Audiovisual incongruent word recognition in children with developmental language disorder: Evidence from eye tracking

Children with developmental language disorder (DLD) have deficits in verbal and non-verbal processing relative to typically developing (TD) peers, potentially reflecting difficulties in working memory, processing speed and inhibition of interference. We examined working memory in children with DLD using the serial-order-in-a-box-complex span (SOB-CS) interference-based model, which posits a time-based mechanism, free time, that governs how interference affects processing performance. (1) To determine the degree to which children with DLD and TD children differ in the amount of free time available during working memory tasks, and whether potential group differences in free time differ depending on the domain of task demands? (2) To determine the relationship between free time and interference effects on working memory accuracy in children with DLD relative to TD peers. We examined the relationship between free time and working memory in children aged 9-13 years with DLD relative to age-matched TD peers. Working memory tasks involved five conditions that varied verbal versus non-verbal task demands in an interference processing phase relative to a recall test phase. Free time was the time between response on the interference processing task and onset of the recall test phase. DLD and TD groups did not differ in total free time in any condition. Results indicated group differences in the relationship between free time and accuracy in the conditions involving verbal recall, but not non-verbal recall. In the verbal-only condition, relatively more free time was associated with worse accuracy for the DLD group, but with better accuracy for the TD group. In the condition with verbal recall paired with non-verbal interference processing, relatively more free time was associated with better accuracy for the DLD group, but not for the TD group. The overall findings suggest that free time between cognitive operations is positively associated with working memory for both verbal and non-verbal recall, except in the presence of high verbal interference for the DLD group (i.e., verbal interference paired with verbal recall). This finding may reflect poor encoding and attention under particularly challenging verbal processing demands for the DLD group. This study also demonstrates the importance of considering the interrelationships between processing speed and interference in working memory performance. What is already known on the subject DLD is characterized by core deficits in verbal processing, but also deficits in non-verbal processing. Processing-based hypotheses of DLD-limited verbal working memory, slowed processing speed and inefficient inhibition-do not fully account for behavioural profiles in DLD when considered separately, yet there is evidence suggesting interrelationships among these factors. What this paper adds to existing knowledge The current study tests the key mechanism posited by a theoretical framework that has the potential to integrate these processing-based hypotheses. Our findings indicate that the effect of this mechanism differed in DLD relative to TD peers in the presence of high verbal task demands. Our findings also demonstrate the importance of considering the interrelationships among cognitive processes in children with DLD. What are the potential or actual clinical implications of this work? In practice, results from the current study suggest that children with DLD may benefit from supplementing verbal information with non-verbal information and from pauses between successive presentations of verbal information. These strategies may support their ability to maintain and act on information during verbal processing.

It is well-established that children with dyslexia and/or Developmental Language Disorder (hereafter children with DDLD) perform poorly on phonological tasks compared to typically developing (TD) children. However, there has been some debate as to whether their phonological deficit arises directly from an impairment in phonological representations, or instead from deficient access to (intact) phonological representations. This study tested the Degraded Phonological Representations Hypothesis and the Deficient Phonological Access Hypothesis using a task that is not often used with children with DDLD, namely phonological fluency. Both hypotheses predict that children with DDLD will retrieve fewer items than their TD peers in the phonological fluency task. However, while the Degraded Phonological Representations Hypothesis predicts smaller clusters of phonologically related items in children with DDLD, the Deficient Phonological Access Hypothesis predicts that the two groups will not differ in cluster size. How phonological fluency performance related to children’s language, literacy, and phonological skills was investigated. Further, the specificity of a phonological fluency deficit in children with DDLD was tested using a nonverbal (design) fluency task. Sixty-six children with DDLD aged 7–12 years and 83 TD children aged 6–12 years, all monolingual Greek speakers, were tested on three phonological fluency categories, on nonverbal IQ, language, literacy, and phonological tasks, and on a design fluency task. The DDLD group produced significantly fewer correct responses and fewer switches compared to the TD group, but the two groups showed similar clustering and average cluster size. After controlling for age, children’s language, literacy, and phonological skills significantly predicted the number of correct responses produced. The two groups did not differ significantly on the number of unique designs generated in the design fluency task. Furthermore, children with DDLD showed poorer phonological fluency performance relative to their TD peers even after design fluency performance was controlled, demonstrating the specificity of their phonological fluency deficit. This study adds to the theoretical debate on the locus of the phonological deficit in dyslexia and DLD. The findings support the hypothesis that the phonological deficit in dyslexia and DLD lies in deficient explicit access to intact phonological representations.

