Narrative abilities of Italian preschool children with Developmental Language Disorder

A Brain Marker for Developmental Speech Disorders

Developmental Language Disorder (DLD) impacts various aspects of children's language abilities, including the processing of inflectional morphology. Prior research suggests that children with DLD exhibit deficits in processing speed and sensitivity to grammatical inflections, yet the relationship between these deficits remains unclear. This study aimed to investigate the relationship between processing speed and sensitivity to inflectional morphology in children with DLD, focusing on their real-time processing abilities in response to regular past tense, third person singular, and regular plural inflections at different rates of sentence articulation. Eighteen children with DLD and 18 age-matched controls underwent word monitoring tasks that assessed sensitivity to grammaticality of inflections in sentences presented at normal and slow rates of articulation. At a normal rate of articulation, children with DLD demonstrated slower response times and reduced sensitivity to grammaticality across all inflections compared to controls. When the articulation rate was slowed, children with DLD showed improved sensitivity, particularly to regular plural and third person singular inflections, although deficits in processing the regular past tense persisted. The findings suggest a significant relationship between processing speed and inflectional morphology sensitivity in children with DLD. Slower articulation rates improved grammatical sensitivity for certain inflections, highlighting the potential of tailored interventions that consider processing speed limitations. Persistent difficulties with the regular past tense inflection indicate the need for targeted support for children with DLD in this area. What is already known on this subject Children with Developmental Language Disorder (DLD) have a wide range of language difficulties, but deficits in inflectional morphology are regarded as a 'hallmark' of the disorder. Children with DLD are also very likely to show deficits in speed of processing, although it is not known if a 'slowness to process' can causally explain the language difficulties these children experience. What this study adds to existing knowledge When grammatical sensitivity was measured using an online real-time task, children with DLD showed widespread inflectional deficits when sentences were spoken at a normal conversational rate. When sentence articulation rate was slowed down, children with DLD were faster, more accurate and more sensitive to the grammaticality of constructions. However, deficits in the regular past tense remained persistent, even in this slow-rate condition. What are the clinical implications of this work? This study has implications for clinical and educational practices that work with children with DLD to improve their language skills. The findings of this study show that when children with DLD are given more time to process incoming information, their grammatical skills significantly improve. This study also shows that deficits in the regular past tense are persistent, and children are likely need extensive and intensive support with this particular grammatical feature.

Public awareness of Developmental Language Disorder (DLD) is lower than other neurodevelopmental disorders, despite its high prevalence of 7.6%. This lower awareness means recruitment for DLD research studies is difficult. DLD is both underfunded and under-researched, resulting in relatively limited research investigating individuals with DLD. Engage with Developmental Language Disorder (E-DLD) is a response to these considerations. E-DLD is the first international participant database of those affected by DLD. Parents of children with DLD under 16 and young people and adults over 16 from anywhere in the world can sign up to be a part of the E-DLD. This paper aims to describe the families of children with DLD and adults with DLD in the database thus far. E-DLD members sign up via our website, reporting demographic characteristics as part of this procedure. We request all E-DLD members subsequently fill in a yearly survey. The content of the yearly survey changes dependent on the age of the child, while the yearly survey for adults remains consistent. We measure a wide range of domains, such as speech and language therapy (SLT) support, school support, socialisation skills, and early developmental milestones for our youngest members, and health care support and mental well-being measurements for our adults. We also collect parent and self-reported reflections on strengths and challenges for the person with DLD using open-ended questions and the Strengths and Difficulties Questionnaire. The database currently consists of 196 parents of children with DLD and 20 individuals over the age of 16 with DLD or suspected DLD across a range of socioeconomic status (SES) backgrounds. Our initial results confirm that E-DLD members meet the linguistic profile of DLD in relation to self- or parent-rated language difficulties. Both children and adults show increased rates of psychosocial difficulties compared to established norms, consistent with past research on clinical samples of people with DLD. The findings indicate that a participant database for DLD research is feasible and useful. The rates of emotional, behavioural and sleep difficulties among the child probands are higher than reported rates amongst typically developing children. Initial data indicate that adults with DLD have poorer well-being than their peers. The E-DLD is a useful collection of data on those affected by DLD and is a promising method for connecting people with DLD with academic researchers. What is already known on this subject Developmental Language Disorder (DLD) is characterised by expressive and/or receptive language difficulties in the absence of another biomedical condition that could explain these difficulties. It is critically under-researched and underfunded. As such, there is a lack of public awareness and difficulty recruiting sufficient sample sizes for DLD research studies. What this paper adds to existing knowledge Engage with Developmental Language Disorder (E-DLD) is the first international participant database of individuals with DLD. This paper provides a preliminary report on the profile of linguistic and psychosocial skills among the individuals on the database, adding to current understanding of DLD across age groups. What are the potential or actual clinical implications of this work? Our aim is that the E-DLD will provide much-needed facilitation of research into DLD. E-DLD will enable those with DLD and their families more readily to shape research agendas and to participate in studies that interest them. Families may be recruited into research that could directly translate to better clinical treatment of DLD. We also believe that the E-DLD yearly survey holds potential to provide key information on the development and longitudinal experience of children and adults with DLD.

