FLP: Factor lattice pattern-based automated detection of Parkinson's disease and specific language impairment using recorded speech

BACKGROUND

Timely detection of neurodevelopmental and neurological conditions is crucial for early intervention. Specific Language Impairment (SLI) in children and Parkinson's disease (PD) manifests in speech disturbances that may be exploited for diagnostic screening using recorded speech signals. We were motivated to develop an accurate yet computationally lightweight model for speech-based detection of SLI and PD, employing novel feature engineering techniques to mimic the adaptable dynamic weight assignment network capability of deep learning architectures.

MATERIALS AND METHODS

In this research, we have introduced an advanced feature engineering model incorporating a novel feature extraction function, the Factor Lattice Pattern (FLP), which is a quantum-inspired method and uses a superposition-like mechanism, making it dynamic in nature. The FLP encompasses eight distinct patterns, from which the most appropriate pattern was discerned based on the data structure. Through the implementation of the FLP, we automatically extracted signal-specific textural features. Additionally, we developed a new feature engineering model to assess the efficacy of the FLP. This model is self-organizing, producing nine potential results and subsequently choosing the optimal one. Our speech classification framework consists of (1) feature extraction using the proposed FLP and a statistical feature extractor; (2) feature selection employing iterative neighborhood component analysis and an intersection-based feature selector; (3) classification via support vector machine and k-nearest neighbors; and (4) outcome determination using combinational majority voting to select the most favorable results.

RESULTS

To validate the classification capabilities of our proposed feature engineering model, designed to automatically detect PD and SLI, we employed three speech datasets of PD and SLI patients. Our presented FLP-centric model achieved classification accuracy of more than 95% and 99.79% for all PD and SLI datasets, respectively.

CONCLUSIONS

Our results indicate that the proposed model is an accurate alternative to deep learning models in classifying neurological conditions using speech signals.

Phonological awareness training and phonological therapy approaches for specific language impairment children with speech sound disorders: a comparative outcome study

PURPOSE

Children with specific language impairment (SLI) might present with speech sound disorder (SSD) and phonological awareness (PA) deficits which put them at risk of potential reading problems. This work aimed to organize an intervention program in Arabic for phonological training and to assess the effect of PA training versus the phonological therapy (PT) for children with SLI and SSD.

METHODS

The study was carried out on 60 children with comorbid SLI and SSD, aged 5-7 years. Children were equally divided into two groups; each group received language therapy combined with (PT or PA training). Measures of language development, phonological output, and PA were taken before therapy and at 4 month post-therapy for all children.

RESULTS

The two therapy groups made nearly the same amount of progress in the development of language and phonological production, with no significant differences regarding language age and percent of consonants correct (PCC). The PA training group progressed more on the PA skills than children who received PT over the same time.

CONCLUSIONS

PA training could facilitate the development of phonological skills by targeting the child's awareness of phonemes and improving the production of sound patterns.

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.

Language abilities in children and adolescents with DLD and ADHD: A scoping review

PURPOSE

There is an emerging view that attention-deficit/hyperactivity disorder (ADHD) is marked by problems with language difficulties, an idea reinforced by the fact that ADHD is highly comorbid with developmental language disorder (DLD). This scoping review provides an overview of literature on language abilities in children with DLD and ADHD while highlighting similarities and differences.

METHOD

A comprehensive search was performed to examine the literature on language abilities in the two disorders, yielding a total of 18 articles that met the inclusion criteria for the present review. Qualitative summaries are provided based on the language domain assessed.

RESULTS

The current literature suggests children and adolescents with ADHD have better morphosyntax/grammar, general/core language abilities, receptive, and expressive abilities than those with DLD. Further, that performance is comparable on assessments of semantic and figurative language but varies by sample on assessments of phonological processing, syntax, narrative language, and vocabulary.

CONCLUSION

Evidence presented points to children and adolescents with DLD as having greater language difficulties compared to those with ADHD, but with some important caveats. Despite limitations related to the paucity of studies and inconsistencies in how the two types of disorders are identified, our review provides a necessary and vital step in better understanding the language profiles of these two highly prevalent childhood disorders. These findings are useful in optimizing language outcomes and treatment efficacy for children and adolescents with ADHD and DLD.

Psycholinguistic profiling of children with sluggish cognitive tempo

Language disorders are frequently comorbid with attention deficit/hyperactivity disorder (ADHD). Sluggish cognitive tempo (SCT), a second attention disorder, may potentially explain some of the links between language disorders and ADHD. In this study we examined the psycholinguistic abilities of 207 children (mean age 7;10) with and without clinically significant levels of SCT symptoms to determine the degree to which symptoms of language disorder co-occur in cases of SCT. Analyses of children's tense-marking, nonword repetition, and sentence recall indicated that deficits in these areas were not associated with SCT. Instead, SCT appears to be more closely aligned with features of social (pragmatic) communication disorder.

Resting-state EEG alpha rhythm spectral power in children with specific language impairment: a cross-sectional study

PURPOSE

This study investigated EEG alpha rhythm spectral power in children with Specific Language Impairment (SLI) and compared it to typically developing children to better understand the electrophysiological characteristics of this disorder. Specifically, we explored resting-state EEG, because there are studies that point to it being linked to speech and language development.

METHODS

EEG recordings of 30 children diagnosed with specific language impairment and 30 typically developing children, aged 4.0-6.11 years, were carried out under eyes closed and eyes open conditions. Differences in alpha rhythm spectral power in relation to brain topography and experimental conditions were calculated.

RESULTS

In the eyes closed condition, alpha rhythm spectral power was statistically significantly lower in children with specific language impairment in the left temporal (T5) and occipital electrodes (O1, O2) than in typically developing children. In the eyes open condition, children with SLI showed significantly lower alpha rhythm spectral power in the left temporal (T3, T5), parietal (P3, Pz), and occipital electrodes (O1, O2). There were no statistically significant differences between the groups in relation to the relative change (the difference between average alpha rhythm spectral power during eyes closed condition and average alpha rhythm spectral power during eyes open condition divided by average alpha rhythm spectral power during eyes closed condition) in the alpha rhythm spectral power between the conditions.

CONCLUSION

Lower alpha rhythm spectral power in the left temporal, left, midline parietal, and occipital brain regions could be a valuable electrophysiological marker in children with SLI. Further investigation is needed to examine the connection between EEG alpha spectral power and general processing and memory deficits in patients with SLI.

Limited Evidence of an Association Between Language, Literacy, and Procedural Learning in Typical and Atypical Development: A Meta-Analysis

The ability to extract patterns from sensory input across time and space is thought to underlie the development and acquisition of language and literacy skills, particularly the subdomains marked by the learning of probabilistic knowledge. Thus, impairments in procedural learning are hypothesized to underlie neurodevelopmental disorders, such as dyslexia and developmental language disorder. In the present meta-analysis, comprising 2396 participants from 39 independent studies, the continuous relationship between language, literacy, and procedural learning on the Serial Reaction Time task (SRTT) was assessed across children and adults with typical development (TD), dyslexia, and Developmental Language Disorder (DLD). Despite a significant, but very small, relationship between procedural learning and overall language and literacy measures, this pattern was not observed at the group-level when examining TD, dyslexic, and DLD groups separately. Based on the procedural/declarative model, a positive relationship was expected between procedural learning and language and literacy measures for the typically developing group; however, no such relationship was observed. This was also the case for the disordered groups (ps > .05). Also counter to expectations, the magnitude of the relationship between procedural learning and grammar and phonology did not differ between TD and DLD (ps > .05), nor between the TD and dyslexic group on reading, spelling, and phonology (ps > .05). While lending little support to the procedural/declarative model, we consider that these results may be the consequence of poor psychometric properties of the SRTT as a measure of procedural learning.

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.