BackgroundAdolescents with Developmental Language Disorder (DLD) are at risk of emotional health problems and low self-esteem. However, little is known about their self-compassion (SC) and satisfaction with life (SWL). The present study compared self-compassion and satisfaction with life reported by Danish adolescents with DLD compared to typically developing (TD) peers, and whether severity of language difficulty is associated with SC and SWL. MethodsResults were obtained from 10 Danish adolescents with DLD compared with 14 age-matched TD adolescents and 132 TD peers, aged 15 years. ResultsFor SC and SWL results showed that adolescents with DLD reported more positive feelings compared to the TD adolescents. Interestingly for SC, the negative, but not the positive, domain differentiated the two groups, as adolescents with DLD reported less symptoms on self-judgment, isolation and overidentification. SC and SWL was strongly correlated with language abilities for the DLD group, but not for the TD group. ConclusionsResults from our pilot study showed that Danish adolescents with DLD reported being less harsh on themselves. Language abilities were associated with self-compassion for the DLD, but not for the TD group. Whether these group differences are due to environmental factors such as the specific Danish school setting of the DLD group or internal factors are discussed and requires further research.

Purpose The aim of the study was to explore the potential of performance on a Danish sentence repetition (SR) task-including specific morphological and syntactic properties-to identify difficulties in children with developmental language disorder (DLD) relative to typically developing (TD) children. Furthermore, the potential of the task as a clinical marker for Danish DLD was explored. Method SR performance of children with DLD aged 5;10-14;1 (years;months; n = 27) and TD children aged 5;3-13;4 (n = 87) was investigated. Results Compared to TD same-age peers, children with DLD were less likely to repeat the sentences accurately but more likely to make ungrammatical errors with respect to verb inflection and use of determiners and personal pronouns. Younger children with DLD also produced more word order errors that their TD peers. Furthermore, older children with DLD performed less accurately than younger TD peers, indicating that the SR task taps into morphosyntactic areas of particular difficulty for Danish children with DLD. The classification accuracy associated with SR performance showed high levels of sensitivity and specificity (> 90%) and likelihood ratios indicating good identification potential for clinical and future research purposes. Conclusion SR performance has a strong potential for identifying children with DLD, also in Danish, and with a carefully designed SR task, performance has potential for revealing morphosyntactic difficulties. Supplemental Material https://doi.org/10.23641/asha.10314437.

The informant matters: Differences in bullying victim categorization rates assessed with self- and peer-reports in children with developmental language disorder and reading difficulties

Purpose Speech perception in noise becomes difficult with age but can be facilitated by audiovisual (AV) speech cues and sentence context in healthy older adults. However, individuals with Alzheimer's disease (AD) may present with deficits in AV integration, potentially limiting the extent to which they can benefit from AV cues. This study investigated the benefit of these cues in individuals with mild cognitive impairment (MCI), individuals with AD, and healthy older adult controls. Method This study compared auditory-only and AV speech perception of sentences presented in noise. These sentences had one of two levels of context: high (e.g., "Stir your coffee with a spoon") and low (e.g., "Bob didn't think about the spoon"). Fourteen older controls (M age = 72.71 years, SD = 9.39), 13 individuals with MCI (M age = 79.92 years, SD = 5.52), and nine individuals with probable Alzheimer's-type dementia (M age = 79.38 years, SD = 3.40) completed the speech perception task and were asked to repeat the terminal word of each sentence. Results All three groups benefited (i.e., identified more terminal words) from AV and sentence context. Individuals with MCI showed a smaller AV benefit compared to controls in low-context conditions, suggesting difficulties with AV integration. Individuals with AD showed a smaller benefit in high-context conditions compared to controls, indicating difficulties with AV integration and context use in AD. Conclusions Individuals with MCI and individuals with AD do benefit from AV speech and semantic context during speech perception in noise (albeit to a lower extent than healthy older adults). This suggests that engaging in face-to-face communication and providing ample context will likely foster more effective communication between patients and caregivers, professionals, and loved ones.

