Phenome risk classification enables phenotypic imputation and gene discovery in developmental stuttering

Developmental stuttering is a speech disorder characterized by disruption in the forward movement of speech. This disruption includes part-word and single-syllable repetitions, prolongations, and involuntary tension that blocks syllables and words, and the disorder has a life-time prevalence of 6-12%. Within Vanderbilt's electronic health record (EHR)-linked biorepository (BioVU), only 142 individuals out of 92,762 participants (0.15%) are identified with diagnostic ICD9/10 codes, suggesting a large portion of people who stutter do not have a record of diagnosis within the EHR. To identify individuals affected by stuttering within our EHR, we built a PheCode-driven Gini impurity-based classification and regression tree model, PheML, by using comorbidities enriched in individuals affected by stuttering as predicting features and imputing stuttering status as the outcome variable. Applying PheML in BioVU identified 9,239 genotyped affected individuals (a clinical prevalence of ∼10%) for downstream genetic analysis. Ancestry-stratified GWAS of PheML-imputed affected individuals and matched control individuals identified rs12613255, a variant near CYRIA on chromosome 2 (B = 0.323; p value = 1.31 × 10-8) in European-ancestry analysis and rs7837758 (B = 0.518; p value = 5.07 × 10-8), an intronic variant found within the ZMAT4 gene on chromosome 8, in African-ancestry analysis. Polygenic-risk prediction and concordance analysis in an independent clinically ascertained sample of developmental stuttering cases validate our GWAS findings in PheML-imputed affected and control individuals and demonstrate the clinical relevance of our population-based analysis for stuttering risk.

How We Fail Children With Developmental Language Disorder

Purpose For over two decades, we have known that children with developmental language disorder (DLD) are underserved. We have also known that DLD does not attract the research attention that it merits given its prevalence and impact. The purposes of this clinical focus article are to present evidence that these failures continue, explore the reasons behind these failures, and propose solutions. Method I reviewed the literature and applied bibliometric analysis procedures from Bishop (2010) to quantify research efforts aimed at DLD compared to other neurodevelopmental disorders. Results The percentage of children who are deemed eligible for clinical services because of DLD continues to fall well short of estimates based on the prevalence of DLD in community samples. The amount of research conducted on DLD relative to other neurodevelopmental disorders remains low. Contributing factors include a lack of awareness of DLD, the hidden nature of DLD, entrenched policies, and the dissonance created when speech-language pathologists must diagnose DLD in school settings. Conclusions Expanded approaches to supporting children with DLD are required. These might include engagement in advocacy and awareness campaigns; clearer communication with the families we serve and enhanced collaborations with classroom teachers; the implementation of school-based language screenings; participation in policymaking; and the development of service delivery models that operate alongside those that exist in our schools and complement their function. Supplemental Material https://doi.org/10.23641/asha.12743273.

Identifying risk for language impairment in children from linguistically diverse low-income schools

PURPOSE

To improve screening procedures for children in a linguistically diverse context, we combined tasks known to reveal grammatical deficits in children with language impairment (LI) with training to facilitate performance on a verb elicitation task.

METHOD

Sixty-four first grade children participated. The objective grammatical measures included elicitation of 12 past tense regular verbs preceded by a teaching phase (teach-test), the sentence recall (SR) subtest of the Clinical evaluation of language fundamentals (CELF-4), and a tally of all conjugated verbs from a narrative retell task. Given the widespread reliance on teacher observation for the referral of children suspected of having LI, we compared our results to the spoken language portion of the CELF-4 teacher observational rating scale (ORS).

RESULT

Using teacher observation as a reference for comparison, the past tense elicitation task and the SR task yielded strong discriminating power, but the verb tally was relatively weak. However, combining the three tasks yielded the highest levels of sensitivity (75%) and specificity (92%) than any single measure on its own.

CONCLUSION

This study contributes to alternative assessment practices by highlighting the potential utility of adding a teaching component prior to administering informal grammatical probes.

Dynamic Assessment of Narratives Among Navajo Preschoolers

PURPOSE

This study examined whether the Predictive Early Assessment of Reading and Language (PEARL), a dynamic assessment of narratives that measures language comprehension and production, accurately classifies Navajo preschoolers with typically developing (TD) language or with language impairment (LI).

METHOD

Ninety 4- and 5-year-old Navajo preschoolers were identified as having LI or are TD (n = 45 each) via a 5-measure battery: parent report, teacher report, English narrative, independent educational plan, and the Clinical Evaluation of Language Fundamental Preschool-Second Edition (Wiig, Secord, & Semel, 2004). Children completed a PEARL pretest, a narrative mediation phase providing principles of narrative structure, and a PEARL posttest. A modifiability score reflected responsiveness to mediation.

RESULTS

The PEARL pretest and posttest each distinguished children with LI versus TD children with 89% accuracy; modifiability scores identified children with 100% accuracy. The PEARL story grammar subtest at pretest and posttest best distinguished LI versus TD. A revised cutoff score on the PEARL pretest decreased the diagnosis of TD children as having LI; the standard PEARL posttest cutoff was retained.

CONCLUSION

The PEARL is a promising assessment for accurately differentiating Navajo preschool children with LI from those with TD language, particularly with a revised pretest cutoff score.

Effects of Specific Language Impairment on a Contrastive Dialect Structure: The Case of Infinitival TO Across Various Nonmainstream Dialects of English

Purpose

Using data from children who spoke various nonmainstream dialects of English and who were classified as either children with specific language impairment (SLI) or typically developing (TD) children, we examined children's marking of infinitival TO by their dialect and clinical status.

