Clinical Evaluation Of Language Fundamentals Research Articles

The language, literacy and mental health profiles of adolescents in out-of-home care: An Australian sample

Adolescents in the care of the state have complex developmental needs that include low academic attainment. The aim of this study was to describe the language and literacy profiles of adolescents (aged 13–19) in out-of-home care (‘looked after children’). Mental health status, biopsychosocial history, and education and employment histories were also documented. Twenty-six adolescents were assessed by a speech and language therapist. Ninety-two percent had oral language skills below the average range on the Clinical Evaluation of Language Fundamentals: 4th edition, with 62% scoring two or more standard deviations below the mean. Ninety-two percent of participants scored below the average range on two or more subtests of the Test of Language Competence: Expanded edition. On the York Assessment of Reading Comprehension, 92% scored in the very low range and 65% were below-average on single-word reading. Fifty percent of participants reported a diagnosis/symptoms of depression and 54% reported a diagnosis/symptoms of anxiety. The correlation between oral language and literacy was modest but significant ( r = 0.502; p ⩽ 0.05); no significant correlations were found between oral language, literacy and mental health status, suggesting that mental health problems are a comorbidity rather than a correlate of language and literacy difficulties. Language and literacy difficulties are highly prevalent in this population. Language disorders are likely to be undiagnosed in the context of significant mental health problems, and disrupted schooling and accommodation. Speech-language therapy scope of practice needs to include out-of-home care populations in order to foster developmentally appropriate language and literacy skills that maximize school success, both academically and socially.

Cortical Morphometry is Associated with Neuropsychological Function in Healthy 8-Year-Old Children.

Cortical development is essential for children's neurocognition. In this study, we evaluated how variations in cortical morphometry in normal children are associated with outcome differences in multiple domains of cognition. Eight-year-old children were recruited for a brain MRI followed by a battery of neuropsychological assessments. The MRI scan included 3D-T1-weighted imaging for cortical morphometry in 34 regions defined by the Desikan atlas. The neuropsychological assessments included the Reynolds Intellectual Assessment Scales (RIAS) for IQ, Clinical Evaluation of Language Fundamentals (CELF-4) for language, Children's Memory Scale (CMS) for memory, Wide Range Achievement Test (WRAT-4) for academic skills, and Behavior Rating Inventory of Executive Function (BRIEF) for executive functions. The relationships between MRI measured cortical features, including gray matter volume, surface area, and cortical thickness for different brain regions and neuropsychological test scores, were evaluated using partial correlation analyses controlled for age and sex. RIAS/CELF-4/CMS/WRAT-4/BRIEF scores showed significant correlations (R: [.38-.44], P: [.005-.046]) with gray matter volume, surface area, or cortical thickness in multiple brain regions. Gray matter volume in the medial orbitofrontal/ventromedial prefrontal cortex appeared to be a sensitive marker for overall neurocognition as it significantly correlated with IQ, language, memory, and executive function behaviors. The superior temporal gyrus and banks of superior temporal sulcus appeared to be most sensitive to reflect overall language function as their cortical features consistently correlated with language-related test scores. Cortical morphometry significantly correlated with neuropsychological function in healthy children; certain regions/features may serve as sensitive imaging markers.

Does Otitis Media Affect Later Language Ability? A Prospective Birth Cohort Study.

Purpose The aim of the study was to examine whether otitis media (OM) in early childhood has an impact on language development in later childhood. Methods We analyzed data from 1,344 second-generation (Generation 2) participants in the Raine Study, a longitudinal pregnancy cohort established in Perth, Western Australia, between 1989 and 1991. OM was assessed clinically at 6 years of age. Language development was measured using the Peabody Picture Vocabulary Test-Revised (PPVT-R) at 6 and 10 years of age and the Clinical Evaluation of Language Fundamentals-Third Edition at 10 years of age. Logistic regression analysis accounted for a wide range of social and environmental covariates. Results There was no significant relationship between bilateral OM and language ability at 6 years of age (β = -0.56 [-3.78, 2.66], p = .732). However, while scores were within the normal range for the outcome measures at both time points, there was a significant reduction in the rate of receptive vocabulary growth at 10 years of age (PPVT-R) for children with bilateral OM at 6 years of age (β = -3.17 [-6.04, -0.31], p = .030), but not for the combined unilateral or bilateral OM group (β = -1.83 [-4.04, 0.39], p = .106). Conclusions Children with OM detected at 6 years of age in this cohort had average language development scores within the normal range at 6 and 10 years of age. However, there was a small but statistically significant reduction in the rate of receptive vocabulary growth at 10 years of age (on the PPVT-R measure only) in children who had bilateral OM at 6 years of age after adjusting for a range of sociodemographic factors.

