Association between CCC-2 and Structural Language, Pragmatics, Social Cognition, and Executive Functions in Children with Developmental Language Disorder

The profile of social communication in Dravet syndrome

Dravet syndrome (DS) presents a multifaceted clinical picture marked by epilepsy, cognitive impairments and behavioral disorders that progresses throughout development. Behavioral disorders include impairments in social relationships and communication, with frequent diagnosis of autism spectrum disorder. This study focused on comprehensively evaluating and comparing social communication profiles among a group of 43 children with Dravet syndrome, 30 children with level 1 autism spectrum disorder, 36 with social (pragmatic) communication disorder, and 18 with intellectual disability. Using validated tools like the Childhood Autism Spectrum Test and Children's Communication Checklist, distinct patterns of social communication deficits were delineated. Our findings indicate that children with Dravet syndrome experience challenges in social relationships, primarily due to difficulties in use of pragmatic language. Areas such as range of interests and social interaction are less affected compared to those with ASD, emphasizing differing profiles between the conditions. While children with DS and ID may have similar intellectual functioning, the different social communication deficits in DS indicate their role in the DS phenotype beyond ID. These results underscore the unique social communication profile of DS and emphasizes the importance of tailored interventions and deep phenotyping efforts for effective DS management.

Development and validation of the Arabic children's strong communication scale: a pilot study

Background

The assessment of communication skills in Arabic-speaking children has been challenged by a lack of culturally and linguistically appropriate tools. The Arabic children's strong communication scale (ACSCS) was developed in response to this need, adapting the children's communication checklist-2 (CCC-2) to better suit the Arabic context.

Aims

This study aimed to validate the ACSCS and establish its utility in measuring communication strengths among Arabic-speaking children.

Methods

A total of 102 participants completed the questionnaire, which included relatives, teachers, and speech therapists of children aged 4-16. Twenty-two items were developed that targeted children communication strengths. The items were based on a theoretical framework that encompassed language proficiency, social communication, and behavioral aspects. Exploratory factor analysis (EFA) and confirmatory composite analysis (CCA) were employed to validate the structure of the ACSCS. The scale's reliability was tested using Cronbach's alpha and composite reliability, while its validity was assessed through convergent and discriminant validity measures.

Results

The EFA and CCA confirmed a clear distinction of communication strengths. Reliability analyses indicated high internal consistency for the ACSCS. Discriminant validity was established, showing that the ACSCS accurately measures distinct facets of communication skills.

Conclusion

The ACSCS is a valid and reliable instrument for assessing communication skills in Arabic-speaking children, reflecting strengths across various domains.

Implications

The scale has significant implications for educational and clinical settings, providing a culturally sensitive tool for practitioners and researchers to assess and support the communication development of Arabic-speaking children.

Influence of socio-family variables on parental assessment of the pragmatic development of children under 4 years of age

Introduction

Interest in pragmatic development and its assessment has increased in recent years, not only because of the predictive value of pragmatic impairments as warning signs in the detection of multiple developmental disorders, but also because of the consideration that pragmatics has received in the field of mental disorders. Current contexts of child development assessment require pragmatic assessment instruments that accurately define profiles and take into account the immediate context in which they develop. Parents' knowledge of their children's abilities is supported by exhaustive observation over time of regularities in their behavior. But it is true that the way a caregiver interprets behavior is mediated by multiple variables. The aim of the present study, therefore, is to shed light on the possible influence of parental belief systems on the assessment of children's pragmatic development by analyzing the relationship between sociofamilial variables and the assessment of pragmatic competence.

Method

A total of 215 educational centers across Spain participated in the study. The final sample was of 262 parents of boys and girls between 6 and 48 months of age. The parental questionnaire for the evaluation of pragmatic development, The Pragmatics Profile, in an adapted Spanish version, was applied along with a number of items for the evaluation of parental beliefs.

Results

Analyses confirm the existence of an effect of child development conceptions and other socio-familial variables on the assessment of pragmatic development between 6 and 48 months of age. Furthermore, the results indicate that better scores on pragmatic development are associated with parents with higher socioeconomic and educational levels, greater number of children and more interactionist conceptions and realistic.

Conclusion

The effect of parental conceptions on the evaluation of pragmatics points to the need to obtain convergent measures in an area as complex as that of communicative development in early childhood, especially taking into account that an evaluation which is neutral and free from context is not possible or indeed desirable. Pragmatic development must be evaluated within this contextual framework and should take into account each of the variables present therein. Hence the complementarity between parental reports and performance-based test.