Method

The data came from 180 kindergartners (91 speakers of African American English, 60 speakers of Southern White English, 29 speakers of +Cajun); 53 were children with SLI, and 127 were TD children. Data included 4,537 infinitival TO contexts extracted from language samples; each was coded as zero or overtly marked and by preceding verb context (i.e., verbs of motion vs. other).

Results

Across dialects, overall rates of zero marking differed by the children's clinical status (SLI > TD), and other verb contexts accounted for this result. Across the TD and SLI groups, dialect variation was evident for verbs of motion contexts, and the effect was stronger for the TD than for the SLI groups, particularly if the TD children's dialects were classified as +Cajun.

Conclusion

Children's marking of infinitival TO can be affected by both their dialect and clinical status. Results support language assessments that include context-specific rate-based measures of infinitival TO and other contrastive structures when they prove useful for understanding the linguistic profile of SLI within a dialect.

Family aggregation of language impairment in an isolated Chilean population from Robinson Crusoe Island

BACKGROUND

It has been reported that the inhabitants of the Chilean Robinson Crusoe Island have an increased frequency of specific language impairment (SLI) or developmental language disorder (DLD).

AIMS

To explore the familial aggregation of DLD in this community.

METHODS & PROCEDURES

We assessed the frequency of DLD amongst colonial children between the ages of 3 and 8;11 years (50 individuals from 45 nuclear families). Familial aggregation rates of language disorder were calculated by assessing all available first-degree relatives (n = 107, 77 parents, 25 siblings, five half-siblings) of the probands.

OUTCOMES & RESULTS

We found that 71% of the child population performed significantly below expected in measures of phonological production or expressive and receptive morphology. The majority of these children presented with severe expressive and/or receptive language difficulties. One-quarter of language-disordered probands primarily had phonological difficulties. Family members of affected probands experienced a higher risk of language disorder than those of typically developing probands. This increased risk was apparent regardless of non-verbal IQ.

CONCLUSIONS & IMPLICATIONS

The study substantiates the existence of a familial form of speech and language disorder on Robinson Crusoe Island. Furthermore, we find that the familiarity is stable regardless of non-verbal IQ, supporting the recent movement to reduce the importance of non-verbal IQ criterion in DLD diagnoses.

Language Assessment With Children Who Speak Nonmainstream Dialects: Examining the Effects of Scoring Modifications in Norm-Referenced Assessment

Purpose

We compared outcomes from 2 measures of language ability in children who displayed a range of dialect variation: 1 using features that do not contrast between mainstream American English (MAE) and nonmainstream dialects (NMAE), and 1 using contrastive features. We investigated how modified scoring procedures affected the diagnostic accuracy of the measure with contrastive features.

Method

Second-grade students (N = 299; 167 White, 106 African American, 26 other) completed measures of language variation and ability (the Diagnostic Evaluation of Language Variation-Screening Test and the Clinical Evaluation of Language Fundamentals-Fourth Edition [CELF-4]). The CELF-4 was scored with and without the recommended scoring modifications for children who spoke African American English.

Results

Partial correlations controlling for socioeconomic status revealed small to moderate correlations between measures of language ability and the use of NMAE features. Modified scoring yielded higher scores for children who spoke African American English and a reduced association between the use of NMAE features and CELF-4 scores. Modified scoring also affected the diagnostic accuracy of the CELF-4, resulting in a lower positive likelihood ratio and a higher negative likelihood ratio.

Conclusions

The decision to apply scoring modifications affects both the false positive and false negative rates. Implications for language assessment for children who speak NMAE dialects are discussed, including the need for further investigation.

Language development, delay and intervention-the views of parents from communities that speech and language therapy managers in England consider to be under-served

BACKGROUND

Evidence-based practice includes research evidence, clinical expertise and stakeholder perspectives. Stakeholder perspectives are important and include parental ethno-theories, which embrace views about many aspects of speech, language and communication, language development, and interventions. The Developmental Niche Framework provides a useful theory to understand parental beliefs. Ethnotheories, including those about language development, delay and interventions, may vary cross culturally and are less well understood in relation to families who may be considered 'under-served' or 'hard-to-reach' by speech and language therapy services. Who is considered to be under-served and the reasons why some families are under-served are complex.

AIM

To describe beliefs and reported practices, in relation to speech and language development, delay and intervention, of parents and carers from a small number of groups in England who were perceived to be under-served in relation to SLT services.

METHODS & PROCEDURES

As part of a wider National Institute for Health Research (NIHR)-funded study (Child Talk), seven focus groups (with a total of 52 participants) were held with parents from three communities in England. Topics addressed included beliefs about language development, language delay and parents' reported responses to language delay. Data were transcribed and analysed using adapted framework analysis, which also drew on directed content analysis.

OUTCOMES & RESULTS

Four themes resulted that broadly matched the topics addressed in the focus groups: language development and the environment; causes and signs of speech and language delay; responses to concerns about speech, language and communication; and improving SLT. These produced some previously unreported ideas, e.g., about how language develops and the causes of delay.

CONCLUSIONS & IMPLICATIONS

The findings are discussed in relation to previous literature and the Developmental Niche Framework. Clinical implications include ideas about issues for SLTs to discuss with families and the need to recognize that parents may see themselves as competent facilitators of language. Suggestions are made for future research, including: expanded investigation of a wider range of under-served groups, an exploration of who parents consult when concerned about their child's language, and how key community figures advise parents in relation to language delay.

