Sentence Repetition Tasks to Detect and Prevent Language Difficulties: A Scoping Review

Sentence Repetition as a Diagnostic Tool for Developmental Language Disorder: A Systematic Review and Meta-Analysis

PURPOSE

This systematic review and multilevel meta-analysis examines the accuracy of sentence repetition (SR) tasks in distinguishing between typically developing (TD) children and children with developmental language disorder (DLD). It explores variation in the way that SR tasks are administered and/or evaluated and examines whether variability in the reported ability of SR to detect DLD is related to these differences.

METHOD

Four databases were searched to identify studies that had used an SR task on groups of monolingual children with DLD and TD children. Searches produced 3,459 articles, of which, after screening, 66 were included in the systematic review. A multilevel meta-analysis was then conducted using 46 of these studies. Multiple preregistered subgroup analyses were conducted in order to explore the sources of heterogeneity.

RESULTS

The systematic review found a great deal of methodological variation, with studies spanning 19 languages, 39 SR tasks, and four main methods of production scoring. There was also variation in study design, with different sampling (clinical and population sampling) and matching (age and language matching) methods. The overall meta-analysis found that, on average, TD children outperformed children with DLD on the SR tasks by 2.08 SDs. Subgroup analyses found that effect size only varied as a function of the matching method and language of the task.

CONCLUSIONS

Our results indicate that SR tasks can distinguish children with DLD from both age- and language-matched samples of TD children. The usefulness of SR appears robust to most kinds of task and study variation.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25864405.

Are comorbidities of poor reading related to elevated anxiety in children?

Studies of the association between dyslexia and mental health have typically tried to minimise the influence of dyslexia comorbidities on the outcomes. However, in the "real world", many children with dyslexia have these comorbidities. In this study, we tested (1) if children with dyslexia with three common comorbidities - inattention, hyperactivity, language difficulties - experience more anxiety than children with dyslexia without these comorbidities; and (2) if any type of comorbidity is related to a certain type of anxiety (reading, social, generalised, or separation). The data of 82 children with dyslexia (mean age = 9 years and 4 months; 25 girls) were analysed using Fisher exact tests, which revealed that those with inattention (40.54%) or hyperactivity (42.30%) were statistically significantly more likely to experience elevated anxiety than children with dyslexia without these comorbidities (8.11 and 14.28%, respectively). This was not the case for language difficulties (24.5% versus 30%). Spearman ρ correlations (α = .05) indicated significant moderate relationships between inattention and reading anxiety (.27), social anxiety (.37), and generalised anxiety (.24); and between hyperactivity and social anxiety (.24) and generalised anxiety (.28). There were no significant correlations between language and anxiety. Examination of highly inter-correlated variables suggested a specific relationship between one type of comorbidity (inattention) and one type of anxiety (reading anxiety).

Secondary language impairment in posterior cortical atrophy: insights from sentence repetition

Introduction

Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterized by progressive impairment in visuospatial and perceptual function linked to atrophy of the occipito-parietal cortex. Besides the salient visual impairment, several studies have documented subtle changes in language may also be present. Sentence repetition is a highly constrained linguistic task involving multiple linguistic and cognitive processes and have been shown to be impaired in other AD spectrum disorders, with little consensus on its relevance in PCA. This aim of this study was to further delineate the linguistic and cognitive features of impaired language in PCA using a sentence repetition task.

Method

Seven PCA patients and 16 healthy controls verbally repeated 16 sentences from the Boston Diagnostic Aphasia Examination. Responses were transcribed orthographically and coded for accuracy (percentage accuracy; percentage Correct Information Units; Levenshtein Distance) and for temporal characteristics (preparation duration (ms); utterance duration (ms); silent pause duration (ms); speech duration (ms); dysfluency duration (ms)). The potential modulating effects of attentional control and working memory capacity were explored.

Results

PCA patients showed lower overall accuracy with retained semantic content of the sentences, and lower phonological accuracy. Temporal measures revealed longer preparation and utterance duration for PCA patients compared to controls, alongside longer speech duration but comparable dysfluency duration. PCA patients also showed comparable silent pause duration to controls. Attentional control, measured using the Hayling sentence completion task, predicted accuracy of sentence repetition.

Discussion

The findings suggest that sentence repetition is impaired in PCA and is characterized by phonological, response planning and execution difficulties, underpinned in part by attentional control mechanisms. The emerging profile of language impairment in PCA suggests vulnerability of similar cognitive systems to other Alzheimer's syndromes, with subtle differences in clinical presentation.

Morphosyntactic skills in Arabic-speaking children with autism spectrum disorder: Evidence from error patterns in the sentence repetition task

Background and aims

Although autism spectrum disorder (ASD) has not traditionally been associated with morphosyntactic impairments, some children with ASD manifest significant difficulties in this domain. Sentence Repetition (SRep) tasks are highly reliable tools for detecting morphosyntactic impairment in different languages and across various populations, including children with ASD. This study is among the first to evaluate morphosyntactic abilities of Palestinian-Arabic (PA) speaking children using a PA SRep task.