Far Transfer Effects of Trainings on Executive Functions in Neurodevelopmental Disorders: A Systematic Review and Metanalysis

Executive Functions are a set of interrelated, top-down processes essential for adaptive goal-directed behaviour, frequently impaired across different neurodevelopmental disorders with variable degrees of severity. Many executive-function-training studies in children with neurodevelopmental disorders have focused on near effects, investigating post-treatment improvements on directly trained processes, while enhancements of skills not directly trained, defined as far effects, are less considered, albeit these could be extremely relevant for reducing the negative impact of a disorder's core symptomatology. This systematic review and metanalysis aims to investigate the far effect outcomes after EF training in children with different types of neurodevelopmental disorders. 17 studies met the inclusion criteria for the systematic review, while 15 studies were selected in the metanalysis. An overall statistically significant effect size was found in the majority of far effect outcome measures considered in the studies. In particular, trainings on executive functions determine significant far effects on daily life functioning (0.46, 95% CI: [0.05-0.87]) and clinical symptoms (0.33, 95% CI: [0.15-0.51]). Despite a high variability of the results, intensity, frequency and the laboratory/life contexts dimension seem to be the most influential variables in determining far effects. This systematic review and metanalysis highlights the need to measure far effects of executive function training in neurodevelopmental disorders, selecting treatments not only on directly targeted processes, but also according to far impacts on the functional weakness of the disorder.

Executive Functions and Public Health: A Narrative Review

Executive functions (EFs) skills are necessary for regulating the thoughts, emotions, and actions which are associated with many aspects of daily functioning. Executive dysfunction (EDFs) is present in a wide range of mental disorders. New study indicates that EFs may predict health behavior and make it easier to engage in a variety of healthy activities. In this narrative review, EFs and public health are briefly discussed. In general, 133 articles met the inclusion criteria (published 2018-2023) which were reviewed. EFs affect the mental and physical health. Besides individual problems, people with mental problems have heavy costs to society. Mental health cannot be considered separately from general health. Consequently, preventive and therapeutic approaches to mental health should be considered not only at the level of the whole society, but also at the global level.

Social-Pragmatic Skills and Length of Bilingualism Predict Inhibitory Control in Children

PURPOSE

There is conflicting evidence regarding effects of bilingualism on inhibition, and the mechanisms that might underlie the effects remain unclear. A prominent account views additional demands on structural language use in bilinguals as being at the root of bilingual effects on inhibition. In this study, we tested the novel hypothesis that social-pragmatic skills (alone or together with structural language skills) are associated with inhibition in bilingual children.

METHOD

Parents of 114 typically developing 8- to 11-year-old Spanish-English bilingual children completed the Children's Communication Checklist-Second Edition to index social pragmatics and the Behavior Rating Inventory of Executive Function to index executive functioning skills. The Inhibit clinical scale score reflected children's inhibition. Children's language ability was indexed by the Clinical Evaluation of Language Fundamentals-Fourth Edition in English and Spanish. Length of bilingualism was operationalized continuously as the length of time children had been exposed to both languages in their lifetime. Moderation analyses tested the effects of structural language, social-pragmatic skills, and length of bilingual experience, and their interactions on inhibition.

RESULTS

While structural language skills were not associated with inhibition, they moderated the relation between social-pragmatic skills and inhibition, such that children with better social-pragmatic skills demonstrated better inhibition, and this effect was stronger for children with better structural language skills. Furthermore, longer length of bilingual experience was associated with better inhibition, and this effect was not moderated by any other predictor.

CONCLUSION

These results confirm a graded relationship between bilingualism and inhibition, and indicate that this association is not qualified by structural language or social-pragmatic skills.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21183916.

Pragmatic Language Markers of Autism Diagnosis and Severity

Purpose

Assessment of pragmatic language difficulties is limited with conventional tests but can be performed with informant reports. We evaluated the performance of a parent-completed language scale in differentiating autism from typical development (TD) and another neurodevelopmental disorder. Specifically, we aimed to gauge the respective values of structural and pragmatic language scores for diagnostic discrimination and for predicting severity of social impairment in autistic children.

Method

174 children aged 7 to 17 (101 with autism, 45 with ADHD, 28 with TD) were evaluated with the ADOS-2 and an abbreviated version of the WISC. Parents completed the Children's Communication Checklist, 2nd Edition (CCC-2) and the Social Responsiveness Scale. CCC-2 mean differences across diagnostic groups were tested with analysis of variance and covariance. Multiple linear regression was used to compare the structural and pragmatic CCC-2 scores in predicting autism symptom severity.

Results

Both structural and pragmatic language scores discriminated between the three diagnostic groups, with stronger effects for the pragmatic scores. Pragmatic scores remained robust predictors of ADHD and ASD diagnoses even after accounting for cognitive and structural linguistic differences. Among autistic children, social impairment severity was associated with pragmatic, but not structural, language profiles.

Conclusions

In order to characterize pragmatic language, easy to administer parent questionnaires such as the CCC-2 may support clinicians who are considering an autism diagnosis and needing to evaluate and monitor social communication.