Developmental language disorder (DLD) is often associated with deficits in executive functions (EFs), but the specific pattern of which components are affected remains unclear. This study examined EF performance in Spanish-speaking children with DLD compared to typically developing (TD) peers matched for age and socioeconomic status. The EFs, interference control, response inhibition, verbal and nonverbal working memory, and cognitive flexibility were assessed in 171 children between 6 and 8 years old: 72 with DLD and 99 who are TD. Group differences in EF performance were assessed after controlling for age and nonverbal reasoning. Children with DLD had significantly lower performance in interference control, response inhibition, and verbal working memory compared to TD children. Nonverbal working memory and cognitive flexibility did not differ significantly between the groups. Interference control was the most affected EF in the DLD group, followed by verbal working memory and then response inhibition. In addition, a proportion of the DLD group had no difficulties when exploring each EF. Spanish-speaking children with DLD have a range of difficulties with EFs, with significant individual variability. https://doi.org/10.23641/asha.30410572.

Background and aims:Previous investigations of word learning problems among people with developmental language disorder suggest that encoding, not retention, is the primary deficit. We aimed to replicate this finding; test the prediction that word form, not the linking of form to referent, is particularly problematic; and determine whether women with developmental language disorder are better word learners than men with developmental language disorder.Methods:Twenty adults with developmental language disorder and 19 age-, sex-, and education-matched peers with typical language development attempted to learn 15 words by retrieval practice. Their retention was measured one day-, one week-, and one month after training.Results:The participants with developmental language disorder required more exposures to the word-referent pairs than the participants with typical language development to reach mastery. While training to mastery, they made more errors in word form production, alone or in combination with errors in linking forms to the correct referents, but the number of no attempts and pure link errors did not differ by group. Women demonstrated stronger retention of the words than men at all intervals. The developmental language disorder and typical language development groups did not differ at the one-day- and one-month retention intervals but the developmental language disorder group was weaker at the one-week interval. Review via retrieval practice at the one-day and one-week interval enhanced retention at the one-month interval; the review at one week was more beneficial than the review at one day. Women benefitted more from the review opportunities than men but the developmental language disorder and typical language development groups did not differ.Conclusions:Adults with developmental language disorder present with weaknesses in the encoding of new words but retention is a relative strength. Encoding word forms is especially challenging but encoding word-to-referent links is not. We interpret this profile, and the evidence of a female advantage, as consistent with the Procedural Circuit Deficit Hypothesis.Implications:When treating a client with developmental language disorder whose goal is to increase vocabulary knowledge, the interventionist should anticipate the need for multiple exposures to new words within activities that highlight the forms of the words and support their memory and production. Periodic review should serve to support long-term retention.

Individual variation in bilingual vocabulary in preschoolers with developmental language disorder

Individuals with developmental language disorder (DLD) often exhibit slower processing on time-based tasks in comparison with age-matched peers. Processing speed has been linked to various linguistic skills and might serve as a global indicator of individual differences in language abilities. Despite an extensive literature on processing speed in DLD, it remains unclear whether slower processing is domain general or restricted to linguistic and/or auditory tasks. This meta-analysis used robust variance estimation to compare response/reaction times (RTs) of DLD and age-matched groups (N = 812 DLD, 870 neurotypical; M age [DLD] = 8.9 years, range: 4.3-22.7 years). Moderators included task (simple RT, choice RT, naming, congruent/baseline conditions of interference control tasks), stimulus type (linguistic/nonlinguistic), stimulus modality (auditory/nonauditory), and response modality (verbal/nonverbal). Age and publication year were covariates. The overall effect based on 46 studies and 144 estimates indicated longer mean RTs in DLD groups (g = .47, p < .001, 95% CI [.38, .55]). Moderator analyses indicated larger effects when tasks required verbal as opposed to nonverbal responses. No other moderators approached significance. All subgroup analyses were significant, indicating longer mean RTs in DLD groups across tasks, stimulus types, stimulus modalities, and response modalities. Individuals with DLD exhibit longer RTs across verbal and nonverbal tasks, which may contribute to observed difficulties in language, motor skills, and executive functioning. Simple processing speed measures should be included in screening for language delays but may not be suitable for differential diagnosis, given that slower processing may occur across multiple disorders. https://doi.org/10.23641/asha.21809355.

