited in their communicative abilities and social competence at school than children with expressive disorder. No differences were found between the two groups in the quality of the teacher-child relationship.

CONCLUSIONS

The results confirm that children with DLD face significant challenges in a variety of communicative situations. We found indications that children with receptive-expressive disorder experience more severe limitations than children with expressive disorder. The involvement of parents and teachers in evaluating a child's communicative ability provides valuable and clinically relevant information.

Do parent-reported early indicators predict later developmental language disorder? A Raine Study investigation

BACKGROUND

Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD.

AIMS

To test the predictive relationship between parent-reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population-based sample.

METHODS

Data were leveraged from the prospective Raine Study (n = 1626 second-generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well-established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years.

RESULTS

No single parent-reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85-1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59-1.32, p = 0.563) were also non-significant.

CONCLUSIONS

Parent reports of early indicators of DLD are well-intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed.

WHAT THIS PAPER ADDS

What is already known on the subject DLD is a relatively common childhood condition; however, children with DLD are under-identified and under-served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge No one parent-reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work? The broad dissemination and use of 'red flags' is well-intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation-based interventions.

Is language impaired in Spanish-speaking children with autism spectrum disorder level 1?

The current diagnostic criteria for the autism spectrum disorder (ASD) include the possibility to specify concomitant language difficulties.

Purpose

Our main aim was to explore whether children with ASD-Level 1 (ASD-L1) present difficulties in the acquisition of structural language, as little work has been done in this regard so far. As a secondary aim we evaluated the degree to which the potential language impairment in ASD is directly associated with their social communication deficits or it represents a distinct deficit.

Methods

To further clarify the nature and characteristics of putative language difficulties in ASD-L1, we evaluated language skills in 89 children and preadolescents diagnosed with ASD-L1, and a group of typically developing participants (TD). All of them were between 8 and 13 years old and had similar socioeconomic backgrounds.

Results

Children with ASD-L1 obtained lower scores than those in TD group in repeating sentences, in finding the semantic relationships between words, and in applying word structure rules (morphology). Congruently, the core language standard score was lower in the ASD-L1 group, and the proportion of language delay was significantly higher in the ASD-L1 group than in the control group.

Conclusion

Language scores were associated with autistic traits; thus, language performance in ASD-L1 is closely related to autistic symptoms. These results are discussed according to the literature on linguistic deficits in ASD-L1 and their relations with phonological working memory.

How do children with language disorder perceive their peer interactions? A qualitative investigation

Background and aims

Peer interaction difficulties are often elevated amongst children with language disorders, yet the mechanisms underlying these difficulties are unclear. Previous research indicates that poor conflict management, social withdrawal, emotion regulation difficulties, and reduced prosocial behavior may contribute to peer interaction difficulties. However, this research often uses adult perspectives, failing to acknowledge child perceptions of these experiences. The present study aimed to qualitatively investigate perceptions of peer interactions from the perspective of children with language disorders.

Methods

Seven participants aged between 7- and 10-years-old took part. All participants were diagnosed with a language disorder and had language as their primary area of difficulty. Participants were recruited from a specialist language school and via an online database. Semi-structured interviews were conducted, with participants given the choice to answer questions verbally or creatively, using toys or drawing materials. Interview transcripts were analyzed using interpretative phenomenological analysis.

Results

Participants valued play, conversation, and helping others. They felt that spending time with peers could alleviate loneliness. However, sometimes solitude was needed as social interaction could be overwhelming. Participants found conflict challenging and exhibited difficulties with regulating emotions. Participants relied on running away, retaliation, or asking an adult for help, to resolve conflict.

Conclusions and implications

The findings suggest that children with language disorders are socially motivated and have relative strengths in displaying prosocial behavior. However, children with language disorders require support to promote positive relationships. This support includes help with making deeper connections with peers, opportunities to spend time alone when needed, and providing adept conflict resolution and emotion regulation strategies.

Low language capacity in childhood: A systematic review of prevalence estimates

BACKGROUND AND AIMS

Epidemiological studies have provided invaluable insight into the origin and impact of low language skills in childhood and adolescence. However, changing terminology and diagnostic guidelines have contributed to variable estimations of the prevalence of developmental language difficulties. The aim of this review was to profile the extent and variability of low language prevalence estimates through a systematic review of epidemiological literature.

METHODS

A systematic review of the empirical research (August 2022) was undertaken to identify studies that aimed to estimate the prevalence of low language skills in children (<18 years). A total of 19 studies published between 1980-2022 met inclusion criteria for review.

RESULTS

Studies reported prevalence estimates of low language skills in children between 1 and 16 years. Estimated rates varied from 0.4% to 25.2%. More stable estimations were observed in studies of children aged 5 years and older and those that applied updated diagnostic criteria to performance on standardised assessments of receptive and expressive language.

CONCLUSIONS AND IMPLICATIONS

The estimated prevalence of low language skills in childhood varies considerably in the literature. Application of updated diagnostic criteria, including the assessment of functional impact, is critical to inform advocacy efforts and govern social, health and educational policies.