Erratum: Involving Individuals with Developmental Language Disorder and their Parents/Carers in Research Priority Setting.

Understanding factors influencing wellbeing is crucial for the development of effective services. Aphasia in older individuals and developmental language disorder (DLD) in children significantly affect how people live and function. Despite the increasing stroke incidence in young adults and the growing recognition of DLD as a lifelong disorder, the literature lacks evidence on the wellbeing of young adults, aged between 18 and 40 years old, with these conditions. To identify factors influencing wellbeing in young adults with aphasia and DLD. This cross-sectional between-group study involved 78 young adults with aphasia, DLD and no language impairments, with mean (SD) age of 30.5 (6.38) years. A total of 12 measures were used to assess wellbeing, language, cognition, health, emotional distress, social functioning and psychological resources. Feasibility and acceptability were informed by a pilot-study. One-way-unrelated analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare groups on language, cognition and wellbeing, while correlation analyses identified factors influencing wellbeing in each group. No significant differences were found between clinical groups in language and cognitive profiles, with both scoring lower than those with no language impairments. The wellbeing of individuals with aphasia and DLD was similar to that of adults with no language impairments. Health, emotional distress and social support were common drivers of wellbeing among all groups, with positive performance in those scales indicating better wellbeing. Language and self-esteem showed significant links with wellbeing for those with DLD, but not for the aphasia group. The higher the self-esteem level of people with DLD, the higher their wellbeing rating. Interestingly, language was negatively related to wellbeing in people with DLD, with higher language scores correlating with lower levels of wellbeing. Aphasia and DLD share factors affecting wellbeing, but the different origins of the disorders seem to influence the overall nature of wellbeing. Wellbeing in DLD is primarily impacted by the language disorder, whereas in aphasia it is influenced by its secondary to the disorder characteristics and primarily emotional health. This study highlights the need for holistic therapy and ongoing psychosocial support to optimize services for young adults with these impairments. What is already known on the subject Aphasia and DLD significantly impact social and emotional aspects of life. However, knowledge about wellbeing in young adults with these disorders remains limited. What this paper adds to the existing knowledge This research is the first to compare wellbeing in aphasia and DLD. It highlights the impact of several psychosocial factors and clinical characteristics including language on wellbeing, considering whether individuals developed language disorders during childhood or acquired them later in adult life. While there is a small amount of evidence on wellbeing in young adults with DLD, this is the first study to investigate wellbeing in young adults with aphasia. What are the potential or actual clinical implications of this work? The type of language disorder may influence wellbeing in diverse ways. Speech and language therapists must evaluate the impact of these disorders on young adults' wellbeing. Rehabilitation should consider both personal factors and external support systems, following appropriate care models. Our findings suggest that aphasia interventions might benefit from focusing on enhancing emotional wellbeing and social networks, particularly in young adults. For individuals with DLD, it appears that the emphasis should be on improving communication skills by addressing functional constraints in social interactions and considering their psychological resources. Further research is needed to confirm these potential intervention strategies. An interdisciplinary approach is essential for optimal outcomes.