Audiovisual multisensory integration in individuals with reading and language impairments: A systematic review and meta-analysis

Differences in sensory function have been documented for a number of neurodevelopmental conditions, including reading and language impairments. Prior studies have measured audiovisual multisensory integration (i.e., the ability to combine inputs from the auditory and visual modalities) in these populations. The present study sought to systematically review and quantitatively synthesize the extant literature on audiovisual multisensory integration in individuals with reading and language impairments. A comprehensive search strategy yielded 56 reports, of which 38 were used to extract 109 group difference and 68 correlational effect sizes. There was an overall difference between individuals with reading and language impairments and comparisons on audiovisual integration. There was a nonsignificant trend towards moderation according to sample type (i.e., reading versus language) and publication/small study bias for this model. Overall, there was a small but non-significant correlation between metrics of audiovisual integration and reading or language ability; this model was not moderated by sample or study characteristics, nor was there evidence of publication/small study bias. Limitations and future directions for primary and meta-analytic research are discussed.

Developmental language disorder - a comprehensive study of more than 46,000 individuals

Developmental language disorder (DLD) is characterized by enduring low language abilities with a significant functional impact, in the absence of biomedical conditions in which language impairment is part of a complex of impairments. There is a lack of awareness of DLD even among healthcare professionals. Here we estimated the prevalence of DLD and its links to reading and learning difficulties and physical and mental health in the Danish Blood Donor Study (N = 46,547), where DLD-related information is based on questionnaires (self-report). We compared the questionnaire-derived DLD status with the relevant language-related diagnoses from hospital registers. We also investigated the genetic architecture of DLD in a subset of the cohort (N = 18,380). DLD was significantly associated with reading and learning difficulties and poorer mental and physical health. DLD prevalence was 3.36%-3.70% based on questionnaires, compared with 0.04% in hospital registers. Our genetic analyses identified one genome-wide significant locus, but not a significant heritability estimate. Our study shows that DLD has health-related implications that may last into adulthood, and that DLD may be undiagnosed in general healthcare. Furthermore, DLD is likely more genetically heterogeneous than narrower developmental language phenotypes. Our results emphasize the need to raise awareness of DLD and consider criteria for molecular studies of DLD to reduce case heterogeneity.

Novel favipiravir pattern-based learning model for automated detection of specific language impairment disorder using vowels

Specific language impairment (SLI) is one of the most common diseases in children, and early diagnosis can help to obtain better timely therapy economically. It is difficult and time-consuming for clinicians to accurately detect SLI through standard clinical assessments. Hence, machine learning algorithms have been developed to assist in the accurate diagnosis of SLI. This work aims to investigate the graph of the favipiravir molecule-based feature extraction function and propose an accurate SLI detection model using vowels. We proposed a novel handcrafted machine learning framework. This architecture comprises the favipiravir molecular structure pattern, statistical feature extractor, wavelet packet decomposition (WPD), iterative neighborhood component analysis (INCA), and support vector machine (SVM) classifier. Two feature extraction models, statistical and textural, are employed in the handcrafted feature generation methodology. A new nature-inspired graph-based feature extractor that uses the chemical depiction of the favipiravir (favipiravir became popular with the COVID-19 pandemic) is employed for feature extraction. Finally, the proposed favipiravir pattern, statistical feature extractor, and wavelet packet decomposition are used to create a feature vector. Moreover, a statistical feature extractor is used in this work. The WPD generates multilevel features, and the most meaningful features are selected using the NCA feature selector. Finally, these chosen features are fed to SVM classifier for automated classification. Two validation methods, (i) leave one subject out (LOSO) and (ii) tenfold cross-validations (CV), are used to obtain robust classification results. Our proposed favipiravir pattern-based model developed using a vowel dataset can detect SLI children with an accuracy of 99.87% and 98.86% using tenfold and LOSO CV strategies, respectively. These results demonstrated the high vowel classification ability of the proposed favipiravir pattern-based model.

Vietnamese children with and without DLD: Classifier use and grammaticality over time

INTRODUCTION

One way to identify Developmental Language Disorder (DLD) is to establish clinical markers in a language to serve as reliable indicators of the disorder. This study embarks on the search for clinical markers for Vietnamese using longitudinal data from children with and without DLD.

METHODS

We matched ten children previously classified with DLD to ten with typical development (TD) by age and gender. Participants completed a story generation task at three time points: kindergarten, first, and second grade. Overall grammatical development was measured using mean length of utterance, MLU, and proportion of grammatical utterances, PGU. We examined a language-specific feature, classifiers, in terms of accuracy (omission errors), diversity (number of different classifiers), and productivity, or the use of classifiers in constructions of two-to-three elements (classifier+noun, numeral+classifier+noun). Longitudinal change and group differences were examined using linear mixed modeling, supplemented by linguistic analysis.

RESULTS

Both groups increased in MLU and PGU over time. The DLD group performed lower in kindergarten and continued to show lower performance over time on these measures. Classifier omission errors decreased over time with no group differences. Classifier diversity increased across groups, with lower performance by the DLD group in kindergarten and over time. For classifier productivity, TD children used classifiers in multiple constructions in kindergarten and maintained the same level over time. In contrast, children with DLD had minimal use of three-element constructions in kindergarten but increased in productivity over time.

CONCLUSIONS

Children with DLD produce shorter utterances with relatively more grammatical errors compared to their TD peers in the early school years. Though no longer committing classifier omission errors, children with DLD showed more restricted use of classifiers in terms of the number of different classifiers and constructions produced. Findings inform the search for Vietnamese clinical markers of DLD.

[Early detection of primary developmental language disorders-increasing relevance due to changes in diagnostic criteria?]

Language development disorders (in German: Sprachentwicklungsstörungen, SES) are the most common developmental disorders in childhood. In contrast to "secondary SES," "primary SES" (prevalence about 7%) are not (co-)caused by other developmental disorders or diseases. In the German modification of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-GM-22), primary SES are referred to as "circumscribed developmental disorders of speech and language" (in German: USES; international previously known as Specific Language Impairment SLI), with an intelligence quotient (IQ) < 85 as an exclusion criterion, among other criteria. In ICD-11, primary SES are listed as "developmental language disorders" (DLD).German-speaking speech and language therapists would now like to replace the term "USES" with "DLD" using the diagnostic criteria proposed by the international CATALISE consortium (Criteria and Terminology Applied to Language Impairments Synthesizing the Evidence), in an effort to redefine the disorder. However, according to this conceptualization, only children with an intellectual disability (IQ < 70) would be excluded from the diagnosis. This change in the diagnostic criteria would most likely result in an increase in prevalence of DLDs. This makes the issue of early detection more important than ever. This discussion paper explains that the public health relevance of primary SES is growing and that systematic early detection examinations will play an even more important role. With early diagnosis and treatment, risks in the areas of mental health, behaviour and skill development can be mitigated.Currently, diagnosis (and therapy) are usually carried out relatively late. The way out could lie in the application of neurobiological parameters. However, this requires further studies that examine child cohorts for early indicators in a prospective longitudinal design. The formation of an early detection index from several indicators should also be considered.

One-dimensional convolutional neural network and hybrid deep-learning paradigm for classification of specific language impaired children using their speech

BACKGROUND AND OBJECTIVE

Screening children for communicational disorders such as specific language impairment (SLI) is always challenging as it requires clinicians to follow a series of steps to evaluate the subjects. Artificial intelligence and computer-aided diagnosis have supported health professionals in making swift and error-free decisions about the neurodevelopmental state of children vis-à-vis language comprehension and production. Past studies have claimed that typical developing (TD) and SLI children show distinct vocal characteristics that can serve as discriminating facets between them. The objective of this study is to group children in SLI or TD categories by processing their raw speech signals using two proposed approaches: a customized convolutional neural network (CNN) model and a hybrid deep-learning framework where CNN is combined with long-short-term-memory (LSTM).

