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.

Lexical skills and gesture use: A comparison between expressive and receptive/expressive late talkers

BACKGROUND

Studies on late talkers (LTs) highlighted their heterogeneity and the relevance of describing different communicative profiles.

AIMS

To examine lexical skills and gesture use in expressive (E-LTs) vs. receptive-expressive (R/E-LTs) LTs through a structured task.

METHODS AND PROCEDURES

Forty-six 30-month-old screened LTs were distinguished into E-LTs (n= 35) and R/E-LTs (n= 11) according to their receptive skills. Lexical skills and gesture use were assessed with a Picture Naming Game by coding answer accuracy (correct, incorrect, no response), modality of expression (spoken, spoken-gestural, gestural), type of gestures (deictic, representational), and spoken-gestural answers' semantic relationship (complementary, equivalent, supplementary).

OUTCOMES AND RESULTS

R/E-LTs showed lower scores than E-LTs for noun and predicate comprehension with fewer correct answers, and production with fewer correct and incorrect answers, and more no responses. R/E-LTs also exhibited lower scores in spoken answers, representational gestures, and equivalent spoken-gestural answers for noun production and in all spoken and gestural answers for predicate production.

CONCLUSIONS AND IMPLICATIONS

Findings highlighted more impaired receptive and expressive lexical skills and lower gesture use in R/E-LTs compared to E-LTs, underlying the relevance of assessing both lexical and gestural skills through a structured task, besides parental questionnaires and developmental scales, to describe LTs' communicative profiles.

What kind of information do early parental report instruments provide on language ability at 3;6 when used at 2;0? A longitudinal comparison study

Introduction

Various parental report instruments are available for assessing children's language skills at the end of the second year. However, comparison studies on their usability are lacking, and it is also open to question what kind of information the instruments provide when used in a parallel manner. This longitudinal study investigated which of the available three parental report instruments, when used at 2;0 (year;month), provides the most representative information on language development at 3;6. In addition, since most of the parental report instruments available focus specifically on expressive language, the role of receptive language ability was also investigated when analyzing the explanatory value of parental report instruments.

Methods

The participants were 68 typically developing children. At 2;0, language skills were measured using the following measures: the Infant-Toddler Checklist of the Communication and Symbolic Behavior Scales Developmental Profile (ITC), the Short Form and Long Form versions of the Finnish Communicative Development Inventories (FinCDI-SF, FinCDI-LF), and the Reynell Developmental Language Scales III (RDLS). The outcome measures were receptive/expressive/ general language ability at 3;6 measured using RDLS.

Results

The results of parental report instruments were significantly and positively associated with language ability at 3;6. The correlation between the combined value of ITC and FinCDI-SF and later language ability was stronger than correlations for each measure separately. The regression models with the results of parental report instruments as predictors explained 18-22% (p < 0.00) of the variability in the total RDLS score. However, when receptive language ability at 2;0 was included in the models as a predictor, R2 increased considerably (46-48%, p < 0.00).

Discussion

The results adduce the usability of parental report measures along with the importance of measuring receptive language skills at 2 years of age. In summary, this study provides important insights into the clinical evaluation of early language ability.

Procedural learning and school-age language outcomes in children with and without a history of late talking

BACKGROUND

'Late talkers' (LTs) are toddlers with late language emergence that cannot be explained by other impairments. It is difficult to predict which of these children continue to present long-term restrictions in language abilities and will later be identified as having a developmental language disorder. Procedural memory weaknesses have been suggested to underlie developmental language disorders, but have not been investigated in LTs.

AIMS

We investigated the relationships between aspects of procedural memory and school-age language abilities in children with and without a history of LT. We hypothesized that children with a history of LT exhibit (1) restrictions in procedural memory when compared with children with typical early development (TED); and (2) a positive association between procedural memory and school-age language abilities.