WHAT THIS PAPER ADDS

What is already known on the subject Epidemiological research has informed our understanding of the origin and impact of low language capacity in childhood. Childhood language disorder is met with a rich history of evolving terminology and diagnostic guidelines to identify children with low language skills. Inconsistent definitions of and methods to identify low language in children have resulted in variable prevalence estimates in population-based studies. Variability in prevalence estimates impacts advocacy efforts to inform social, health and educational policy for child language disorder. What this study adds A total of 19 studies published at the time of this review aimed to provide estimates of the proportion of children who experience low language skills. Prevalence estimates varied between 0.4% and 25.2%, with more stable estimates reported in studies of older school-age children and those which utilised standardised assessments of both expressive and receptive language. Few studies utilised assessments of functional impact of language difficulties, which is misaligned with updated diagnostic criteria for child language disorder. What are the clinical implications of this work? This review reports substantial variability in estimates of the proportion of children and adolescents who live with low language skills. This variability underscores the importance of applying updated diagnostic criteria to identify the prevalence low language in childhood. Efforts to estimate the prevalence of low language must include measures of functional impact of low language skills. This aligns with clinical recommendations, which call for routine assessment of functional outcomes. To this end, we require a unified understanding of the term 'functional impact' in the context of low language, including the development and evaluation of measures that assess impact across emotional, social and academic domains.

Selective short-term memory impairment for verbalizable visual objects in children with Developmental Language Disorder

BACKGROUND

Developmental language disorder (DLD) affects the ability to acquire and make use of native language. Possible underlying cognitive mechanisms are related to memory functions.

AIMS

The aim was examination of the relationship between visual short-term memory of objects as well as audiovisual short-term memory, and particular nonverbal and language abilities.

METHODS AND PROCEDURES

The study included 7-9-year-old children with DLD and matched control group. Participants completed the Language Development Test, the Stanford-Binet IQ scale (SB5), and two short-term memory tasks: immediate recall of the visually presented pictograms and immediate recall of audiovisually presented sequences of syllables.

OUTCOMES AND RESULTS

The results revealed diminished levels of short-term visual memory for objects as well as audiovisual memory in children with DLD. However, there were no group differences in the control task of WM.

CONCLUSIONS AND IMPLICATIONS

Results supported the idea of diminished abilities in children with DLD to perform mental operations on verbalizable visual objects. Importantly non-verbal working memory ability, which cannot easily be supported by verbal representations, is at typical levels. This suggests that verbalization ability should be taken into account in the assessment of seemingly non-verbal cognitive functions among children with DLD.

THE USE OF CLASSIFIERS IN VIETNAMESE IN TYPICAL AND ATYPICAL LANGUAGE DEVELOPMENT

The acquisition of numeral classifiers and their associated syntactic structures has been documented and studied in a broad range of East and Southeast Asian languages among typically-developing (TD) young speakers. However, little research has considered how classifiers are acquired by children with developmental language disorder (DLD). The current paper compares and analyzes the development of numeral classifier patterns among a set of Vietnamese speakers, TD and DLD, studied over three years, from kindergarten to second grade. The investigation highlights differences in the performance of children with TD and DLD and describes the areas of classifier use that seem to be most challenging. Children with DLD produced more errors of classifier omission in kindergarten, showed more random alternations in representational forms, and delays in the development of three element classifier structures. Findings are discussed in terms of future directions in the study of classifier use in Vietnamese speakers with DLD.

Spanish Bilingual Morphosyntactic Development in Bilingual Children With and Without Developmental Language Disorder: Articles, Clitics, Verbs, and the Subjunctive Mood

PURPOSE

The purpose of this study was to examine the growth of previously established clinical markers of developmental language disorder (DLD) in Spanish-speaking bilingual children with and without DLD.

METHOD

Forty-three bilingual children with DLD and 57 typically developing children were tested 3 times over a 2-year period. Their average age at Time 1 was 5;10 (years;months). All children completed an elicitation task examining the production of articles, clitics, verbs, and the subjunctive mood in Spanish at each time point, in addition to other behavioral testing in Spanish and English. We used growth curve analysis to examine change patterns of the morphosyntactic structures over time.

RESULTS

At the onset of the study, children without DLD produced higher accuracy rates than children with DLD across all morphosyntactic structures. In addition, there was a positive effect of time on all structures. Furthermore, the interaction between time and DLD was statistically significant for clitic pronouns.

CONCLUSION

In agreement with previous literature on language growth in monolingual children with DLD, bilingual children with DLD showed language growth that was parallel to that of bilingual children without DLD but with significantly lower levels of attainment.

SUPPLEMENTAL MATERIAL AND PRESENTATION VIDEO

https://doi.org/10.23641/asha.23810820.

Atypical phonological processes in naming errors of children with language impairment

The current study explored the characteristics of phonological errors of preschool children with DLD (Developmental Language Disorder), distinguishing between typical versus atypical phonological processes in segmental, syllabic and word levels. The analysis included 87 responses of words with phonological errors from a naming test, produced by 13 preschool children with DLD, aged 4;4-6;3 years. These responses included 166 phonological processes, which were classified into typical and atypical processes at the levels of: segments, syllables, and prosodic words. The findings revealed that 70% of the phonological processes were atypical. Furthermore, ten children produced more atypical processes, and there were more atypical than typical processes in segmental and word levels. It is suggested that some children with DLD represent phonological processes that are similar to those that children with speech and sound disorders produce. Therefore, clinically, the results emphasise the importance of analysing the typical and atypical characteristics of phonological errors as part of language assessment.