METHOD

We considered a publicly available speech database of SLI and typical children of Czech accents for this study. The convolution filters in both the proposed CNN and hybrid models (CNN-LSTM) estimated fuzzy-automated features from the speech utterance. We performed the experiments in five separate sessions. Data augmentations were performed in each of those sessions to enhance the training strength.

RESULTS

Our hybrid model exhibited a perfect 100% accuracy and F-measure for almost all the session-trials compared to CNN alone which achieved an average accuracy close to 90% and F-measure ≥ 92%. The models have further illustrated their robust classification essences by securing values of reliability indexes over 90%.

CONCLUSION

The results confirm the effectiveness of proposed approaches for the detection of SLI in children using their raw speech signals. Both the models do not require any dedicated feature extraction unit for their operations. The models may also be suitable for screening SLI and other neurodevelopmental disorders in children of different linguistic accents.

Pleiotropy between language impairment and broader behavioral disorders-an investigation of both common and rare genetic variants

BACKGROUND

Language plays a major role in human behavior. For this reason, neurodevelopmental and psychiatric disorders in which linguistic ability is impaired could have a big impact on the individual's social interaction and general wellbeing. Such disorders tend to have a strong genetic component, but most past studies examined mostly the linguistic overlaps across these disorders; investigations into their genetic overlaps are limited. The aim of this study was to assess the potential genetic overlap between language impairment and broader behavioral disorders employing methods capturing both common and rare genetic variants.

METHODS

We employ polygenic risk scores (PRS) trained on specific language impairment (SLI) to evaluate genetic overlap across several disorders in a large case-cohort sample comprising ~13,000 autism spectrum disorder (ASD) cases, including cases of childhood autism and Asperger's syndrome, ~15,000 attention deficit/hyperactivity disorder (ADHD) cases, ~3000 schizophrenia cases, and ~21,000 population controls. We also examine rare variants in SLI/language-related genes in a subset of the sample that was exome-sequenced using the SKAT-O method.

RESULTS

We find that there is little evidence for genetic overlap between SLI and ADHD, schizophrenia, and ASD, the latter being in line with results of linguistic analyses in past studies. However, we observe a small, significant genetic overlap between SLI and childhood autism specifically, which we do not observe for SLI and Asperger's syndrome. Moreover, we observe that childhood autism cases have significantly higher SLI-trained PRS compared to Asperger's syndrome cases; these results correspond well to the linguistic profiles of both disorders. Our rare variant analyses provide suggestive evidence of association for specific genes with ASD, childhood autism, and schizophrenia.

CONCLUSIONS

Our study provides, for the first time, to our knowledge, genetic evidence for ASD subtypes based on risk variants for language impairment.

A multi-study examination of the role of repeated spaced retrieval in the word learning of children with developmental language disorder

BACKGROUND

Many children with developmental language disorders (DLD) have well-documented weaknesses in vocabulary. In recent years, investigators have explored the nature of these weaknesses through the use of novel word learning paradigms. These studies have begun to uncover specific areas of difficulty and have provided hints about possible intervention strategies that might help these children learn words more accurately and efficiently. Among the studies of this type are those that incorporate repeated spaced retrieval activities in the learning procedures.

METHODS

In this study, we examined the data from four of these studies that employed the same types of participants (4- and 5-year-old children with DLD and same-age children with typical language development), research design, and outcome measures. The studies differed primarily in the type of learning condition that was being compared to a spaced retrieval condition. A mixed-effects modeling framework was used, enabling the data from the four studies and different outcome measures to be aggregated.

RESULTS

Across the studies, more words in the repeated spaced retrieval condition were recalled than those in the comparison conditions. This was true regardless of outcome measure. Children with typical language development recalled more words than the children with DLD. Both groups benefited from spaced retrieval, though effects were larger for the group with DLD. Children recalled words as accurately 1 week after learning as they did at the 5-min mark; the two groups were essentially identical in this respect.

CONCLUSIONS

Overall, the findings support the continued refinement of these types of repeated spaced retrieval procedures, as they may have potential to serve as effective approaches to intervention.

Simulating the Acquisition of Verb Inflection in Typically Developing Children and Children With Developmental Language Disorder in English and Spanish

Children with developmental language disorder (DLD) have significant deficits in language ability that cannot be attributed to neurological damage, hearing impairment, or intellectual disability. The symptoms displayed by children with DLD differ across languages. In English, DLD is often marked by severe difficulties acquiring verb inflection. Such difficulties are less apparent in languages with rich verb morphology like Spanish and Italian. Here we show how these differential profiles can be understood in terms of an interaction between properties of the input language, and the child's ability to learn predictive relations between linguistic elements that are separated within a sentence. We apply a simple associative learning model to sequential English and Spanish stimuli and show how the model's ability to associate cues occurring earlier in time with later outcomes affects the acquisition of verb inflection in English more than in Spanish. We relate this to the high frequency of the English bare form (which acts as a default) and the English process of question formation, which means that (unlike in Spanish) bare forms frequently occur in third-person singular contexts. Finally, we hypothesize that the pro-drop nature of Spanish makes it easier to associate person and number cues with the verb inflection than in English. Since the factors that conspire to make English verb inflection particularly challenging for learners with weak sequential learning abilities are much reduced or absent in Spanish, this provides an explanation for why learning Spanish verb inflection is relatively unaffected in children with DLD.

Oral language comprehension interventions in school-age children and adolescents with developmental language disorder: A systematic scoping review

BACKGROUND & AIMS

Difficulties understanding spoken language are associated with several social and academic risks in school-age children and adolescents with developmental language disorder (DLD). Still, interventions for this group have received little attention, and there are no reviews focusing on oral language comprehension interventions in school-age children and adolescents. The objective of this systematic scoping review was to identify interventions targeting oral language comprehension in school-age children and adolescents with DLD. Further, the aim was to examine the focus of intervention, efficacy, and level of evidence of the identified interventions. The present review is the second part of a larger search on oral language comprehension interventions. The first review examined the same factors in children 8 years and younger.

METHODS

A systematic scoping review of eight databases was conducted. Of the 2399 sourced articles, 12 met the inclusion criteria. Another 8 articles were identified through reference lists of sourced articles. In these 20 articles, containing 21 studies, 1661 children aged 5-16 years participated. The data were extracted and analysed, and the intervention focus, efficacy, and level of evidence were examined.Main contribution: In the interventions intended for school-age children and adolescents with DLD, three intervention foci were identified that targeted aspects of language and language processing, as well as modifying the communicative environment. Of the included studies, 57% reported positive results, 14% reported mixed results, and 29% reported no effects on oral language comprehension. The level of evidence varied. One can have high confidence in the results of 19%, moderate in 38%, and indicative confidence in 43% of the included studies.

CONCLUSIONS

Results of the present review suggest that there are a few interventions providing high confidence on the efficacy of improving oral language comprehension difficulties in school-age children and adolescents with DLD. Most interventions indicating efficacy provide moderate or indicative confidence in the results. More research with a high level of evidence is urgently needed. Most of the interventions indicating efficacy focused directly on language skills or modified the communicative environment. The results suggest that the therapy techniques focusing on improving language processing skills indicate efficacy only when they aim at compensating current language processing skills, not trying to improve them.Implications: The findings on different therapy techniques, their focus of intervention, efficacy, and level of evidence provide information for clinical practice and direct future investigations in this sparsely researched topic.