Health-related quality of life of children with low language from early childhood to adolescence: results from an Australian longitudinal population-based study.

Low language abilities are known to be associated with significant adverse long-term outcomes. However, associations between low language and health-related quality of life (HRQoL) are unclear. We aimed to (a) examine the association between low language and HRQoL from 4 to 13years and (b) classify the children's trajectories of HRQoL and language and examine the association between language and HRQoL trajectories. Data were from an Australian community-based cohort of children. HRQoL was measured at ages 4-13years using the parent-reported Pediatric Quality of Life Inventory 4.0. Language was assessed using the Clinical Evaluation of Language Fundamentals (CELF)-Preschool 2nd edition at 4years and the CELF-4th edition at 5, 7 and 11years. Multivariable linear regression and mixed effect modelling were used to estimate cross-sectional and longitudinal associations between low language and HRQoL from 4 to 13years. A joint group-based trajectory model was used to characterize associations between HRQoL and language trajectories over childhood. Children with low language had substantially lower HRQoL than children with typical language from 4 to 13years. Higher language scores were associated with better HRQoL, particularly in social and school functioning. Three HRQoL trajectories were identified: stable-high (51% of children), reduced with slow decline (40%) and low with rapid decline (9%). Children with low language were less likely to follow a stable-high HRQoL trajectory (40%) while 26% and 34% followed the reduced with slow decline and low with rapid decline trajectories, respectively. Children with low language experienced reduced HRQoL from 4 to 13years. More than half had declining trajectories in HRQoL highlighting the need to monitor these children over time. Interventions should not only aim to improve children's language ability but also address the wider functional impacts of low language.

Bilingualism and Processing Speed in Typically Developing Children and Children With Developmental Language Disorder.

Purpose The aim of the current study was to investigate whether dual language experience modulates processing speed in typically developing (TD) children and in children with developmental language disorder (DLD). We also examined whether processing speed predicted vocabulary and sentence-level abilities in receptive and expressive modalities. Method We examined processing speed in monolingual and bilingual school-age children (ages 8-12 years) with and without DLD. TD children (35 monolinguals, 24 bilinguals) and children with DLD (17 monolinguals, 10 bilinguals) completed a visual choice reaction time task. The Clinical Evaluation of Language Fundamentals, the Peabody Picture Vocabulary Test, and the Expressive Vocabulary Test were used as language measures. Results The children with DLD exhibited slower response times relative to TD children. Response time was not modified by bilingual experience, neither in children with typical development nor children with DLD. Also, we found that faster processing speed was related to higher language abilities, but this relationship was not significant when socioeconomic status was controlled for. The magnitude of the association did not differ between the monolingual and bilingual groups across the language measures. Conclusions Slower processing speed is related to lower language abilities in children. Processing speed is minimally influenced by dual language experience, at least within this age range. Supplemental Material https://doi.org/10.23641/asha.12210311.

Assessment of Language Abilities in Minority Adolescents and Young Adults With Autism Spectrum Disorder and Extensive Special Education Needs: A Pilot Study.