Lexical and grammatical development in trilingual speakers of isiXhosa, English and Afrikaans

BACKGROUND

There is a dearth of normative data on linguistic development among child speakers of Southern African languages, especially in the case of the multilingual children who constitute the largest part of this population. This inevitably impacts on the accuracy of developmental assessments of such speakers. Already negative lay opinion on the effect of early multilingualism on language development rates could be exacerbated by the lack of developmental data, ultimately affecting choices regarding home and school language policies.

OBJECTIVES

To establish whether trilinguals necessarily exhibit developmental delay when compared to monolinguals and, if so, whether this delay (1) occurs in terms of both lexical and grammatical development; and (2) in all three the trilinguals' languages, regardless of input quantity.

METHOD

Focusing on isiXhosa, South African English and Afrikaans, the study involved a comparison of 11 four-year-old developing trilinguals' acquisition of vocabulary and passive constructions with that of 10 age-matched monolingual speakers of each language.

RESULTS

The trilinguals proved to be monolingual-like in their lexical development in the language to which, on average, they had been exposed most over time, that is, isiXhosa. No developmental delay was found in the trilinguals' acquisition of passive constructions, regardless of the language of testing.

CONCLUSION

As previously found for bilingual development, necessarily reduced quantity of exposure does not hinder lexical development in the trilinguals' input dominant language. The overall lack of delay in their acquisition of the passive is interpreted as possible evidence of cross-linguistic bootstrapping and support for early multilingual exposure.

Comparison of African American Children's Performances on a Minimal Competence Core for Morphosyntax and the Index of Productive Syntax

PURPOSE

This study is a response to the need for evidence-based measures of spontaneous oral language to assess African American children under the age of 4 years. We determined if pass/fail status on a minimal competence core for morphosyntax (MCC-MS) was more highly related to scores on the Index of Productive Syntax (IPSyn)-the measure of convergent criterion validity-than to scores on 3 measures of divergent validity: number of different words (Watkins, Kelly, Harbers, & Hollis, 1995), Percentage of Consonants Correct-Revised (Shriberg, Austin, Lewis, McSweeney, & Wilson, 1997), and the Leiter International Performance Scale-Revised (Roid & Miller, 1997).

METHOD

Archival language samples for 68 African American 3-year-olds were analyzed to determine MCC-MS pass/fail status and the scores on measures of convergent and divergent validity.

RESULTS

Higher IPSyn scores were observed for 60 children who passed the MCC-MS than for 8 children who did not. A significant positive correlation, rpb = .73, between MCC-MS pass/fail status and IPSyn scores was observed. This coefficient was higher than MCC-MS correlations with measures of divergent validity: rpb = .13 (Leiter International Performance Scale-Revised), rpb = .42 (number of different words in 100 utterances), and rpb = .46 (Percentage of Consonants Correct-Revised).

CONCLUSION

The MCC-MS has convergent criterion validity with the IPSyn. Although more research is warranted, both measures can be potentially used in oral language assessments of African American 3-year-olds.

Impacts of parent-implemented early-literacy intervention for Spanish-speaking children with language impairment

BACKGROUND

Children with language impairment (LI) often have lags in development of print knowledge, an important early-literacy skill. This study explores impacts of a print-focused intervention for Spanish-speaking children with LI in Southeastern Mexico.

AIMS

Aims were twofold. First, we sought to describe the print knowledge (print-concept knowledge, alphabet knowledge) of Spanish-speaking children with LI. Second, we determined the extent to which print-referencing intervention delivered by children's parents could improve print knowledge.

METHODS & PROCEDURES

Using a pre-test-post-test delayed treatment research design, 13 parent-child dyads were assigned to an intervention (n = 8) versus control (n = 5) condition. Children were drawn from a speech-language clinic and all were receiving services for LI. Caregivers in the intervention group implemented an 8-week home-reading programme following a systematic scope and sequence for improving children's print knowledge.

OUTCOMES & RESULTS

Children showed individual differences in their print knowledge based on three baseline measures examining print-concept knowledge, alphabet knowledge and letter-sound knowledge. Those whose caregivers implemented the 8-week programme showed statistically and practically significant gains on two of the three measures over the intervention period.

CONCLUSIONS & IMPLICATIONS

The results presented here may stimulate future research on the print knowledge of Spanish-speaking children with LI. Sources of individual differences are important to determine. Caregivers may use the intervention presented here as a potential avenue for improving children's print knowledge.

Ramathibodi Language Development Questionnaire: A Newly Developed Screening Tool for Detection of Delayed Language Development in Children Aged 18-30 Months

OBJECTIVE

To develop a parental questionnaire for screening children with delayed language development in primary care settings.

MATERIAL AND METHOD

Ramathibodi Language Development (RLD) questionnaire was developed and completed by groups of 40 typically developing children age 18 to 30 months old and 30 children with delayed language development.

RESULTS

The mean score was significantly lower in the delay language group (6.7 ± 1.9), comparing with the typically developing group (9.6 ± 0.7). The optimal ROC curve cut-off score was 8 with corresponding sensitivity and specificity were 98% and 72%, respectively. The corresponding area under the curve was 0.96 (95% CI = 0.92-0.99).

CONCLUSION

The RLD questionnaire was the promising language developmental screening instrument that easily utilized in well-child examination settings.