Functional organisation for verb generation in children with developmental language disorder

Developmental language disorder (DLD) is characterised by difficulties in learning one's native language for no apparent reason. These language difficulties occur in 7% of children and are known to limit future academic and social achievement. Our understanding of the brain abnormalities associated with DLD is limited. Here, we used a simple four-minute verb generation task (children saw a picture of an object and were instructed to say an action that goes with that object) to test children between the ages of 10-15 years (DLD N = 50, typically developing N = 67). We also tested 26 children with poor language ability who did not meet our criteria for DLD. Contrary to our registered predictions, we found that children with DLD did not have (i) reduced activity in language relevant regions such as the left inferior frontal cortex; (ii) dysfunctional striatal activity during overt production; or (iii) a reduction in left-lateralised activity in frontal cortex. Indeed, performance of this simple language task evoked activity in children with DLD in the same regions and to a similar level as in typically developing children. Consistent with previous reports, we found sub-threshold group differences in the left inferior frontal gyrus and caudate nuclei, but only when analysis was limited to a subsample of the DLD group (N = 14) who had the poorest performance on the task. Additionally, we used a two-factor model to capture variation in all children studied (N = 143) on a range of neuropsychological tests and found that these language and verbal memory factors correlated with activity in different brain regions. Our findings indicate a lack of support for some neurological models of atypical language learning, such as the procedural deficit hypothesis or the atypical lateralization hypothesis, at least when using simple language tasks that children can perform. These results also emphasise the importance of controlling for and monitoring task performance.

Lexical Access in Persian Speaking Children With and Without Specific Language Impairment

INTRODUCTION

Word retrieval problems are among the limitations observed in children with specific language impairment during the initial schooling years. These restrictions are predictive of reading problems and poor performance at school. Additionally, studies on lexical access in Persian speaking children are scarce. Therefore, this study aimed to investigate and compare naming accuracy and latency in children with and without specific language impairment.

METHODS

Twenty 7-9-year-old children with specific language impairment and 20 age-matched peers were recruited as the study participants. They were requested to name the 128 black and white line-drawing pictures from a Persian picture naming set for children, as rapidly as possible. We compared the effects of psycholinguistic variables on naming latency in the explored children with and without specific language impairment.

RESULTS

Linear mixed-effects modeling presented an interaction between the research groups and the psycholinguistic variables. Significant main effects were found for name agreement (P≤0.00) and the age of acquisition (P=0.05) in children with typical language development; significant effects for name agreement (P≤0.00) and log frequency (P≤0.00) were revealed in children with specific language impairment.

CONCLUSION

The obtained models indicated that psycholinguistic factors could differently affect the naming latency in children with and without specific language impairment. Factors that may have accounted for the findings are discussed in this paper.

Exploring gender as a potential source of bias in adult judgments of children with specific language impairment and attention-deficit/hyperactivity disorder

The purpose of this follow-up study to Ludlow (2013) was to examine potential sources of variability within attributional ratings adults (age range: 21-73) assigned to child speakers affected by either Specific Language Impairment (SLI) or Attention-Deficit/Hyperactivity Disorder (ADHD). Factors considered were rater's gender [Rater Male (RM) or Rater Female (RF)], the reported gender of the speakers [Speaker Male (SM) or Speaker Female (SF)], and the type of neurodevelopmental disorder involved (SLI or ADHD). Eighty participants (40 male and 40 female) rated brief, transcribed, narratives previously produced in Ludlow (2013) by boys affected by either SLI, ADHD, or who had typical neurodevelopment (TN). Narratives were presented to raters as having been generated by either a boy or a girl. After reading each narrative, participants provided ratings in response to 15 questions about the narrative, the child speaker's attributes, and family background. Analyses revealed a significant main effect for speaker group, such that raters assigned more pejorative attributes to children with a disorder (ADHD = SLI < TN and ADHD < SLI < TN) across all dimensions. Significant speaker gender main effects (SM < SF) were limited to questions targeting the speaker's behavioral attributes. Results obtained in this study with transcription stimuli replicated previous reports that had used audio stimuli. These findings contribute to a growing body of research documenting the presence of robust, multidimensional, implicit, negative biases among most individuals towards children displaying language differences associated with common neurodevelopmental disorders.

Positive Aspects of Emotional Competence in Preventing Internalizing Symptoms in Children with and without Developmental Language Disorder: A Longitudinal Approach

In order to better understand protective factors for internalizing problems, this longitudinal study examined positive emotions, emotion awareness and (non-)emotional communication skills in relation to somatic complaints and social anxiety in children with (N = 104) and without (N = 183) Developmental Language Disorder (DLD) using self-reported measures twice with a 9-month interval. Additionally, parents reported on their child’s communication problems and emotion communication at Time 1. Most importantly, since we found that increasing levels of emotion awareness related to decreases in social anxiety and somatic complaints in children with and without DLD, we conclude that children with DLD are likely to benefit from interventions aimed at improving their emotion awareness in addition to language interventions.

Oral language comprehension interventions in 1-8-year-old children with language disorders or difficulties: A systematic scoping review

BACKGROUND AND AIMS

The most severe problems in language manifest as difficulties in comprehending oral language. These difficulties are persistent and expose individuals to several risk factors. There is a lack of intervention research in the area of oral language comprehension, and no reviews have focused solely on oral language comprehension interventions in young children. The aim of this review was to identify interventions targeting oral language comprehension in children 8 years or younger with language disorders or difficulties. The review also examined the possible intervention foci, efficacy, and level of evidence of these interventions.

METHODS

A systematic scoping review of eight databases was carried out. Twenty of 2399 articles met the inclusion criteria and a further six articles were identified through reference lists of sourced articles. These 26 articles described 25 studies. Altogether 2460 children aged 1-8 years participated in the 25 studies. The data from these studies were extracted and analysed, and the intervention foci, efficacy, and level of evidence were evaluated.Main contribution: The reviewed interventions focused on three aspects: modifying the communicative environment of the child; targeting aspects of the child's language; or targeting the child's language processing. Of the included studies, 80% indicated positive effects on participants' oral language comprehension. The level of evidence of the included studies varied. With few exceptions, researchers and practitioners can have moderate confidence in the results of the included studies indicating that it is possible to ameliorate difficulties in oral language comprehension.

CONCLUSIONS

This review summarises the existing evidence on oral language comprehension interventions in young children with language disorders or difficulties. The evidence base is still limited, and more research is urgently needed. The results suggest that though not all interventions seem to provide desired outcomes, there are several interventions indicating efficacy to target problems in oral language comprehension in 1-8-year-old children with language disorders or difficulties. A careful choice of therapy technique and collaboration with people in the child's environment is required to maximize outcomes.Implications: The results suggest that young children's oral language comprehension skills can be improved by guiding parents and clinicians in their communication strategies, and by clinician-implemented interventions targeting aspects of the child's language. The research on interventions targeting children's language processing is limited, and the results mixed. The present study provides information on different oral language comprehension interventions and their outcomes. The findings are readily applicable for clinical use.

Language disorders

Developmental language disorders (DLD) are prevalent and persistent among school-age children but are often underrecognized. This chapter discusses the ways in which the various components of communication are impacted by these disorders and outlines the differences in expression seen in different languages. Research on biological and psychologic roots of the syndrome is also reviewed. As yet, no single definitive cause has been identified; the disorders are likely to result from a constellation of genetic, biological, and cognitive weaknesses that are influenced by environmental experiences. Basic methods of assessment and differential diagnosis are presented and the principles guiding the development of intervention programs are discussed.

Visual and verbal semantic productions in children with ASD, DLD, and typical language

PURPOSE

Associations between visual and verbal input allow children to form, augment, and refine their semantic representations within their mental lexicons. However, children with autism spectrum disorder (ASD) and with developmental language disorder (DLD; also known as specific language impairment) process visual and verbal information differently than their typically developing peers, which may impact how they incorporate visual and verbal features into their semantic representations. The purpose of this exploratory study was to investigate how children with ASD and DLD use visually and verbally presented input to produce semantic representations of newly learned words.

METHOD

Semantic features produced by 36 school-aged children (12 with ASD, 12 with DLD, and 12 with typical language development) were extracted from previously collected novel word definitions and coded based on their initial presentation modality (either visual, verbal, or both in combination) during an extended novel word learning paradigm. These features were then analyzed to explore group differences in the use of visual and verbal input.