Students with developmental language disorder (DLD) often experience academic underachievement, and require adjustments and accommodations to access the curriculum. Teachers, allied health professionals and parents/caregivers have varying roles in the education process, and it is essential they work together to provide optimal support. However, their perspectives on the areas of functioning most impacting learning, the difficulty of school-based tasks and the helpfulness of educational support have received limited attention. A between-group survey design was used with recruitment occurring from September 2020 to October 2021. A total of 293 participants was comprised of teachers (n = 78), allied health professionals (n = 138) and parents/caregivers (n = 77). All respondents rated the learning impact of seven areas of functioning (academic behaviour, fine/gross motor, language/communication, literacy, numeracy, sensory and social/emotional), the difficulty of 39 school-based tasks, and the helpfulness of 27 educational supports for primary and/or secondary school-aged students with DLD. The groups of school-based tasks were combined into seven subscales (academic behaviour-related tasks, fine/gross motor tasks, language/communication tasks, literacy tasks, numeracy tasks, sensory-related tasks and social/emotional tasks) for analysis. The educational supports were also combined into six subscales (additional time, differentiation/adjustments, individualized support, social/emotional support, technology and visual supports). All participants rated literacy and language/communication as the areas of functioning most impacting learning and requiring the highest level of support for students with DLD. Literacy tasks were rated the most difficult across stakeholder groups. However, comparison between stakeholder groups showed statistically significant differences between ratings for six (of seven) areas of functioning. Statistically significant differences were identified when rating the difficulty of four (of seven) school-based task subscales. Additional time and visual supports were rated the most helpful educational supports across groups. Overall, teachers and allied health professionals rated areas of functioning and school-based tasks as more difficult than parents/caregivers, although they shared similar perspectives on five (of six) educational support subscales. Literacy and language/communication are the areas of functioning rated to be most impacting learning for students with DLD. However, literacy tasks were reported to be the most difficult for students with DLD to complete. Teachers, allied health professionals and parents/caregivers are recommended to regularly discuss the areas of functioning, school-based tasks and educational support to facilitate inclusive educational practices. Future research needs to consider the perspectives of students with DLD. What is already known on the subject There is extensive evidence demonstrating the increased risk of academic failure for students with DLD, particularly with literacy and numeracy. Although research on academic achievement or individual groups has occurred, limited research has compared stakeholders supporting students with DLD, which is vital for collaboration and optimal inclusive educational practices. What this study adds to the existing knowledge Teachers, allied health professionals and parents/caregivers have unique roles in the education of students with DLD and show differing perspectives that may link to these roles. Literacy and language/communication were the areas of functioning rated as most impacting learning, whilst literacy tasks were the most difficult activity undertaken at school for primary and secondary school-aged students with DLD. Additional time and visual support were rated as the most helpful educational supports for students with DLD. What are the practical and clinical implications of this work? Stakeholders demonstrate variable views on the areas of functioning and school-based tasks requiring support for students with DLD; however, they agreed on the helpfulness of most educational supports. Participants rated social/emotional tasks easier and their related supports less helpful than other areas of functioning. Given the associations between academic underachievement and mental health difficulties, more consideration needs to be given to the social/emotional well-being of students with DLD in school. Taken together, establishing differences in perspective will help with the implementation of inclusive educational practices.

Developmental language disorder (DLD) and developmental speech disorder (DSD) are common, yet their etiologies are not well understood. Atypical volume of the inferior and posterior language regions and striatum have been reported in DLD; however, variability in both methodology and study findings limits interpretations. Imaging research within DSD, on the other hand, is scarce. The present study compared grey matter volume in children with DLD, DSD, and typically developing speech and language. Compared to typically developing controls, children with DLD had larger volume in the right cerebellum, possibly associated with the procedural learning deficits that have been proposed in DLD. Children with DSD showed larger volume in the left inferior occipital lobe compared to controls, which may indicate a compensatory role of the visual processing regions due to sub-optimal auditory-perceptual processes. Overall, these findings suggest that different neural systems may be involved in the specific deficits related to DLD and DSD.