The aim of the study was to determine the ability of children with developmental language disorder (DLD) to infer word class and meaning from text and to document variations by word class (noun, verb, adjective) and modality (listening, reading). We also asked whether the children could integrate global cues across the entire passage as well as local cues from the immediate sentence frame to support inferences. Fourth graders with DLD (n = 28) and typical language development (TLD; n = 41) read and listened to expository texts and guessed the noun, verb, and adjective removed from each. Adults (n = 20) completed the task to establish a baseline of correct responses. We used latent semantic analysis (LSA) to determine the semantic fit of the responses to the texts and to determine whether global cues were more difficult for children with DLD than local cues. The DLD group was 24% less accurate than the TLD group. In both diagnostic groups, accuracy varied by word class (nouns > adjectives > verbs) but not modality (reading = listening). Word class errors were rare, and errors of semantic fit were frequent. LSA cosines were higher for correct responses relative to the passage as a whole than the immediate sentence frame, suggesting that both groups mined the more extensive information in the global cues to support inferences. Compared to the TLD group, the DLD group tended to make "worse" errors: repeating words from the sentence frame or coming up with no response at all. Accuracy in the DLD group, but not the TLD group, was related to vocabulary knowledge. When the two groups were collapsed, scores on verbal short-term/working memory and sustained attention also predicted performance, but weaknesses in these aspects of executive function on the part of individuals with DLD did not fully explain the difference between the performance of the DLD and TLD groups. Whether listening or reading, fourth graders with DLD are less able to infer word meaning from texts than their age-mates. The problem reflects, in part, deficits in executive function and lexical semantic knowledge.

Previous research indicates that children with Developmental Language Disorder (DLD) face challenges learning from feedback, resulting in suboptimal performance and learning outcomes. Feedback processing, a key developing executive function, involves cognitive processes critical for goal-directed behavior. This study examined the neural mechanisms underlying feedback processing in school-age children with DLD compared to typically developing (TD) peers, focusing on midfrontal theta band (4-8 Hz) oscillations as an index of cognitive control and error monitoring. We measured midfrontal theta inter-trial coherence (ITC) and inter-site coherence (ISC) at midfrontal (FCz), lateral prefrontal (F3/F4), and lateral central (C3/C4) sites in children with and without DLD (n = 33, age 8-13 years) in response to feedback provision within a Wisconsin Card Sorting Test (WCST) in two time windows (200-400 ms, which is associated with the Feedback-Related Negativity, or FRN, and 400-600 ms, which is associated with the P3a). Children with and without DLD showed elevated midfrontal theta oscillations in response to negative feedback that was followed by successful behavioral adjustments in the FRN time window. Activation in the P3a time window was only found in the TD group. Group differences were also noted in the inter-site coherence (ISC) associated with the effective processing of negative feedback. While in the TD group, effective processing of negative feedback was linked to high connectivity between midfrontal and right sensorimotor regions, in the DLD group, effective processing of negative feedback was associated with high connectivity between midfrontal and left sensorimotor sites. Differential ISC patterns in children with DLD may indicate that they employ alternative or compensatory neural strategies, possibly due to atypical right sensorimotor engagement.

Children with developmental language disorder (DLD) often exhibit motor difficulties and impaired somatosensory perception. While limb proprioceptive function is crucial for motor control, upper limb position sense performance in DLD remains unclear. This study investigated motor proficiency and wrist position sense acuity in Mandarin-speaking children with DLD, compared to typically developing (TD) peers. Twenty-seven children with DLD and 27 age-matched TD children (aged 6-12 years) completed motor and proprioceptive tasks. Motor function was evaluated using the Movement Assessment Battery for Children-Second Edition (MABC-2), which assessed three domains: Manual Dexterity, Aiming and Catching, and Balance. Proprioceptive function was evaluated through wrist position sense matching tasks, including ipsilateral and contralateral matching, with performance quantified by position error (PE) and standard deviation of PE (SDPE). Children with DLD exhibited significantly lower scores across all MABC-2 domains compared to TD peers (p < .001), with 77.8% scoring below the 5th percentile, suggesting comorbidity with developmental coordination disorder. For proprioceptive measures, while no group differences were found in PE, the DLD group exhibited significantly higher SDPE values (p < .05), indicating reduced wrist position sense precision. Our findings demonstrate that children with DLD exhibit impairments in both motor skills and upper limb proprioceptive acuity. This study extends our understanding of somatosensory deficits in DLD by specifically characterizing wrist proprioceptive function, highlighting the widespread nature of sensorimotor difficulties in this population.