RESULTS

The children with ASD and DLD produced significantly more visually-presented semantic features than their typical peers in their novel word definitions. There were no differences between groups in the proportion of semantic features presented verbally or via both modalities in combination. Also, the children increased their production of semantic features presented via both modalities combined across the sessions; this same increase in production was not observed for the semantic features taught in either the visual or verbal modality alone.

CONCLUSION

Children with ASD and DLD benefit from visually presented semantic information, either in isolation or combined with verbal input, during tasks of word learning. Also, the reinforcement of combined visual-verbal input appears to enhance semantic learning over time.

A real-time mechanism underlying lexical deficits in developmental language disorder: Between-word inhibition

Eight to 11% of children have a clinical disorder in oral language (Developmental Language Disorder, DLD). Language deficits in DLD can affect all levels of language and persist through adulthood. Word-level processing may be critical as words link phonology, orthography, syntax and semantics. Thus, a lexical deficit could cascade throughout language. Cognitively, word recognition is a competition process: as the input (e.g., lizard) unfolds, multiple candidates (liver, wizard) compete for recognition. Children with DLD do not fully resolve this competition, but it is unclear what cognitive mechanisms underlie this. We examined lexical inhibition-the ability of more active words to suppress competitors-in 79 adolescents with and without DLD. Participants heard words (e.g. net) in which the onset was manipulated to briefly favor a competitor (neck). This was predicted to inhibit the target, slowing recognition. Word recognition was measured using a task in which participants heard the stimulus, and clicked on a picture of the item from an array of competitors, while eye-movements were monitored as a measure of how strongly the participant was committed to that interpretation over time. TD listeners showed evidence of inhibition with greater interference for stimuli that briefly activated a competitor word. DLD listeners did not. This suggests deficits in DLD may stem from a failure to engage lexical inhibition. This in turn could have ripple effects throughout the language system. This supports theoretical approaches to DLD that emphasize lexical-level deficits, and deficits in real-time processing.

Subject-Aux Inversion in Children with SLI

An elicited production study investigated subject-aux inversion in 5-year-old children with specific language impairment (SLI) and 2 control groups, typically-developing 5-year-old children and 3-year-old children matched by mean length of utterance. The experimental findings showed that children with specific language impairment produced subject-aux inversion in yes/no questions significantly less often than either of the control groups. However, the fact that lack of inversion is reflected in the input led to the proposal that children with specific language impairment choose the most economical grammatical option. For main clause wh-questions, children with SLI carried out subject-aux inversion at a rate that was not significantly different from the control groups. This finding suggests that these children have access to hierarchical phrase structure representations for questions and the relevant movement operations. In embedded wh-questions, where subject-aux inversion is not permitted, children with SLI implemented SAI more frequently than the control groups. Our interpretation of this finding is that once children with SLI acquire the subject-aux inversion rule, that they are slower to learn that embedded clauses present an exception to the rule.

Narrative abilities of bilingual children with and without Developmental Language Disorder (SLI): Differentiation and the role of age and input factors

PURPOSE

The narrative abilities of bilinguals with TD and with DLD/SLI in their English L2 were examined in order to 1) identify the narrative components that differentiate these two groups and 2) determine the role of age and input factors in predicting L2 narrative abilities in each group.

METHOD

Participants were 24 English L2 children with DLD and 63 English L2 children with TD, matched on age (mean = 5; 8) and length of exposure to the L2 (mean = 24 months). Narrative samples were elicited using a story generation task and a parent questionnaire provided age and input variables.

RESULTS

Bilinguals with DLD had significantly lower scores for story grammar than their TD peers, but showed similar scores for narrative microstructure components. Length of L2 exposure in school and richness of the L2 environment predicted better narrative abilities for the group with TD but not with DLD. Older age predicted better narrative abilities for the group with DLD but not with TD. Quantity of L2 input/output at home did not predict story grammar or microstructure abilities in either group.

CONCLUSION

Story grammar might differentiate between children with TD and DLD better than microstructure among bilinguals with less exposure to the L2 and when a story generation task is used. Bilinguals with TD make more efficient use of L2 input than bilinguals with DLD.

Concise tool based on language milestones identifies children with specific language impairment at 24-45 months of age

AIM

This study aimed to develop a concise tool with acceptable predictive properties to identify young children with specific language impairment (SLI).

METHODS

In this nested case-control study children with SLI attending two special needs schools for severe speech and language difficulties in the Netherlands were matched by date of birth and sex with control children attending mainstream education. This study analysed the predictive validity for having SLI at a mean age of eight years and three months (range 4-11 years) using combinations of six language milestones that were registered at 24, 36 and 45 months and retrieved from the children's healthcare files in 2012.

RESULTS

We included 253 pairs of children with and without SLI. During a single visit, combinations of two milestones at one age achieved a specificity of at least 97% and sensitivities ranged from 32% to 64%. However, the concise tool, which combined five milestones at three different ages - 24, 36 and 45 months - had a specificity of 96% (95% confidence interval 94-99%) and a sensitivity of 71% (95% confidence interval 66-77%).

CONCLUSION

Combining milestones at different ages provided a concise tool that could help to detect children with SLI at a young age.

Case marking in German-speaking children with specific language impairment and with phonological impairment

Identification of children with specific language impairment (SLI, now known as Developmental Language Disorder) remains challenging. Morphosyntax difficulties have been proposed as potential linguistic 'markers' for SLI across a number of languages. This study investigates the existence of such a clinical marker in German-speaking children with SLI, looking in particular at German case marking, and makes comparisons with matched typically developing groups and a group with isolated phonological impairment (PI). A case-control study was completed with 66 pre-school children in four groups (1) SLI, (2) PI, (3) age-matched typically developing children (TD-A) (4) language-matched typically developing children (TD-L). Errors in nominative, accusative and dative marking were analysed from the production of articles in elicitation tasks and spontaneous language samples. The performance of the SLI group was poorer than the TD-A group across all three grammatical cases investigated, but there was little supportive evidence for this being a diagnostic marker. It is, however, suggested that poor case marking may alert clinicians to the need for further linguistic assessment. No significant differences were found between the SLI and PI groups; rather scores for the PI group suggested they fell on a gradient between the SLI TD-A groups. Findings are discussed in relation to the proposed new diagnostic category of developmental language disorder.

Discriminating autism and language impairment and specific language impairment through acuity of musical imagery

Deficits in auditory short-term memory have been widely reported in children with Specific Language Impairment (SLI), and recent evidence suggests that children with Autism Spectrum Disorder and co-morbid language impairment (ALI) experience similar difficulties. Music, like language relies on auditory memory and the aim of the study was to extend work investigating the impact of auditory short-term memory impairments to musical perception in children with neurodevelopmental disorders. Groups of children with SLI and ALI were matched on chronological age (CA), receptive vocabulary, non-verbal intelligence and digit span, and compared with CA matched typically developing (TD) controls, on tests of pitch and temporal acuity within a voluntary musical imagery paradigm. The SLI participants performed at significantly lower levels than the ALI and TD groups on both conditions of the task and their musical imagery and digit span scores were positively correlated. In contrast ALI participants performed as well as TD controls on the tempo condition and better than TD controls on the pitch condition of the task. Whilst auditory short-term memory and receptive vocabulary impairments were similar across ALI and SLI groups, these were not associated with a deficit in voluntary musical imagery performance in the ALI group.

German dative case marking in monolingual and simultaneous bilingual children with and without SLI

This study explores the role of German dative case marking in disentangling effects of specific language impairment (SLI) and bilingualism. Longitudinal data of German-Italian bilingual children with SLI (N = 3) is compared to cross-sectional data (N = 42) of monolingual and bilingual typically developing (TD) children and monolingual children with SLI (ages four and seven). Spontaneous and elicited speech data is analysed in terms of target-like dative case marking in German. Results show differences between the acquisition of case marking of pronouns and of full Determiner Phrases (DPs). Regarding the target-like dative case marking in total, there were no differences found between bilingual TD, monolingual and bilingual children with SLI by the age of four. They demonstrated a similar delay when compared to monolingual TD children. By the age of seven, however, bilingual TD children 'catch up' with their monolingual peers. Children with SLI do not master the acquisition of dative case marking by this age. Cumulative effects of bilingualism and SLI were not found neither in younger nor in older bilingual children. These findings underline the importance of further research on linguistic markers and of distinguishing between effects of SLI and bilingualism.