Utility of a Language Screening Measure for Predicting Risk for Language Impairment in Bilinguals

PURPOSE

This study evaluated the accuracy of an experimental version of the Bilingual English Spanish Oral Screener (BESOS; Peña, Bedore, Iglesias, Gutiérrez-Clellen, & Goldstein, 2008) for predicting the long-term risk for language impairment (LI) for a matched group of preschool-aged Spanish-English bilingual children with and without LI.

METHOD

A total of 1,029 Spanish-English bilingual children completed the BESOS before entering kindergarten. A subset of 167 participants completed a follow-up language evaluation in 1st grade. Twenty-one of these children were identified as having LI and were matched to a group of 21 typically developing peers from the larger sample. A series of discriminant analyses were used to determine the combination of scores on the BESOS that most accurately predicted 2 years later which children presented with and without LI.

RESULTS

The linear combination of the semantics and morphosyntax scores in the best language resulted in predictive sensitivity of 95.2% and predictive specificity of 71.4%, with an overall accuracy of 81% for predicting risk for LI.

CONCLUSION

A bilingual language screener administered before kindergarten can be useful for predicting risk for LI in bilingual children in 1st grade.

Rates of auxiliary is and are in African American English speaking children with specific language impairment following language treatment

The purpose of this exploratory study is to examine rates of auxiliary is and are across dialect patterns produced by African American English with specific language impairment (AAE-SLI) children following language treatment. The following research question is asked: Do AAE-SLI children exhibit rates of auxiliary is and are across dialect patterns consistent with previous reports of typically developing children and adult AAE speakers? A pre-/post-test design was used to identify patterns in which auxiliary is and are were produced at significant levels. Individual performance was included to examine variable rates of use across patterns. Group and individual results suggest children used auxiliary is and are in dialect patterns at rates consistent with typically developing child and adult AAE speakers. We conclude that rates of use may contribute to evidence-based guidelines for morphological intervention with AAE-SLI children.

Specific language impairment in language-minority children from low-income families

BACKGROUND

Recent evidence suggests that specific language impairment (SLI) might be secondary to general cognitive processing limitations in the domain of executive functioning. Previous research has focused almost exclusively on monolingual children with SLI and offers little evidence-based guidance on executive functioning in bilingual children with SLI. Studying bilinguals with SLI is important, especially in the light of increasing evidence that bilingualism can bring advantages in certain domains of executive functioning.

AIMS

To determine whether executive functioning represents an area of difficulty for bilingual language-minority children with SLI and, if so, which specific executive processes are affected.

METHODS & PROCEDURES

This cross-cultural research was conducted with bilingual children from Luxembourg and monolingual children from Portugal who all had Portuguese as their first language. The data from 81 eight-year-olds from the following three groups were analysed: (1) 15 Portuguese-Luxembourgish bilinguals from Luxembourg with an SLI diagnosis; (2) 33 typically developing Portuguese-Luxembourgish bilinguals from Luxembourg; and (3) 33 typically developing Portuguese-speaking monolinguals from Portugal. Groups were matched on first language, ethnicity, chronological age and socioeconomic status, and they did not differ in nonverbal intelligence. Children completed a battery of tests tapping: expressive and receptive vocabulary, syntactic comprehension, verbal and visuospatial working memory, selective attention and interference suppression.

OUTCOMES & RESULTS

The bilingual SLI group performed equally well compared with their typically developing peers on measures of visuospatial working memory, but had lower scores than both control groups on tasks of verbal working memory. On measures of selective attention and interference suppression, typically developing children who were bilingual outperformed their monolingual counterparts. For selective attention, performance of the bilingual SLI group did not differ significantly from the controls. For interference suppression the bilingual SLI group performed significantly less well than typically developing bilinguals but not monolinguals.

CONCLUSIONS & IMPLICATIONS

This research provides further support to the position that SLI is not a language-specific disorder. The study indicates that although bilingual children with SLI do not demonstrate the same advantages in selective attention and interference suppression as typically developing bilinguals, they do not lag behind typically developing monolinguals in these domains of executive functioning. This finding raises the possibility that bilingualism might represent a protective factor against some of the cognitive limitations that are associated with SLI in monolinguals.

Variability in the language input to children enhances learning in a treatment context

PURPOSE

Artificial language learning studies have demonstrated that learners exposed to many different nonword combinations representing a grammatical form demonstrate rapid learning of that form without explicit instruction. However, learners presented with few exemplars, even when they are repeated frequently, fail to learn the underlying grammar. This study translated this experimental finding in a therapeutic context.

METHOD

Eighteen preschool children with language impairment received conversational recast treatment for morpheme errors. Over a 6-week period, half heard 12 unique verbs twice each during recasts (low-variability condition), and half heard 24 unique verbs (high-variability condition). Children's use of trained and untrained morphemes on generalization probes as well as spontaneous use of trained morphemes was tracked throughout treatment.

RESULTS

The high-variability condition only produced significant change in children's use of trained morphemes, but not untrained morphemes. Data from individual children confirmed that more children in the high- than the low-variability condition showed a strong treatment effect. Children in the high-variability condition also produced significantly more unique utterances containing their trained morpheme than children in the low-variability condition.

CONCLUSION

The results support the use of highly variable input in a therapeutic context to facilitate grammatical morpheme learning.

Effectiveness of domain-based intervention for language development in Japanese hearing-impaired children: a multicenter study

OBJECTIVE

Decreasing language delay in hearing-impaired children is a key issue in the maintenance of their quality of life. Language training has been presented mainly by experience-based training; effective intervention programs are crucially important for their future. The aim of this study was to confirm the efficacy of 6-month domain-based language training of school-age, severe-to-profound hearing-impaired children.