METHODS & PROCEDURES

We recruited 79 children (7;5-10;5), 43 of whom had a history of LT. Aspects of procedural memory, procedural learning and motor planning were assessed using the serial reaction time and the end-state comfort tasks. School-age language abilities were measured using standardized tests.

OUTCOMES & RESULTS

Counter to expectations, motor planning was not associated with a history of LT or school-age language abilities, and the children with TED did not show stronger procedural learning as compared with peers with a history of LT. However, weaker school-age language abilities were associated with weak procedural learning in TED group.

CONCLUSIONS & IMPLICATIONS

Factors other than deficits in procedural memory are likely to underlie LT. Procedural learning shows promise as a potential predictor of language development in children that are not identified as LTs.

WHAT THIS PAPER ADDS

What is already known on the subject Poor procedural learning has been associated with developmental language disorders and suggested to underlie language difficulties. However, to our knowledge, this study is the first to investigate procedural learning and its associations with language outcomes in LTs. What this paper adds to existing knowledge Consistent with prior research, we found an association between language abilities and procedural learning in school-aged children, but found no evidence for poor procedural learning in children with a history of LT. Furthermore, the school-age language outcomes were only associated with procedural learning in children with no history of LT. What are the potential or actual clinical implications of this work? Our findings suggest that factors other than limitations in procedural learning underlie LT. However, procedural learning could be a useful predictor for school-aged language outcomes in children not identified as LTs.

Integrating Gestures and Words to Communicate in Full-Term and Low-Risk Preterm Late Talkers

Young children use gestures to practice communicative functions that foster their receptive and expressive linguistic skills. Studies investigating the use of gestures by late talkers are limited. This study aimed to investigate the use of gestures and gesture–word combinations and their associations with word comprehension and word and sentence production in late talkers. A further purpose was to examine whether a set of individual and environmental factors accounted for interindividual differences in late talkers’ gesture and gesture–word production. Sixty-one late talkers, including 35 full-term and 26 low-risk preterm children, participated in the study. Parents filled out the Italian short forms of the MacArthur–Bates Communicative Development Inventories (MB–CDI), “Gesture and Words” and “Words and Sentences” when their children were 30-months-old, and they were then invited to participate in a book-sharing session with their child. Children’s gestures and words produced during the book-sharing session were transcribed and coded into CHAT of CHILDES and analyzed with CLAN. Types of spontaneous gestures (pointing and representational gestures) and gesture–word combinations (complementary, equivalent, and supplementary) were coded. Measures of word tokens and MLU were also computed. Correlational analyses documented that children’s use of gesture–word combinations, particularly complementary and supplementary forms, in the book-sharing session was positively associated with linguistic skills both observed during the session (word tokens and MLU) and reported by parents (word comprehension, word production, and sentence production at the MB–CDI). Concerning individual factors, male gender was negatively associated with gesture and gesture–word use, as well as with MB–CDI action/gesture production. In contrast, having a low-risk preterm condition and being later-born were positively associated with the use of gestures and pointing gestures, and having a family history of language and/or learning disorders was positively associated with the use of representational gestures. Furthermore, a low-risk preterm status and a higher cognitive score were positively associated with gesture–word combinations, particularly complementary and supplementary types. With regard to environmental factors, older parental age was negatively associated with late talkers’ use of gestures and pointing gestures. Interindividual differences in late talkers’ gesture and gesture–word production were thus related to several intertwined individual and environmental factors. Among late talkers, use of gestures and gesture–word combinations represents a point of strength promoting receptive and expressive language acquisition.