Understanding developmental language disorder - the Helsinki longitudinal SLI study (HelSLI): a study protocol

BACKGROUND

Developmental language disorder (DLD, also called specific language impairment, SLI) is a common developmental disorder comprising the largest disability group in pre-school-aged children. Approximately 7% of the population is expected to have developmental language difficulties. However, the specific etiological factors leading to DLD are not yet known and even the typical linguistic features appear to vary by language. We present here a project that investigates DLD at multiple levels of analysis and aims to make the reliable prediction and early identification of the difficulties possible. Following the multiple deficit model of developmental disorders, we investigate the DLD phenomenon at the etiological, neural, cognitive, behavioral, and psychosocial levels, in a longitudinal study of preschool children.

METHODS

In January 2013, we launched the Helsinki Longitudinal SLI study (HelSLI) at the Helsinki University Hospital ( http://tiny.cc/HelSLI ). We will study 227 children aged 3-6 years with suspected DLD and their 160 typically developing peers. Five subprojects will determine how the child's psychological characteristics and environment correlate with DLD and how the child's well-being relates to DLD, the characteristics of DLD in monolingual versus bilingual children, nonlinguistic cognitive correlates of DLD, electrophysiological underpinnings of DLD, and the role of genetic risk factors. Methods include saliva samples, EEG, computerized cognitive tasks, neuropsychological and speech and language assessments, video-observations, and questionnaires.

DISCUSSION

The project aims to increase our understanding of the multiple interactive risk and protective factors that affect the developing heterogeneous cognitive and behavioral profile of DLD, including factors affecting literacy development. This accumulated knowledge will form a heuristic basis for the development of new interventions targeting linguistic and non-linguistic aspects of DLD.

The comparison of perceived health-related quality of life between Australian children with severe specific language impairment to age and gender-matched peers

BACKGROUND

Children with specific language impairment often present with multiple comorbidities, which may adversely affect both participation in play and academic performance, potentially impacting a child's health-related quality of life. This study 1) explored the suitability of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL™) for use with a typically developing Australian control group, and 2) compared the health-related quality of life between a control group and Australian children with severe specific language impairment.

METHODS

Health-related quality of life data collected as part of a broader study of 43 children with severe specific language impairment (males = 35, age range 5-16, mean age = 8.79+/- 2.92) enrolled at a special school were used to explore previously unreported findings. Typically developing gender and age matched (+/- 3 months) peers were recruited from local schools. The PedsQL™ child self-report and proxy-report were individually or interviewer-administered to the control group as required, and then compared to the group with specific language impairment.

RESULTS

The PedsQL™ was reliable and feasible for use with the control group (N = 43, males = 35, age range = 5-16 years, mean age = 8.74+/- 2.94 years). Control group performance was as expected as per the manual. Parents of the control group scored their children significantly higher than did the children themselves on all scales except the emotional functioning scale. Both the control group children and their parents scored themselves significantly higher on all scales, compared to children with severe specific language impairment and their parents.

CONCLUSIONS

The PedsQL™ was suitable for use with the control group. Further, the recruitment of a control group provided additional clarity on the extent a severe specific language impairment impacts on an Australian child's perceived health-related quality of life, compared to the manual cut-off scores. Severe specific language impairment significantly impacts negatively on the health-related quality of life of Australian children across all domains, particularly when compared to an age and gender-matched group of peers. These results warrant the inclusion of health-related quality of life evaluations in the assessment of these children along with a multidisciplinary approach.

Late Talkers: Why the Wait-and-See Approach Is Outdated

From a speech-language pathology perspective, there is a gap in interprofessional education/practice (IPE/IPP) that leads to a wait-and-see approach with late talkers (LT). In line with the American Speech-Language-Hearing Association's Strategic Pathway to Excellence, this article attempts to bridge the gap, reexamining the panoptic view that most LT "catch up" to their peers. The LT who persist with language disorder should not be overlooked. Late talking can impact socialization and school readiness, and can place some toddlers at risk for life-long disability. Each state's early intervention program has an established IPP infrastructure. Parent-implemented intervention addresses risks and maximizes protective factors.

Retelling stories: Grammatical and lexical measures for identifying monolingual spanish speaking children with specific language impairment (SLI)

Children with Specific Language Impairment (SLI) have grammatical and lexical difficulties when telling stories. The aim of this work was to explore whether language productivity measures, such as mean length of utterance (MLU), percentage of ungrammatical sentences (%UGS), total number of words (TNW), and number of different words (NDW) produced by young children during a story retell task, can be used to accurately differentiate monolingual Spanish-speaking children with SLI from children with typical language development (TLD). Fifty monolingual Spanish-speaking children between 4; 0 and 6; 11 years were assigned to one of two groups: 25 children with SLI and 25 TLD age-matched peers. A scripted picture book was read to each child and the child was subsequently asked to retell the story using pictures. Story retells were analyzed for MLU, %UGS, TNW, and NDW. Results showed significant differences between groups on all four measures. Children with SLI showed significantly lower MLU, TNW and NDW, and significantly higher%UGS when compared with age-matched peers with TLD. Results suggest that measures of language productivity obtained during story retells may be used to accurately detect differences in language performance and differentiate monolingual Spanish-speaking children with SLI from their typical peers. The findings from this study have clinical implications for assessment and identification of monolingual Spanish-speaking children with language impairments.

Is interference control in children with specific language impairment similar to that of children with autistic spectrum disorder?

AIMS

The purpose of the study was to examine resistance to proactive interference, which is strongly associated with working memory (WM) performance and language processing, in children with specific language impairment (SLI), with autism spectrum disorder (ASD), and with typical development (TD).

METHODS

Sixty children (eight to ten years; matched in age and nonverbal IQ) participated in the study. Resistance to proactive interference was measured using a verbal conflict paradigm.

RESULTS

Children with SLI and ASD show a deficit in resistance to proactive interference compared to their TD peers, but the source of the problem appears to be different for the two clinical groups. The interference problem exhibited by the children with SLI is related to a more complex deficit involving different cognitive-linguistic functions, whereas the children with ASD show a specific problem in cognitive flexibility.

IMPLICATIONS

The theoretical implications are that poor resistance to interference may be caused by weaknesses in different WM functions, such as a deficit in updating or responses based on familiarity rather than recollection. The clinical implications are that children with SLI and ASD show distinct patterns of performance; therefore they need different types of intervention to strengthen their resistance to proactive interference.

Procedural memory and speed of grammatical processing: Comparison between typically developing children and language impaired children

BACKGROUND

Procedural memory has been proposed to underlie the acquisition of a range of skills including grammar, reading, and motor skills. In developmental language disorder (DLD) it has been suggested that procedural memory problems lead to the difficulties with grammar in this group.

AIMS

This study aimed to extend previous research by exploring associations between procedural memory and a range of cognitive skills, in children with and without language impairments.

METHODS AND PROCEDURES

Twenty children with DLD and 20 age-matched non-language impaired children undertook tasks assessing procedural memory, grammatical processing speed, single word and nonword reading, and motor skills (as indexed by a pegboard task).

OUTCOMES AND RESULTS

For the DLD group, no significant correlations between procedural memory and any of the variables were observed. The typically developing group showed a significant correlation (r=.482, p<0.05) between the measure of procedural memory and grammatical processing speed. Correlations between procedural memory and the remaining variables were all non-significant for this group.