METHODS

We conducted a controlled before-after study involving 728 severe-to-profound prelingual hearing-impaired children, including an intervention group (n = 60), control group (n = 30), and baseline study group (n = 638). Language scores of the participants and questionnaires to the caregivers/therapists were compared before and after the intervention. Average monthly increase in each language score of the control group and baseline study group were compared with those of the intervention group.

RESULTS

Language scores and the results of the questionnaire of the intervention group showed a significant improvement (P < .05). The average monthly language growth of the intervention group was twice that of the control group and 3 to 4 times that of the baseline study group (P < .05). The effect size was largest in communication (1.914), followed by syntax (0.931).

CONCLUSION

Domain-based language training improved the language development and daily communication of hearing-impaired children without any adverse effects.

The impact of extrinsic demographic factors on Cantonese speech acquisition

This study modeled the associations between extrinsic demographic factors and children's speech acquisition in Hong Kong Cantonese. The speech of 937 Cantonese-speaking children aged 2;4 to 6;7 in Hong Kong was assessed using a standardized speech test. Demographic information regarding household income, paternal education, maternal education, presence of siblings and having a domestic helper as the main caregiver was collected via parent questionnaires. After controlling for age and sex, higher maternal education and higher household income were significantly associated with better speech skills; however, these variables explained a negligible amount of variance. Paternal education, number of siblings and having a foreign domestic helper did not associate with a child's speech acquisition. Extrinsic factors only exerted minimal influence on children's speech acquisition. A large amount of unexplained variance in speech ability still warrants further research.

Association of postpartum maternal morbidities with children's mental, psychomotor and language development in rural Bangladesh

Little is known from developing countries about the effects of maternal morbidities diagnosed in the postpartum period on children's development. The study aimed to document the relationships of such morbidities with care-giving practices by mothers, children's developmental milestones and their language, mental and psychomotor development. Maternal morbidities were identified through physical examination at 6-9 weeks postpartum (n=488). Maternal care-giving practices and postnatal depression were assessed also at 6-9 weeks postpartum. Children's milestones of development were measured at six months, and their mental (MDI) and psychomotor (PDI) development, language comprehension and expression, and quality of psychosocial stimulation at home were assessed at 12 months. Several approaches were used for identifying the relationships among different maternal morbidities, diagnosed by physicians, with children's development. After controlling for the potential confounders, maternal anaemia diagnosed postpartum showed a small but significantly negative effect on children's language expression while the effects on language comprehension did not reach the significance level (p=0.085). Children's development at 12 months was related to psychosocial stimulation at home, nutritional status, education of parents, socioeconomic status, and care-giving practices of mothers at six weeks of age. Only a few mothers experienced each specific morbidity, and with the exception of anaemia, the sample-size was insufficient to make a conclusion regarding each specific morbidity. Further research with a sufficient sample-size of individual morbidities is required to determine the association of postpartum maternal morbidities with children's development.

Temporal processing impairment in children with attention-deficit-hyperactivity disorder

The current study aimed to investigate temporal processing in Chinese children with Attention-Deficit-Hyperactivity Disorder(ADHD) using time production, time reproduction paradigm and duration discrimination tasks. A battery of tests specifically designed to measure temporal processing was administered to 94 children with ADHD and 100 demographically matched healthy children. A multivariate analysis of variance (MANOVA) and a repeated measure MANOVA indicated that children with ADHD were impaired in time processing functions. The results of pairwise comparisons showed that the probands with a family history of ADHD performed significantly worse than those without family history in the time production tasks and the time reproduction task. Logistic regression analysis showed duration discrimination had a significant role in predicting whether the children were suffering from ADHD or not, while temporal processing had a significant role in predicting whether the ADHD children had a family history or not. This study provides further support for the existence of a generic temporal processing impairment in ADHD children and suggests that abnormalities in time processing and ADHD share some common genetic factors.

The joint effects of risk status, gender, early literacy and cognitive skills on the presence of dyslexia among a group of high-risk Chinese children

This study sought to examine factors that are predictive of future developmental dyslexia among a group of 5-year-old Chinese children at risk for dyslexia, including 62 children with a sibling who had been previously diagnosed with dyslexia and 52 children who manifested clinical at-risk factors in aspects of language according to testing by paediatricians. The age-5 performances on various literacy and cognitive tasks, gender and group status (familial risk or language delayed) were used to predict developmental dyslexia 2 years later using logistic regression analysis. Results showed that greater risk of dyslexia was related to slower rapid automatized naming, lower scores on morphological awareness, Chinese character recognition and English letter naming, and gender (boys had more risk). Three logistic equations were generated for estimating individual risk of dyslexia. The strongest models were those that included all print-related variables (including speeded number naming, character recognition and letter identification) and gender, with about 70% accuracy or above. Early identification of those Chinese children at risk for dyslexia can facilitate better dyslexia risk management.

Predictors of second language acquisition in Latino children with specific language impairment

PURPOSE

This study evaluated the extent to which the language of intervention, the child's development in Spanish, and the effects of English vocabulary, use, proficiency, and exposure predict differences in the rates of acquisition of English in Latino children with specific language impairment (SLI).