Do Spoken Vocabulary and Gestural Production Distinguish Children with Transient Language Delay from Children Who Will Show Developmental Language Disorder? A Pilot Study

The literature on the role of gestures in children with language delay (LD) is partial and controversial. The present study explores gestural production and modality of expression in children with LD and semantic and temporal relationships between gestures and words in gesture + word combinations. Thirty-three children participated (mean age, 26 months), who were recruited through a screening programme for LD. Cognitive skills, lexical abilities, and the use of spontaneous gestures in a naming task were evaluated when the children were 32 months old. When the children were 78 months old, their parents were interviewed to collect information about an eventual diagnosis of developmental language disorder (DLD). According to these data, the children fell into three groups: children with typical development (n = 13), children with LD who did not show DLD (transient LD; n = 9), and children with LD who showed DLD (n = 11). No significant differences emerged between the three groups for cognitive and lexical skills (comprehension and production), for number of gestures spontaneously produced, and for the sematic relationships between gestures and words. Differences emerged in the modality of expression, where children with transient LD produced more unimodal gestural utterances than typical-development children, and in the temporal relationships between gestures and words, where the children who would show DLD provided more frequent representational gestures before the spoken answer than typical-development children. We suggest a different function for gestures in children with T-LD, who used representational gestures to replace the spoken word they were not yet able to produce, and in children with LD-DLD, who used representational gestures to access spoken words.

Language Profiles and Their Relation to Cognitive and Motor Skills at 30 Months of Age: An Online Investigation of Low-Risk Preterm and Full-Term Children

Purpose Wide interindividual variability characterizes language development in the general and at-risk populations of up to 3 years of age. We adopted a complex approach that considers multiple aspects of lexical and grammatical skills to identify language profiles in low-risk preterm and full-term children. We also investigated biological and environmental predictors and relations between language profiles and cognitive and motor skills. Method We enrolled 200 thirty-month-old Italian-speaking children-consisting of 100 low-risk preterm and 100 comparable full-term children. Parents filled out the Italian version of the MacArthur-Bates Communicative Development Inventories Infant and Toddler Short Forms (word comprehension, word production, and incomplete and complete sentence production), Parent Report of Children's Abilities-Revised (cognitive score), and Early Motor Questionnaire (fine motor, gross motor, perception-action, and total motor scores) questionnaires. Results A latent profile analysis identified four profiles: poor (21%), with lowest receptive and expressive vocabulary and absent or limited word combination and phonological accuracy; weak (22.5%), with average receptive but limited expressive vocabulary, incomplete sentences, and absent or limited phonological accuracy; average (25%), with average receptive and expressive vocabulary, use of incomplete and complete sentences, and partial phonological accuracy; and advanced (31.5%), with highest expressive vocabulary, complete sentence production, and phonological accuracy. Lower cognitive and motor scores characterized the poor profile, and lower cognitive and perception-action scores characterized the weak profile. Having a nonworking mother and a father with lower education increased the probability of a child's assignment to the poor profile, whereas being small for gestational age at birth increased it for the weak profile. Conclusions These findings suggest a need for a person-centered and cross-domain approach to identifying children with language weaknesses and implementing timely interventions. An online procedure for data collection and data-driven analyses based on multiple lexical and grammatical skills appear to be promising methodological innovations. Supplemental Material https://doi.org/10.23641/asha.14818179.

Adaptación y normativización del Inventario del Desarrollo Comunicativo Mac Arthur Bates (CDI-Forma II) al español rioplatense

En este trabajo se presenta la adaptación al español rioplatense de la Forma II de los Inventarios del Desarrollo Comunicativo Mac Arthur-Bates (CDI), destinado a evaluar el vocabulario expresivo y las habilidades morfosintácticas entre los 16 y los 30 meses. Se expone, en primer lugar, el procedimiento de adaptación del instrumento. En segundo lugar, se presentan algunas evidencias de su fiabilidad y validez, al tiempo que se describen las principales tendencias evolutivas encontradas tras la aplicación del inventario a una muestra de 726 madres y/o padres de niños y niñas de las edades arriba mencionadas. Los resultados indican, en primer lugar, que   la versión rioplatense del CDI presenta elevados niveles de consistencia interna y de representatividad de sus ítems léxicos. En segundo lugar, las trayectorias del desarrollo léxico y gramatical observadas se han mostrado sensibles a los cambios en relación con la edad, de modo comparable al de otras adaptaciones del CDI. Al mismo tiempo, se han encontrado correlaciones moderadas y significativas entre el aumento del vocabulario y la complejidad morfosintáctica, aún después de controlar el efecto de la edad. Por último, se ha observado un efecto significativo del nivel educativo materno sobre el tamaño del léxico expresivo y la longitud media de las primeras frases. Se concluye que la versión rioplatense del CDI representa una contribución necesaria y promisoria para la evaluación del lenguaje temprano en el contexto sudamericano.