Neurodiversity is increasingly discussed in relation to autism research and practice. However, there is a lack of scholarship concerning the neurodevelopmental condition of Developmental Language Disorder (DLD) and the neurodiversity movement. While this movement may hold opportunities for the DLD community, the application of the concept of neurodiversity to DLD research and practice needs consideration, as DLD and autism have very different levels of public and professional awareness and understanding. In this article, we discuss what the concept of neurodiversity and the associated neurodiversity movement could mean for DLD research and practice. We aim to critique some assumptions that may arise from the application of neurodiversity principles (or assumed principles) to the field of DLD. This is a discussion paper, drawing on the personal experiences and reflections of the author team. We make the case for why DLD should be included in discussions about neurodivergence and outline considerations for doing so, and why some issues and applications may be particular to DLD. We outline points of similarity and contrast with autism in relation to our understanding of neurodiversity. We consider the issues around diagnosis and terminology and urge practitioners to continue to diagnose DLD using currently agreed terminology, so as not to undermine recent awareness efforts. We note that a neurodiversity-informed perspective challenges us to offer interventions that operate at the level of our environments, not just at the level of an individual. Indeed, neurodiversity offers a platform to argue for better rights and more inclusive spaces in mental health settings, education and work for children and adults with DLD. DLD should be considered from a neurodiversity-informed perspective, and it is our hope that this will lead to neurodiversity-affirming practice that will afford young people with DLD better understanding from members of the public and the professionals who work with them. Further work is needed to better support children, young people and adults with DLD to have a voice in the neurodiversity movement. What is already known on the subject Neurodiversity approaches are increasingly being taken up in research and practice in relation to autism, meaning that our understanding of autism and how autistic people are supported is increasingly drawing on the principles of neurodiversity. However, autism is not the only neurodivergent population. Developmental Language Disorder (DLD) is another neurodevelopmental condition; however, relative to autism, DLD has lower awareness amongst professionals and the public. There has been no scholarship that has examined DLD through the lens of neurodiversity, or considered the application of neurodiversity-affirming approaches to DLD. What this paper adds to existing knowledge In this paper, we examine what the neurodiversity movement means for DLD research and practice. In particular, we consider what neurodiversity in the field of autism might teach us about the application of neurodiversity in the field of DLD, and highlight where we believe there are important differences between the two populations. We reflect on what neurodiversity means for intervention, diagnosis, terminology and championing the need for accessibility, especially with regard to mental health support, education and employment. What are the potential or actual clinical implications of this work? Neurodiversity highlights the need to consider interventions at the level of an individual's environment (e.g., how can we make this space more inclusive?) as well as interventions operating at the level of the individual themselves (e.g., interventions focusing on an individual's language skills). We challenge the notion that neurodiversity-affirming approaches mean not diagnosing DLD or changing DLD's terminology: we argue that this is not in the spirit of the original neurodiversity movement, but also that for a condition with such low public awareness, these actions could do more harm than good for families affected by DLD. We call for more in-depth scholarship and discussion around the application of neurodiversity approaches to DLD and argue that the neurodiversity movement offers an important opportunity to raise better awareness and understanding of DLD in multiple sectors, including (but not limited to) mental health, education and employment.

Background Developmental Language Disorder (DLD) is a persistent difficulty with the use and understanding of language, emerging in childhood and enduring into adulthood. Despite research on DLD increasing in recent years, there is a dearth of literature on adult life with DLD. Increasing our understanding of the lived experience of DLD has the potential to lead to more targeted and meaningful interventions, enhance intervention outcomes, and increase client satisfaction with interventions. Objective This study aimed to explore the lived experience of DLD for adults. Specifically, it examined the impact of DLD on education, employment, relationships, and recreational activities. Methods Semi-structured interviews were completed with seven adults with DLD, aged from 24 to 66 years. Interview questions were developed following a review of the literature, and centred on five topics: education, employment, relationships, recreational activities and personal strengths. Interviews were conducted in person and online. Reflexive thematic analysis was used to analyse the data. Results Two themes and five subthemes were identified. The themes were: Society’s reduced awareness and understanding of DLD and its impact on the individual and Participation in daily living activities. Conclusions This study illustrates the profound impact that DLD has on an individual’s life. Speech and language therapists working with this client group should be cognisant of this multifaceted impact and ensure that intervention is person-centred and tailored to an individual’s specific goals. Future research should continue to explore the impact of DLD on the lives of adults, and ensure their voices are adequately represented in the literature.