CONCLUSIONS AND IMPLICATIONS

This study provides new evidence showing that grammatical processing speed is correlated with procedural memory in typically developing children. Furthermore, results suggest that the relationship with procedural memory does not extend to reading or the types of motor skills used on a pegboard task. For the DLD group the pattern of result indicate grammatical processing, reading, and motor sequencing are not supported by procedural memory or a common memory system.

Statistical word learning in children with autism spectrum disorder and specific language impairment

BACKGROUND

Word learning is an important component of language development that influences child outcomes across multiple domains. Despite the importance of word knowledge, word-learning mechanisms are poorly understood in children with specific language impairment (SLI) and children with autism spectrum disorder (ASD). This study examined underlying mechanisms of word learning, specifically, statistical learning and fast-mapping, in school-aged children with typical and atypical development.

METHODS

Statistical learning was assessed through a word segmentation task and fast-mapping was examined in an object-label association task. We also examined children's ability to map meaning onto newly segmented words in a third task that combined exposure to an artificial language and a fast-mapping task.

RESULTS

Children with SLI had poorer performance on the word segmentation and fast-mapping tasks relative to the typically developing and ASD groups, who did not differ from one another. However, when children with SLI were exposed to an artificial language with phonemes used in the subsequent fast-mapping task, they successfully learned more words than in the isolated fast-mapping task. There was some evidence that word segmentation abilities are associated with word learning in school-aged children with typical development and ASD, but not SLI. Follow-up analyses also examined performance in children with ASD who did and did not have a language impairment. Children with ASD with language impairment evidenced intact statistical learning abilities, but subtle weaknesses in fast-mapping abilities.

CONCLUSIONS

As the Procedural Deficit Hypothesis (PDH) predicts, children with SLI have impairments in statistical learning. However, children with SLI also have impairments in fast-mapping. Nonetheless, they are able to take advantage of additional phonological exposure to boost subsequent word-learning performance. In contrast to the PDH, children with ASD appear to have intact statistical learning, regardless of language status; however, fast-mapping abilities differ according to broader language skills.

Low-level neural auditory discrimination dysfunctions in specific language impairment-A review on mismatch negativity findings

In specific language impairment (SLI), there is a delay in the child’s oral language skills when compared with nonverbal cognitive abilities. The problems typically relate to phonological and morphological processing and word learning. This article reviews studies which have used mismatch negativity (MMN) in investigating low-level neural auditory dysfunctions in this disorder. With MMN, it is possible to tap the accuracy of neural sound discrimination and sensory memory functions. These studies have found smaller response amplitudes and longer latencies for speech and non-speech sound changes in children with SLI than in typically developing children, suggesting impaired and slow auditory discrimination in SLI. Furthermore, they suggest shortened sensory memory duration and vulnerability of the sensory memory to masking effects. Importantly, some studies reported associations between MMN parameters and language test measures. In addition, it was found that language intervention can influence the abnormal MMN in children with SLI, enhancing its amplitude. These results suggest that the MMN can shed light on the neural basis of various auditory and memory impairments in SLI, which are likely to influence speech perception.

Screening for Specific Language Impairment in Preschool Children: Evaluating a Screening Procedure Including the Token Test

Specific language impairment (SLI) comprises impairments in receptive and/or expressive language. Aim of this study was to evaluate a screening for SLI. 61 children with SLI (SLI-children, age-range 4-6 years) and 61 matched typically developing controls were tested for receptive language ability (Token Test-TT) and for intelligence (Wechsler Preschool-and-Primary-Scale-of-Intelligence-WPPSI). Group differences were analyzed using t tests, as well as direct and stepwise discriminant analyses. The predictive value of the WPPSI with respect to TT performance was analyzed using regression analyses. SLI-children performed significantly worse on both TT and WPPSI ([Formula: see text]). The TT alone yielded an overall classification rate of 79%, the TT and the WPPSI together yielded an overall classification rate of 80%. TT performance was significantly predicted by verbal intelligence in SLI-children and nonverbal intelligence in controls whilst WPPSI subtest arithmetic was predictive in both groups. Without further research, the Token Test cannot be seen as a valid and sufficient tool for the screening of SLI in preschool children but rather as a tool for the assessment of more general intellectual capacities. SLI-children at this age already show impairments typically associated with SLI which indicates the necessity of early developmental support or training. Token Test performance is possibly an indicator for a more general developmental factor rather than an exclusive indicator for language difficulties.

The roles of cognitive and language abilities in predicting decoding and reading comprehension: comparisons of dyslexia and specific language impairment

This study aimed to (a) explore the roles of cognitive and language variables in predicting reading abilities of two groups of individuals with reading disabilities (i.e., dyslexia and specific language impairment) and (b) examine which variable(s) is the most predictive in differentiating two groups. Inclusion/exclusion criteria applied to categorize the two groups yielded a total of 63 participants (n = 44 for the dyslexia; n = 19 for the specific language impairment). A stepwise multiple regression approach was conducted to examine which cognitive and/or language variables made the largest contribution to reading abilities (i.e., Phonetic Decoding Efficiency, Word Attack, Sight Word Efficiency, and Passage Comprehension). Results revealed that there were significant differences in which measures of cognitive and language ability predicted individuals with dyslexia and speech and language impairments reading ability, showing that the cognitive and language variables underlying their difficulty with reading abilities were not the same across the two groups. A discriminant function analysis showed that a measure of Verbal Comprehension, Phonological Awareness, and Phonetic Decoding Efficiency can be used to differentiate the two groups. These findings support the tenet that dyslexia and specific language impairment are two subgroups of reading disabilities and that thorough diagnostic evaluations are needed to differentiate between these two subgroups. Distinctions of this nature are central to determining the type and intensity of language-based interventions.

The role of nonverbal working memory in morphosyntactic processing by children with specific language impairment and autism spectrum disorders

BACKGROUND

Both children with autism spectrum disorders (ASD) and children with specific language impairment (SLI) have been shown to have difficulties with grammatical processing. A comparison of these two populations with neurodevelopmental disorders was undertaken to examine similarities and differences in the mechanisms that may underlie grammatical processing. Research has shown that working memory (WM) is recruited during grammatical processing. The goal of this study was to examine morphosyntactic processing on a grammatical judgment task in children who varied in clinical diagnosis and language abilities and to assess the extent to which performance is predicted by nonverbal working memory (WM). Two theoretical perspectives were evaluated relative to performance on the grammatical judgment task-the "working memory" account and the "wrap-up" account. These accounts make contrasting predictions about the detection of grammatical errors occurring early versus late in the sentence.

METHODS

Participants were 84 school-age children with SLI (n = 21), ASD (n = 27), and typical development (TD, n = 36). Performance was analyzed based on diagnostic group as well as language status (normal language, NL, n = 54, and language impairment, LI, n = 30). A grammatical judgment task was used in which the position of the error in the sentence (early versus late) was manipulated. A visual WM task (N-back) was administered and the ability of WM to predict morphosyntactic processing was assessed.

RESULTS

Groups differed significantly in their sensitivity to grammatical errors (TD > SLI and NL > LI) but did not differ in nonverbal WM. Overall, children in all groups were more sensitive and quicker at detecting errors occurring late in the sentence than early in the sentence. Nonverbal WM predicted morphosyntactic processing across groups, but the specific profile of association between WM and early versus late error detection was reversed for children with and without language impairment.

CONCLUSIONS

Findings primarily support a "wrap up" account whereby the accumulating sentence context for errors positioned late in the sentence (rather than early) appeared to facilitate morphosyntactic processing. Although none of the groups displayed deficits in visual WM, individual differences in these nonverbal WM resources predicted proficiency in morphosyntactic processing.