Arabic Validation of the Pragmatic Language Skills Inventory to Assess Pragmatic Language Development in Preschoolers with and without Pragmatic Language Impairment

Objective: An individual’s articulation of pragmatic language development (PLD) signifies successful social interaction with others. Therefore, it is important to detect early pragmatic language impairment (PLI), whether as a primary disorder or as a symptom of other neurodevelopmental disorders. This study reports on validating the Arabic version of the Pragmatic Language Skills Inventory (A-PLSI). Methods: The PLSI was subjected to various validation stages before the A-PLSI was created. To assess PLD in preschoolers with and without psychiatric histories, 264 preschoolers were assessed in several cities in Saudi Arabia by their teachers and speech–language pathologists. Results: The results of this study included three key findings. First, the established psychometric features, including construct validity, criterion-related validity, and (confirmatory) factor analysis, all reported a high level of measurability to consider the A-PLSI a valid instrument for assessing PLD in school settings and diagnosing PLI in clinical settings. Second, the A-PLSI provided empirical evidence by identifying children with and without PLI, documenting their progress on pragmatic language ability, and distinguishing between preschool children in school and clinical settings. In addition, the A-PLSI approved the typical norm that the older the children, the higher their level of PLD: the data showed higher performance for children aged 6–7 compared to the lower PLD level of children aged 4–5. Conclusion: The present study contributes to the existing literature on PLD assessment in a school setting and PLI diagnosis in a clinical setting. More importantly, it adds a new validated tool to the few available instruments in Arabic to assess PLD and diagnose PLI in Arabian contexts.

Reliability, validity and developmental sensitivity of the Language Use Inventory (LUI) in the Chinese context

BACKGROUND

Pragmatics has generally been defined as the ability to use language in social situations, it is commonly regarded as the third major component of language ability. To date, there is no tool for assessing early pragmatic development of Chinese-speaking children.

AIMS

To describe the translation of the Language Use Inventory (LUI) from English to Mandarin Chinese and to report findings on the Chinese version's reliability, validity and developmental sensitivity.

METHODS & PROCEDURES

The original English version of the LUI was translated into Mandarin Chinese. Parents of 177 typically developing (TD) toddlers and preschool children completed the inventory to examine its internal reliability and construct validity and how scores differed across ages and sexes. A total of 31 parents out of the 177 completed the LUI-Mandarin, again within 4 weeks, to assess test-retest reliability. To examine discriminative validity, 43 parents of age- and sex-matched TD children and children with autism spectrum disorder (ASD) recruited from Nanjing Brain Hospital affiliated with Nanjing Medical University completed the LUI-Mandarin.

OUTCOMES & RESULTS

Cronbach's alpha values for the LUI-Mandarin's three parts and for 11 of 12 LUI-Mandarin subscales were 0.707-0.992, with most values in the 0.825-0.992 range. Test-retest reliability ranged from 0.66 to 0.95, indicating good to excellent reliability. Factor analysis of the LUI-Mandarin revealed two different factors, and the total variance explained was 74.38%. The LUI-Mandarin total scores and subscale scores increased with age for both boys and girls, providing evidence of the inventory's developmental sensitivity. Girls, however, had higher total scores than boys at earlier ages (18-23 months). The results of the discriminant validity study revealed that performance was significantly lower in the ASD group than in the TD group with respect to LUI total scores and subscale scores (except for subscale A).

CONCLUSIONS & IMPLICATIONS

The LUI-Mandarin is the first and only questionnaire available in China that evaluates the pragmatic language skills of children aged between 18 and 47 months. The results of the study show that the LUI-Mandarin is a valid and reliable tool for Chinese toddlers and preschool children.

WHAT THIS PAPER ADDS

What is already known on this subject The LUI is a parent-report questionnaire that can provide comprehensive information about very young children's communicative competence. It is widely used both for assessment and to guide intervention. Additionally, it has been translated into French, Italian, Polish, Arabic, Portuguese and Norwegian and it shows good reliability and validity. What this paper adds to existing knowledge In the present study we describe the translation of the LUI from English to Mandarin Chinese and report findings on the Chinese version's reliability, validity and developmental sensitivity. What are the potential or actual clinical implications of this work? The LUI-Mandarin is the first and only questionnaire available in China that can evaluate pragmatic language skills of children aged between 18 and 47 months. The results show that the LUI-Mandarin is a valid and reliable tool for use with Chinese toddlers and preschool children.

Effects of a Home Literacy Environment Program on Psychlinguistic Variables in Children from 6 to 8 Years of Age

(1) Background: the objective of this study was to improve certain psycholinguistic and cognitive skills that are fundamental to the development of the reading process, such as phonological awareness, reading decoding, vocabulary and oral narrative comprehension, through the introduction of an Home Literacy Environment Active (HLE(A)) program that involved 54 participants enrolled in the first and second grades of elementary school (from 6 to 8 years old) in the city of Malaga area. (2) Methods: The central task of the intervention program was for the child to read aloud to an adult in the family for between 10 and 15 min, four days per week. In addition, the school students were evaluated on four occasions, at the beginning and end of each academic year, using the Batería de Evaluación de los Procesos Lectores Revisada, Test para la Detección de la Dislexia en niños and Escala Weschsler de Inteligencia instruments. (3) Results: the results demonstrated the efficacy of the HLE(A) program in the improvement of psycholinguistic and cognitive variables measured and, consequently, to an improvement in reading learning and cognitive development. Ultimately, the scientific literature on the subject and the data from the study led us to suggest that it would not only be beneficial for HLE(A) programs to be instituted in early childhood education stage (up to 6 years of age), but that they should be continued after age 6, in elementary education.