There is a clear predominance of programmes aimed at improving aspects related to language production in pupils with developmental language disorder (DLD). However, programmes aimed at improving their receptive skills are limited. The main aim was to assess the effectiveness of an intervention programme for oral language comprehension skills in preschoolers with typical development (TD) and pupils with DLD. Participants were 99 five-year-old pupils, with and without DLD, divided into four groups: two control groups (TD-C = 25; DLD-C = 25) and two experimental groups (TD-T = 24; DLD-T = 25), from schools on the Spanish island of Tenerife. The study used, as pre- and post-measures, the receptive language subtests of the CELF-4-Spanish: Concepts and Following Directions, Word Classes-Receptive and Sentence Structure, as well as two tasks assessing comprehension of paragraphs and narratives. Due to the strong link between oral comprehension skills and executive functions, working memory and semantic fluency are included in this research. The Backward Digit Span subtest of the Wechsler Intelligence Scale for Children (WISC-IV) and Semantic Fluency subtest of the Controlled Oral Word Association Test (COWAT) were used to assess working memory and semantic fluency, respectively. The intervention programme followed a multitiered system of support (MTSS) model, with 95 sessions lasting 60 min each delivered jointly by teachers and speech and language therapists, and focused on lexical-semantic, morphological, syntactic and narrative skills; inferences; verbal working memory; and semantic fluency. The results showed, as expected, that pupils diagnosed with DLD initially performed worse on oral language comprehension and executive functions than pupils with TD. Further, the DLD-T and TD-T groups showed greater gains following the programme, especially in word classes-receptive, sentence structure, verbal working memory and semantic fluency. Finally, a significant positive correlation was found between the gains obtained by the participants in verbal working memory and semantic fluency, with the gains obtained in the three CELF-4-Spanish subtests. An intervention programme applied at an early age fosters oral language comprehension skills and executive functions in pupils with DLD and TD. The intervention organized at different levels of support, following an MTSS model, showed clear progress of the DLD and TD groups in oral language comprehension and executive functions. Pupils with DLD present deficits in linguistic comprehension and executive functions. There are many intervention programs focused on improving language production skills. It is also necessary to consider the skills underlying language problems in pupils with DLD. Oral language, inference, working memory and semantic fluency activities improve comprehension. A collaborative and inclusive intervention of teachers and speech language therapists. Psycholinguistic and neuropsychological skills training should become part of the academic curriculum as early as preschool age. What is already known on the subject Pupils with DLD show problems related to both comprehension and production language. However, there is a clear predominance of programs just aimed at improving aspects related to language production. Clinical implications of this study An intervention program applied at an early age fosters oral language comprehension skills and executive function in pupils with DLD. The intervention organized at different levels of support, following an adaptation of the Response Tier Intervention models, showed clear progress of the DLD in comprehension oral language and executive functions.

Background: A narrative requires the integration and management of linguistic and cognitive skills. It has been observed that children with Developmental Language Disorder (DLD) have difficulties in narrating stories. This research proposes an intervention in a case of a child 9 years and 2 months old with DLD, with the aim of improving his oral narrative skills through a retelling task via telepractice. Methods: In the evaluation, standardized tests have been used and a ‘remembering a story’ task, with a story titled The Lost Backpack, elaborated by one of the authors. Narratives were elicited in two sessions, and were transcribed, coded, and analysed using the Child Language Data Exchange System CHILDES Project tool. The participant received a total of 10 sessions through the Skype platform, which included intervention-addressed explicit instruction about the narrative structure and the use of discourse markers to improve cohesion in story retelling. Results: Significant changes were observed in the retelling of the story at microstructure and macrostructure levels: an increase of the Mean Length of Utterance (MLU), Types and Tokens, specific vocabulary, discourse markers and the recall of events. Conclusions: These results demonstrate the effectiveness of intervention in narrative skills through the oral retelling of a story with visual support via tele-practice.