METHOD

In this randomized controlled trial, 188 Latino preschoolers with SLI participated in a small-group academic enrichment program for 12 weeks and were followed up 3 and 5 months later. Children were randomly assigned to either a bilingual or an English-only program. Predictors of English growth included measures of Spanish language skills and English vocabulary, use, proficiency, and exposure. Performance on English outcomes (i.e., picture description and narrative sample) was assessed over time. A series of longitudinal models were tested via multilevel modeling with baseline and posttreatment measures nested within child.

RESULTS

Children demonstrated growth on the English outcomes over time. The language of intervention, Spanish skills, English vocabulary, and English use significantly predicted differences in rates of growth across children for specific measures of English development.

CONCLUSIONS

This study underscores the role of the child's first language skills, the child's level of English vocabulary development, and level of English use for predicting differences in English acquisition in Latino preschoolers with SLI. These factors should be carefully considered in making clinical decisions.

Implications of bilingual development for specific language impairments in Turkey

The potential impact of bilingualism on children's language development has emerged as a crucial concern for Turkey, but so far it has not been addressed from the point of view of language disorders. This short review examines the potential impact of bilingual language development for language impairments in Turkey, with special emphasis on the largest minority population speaking Kurdish and Turkish.

Risk for poor performance on a language screening measure for bilingual preschoolers and kindergarteners

PURPOSE

This study documents the risk for language impairment in Latino children who had different levels of exposure to English and Spanish.

METHOD

A total of 1,029 preschool- and kindergarten-age children were screened in the domains of semantics and morphosyntax in both Spanish and English. Parent report was used to document current exposure to and use of Spanish and English, as well as year of first exposure to English. Risk for language impairment was compared for language group, year of first English exposure, age, and mother's education.

RESULTS

While bilingual children's scores on each subtest were significantly lower compared to their functional monolingual peers, they were no more likely to fall in the at-risk range based on a combination of all 4 subtests. Maternal education and year of first English exposure were weakly associated with risk for language impairment but not with language group (via 5 levels of first and second language exposure).

CONCLUSIONS

Prevalence of risk for language impairment when both languages are tested is not related to language group.

Adapting a receptive vocabulary test for preschool-aged Greek-speaking children

BACKGROUND

Receptive vocabulary is an important measure for language evaluations. Therefore, norm-referenced receptive vocabulary tests are widely used in several languages. However, a receptive vocabulary test has not yet been normed for Modern Greek.

AIMS

To adapt an American English vocabulary test, the Receptive One-Word Picture Vocabulary Test-II (ROWPVT-II), for Modern Greek for use with Greek-speaking preschool children.

METHODS & PROCEDURES

The list of 170 English words on ROWPVT-II was adapted by (1) developing two lists (A and B) of Greek words that would match either the target English word or another concept corresponding to one of the pictured objects in the four-picture array; and (2) determining a developmental order for the chosen Greek words for preschool-aged children. For the first task, adult word frequency measures were used to select the words for the Greek wordlist. For the second task, 427 children, 225 boys and 202 girls, ranging in age from 2;0 years to 5;11 years, were recruited from urban and suburban areas of Greece. A pilot study of the two word lists was performed with the aim of comparing an equal number of list A and list B responses for each age group and deriving a new developmental list order.

OUTCOMES & RESULTS

The relative difficulty of each Greek word item, that is, its accuracy score, was calculated by taking the average proportion of correct responses across ages for that word. Subsequently, the word accuracy scores in the two lists were compared via regression analysis, which yielded a highly significant relationship (R(2) = 0.97; p < 0.0001) and a few outlier pairs (via residuals). Further analysis used the original relative ranking order along with the derived ranking order from the average accuracy scores of the two lists in order to determine which word item from the two lists was a better fit. Finally, new starting levels (basals) were established for preschool ages.

CONCLUSIONS & IMPLICATIONS

The revised word list can serve as the basis for adapting a receptive vocabulary test for Greek preschool-aged children. Further steps need to be taken when testing larger numbers of 2;0 to 5;11-year-old children on the revised word list for determination of norms. This effort will facilitate early identification and remediation of language disorders in Modern Greek-speaking children.

Auxiliary BE production by African American English-speaking children with and without specific language impairment

PURPOSE

To examine 3 forms (am, is, are) of auxiliary BE production by African American English (AAE)-speaking children with and without specific language impairment (SLI).

METHOD

Thirty AAE speakers participated: 10 six-year-olds with SLI, 10 age-matched controls, and 10 language-matched controls. BE production was examined through samples and a probe.

RESULTS

Across tasks, visual inspection suggested that the children with SLI overtly marked BE at lower rates than the controls, and all groups marked am at higher rates than is and are, with few dialect-inappropriate errors. Within the samples, the children also overtly marked is at higher rates when preceded by it/that/what than when it was preceded by a personal pronoun. A subset of these results was confirmed statistically. The children's marking of BE also varied across tasks; for the age-matched controls, this variation was tied to their AAE dialect densities.

CONCLUSIONS

These findings show across-dialect similarities and differences between children's acquisition of AAE and mainstream American English. Similarities involve the rate of the children's BE marking as a function of their clinical status and the nature of their dialect-inappropriate errors. Differences involve the children's rates of BE marking as a function of the form, context, and task.

The effects of measures of language experience and language ability on segmental accuracy in bilingual children

PURPOSE

The present study investigated the effects of selected measures of language experience (parent-reported estimates of frequency of output and language use) and language ability (parent-reported language proficiency and mean length of utterance in words) on the segmental accuracy of Spanish- and English-speaking bilingual children.