Generalized Slowing Rather Than Inhibition Is Associated With Language Outcomes in Both Late Talkers and Children With Typical Early Development

Purpose While most of the children who are identified as late talkers at the age of 2 years catch up with their peers before school age, some continue to have language difficulties and will later be identified as having developmental language disorder. Our understanding of which children catch up and which do not is limited. The aim of the current study was to find out if inhibition is associated with late talker outcomes at school age. Method We recruited 73 school-aged children (ages 7-10 years) with a history of late talking (n = 38) or typical development (n = 35). Children completed measures of language skills and a flanker task to measure inhibition. School-age language outcome was measured as a continuous variable. Results Our analyses did not reveal associations between inhibition and school-age language index or history of late talking. However, stronger school-age language skills were associated with shorter overall response times on the flanker task, in both congruent and incongruent trials. This effect was not modulated by history of late talking, suggesting that a relationship between general response times and language development is similar in both children with typical early language development and late talkers. Conclusions Inhibition is not related to late talker language outcomes. However, children with better language outcomes had shorter general response times. We interpret this to reflect differences in general processing speed, suggesting that processing speed holds promise for predicting school-age language outcomes in both late talkers and children with typical early development. Supplemental Material https://doi.org/10.23641/asha.14226722.

Toddlers' Early Communicative Skills as Assessed by the Short Form Version of the Estonian MacArthur-Bates Communicative Development Inventory II

Purpose The purpose of the current study is to develop a valid and reliable screening tool to identify children with risk of developing language difficulties for Estonian-speaking 2- to 3-year-old children. Method Nine hundred ninety parents of children ages 1;8-3;1 (years;months) filled in the Estonian MacArthur-Bates Communicative Development Inventory II (ECDI-II SF)-containing a 100-word vocabulary checklist, questions about decontextualized language use, and sentence production. A subset of parents filled in the long form of the MacArthur-Bates Communicative Development Inventory: Words and Sentences (n = 131). We examined the results of 31 children with language problems on the ECDI-II SF to assess the accuracy of the instrument. Results The concordance of scores on the ECDI-II long form and ECDI-II SF is high. Toddlers' results on the ECDI-II SF are related to their gender, with girls outscoring boys on the expressive vocabulary and sentence complexity subscales. We also found that children of highly educated mothers outperform others in the acquisition of grammatical skills. The sensitivity and specificity of the ECDI-II SF vocabulary section supported the implementation of this screening tool in order to identify toddlers with difficulties in their language development. Conclusions ECDI-II SF vocabulary scores are the most informative for determining whether a 2- or 3-year-old is following typical developmental patterns or should be referred to a speech and language specialist for a direct assessment. We provide a discussion on early language screening process and its implications for public health policies.

Reliability of Speech-Language Pathologists' Categorizations of Preschoolers' Communication Impairments in Practice

Purpose An efficient and reliable way to categorize children's communication impairments based on routine clinical assessments is needed to inform research and clinical decisions. This preliminary study assessed interrater reliability of speech-language pathologists' categorization of preschoolers' speech, language, and communication impairments using a clinical consensus document. Method Six speech-language pathologists at three community sites worked in pairs to assess 38 children aged 1-5 years, then used the clinical consensus document to categorize children's communication impairments broadly. Identified language and speech sound impairments were further subcategorized. Results Speech-language pathologists had substantial to almost perfect agreement for three broadly focused impairment categories. Agreement for whether language difficulties/disorders were developmental or associated with a biomedical condition was almost perfect, but moderate for whether difficulties impacted receptive or expressive language, or social communication skills. Agreement was fair for rule-based speech delays/disorders, but low for motor-based and mixed speech impairments. Conclusions Results support use of the clinical consensus document to collect data for reliable categories. Additional work is needed to confirm reliability for some broadly focused impairment categories and for subcategorization of speech impairments.