Visual speech influences the perception of heard speech. A classic example of this is the McGurk effect, whereby an auditory /pa/ overlaid onto a visual /ka/ induces the fusion percept of /ta/. Recent behavioral and neuroimaging research has highlighted the importance of both articulatory representations and motor speech regions of the brain, particularly Broca's area, in audiovisual (AV) speech integration. Alternatively, AV speech integration may be accomplished by the sensory system through multisensory integration in the posterior STS. We assessed the claims regarding the involvement of the motor system in AV integration in two experiments: (i) examining the effect of articulatory suppression on the McGurk effect and (ii) determining if motor speech regions show an AV integration profile. The hypothesis regarding experiment (i) is that if the motor system plays a role in McGurk fusion, distracting the motor system through articulatory suppression should result in a reduction of McGurk fusion. The results of experiment (i) showed that articulatory suppression results in no such reduction, suggesting that the motor system is not responsible for the McGurk effect. The hypothesis of experiment (ii) was that if the brain activation to AV speech in motor regions (such as Broca's area) reflects AV integration, the profile of activity should reflect AV integration: AV > AO (auditory only) and AV > VO (visual only). The results of experiment (ii) demonstrate that motor speech regions do not show this integration profile, whereas the posterior STS does. Instead, activity in motor regions is task dependent. The combined results suggest that AV speech integration does not rely on the motor system.

Language exposure is known to be a key factor influencing bilingual vocabulary development in typically developing (TD) children. There is, however, a lack of knowledge in terms of exposure effects in children with developmental language disorder (DLD) and, especially, in interaction with age of onset (AoO) of second language acquisition. In the Helsinki longitudinal SLI study (HelSLI), we investigated the receptive and expressive second language (L2) vocabulary performance and cross-sectional vocabulary development of sequentially bilingual children with TD and DLD in order to resolve whether the groups could be differentiated based on their vocabulary performance. More importantly, we examined the effects of AoO and exposure in the vocabulary performance of these two bilingual groups. A total of 70 children with DLD from a hospital clinic and 82 with TD from kindergartens were recruited. Children were 3-7 years old with different AoOs for the L2 and varying degrees of language exposure. Multiple regression analysis was used to compare the groups in two receptive and three expressive vocabulary tests while considering the effects of AoO and language exposure. Children with TD outperformed children with DLD in both receptive and expressive vocabulary measures. Exposure predicted vocabulary but AoO did not. The effect of exposure was different in TD and DLD groups in receptive but not in expressive vocabulary. Additionally, the interaction of exposure and AoO was found for receptive vocabulary, but similarly in both groups. With increasing exposure, a difference in performance between the groups became more notable in receptive vocabulary compared with the expressive vocabulary. Bilingual children with TD and DLD can be differentiated by using L2 vocabulary tests when exposure is taken into consideration. Non-significant AoO effects in 3-7 year olds suggest flexibility in terms of when to start L2 immersion. However, exposure is important, and especially children with DLD would need a substantial amount of it relative to their TD peers, so that they would not fall even further behind over time. Differences in benefiting from exposure in receptive mode might offer clinicians and kindergarten personnel an insight for evaluating challenges in bilingual development. Severe challenges in vocabulary development in the DLD group also call for both individually targeted small-group activities for learning words as well as strategies for strengthening vocabulary in various environments and everyday life situations. What this paper adds What is already known on the subject Language exposure is often found to explain more of the variation compared with AoO in early L2 vocabulary. On the other hand, it has been suggested by some researchers, but not all, that AoO effects would be found. Exposure and AoO might also interact differently depending on the task and whether the development is typical or disordered. Contrary to the clinical observation, diagnostic value of receptive vocabulary has often been questioned. What this paper adds to existing knowledge This study indicates that receptive vocabulary might be useful in differentiating bilingual TD and DLD. Language exposure effects differ between TD and DLD groups, but depending on task. Lower performance, but also slower cross-sectional development, is found in receptive vocabulary for children with DLD. Interaction between language exposure and AoO stresses the importance of taking both into consideration when studying bilingual development. What are the potential or actual clinical implications of this work? L2 vocabulary tests can be used in differentiating bilingual children with TD and DLD when exposure is taken into consideration. Difficulties using exposure and, hence, slower development in children with DLD suggest that especially receptive vocabulary might be diagnostic by the accumulating exposure. Investing in ways of supporting vocabulary development through small-group activities and in everyday situations of bilingual children at risk of DLD is highly recommended. This is important to prevent them from incrementally falling further behind their TD peers over time. A limited AoO effect suggests that families have more flexibility in terms of when to place their child in L2 immersion in their early years.