METHOD

The phonological skills of 50 typically developing bilingual Spanish-English children (mean age = 5;9 [years;months]) were examined. Independent variables included parent estimates of language use, language proficiency, and frequency of language output (5 groups), as well as a direct language measure (mean length of utterance in words) to predict the dependent segmental accuracy measures (percentage of consonants and vowels correct).

RESULTS

Frequency of language output did not have an effect on any of the English or Spanish segmental accuracy measures. However, parent-reported language use and language proficiency as well as the direct measure of language ability (mean length of utterance in words) had various effects on segmental accuracy. Those effects differed, however, in language-specific patterns.

CONCLUSIONS

Parental estimates of language use and language proficiency are useful for predicting the phonological skills of bilingual Spanish- and English-speaking children, and augmenting them with a direct measure of language ability as a predictor of segmental accuracy is desirable.

Measurement properties and classification accuracy of two spanish parent surveys of language development for preschool-age children

PURPOSE

To describe the concurrent validity and classification accuracy of 2 Spanish parent surveys of language development, the Spanish Ages and Stages Questionnaire (ASQ; Squires, Potter, & Bricker, 1999) and the Pilot Inventario-III (Pilot INV-III; Guiberson, 2008a).

METHOD

Forty-eight Spanish-speaking parents of preschool-age children participated. Twenty-two children had expressive language delays, and 26 had typical language development. The parents completed the Spanish ASQ and the Pilot INV-III at home, and the Preschool Language Scale, Fourth Edition: Spanish Edition (PLS-4 Spanish; Zimmerman, Steiner, & Pond, 2002) was administered to the children at preschool centers.

RESULTS

The Spanish ASQ and Pilot INV-III were significantly correlated with the PLS-4 Spanish, establishing concurrent validity. On both surveys, children with expressive language delays scored significantly lower than children with typical development. The Spanish ASQ demonstrated unacceptably low sensitivity (59%) and good specificity (92%), while the Pilot INV-III demonstrated fair sensitivity (82%) and specificity (81%). Likelihood ratios and posttest probability revealed that the Pilot INV-III may assist in detection of expressive language delays, but viewed alone it is insufficient to make an unconditional screening determination.

CONCLUSIONS

Results suggest that Spanish parent surveys hold promise for screening language delay in Spanish-speaking preschool children; however, further refinement of these tools is needed.

Language-minority learners in special education: rates and predictors of identification for services

Using data from the Early Childhood Longitudinal Study-Kindergarten Cohort, this study was designed to investigate proportional representation, identification rates, and predictors of language-minority (LM) learners in special education using a nationally representative sample of kindergarten, first graders, and third graders. The findings indicate that although LM learners were underrepresented in special education in kindergarten and first grade, they were overrepresented in third grade across all disability categories. LM status, teacher ratings of language and literacy skills, and reading proficiency level were significant predictors of placement in special education. Kindergarten teacher ratings of language and literacy skills were highly predictive of subsequent placement in special education. The implications for developing a model of early identification, the response-to-intervention model in particular, for LM learners at risk for academic difficulties are discussed.

Child maltreatment: a global issue

PURPOSE

This article explains why children with speech and language impairments are at increased risk for having experienced abuse, neglect, and trauma and how maltreatment may vary across cultures.

METHOD

International literature on maltreatment is reviewed in order to provide frameworks for identifying what constitutes maltreatment across cultures; how cultural variations in discipline practices impact maltreatment; and professionals' roles in treatment when they encounter children who have experienced abuse, neglect, or trauma.

CONCLUSION

Speech-language pathologists and audiologists are required to document and report any instance of suspected child abuse. To intervene effectively with children and families from diverse cultures who experience maltreatment, professionals must understand when a practice causes harm and be able to modify childrearing practices in culturally acceptable ways.

Differences in neuropsychological performance associated with ethnicity in children with HIV-1 infection: preliminary findings

This study investigated the relationship between ethnicity (African American and European American) and neuropsychological performance in two specific neuropsychological domains (language and speed of information processing) in a group of HIV-1+ children. The Expressive One-Word Picture Vocabulary Test-Revised and the Rapid Color Naming subtest of the Comprehensive Test of Phonological Processing were administered to 5- to 7-year-old children (n = 22) as part of a comprehensive research or clinical protocol. African American children scored lower than European American children (p < .05) on both procedures. The observed performance difference emerged despite the fact that there were no group differences in age, immunologic clinical categories, intellect, level of maternal education, or CD4+ percentage and after using stringent exclusionary criteria, including history of enrollment in special education services and the presence of other chronic medical conditions. The implications of such findings are discussed within biological and demographic frameworks.

Exploring Possible Sociocultural Bias on the SCAN-C

Sociocultural bias on the SCAN-C (R. W. Keith, 2000) was investigated with 20 Anglo American and 20 Latino American 8-year-old children from low- and mid-high-socioeconomic status (SES) backgrounds. Univariate and repeated measures analyses of variance (ANOVAs) failed to reveal any significant differences between the groups when clustered by ethnicity and SES. The Latino American participants' scores were analyzed for dialectal variations, and the ANOVA analyses were repeated using the corrected scores. No significant interactions were observed. Classification analyses revealed that 10% more Latino American children than Anglo American children fell into the borderline-to-disordered category based on SCAN-C composite scores; these classification differences were most apparent on the Filtered Words subtest (with a difference of 25%). When scores with dialectal rescoring were considered, the classification distribution for the Latino American children more closely matched that of the Anglo American children. Given the increased likelihood of Latino American children scoring in the borderline-to-disordered category, caution should be used in interpreting SCAN-C results for Latino American children. Dialect scoring should be applied when Latino American children fall in the borderline-to-disordered category.