A Parent-Implemented Language Intervention for Late Talkers: An Exploratory Study on Low-Risk Preterm and Full-Term Children

Parent-implemented language interventions have been used for children with expressive language delays, but no study has yet been carried out using this intervention for low-risk preterm children. The current study examined the effect of a parent-implemented dialogic book reading intervention, determining also whether the intervention differently impacted low-risk preterm and full-term children. Fifty 31-month-old late talkers with their parents participated; 27 late talkers constituted the intervention group, and 23 constituted the control group. The overall results indicated that more children in the intervention group showed partial or full recovery of their lexical expressive delay and acquired the ability to produce complete sentences relative to the control group. Concerning full-term late talkers, those in the intervention group showed a higher daily growth rate of total words, nouns, function words, and complete sentences, and more children began to produce complete sentences relative to those in the control group. Concerning low-risk preterm late talkers, children in the intervention group increased their ability to produce complete sentences more than those in the control group. We conclude that a parent-focused intervention may be an effective, ecological, and cost-effective program for improving expressive lexical and syntactic skills of full-term and low-risk preterm late talkers, calling for further studies in late talkers with biological vulnerabilities.

Speech and Language Skills of Low-Risk Preterm and Full-Term Late Talkers: The Role of Child Factors and Parent Input

Among children in the third year of life, late talkers comprise from 9% to 20%. This range seems to increase when addressing preterm children. This study examined video-recorded child spontaneous speech during parent-child book sharing as well as linguistic skills reported through the MacArthur Bates Communicative Development Inventories (MB-CDI) Short Form in 61 late talkers aged 30 months old (26 low-risk preterm, 8 females; 35 full-term, 12 females). Differences between low-risk preterm and full-term late talkers in child language measures and parental speech input were tested, as were the roles of child and parent factors on child language. Low-risk preterm and full-term late talkers showed similar speech and language skills. Similarly, no differences were found in measures of parental speech between groups. Child cognitive score, chronological age, and low-risk preterm status were positively associated with lexical diversity, rate, and composition of child speech production, whereas family history for language and/or learning disorders as well as parent measures of lexical diversity, rate, and grammatical complexity were negatively associated with the above child variables. In addition, child cognitive score and low-risk preterm status were positively associated with the MB-CDI measures of word and sentence production. Findings are discussed in terms of the need of good practices when following up on low-risk preterm children and of interventions targeting parents' input to preterm and full-term late talkers.

Prediction and persistence of late talking: A study of Italian toddlers at 29 and 34 months

This study analyzed the communicative, linguistic and symbolic skills in Italian Late Talking (LT) toddlers. Thirty-five participants were identified through a language-screening program at 29 months by using the Italian version of MB-CDI W&S Short Form. Cognitive, communicative and linguistic skills were evaluated 5 later, with indirect and direct tools. The MB-CDI WS Short Form revealed, in LT children, weakness in gesture production, decontextualized comprehension, verbal imitation, symbolic play, and phonological accuracy. Our results confirmed lexical size at 29 months is the predictive factor to identify language delay at 34 months. The clinical assessment at 34 months confirmed that 89% of the LT children had a vocabulary size below the 10th percentile on the MB-CDI Complete Form. On a structured task, LT children showed lexical comprehension more preserved than lexical production, and more advanced skills in nouns than in predicates. Weakness in socioconversational abilities emerged. Correlation among maternal education, expressive vocabulary and socio-conversational competence in LT children was evidenced. Strong association among cognitive, communicative and linguistic skills were documented.