Methods

A total of 142 PA-speaking children, aged 5-11, participated in the study: 75 children with typical language development (TLD) and 67 children with ASD. The PA SRep task targeted morphosyntactic structures of varying complexity (simple subject-verb-object [SVO] sentences, biclausal sentences, wh-questions, relative clauses). Children's accuracy scores were assessed across these structures and error patterns encompassing morphosyntactic and pragmatic aspects were analyzed.

Results

Two subgroups of ASD emerged: 43% showed age-appropriate language skills (ASD  +  NL) pairing up with TLD peers, while 57% showed signs of morphosyntactic impairment (ASD  +  LI). Children in both groups exhibited a higher frequency of morphosyntactic errors than pragmatic ones. Children with ASD  +  LI showed difficulties with producing complex morphosyntactic structures, such as relative clauses and object wh-questions. Error analysis revealed that children in the ASD  +  LI group produced sentence fragments and simplified constructions when complex structures were targeted.

Conclusions

The current study extends the cross-linguistic evidence of the heterogeneity of morphosyntactic profiles in children with ASD to Arabic-speaking children. Error analysis indicates that poor morphosyntax, rather than pragmatics, challenges children's performance on the SRep task.

Implications

Our results emphasize the importance of comprehensive language assessment in children with ASD and underscore the need for tailored intervention plans targeting impaired morphosyntactic structures in some children with ASD.

Language in autism: domains, profiles and co-occurring conditions

This article reviews the current knowledge state on pragmatic and structural language abilities in autism and their potential relation to extralinguistic abilities and autistic traits. The focus is on questions regarding autism language profiles with varying degrees of (selective) impairment and with respect to potential comorbidity of autism and language impairment: Is language impairment in autism the co-occurrence of two distinct conditions (comorbidity), a consequence of autism itself (no comorbidity), or one possible combination from a series of neurodevelopmental properties (dimensional approach)? As for language profiles in autism, three main groups are identified, namely, (i) verbal autistic individuals without structural language impairment, (ii) verbal autistic individuals with structural language impairment, and (iii) minimally verbal autistic individuals. However, this tripartite distinction hides enormous linguistic heterogeneity. Regarding the nature of language impairment in autism, there is currently no model of how language difficulties may interact with autism characteristics and with various extralinguistic cognitive abilities. Building such a model requires carefully designed explorations that address specific aspects of language and extralinguistic cognition. This should lead to a fundamental increase in our understanding of language impairment in autism, thereby paving the way for a substantial contribution to the question of how to best characterize neurodevelopmental disorders.

Positive Predictive Values Associated With Adapting the Redmond Sentence Recall Measure Into a Kindergarten Screener for Developmental Language Disorder

PURPOSE

Researchers estimate the prevalence of developmental language disorder (DLD) in 5-year-olds to be between 7% and 12%. Current identification systems in public schools typically favor referral identification formats over targeted or universal screenings. Public schools face unique challenges when assessing the value of screening measures for DLD that include real-world considerations such as administration, time, and resource constraints. This study used the positive predictive value (PPV) of the Redmond Sentence Recall (RSR) to assess its fidelity when administered by special education paraprofessionals. Our obtained PPV was compared across three areas: (a) previous studies that have utilized the RSR, (b) rates extrapolated from the participating school district's preexisting referral system from a previous study, and (c) expectations based on DLD prevalence.

METHOD

Language screenings were conducted in two elementary schools using the RSR administered by school-based paraprofessionals trained on the screener protocol. One hundred sixty-four kindergarten students (age range: 5-6 years) were screened. Confirmatory testing was completed on all students who failed the screener.

RESULTS

Of the 164 students screened, 19 failed the RSR (11.5%), and 14 met criteria (8.5%) for DLD (PPV = .74). Our PPV was similar to previously published studies that utilized the RSR using research assistants and was higher than the PPV associated with teacher-based referrals from the participating school district.

CONCLUSION

The RSR represents a potentially useful screener for identifying children at risk for previously unidentified language disorders in public schools.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22044479.

Identifying the risk of dyslexia in bilingual children: The potential of language-dependent and language-independent tasks

This study investigates the linguistic processing and non-linguistic cognitive abilities of monolingual and bilingual children with and without reading difficulties and examines the relationship between these skills and reading. There were 72 Italian-speaking children: 18 monolingual good readers (MONO-GR, M_age = 10;4), 19 monolingual poor readers (MONO-PR, M_age = 10;3), 21 bilingual good readers (BI-GR, M_age = 10;6), and 16 bilingual poor readers (BI-PR, M_age = 10;6). All bilingual children spoke Italian as their L2. Children completed a battery of standardized Italian reading tests, language-dependent tasks: nonword repetition (NWR), sentence repetition (SR), and phonological awareness (PA), and language-independent tasks: timing anticipation, beat synchronization, inhibition control, auditory reaction time, and rapid automatized naming (RAN). Poor readers scored below good readers on the language-dependent tasks, including NWR, PA, and SR. Beat synchronization was the only language-independent task sensitive to reading ability, with poor readers showing greater variability than good readers in tapping to fast rhythms. SR was the only task influenced by language experience as bilinguals underperformed monolinguals on the task. Moreover, there were weak to moderate correlations between performance on some language-dependent tasks (NWR, PA), language-independent tasks (inhibition control, RAN), and reading measures. Performance on the experimental tasks (except for RAN) was not associated with the length of exposure to Italian. The results highlight the potential of NWR, PA, SR, and beat synchronization tasks in identifying the risk of dyslexia in bilingual populations. Future research is needed to validate these findings and to establish the tasks' diagnostic accuracy.