The acquisition of relative clause comprehension in Hebrew: a study of SLI and normal development

Comprehension of relative clauses was assessed in 10 Hebrew-speaking school-age children with syntactic SLI and in two groups of younger children with normal language development. Comprehension of subject- and object-relatives was assessed using a binary sentence-picture matching task. The findings were that while Hebrew-speaking children with normal development comprehend right-branching object relatives around the age of 6 ; 0, children with syntactic SLI are still at chance level in object relatives by age 11 ; 0. The four-year-olds were also at chance on object relatives. Comprehension of subject relatives was good in the SLI group, similar to the six-year-olds, and significantly better than the four-year-olds. The syntactic impairment is interpreted as a selective deficit to non-canonical sentences that are derived by movement.

The development of discourse referencing in Cantonese-speaking children

The ability to make clear reference in connected discourse was examined in children learning Cantonese, a Chinese language where noun phrase constituents, whatever their grammatical role, are omissible from sentences under discourse conditions that are not well-understood. Forty-three typically developing children aged 3 ; 0, 5 ; 0, 7 ; 0 and 12 ; 0 told 16 stories based on picture sequences. A panel of adult native Cantonese speakers was asked to judge the referential adequacy of each child's stories by identifying the character the child was talking about in 32 targeted referential acts. The targeted acts were of three sorts: MAINTENANCE of a known character, INTRODUCTION of a second new character, and REINTRODUCTION of a known character. Reference was judged to be adequate when 3 out of 4 'listeners' could successfully identify the character. Children's referential expressions were most adequate for Maintenance, less adequate for Introduction, and least adequate for Reintroduction. The twelve- and seven-year-olds approached ceiling on all three functions. The five-year-olds scored poorly on Reintroduction, and the three-year-olds failed both Introduction and Reintroduction, despite knowledge of at least one of the possible linguistic forms required for these acts as evidenced in a sentence imitation task. Viewed within the framework of Levelt's (1989) discourse model, the data improve our understanding of the developmental period during which children learn to make appropriate presuppositions about the listener's knowledge and attentional states.

Together we are heard: Effectiveness of daily 'language' groups in a community preschool

Strong oral language skills are a prerequisite for successful literacy and there is a strong interdependence between oral language acquisition and emergent literacy development. Ramifications of this are that children with language impairments are at great risk for difficulties in learning to read and write, with problems often persisting throughout the school years into adulthood. The Together we are heard program involved improving each child's oral language skills through group sessions facilitated by a speech pathologist on a daily basis at preschool. The aim of the present research was to determine the effectiveness of the program to identify the best way to assist children to develop appropriate language skills. The study showed that the children improved significantly in all four levels of the Preschool Language Assessment Inventory (PLAI). Importantly, the program was effective for both genders and there was no difference in the success of Indigenous children when compared to their European counterparts. There is a strong recommendation for further research and to expand such programs, particularly in areas that target children from impoverished and deprived environmental backgrounds.

Lexical diversity and productivity in Cantonese-speaking children with specific language impairment

Recent studies of lexical diversity in English-speaking children with specific language impairment (ESLI) have produced conflicting results. Differences between SLI and age-matched (AM) groups on verb types, and overall types have been reported, as have differences between SLI and language-matched (LM) groups on verb types and/or verb tokens, and noun types and noun tokens. At the same time there have been other claims that there is no difference between SLI and LM groups in terms of lexical diversity. This comparison of the lexical diversity of Cantonese-speaking children with SLI (CSLI) and their language-matched peers controlled the length of the samples and the number of tokens as the basis for comparison. There was no difference between the groups in use of verb tokens or types, but there were significant differences in noun tokens and types and 'other' open class tokens and types. Although there was no difference between the groups in the use of a specific grammatical marker (aspect markers), the way in which the CSLI children deployed these markers was severely restricted in comparison with their LM peers. A limited capacity model of language production is invoked to explain the findings.

Factors affecting language development in West African children: a pilot study using a qualitative methodology

Data on referral patterns to pre-school facilities for speech- and language-delayed children suggest that West African children are over represented relative to other ethnic/language groups. This study was set up as a pilot to explore some of the issues which distinguish this group of children and their families. A qualitative methodology was adopted to access the views of a small group of parents (nine) and professionals with direct experience of these services (three). Between them the parents had a total of 11 children who had received speech and language therapy services. Extensive in-depth interviews were transcribed and coded. The families are predominantly well educated with high expectations for their children. Their beliefs about child development in general and language development often differed from those of the professionals interviewed. For example, parents saw little direct link between very early language stimulation and subsequent school performance. West African parents also perceived that they had different (higher) expectations of behaviour than other families. It was generally accepted by all parties that the West African community experiences a high degree of stress resulting from a combination of interacting factors, namely pressures relating to employment, to immigration status, to matters financial and to expectations from family back in their own country. It is unclear exactly how these impact on the development of the child but there is an awareness that there may be a negative effect of such stress and that children's speech and language development may be one aspect of development that is affected. As a result of this pilot study a number of mechanisms relating to the relationship between environment factors and language development are proposed and suggestions are made regarding service provision for this community.

Measuring linguistic development in a child adopted from Romania

This study explored the clinical utility of two established linguistic measures with a developmentally delayed preschool child adopted from a Romanian orphanage.