Evaluation of the language profile in children with rolandic epilepsy and developmental dysphasia: Evidence for distinct strengths and weaknesses

Although benign, rolandic epilepsy (RE) or benign childhood epilepsy with centro-temporal spikes is often associated with language impairment. Recently, fronto-rolandic EEG abnormalities have been described in children with developmental dysphasia (DD), suggesting an interaction between language impairment and interictal epileptiform discharges. To investigate if a behavioral-linguistic continuum between RE and DD exists, a clinical prospective study was carried out to evaluate the language profile of 15 children with RE and 22 children with DD. Language skills were assessed using an extensive, standardized test battery. Language was found to be impaired in both study groups, however RE and DD were associated with distinct language impairment profiles. Children with RE had difficulties with sentence comprehension, semantic verbal fluency and auditory short-term memory, which are unrelated to age of epilepsy onset and laterality of epileptic focus. In children with DD, sentence comprehension and verbal fluency were among their relative strengths, whereas sentence and lexical production constituted relative weaknesses.

Neural patterns elicited by sentence processing uniquely characterize typical development, SLI recovery, and SLI persistence

Background

A substantial amount of work has examined language abilities in young children with specific language impairment (SLI); however, our understanding of the developmental trajectory of language impairment is limited. Along with studying the behavioral changes that occur across development, it is important to examine the neural indices of language processing for children with different language trajectories. The current study sought to examine behavioral and neural bases of language processing in adolescents showing three different trajectories: those with normal language development (NL), those exhibiting persistent SLI (SLI-Persistent), and those with a history of SLI who appear to have recovered (SLI-Recovered).

Methods

Through a sentence judgment task, we examined semantic and syntactic processing. Adolescents judged whether or not each sentence was semantically and syntactically correct. Stimuli consisted of naturally spoken sentences that were either correct, contained a semantic verb error, or contained a syntactic verb agreement error. Verb agreement errors consisted of omission and commission violations of the third-person singular -s. Behavioral button-press responses and electroencephalographic recordings were collected. Behavioral judgments and mean amplitude of the N400 and P600 components were examined.

Results

Adolescents in the SLI-Persistent group had lower sentence judgment accuracy overall, relative to the NL and SLI-Recovered groups. Accuracy in judging omission and commission syntactic errors were marginally different, with marginally lower accuracy for commission errors. All groups demonstrated an N400 component elicited by semantic violations. However, adolescents in the SLI-Persistent group demonstrated a less robust P600 component for syntactic violations. Furthermore, adolescents in the SLI-Recovered group exhibited a similar neural profile to the NL group for the semantic and syntactic omission violations. However, a unique profile with initial negativity was observed in the SLI-Recovered group in the commission violation condition.

Conclusions

Adolescents with persistent language impairment continue to demonstrate delays in language processing at the behavioral and neural levels. Conversely, the adolescents in the SLI-Recovered group appear to have made gains in language processing skills to overcome their initial impairments. However, our findings suggest that the adolescents in the SLI-Recovered group may have compensatory processing strategies for some aspects of language, as evidenced by a unique event-related potential profile.

Can you spell dyslexia without SLI? Comparing the cognitive profiles of dyslexia and specific language impairment and their roles in learning

The aim of the present study is to explore whether those with Specific Language Impairment (SLI) and dyslexia display distinct or overlapping cognitive profiles with respect to learning outcomes. In particular, we were interested in two key cognitive skills associated with academic performance - working memory and IQ. We recruited three groups of children - those with SLI, those with dyslexia, and a control group. All children were given standardized tests of working memory, IQ (vocabulary and matrix), spelling, and math. The pattern of results suggests that both children with dyslexia and SLI are characterized with poorer verbal working memory and IQ compared to controls, but preserved nonverbal cognitive skills. It appears that that these two disorder groups cannot be distinguished by the severity of their cognitive deficits. However, there was a differential pattern with respect to learning outcomes, where the children with dyslexia rely more on visual skills in spelling, while those with SLI use their relative strengths in vocabulary. These findings can have important implications for how intervention is tailored in the classroom, as disorder-specific support could yield important gains in learning.

When Autistic Behavior Suggests a Disease Other than Classic Autism

Most neurodevelopmental disorders are defined by their clinical symptoms and many disorders share common features. Recently there has been an increase in the number of children diagnosed with autism spectrum disorder, although concerns have been raised about the accuracy of the reported prevalence rates. This article reviews the essential features of autism spectrum disorder and describes other conditions that may include similar symptoms that may be misdiagnosed as autism spectrum disorder (primary communication disorders, anxiety disorders, attachment disorders, intellectual disability, vision and hearing impairment, and normal variations). An approach to differential diagnosis is discussed with particular attention to evaluation of young children.

The clinical examination of non-word repetition tasks in identifying Persian-speaking children with primary language impairment

OBJECTIVE

This study aimed to examine the diagnostic accuracy of a non-word repetition (NWR) test in identifying Persian-speaking preschool children with specific/primary language impairment (PLI). Children with PLI show consistently poorer performance in non-word repetition tasks than their typically developing language (TDL) counterparts. It is assumed that the ability to repeat non-words triggers language skills and that the absence of this ability may be responsible for language impairment in PLI children.

METHODS

Twenty preschool children with PLI participated in this study and were compared with 31 peers whose language skills were developing typically. The TDL children were randomly selected from daycare centers, and the children with PLI were referred by qualified speech-language pathologists from speech therapy clinics. A Persian NWR test was administered and scored using two levels of scoring: item-level scoring and syllable-level scoring. Data were analyzed in two phases. The first phase aimed to determine any differences between the two groups of children in terms of NWR ability. The second phase examined the diagnostic measures of the test.

RESULTS

The results of first phase documented that both scoring methods for the NWR test significantly differentiated between children with PLI and their normal peers. The second phase indicated that both scoring methods for the NWR test have good sensitivity and specificity in differentiating Persian-speaking children with PLI from their normal peers.

CONCLUSION

Non-word repetition can be a reliable clinical marker of PLI in Persian-speaking preschool children.

An fMRI study of implicit language learning in developmental language impairment

Individuals with developmental language impairment can show deficits into adulthood. This suggests that neural networks related to their language do not normalize with time. We examined the ability of 16 adults with and without impaired language to learn individual words in an unfamiliar language. Adults with impaired language were able to segment individual words from running speech, but needed more time to do so than their normal-language peers. ICA analysis of fMRI data indicated that adults with language impairment activate a neural network that is comparable to that of adults with normal language. However, a regional analysis indicated relative hyperactivation of a collection of regions associated with language processing. These results are discussed with reference to the Statistical Learning Framework and the sub-skills thought to relate to word segmentation.

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Adults with developmental language impairment were imaged during a word segmentation task in an unfamiliar natural language.

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Impaired adults learned to identify individual words, although it took them longer than their typical language peers.

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The impaired group used the same learning network as the typical group, arguing against recruitment of additional regions.

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Hyper-activation in language regions characterized the impaired group, unless performance was equated between groups.

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This suggests that hyper-activation for the impaired group reflects greater effort by learners at earlier stages of learning.

The Real-Time Comprehension of Idioms by Typical Children, Children with Specific Language Impairment and Children with Autism

Objective

We examined on-line auditory idiom comprehension in typically developing (TD) children, children with specific language impairment (SLI), and children with autism. Theories of idiom processing in adults agree on a reliance on lexical/semantic memory for these forms, but differ in their specifics. The Lexical Representation hypothesis claims that literal and non-literal meanings are activated in parallel. The Configuration hypothesis claims that a non-literal meaning will take precedence, such that a literal meaning may not be activated at all.

Method

Children aged 6–16 years listened to sentences containing idioms for a cross-modal priming task. The idioms were ambiguous between an idiomatic and a literal meaning. We looked at priming for both meanings at the offset of the idiom.

Results

TD children (n=14) and children with SLI (n=7) primed for the idiomatic but not literal meaning of the idiom. Children with autism (n=5) instead primed for the literal but not idiomatic meaning.

Conclusions

TD children showed an adult-like pattern, consistent with predictions of the Configuration Hypothesis. Children with SLI showed the typical pattern, whereas the atypical pattern observed for children with autism may reflect a particular deficit with complex material in semantic memory.