Can Bilingual Children Self-Report Their Bilingual Experience and Proficiency? The Houston Questionnaire

PURPOSE

The aim of this study was to develop a child self-report questionnaire measuring bilingual experience and self-perceptions of Spanish and English proficiency and establish preliminary evidence of validity and reliability for the questionnaire.

METHOD

Participants included 113 Spanish-English bilingual children with and without developmental language disorders ranging in age from 4 to 8 years. All children completed the questionnaire in Spanish and participated in behavioral assessment of their language skills in both Spanish and English.

RESULTS

Using confirmatory factor analysis, a model with three correlated factors (self-perception of proficiency in Spanish, self-perception of proficiency in English, and bilingual experience) emerged with the best global fit, reasonableness, consistency with theory, and model parsimony, suggesting that the questionnaire has good internal reliability. The scaled results of the questionnaires significantly correlated with behavioral measures of both Spanish and English, supporting the convergent validity of the measure.

CONCLUSIONS

The Houston Questionnaire is an assessment tool for the assessment of bilingual experience and self-perception of proficiency in Spanish and English bilingual children between the ages of 4 and 8 years. The results provide foundational evidence supporting the reliability and convergent validity of this tool.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21158887.

Tell or Retell? The Role of Task and Language in Spanish-English Narrative Microstructure Performance

PURPOSE

This study examined performance of dual language learners (DLLs) on Spanish- and English-language narrative story retells and unique tells. Transcription and analysis focused on comparisons of common microstructural language sample measures in Spanish and English across tasks. Each language sample measure was evaluated for its possible convergence with norm-referenced standardized assessments for DLL children.

METHOD

Spanish-English DLLs (N = 133) enrolled in English-only kindergarten or first-grade classrooms completed two-language sample tasks (one in each language), which were transcribed and analyzed using Systematic Analysis of Language Transcripts (Miller & Iglesias, 2017) for measures of syntactic complexity (mean length of utterance [MLU] in words), lexical diversity (number of different words [NDW]), and grammaticality (percent grammatical utterances [PGU]). Students also completed a norm-referenced sentence repetition task (Peña et al., 2014) and expressive vocabulary assessment (Martin, 2013).

RESULTS

Comparison of story retells and unique stories revealed similar performance on MLU, NDW, and PGU across elicitation techniques, with one exception: NDW in Spanish was higher in the story retell condition. Predictive models revealed several differences in the relations between the microstructure measures and norm-referenced language measures by elicitation technique, although neither context demonstrated a consistent advantage across all metrics.

CONCLUSIONS

Measures derived from story retells and unique tells offer practical findings for speech-language pathologists and other educators to use in assessment of early grade DLLs. This work increases knowledge of procedural differences across narrative assessments and their influence on language variables, supporting school-based speech-language pathologists in making assessment decisions for DLLs on their caseload.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19191278.

Sentence Repetition as a Clinical Marker of Developmental Language Disorder: Evidence From Arabic

PURPOSE

Research on the typical and impaired grammatical acquisition of Arabic is limited. This study systematically examined the morphosyntactic abilities of Arabic-speaking children with and without developmental language disorder (DLD) using a novel sentence repetition task. The usefulness of the task as an indicator of DLD in Arabic was determined.

METHOD

A LITMUS (Language Impairment Testing in Multilingual Settings) sentence repetition task was developed in Palestinian Arabic (LITMUS-SR-PA-72) and administered to 30 children with DLD (M = 61.50 months, SD = 11.27) and 60 age-matched typically developing (TD) children (M = 63.85 months, SD = 10.16). The task targeted grammatical structures known to be problematic for Arabic-speaking children with DLD (language specific) and children with DLD across languages (language independent). Responses were scored using binary, error, and structural scoring methods.

RESULTS

Children with DLD scored below TD children on the LITMUS-SR-PA-72, in general, and in the repetition of language-specific and language-independent structures. The frequency of morphosyntactic errors was higher in the DLD group relative to the TD group. Despite the large similarity of the type of morphosyntactic errors between the two groups, some atypical errors were exclusively produced by the DLD group. The three scoring methods showed good diagnostic power in the discrimination between children with DLD and children without DLD.

CONCLUSIONS

Sentence repetition was an area of difficulty for Palestinian Arabic-speaking children with DLD. The DLD group demonstrated difficulties with language-specific and language-independent structures, particularly complex sentences with noncanonical word order. Most grammatical errors made by the DLD group resembled those of the TD group and were mostly omissions or substitutions of grammatical affixes or omissions of function words. SR appears to hold promise as a good indicator for the presence or absence of DLD in Arabic. Further validation of these findings using population-based studies is warranted. Supplemental Material https://doi.org/10.23641/asha.16968043.