Approximately 9.9 % of children present with difficulties in language development (DLD), 7.6 % without serious additional impairments and 2.3 % associated with languagerelevant comorbidities, e.g., hearing loss. Notably, in a consensus statement by experts in German-speaking countries, in the guideline presented here, and further in this article, all of these disorders are referred to as "developmental language disorders" (DLD), whereas the international consortium CATALISE only refers to those without comorbidities as DLD. DLDs are among the most commonly treated childhood disorders and, if persistent, often reduce educational and socio-economic outcome. Children in their third year of life with developmental language delay (late talkers, LT) are at risk of a later DLD. This German interdisciplinary clinical practice guideline reflects current knowledge regarding evidence-based interventions for developmental language delay and disorders. A systematic literature review was conducted on the effectiveness of interventions for DLD. The guideline recommends parent training (Hedges g = 0.38 to 0.82) for LTs with expressive language delay, language therapy (Cohen's d = -0.20 to 0.90) for LTs with additional receptive language delay or further DLD risk factors, phonological or integrated phonological treatment methods (Cohen's d = 0.89 to 1.04) for phonological speech sound disorders (SSDs), a motor approach for isolated phonetic SSDs (non-DLD), and for lexical-semantic and morpho-syntactic impairments combinations of implicit and explicit intervention approaches (including input enrichment, modeling techniques, elicitation methods, creation of production opportunities, metalinguistic- approaches, visualizations; Cohen's d = 0.89-1.04). Recom mendations were also made for DLD associated with pragmatic-communicative impairment, bi-/ multilingualism, hearing loss, intellectual disability, autism-spectrum disorders, selective mutism, language- relevant syndromes or multiple disabilities, and for intensive inpatient language rehabilitation. Early parent- and child-centered speech and language intervention implementing evidence-based intervention approaches, frequency, and settings, combined with educational language support, can improve the effectiveness of management of developmental language delay and disorders.

This thesis used a combination of neuroimaging techniques and measures of speech and language to examine brain structure and function in children with developmental language disorder (DLD) and developmental speech disorder (DSD). The findings from this thesis suggest a link between DLD and grey matter volume in the cerebellum, as well as an association between DSD and grey matter volume in the inferior occipital lobe. This research also highlights the multidimensional nature of the nonword repetition task, and suggests that this task is not a particularly sensitive brain MRI marker in DLD or DSD.

Examining the relationship between oral language skills and executive functions: Evidence from Greek-speaking 4–5-year-old children with and without Developmental Language Disorder

Research on the grammatical characteristics of children with developmental language disorder (DLD) across languages has challenged accounts about the nature of DLD. Studies of the characteristics of DLD in different languages can reveal which components of DLD emerge irrespective of language and which components are language specific. To examine the grammatical characteristics of children with DLD acquiring Danish (microstructure and error types) in order to contribute to research on language-general and language-specific characteristics of DLD. Language samples from two telling narratives, one retelling narrative and one session of semi-spontaneous talk were collected from 39 Danish-speaking children aged 5;0-8;6, comprising one group of children with DLD (n = 15) and two control groups (age- and language-matched: n = 15 and = 9, respectively). The data were analysed with reference to microstructure and grammatical errors. The DLD children's performance was compared with that of their peers with typical language development (AM) and to that of a younger group matched on language comprehension (LM). Task effects were also analysed. A significant group difference in microstructure was present in the results for mean length of utterance (MLU), where the AM group had significant higher MLU compared with the DLD group. Two variables clearly distinguished DLD children from both AM and LM children in terms of errors, namely word order errors and omission errors. The analysis of grammatical errors also revealed that the most salient challenges for Danish-speaking children with DLD were not clearly morphological in nature. Although the children with DLD, as expected, made more morphological errors compared with the AM group, they did not produce more errors compared with the LM group. Task effects were present for some but not all results. This research emphasizes the importance of cross-linguistic comparisons of the linguistic error profiles in the elicited language of children with DLD and the importance of considering the methodological context when analysing the grammatical language abilities of children with DLD. The results are relevant for clinicians and for developing screening tools. What is already known on this subject DLD is characterized by challenges in producing and comprehending language. Ample research is available on English-speaking children with DLD, and which has reported on challenges acquiring morphology. Studies of children with DLD acquiring other languages than English show challenges related to specific grammatical features of the respective language. What this study adds to the existing knowledge This study is the first to investigate microstructure abilities and grammatical errors produced by Danish-speaking children with DLD and using different language samples (narrative telling, narrative retelling and spontaneous language). It enhances our knowledge about DLD in Scandinavian languages and cross-linguistically and reinforces cross-linguistic findings that grammatical and structural challenges in language acquisition for children with DLD might not be reducible exclusively to morphology. While some components of DLD children's language challenges may appear universal and be attributed to overarching factors other components seem more specific to the structure of the target language. Results from this study additionally draw attention to the importance of considering contextual constraints when investigating productive grammatical abilities in children with DLD. What are the practical and clinical implications of this work? More detailed analysis of grammatical error types seen in children with DLD acquiring languages other than English and of individual differences contribute to clinical advancement in the field. A better insight into grammatical difficulties of Danish-speaking children with DLD may contribute to improved assessment procedures and planning of therapy for children with DLD.