Purpose Little is known about the language abilities of adolescents and young adults with autism spectrum disorder (ASD) despite the importance of language in their other life outcomes. Even less is known about the language abilities of racial/ethnic minorities with ASD and extensive special education needs. These gaps limit our understanding of adolescents and young adults with ASD. Method A pilot study evaluated the efficacy of individualized age-referenced language assessment for minority adolescents and young adults with ASD in self-contained special education settings. Participants (n = 10) completed the Clinical Evaluation of Language Fundamentals-Third Edition, Test for Early Grammatical Impairment (TEGI), Columbia Mental Maturity Scale, and Wechsler Intelligence Scale for Children-Third Edition Digit Span. Results Clinical Evaluation of Language Fundamentals-Third Edition scores showed little variation, with most participants showing a floor effect. TEGI, Columbia Mental Maturity Scale, and Digit Span scores showed greater variation. Some participants had ceiling TEGI scores, and some had variable assessment profiles. Conclusion Assessment was sensitive to variability across some measures. The pilot study outcomes support the feasibility and potential informativeness of additional investigation of conventional language assessments and change over time.

Does a narrative retelling task improve the assessment of language proficiency in school-aged children born very preterm?

ABSTRACT Almost half of the children born very preterm (VP) experience language difficulties at school-age, specifically with more complex language tasks. Narrative retelling is such a task. Therefore, we explored the value of narrative retelling assessment in school-aged children born VP, compared to item-based language assessment. In 63 children born VP and 30 age-matched full-term (FT) controls Renfrew’s Bus Story Test and Clinical Evaluation of Language Fundamentals were assessed. The retelling of the Bus Story was transcribed and language complexity and content measures were analyzed with Computerised Language Analysis software. Narrative outcomes of the VP group were worse than that of the FT group. Group differences were significant for the language complexity measures, but not for the language content measures. However, the mean narrative composite score of the VP group was significantly better than their mean item-based language score, while in the FT group the narrative score was worse than the item-based score. Significant positive correlations between narrative and item-based language scores were found only in the VP group. In conclusion, in VP children narrative retelling appears to be less sensitive to detecting academic language problems than item-based language assessment. This might be related to the mediating role of attention in item-based tasks, that appears not to affect more spontaneous language tasks such as retelling. Therefore, in school-aged children born VP we recommend using narrative assessment, in addition to item-based assessments, because it is more related to spontaneous language and less sensitive to attention problems.

Vocabulary comprehension in adults with fragile X syndrome (FXS)

BackgroundReceptive and expressive vocabulary in adult and adolescent males with fragile X syndrome (FXS) have been shown as significantly lower than their chronological age; however, receptive vocabulary has been considered a strength relative to mental age. This has not been formally examined, however, and data are needed to compare receptive vocabulary with other language skills and with mental age in individuals with FXS. This is especially important as vocabulary measures are sometimes used as a proxy to estimate language ability.MethodsThis preliminary study examined receptive vocabulary, global language, and cognitive skills in 42 adults (33 males and 9 females) with FXS as a portion of the baseline evaluation prior to randomization in a clinical trial of ampakine CX516. The battery of standardized tests addressed receptive vocabulary with the Peabody Picture Vocabulary Test, Third Edition (PPVT-III), receptive and expressive language (termed henceforth as global language) via the Preschool Language Scale, Fourth Edition or the Clinical Evaluation of Language Fundamentals, Third Edition, and non-verbal cognition via the Stanford-Binet Intelligence Scales, Fourth Edition (SB-IV).ResultsResults showed (1) significantly higher receptive vocabulary than global language, (2) significantly better receptive vocabulary than non-verbal cognition, (3) equivalent non-verbal cognition and global language, and (4) severity of autism symptomatology was not correlated to receptive vocabulary or global language once non-verbal cognition was removed as factor. The scores from the PPVT-III did not represent the global language skills in our sample of adults with FXS.ConclusionsFindings from this investigation strongly suggest that the PPVT-III should not be used as a screening tool for language levels or cognitive function in clinical studies since the scores from the PPVT-III were not representative of global language or non-verbal cognitive skills in adults with intellectual disabilities. This finding is critical in order to understand how to evaluate, as well as to treat, language in individuals with FXS. Development of efficient and appropriate tools to measure language, cognition, and behavior in individuals with FXS is essential.

Early Cognitive Predictors of 9-Year-Old Spoken Language in Children With Mild to Severe Hearing Loss Using Hearing Aids.

This study examined the extent to which cognitive ability at 5 years of age predicted language development from 5 to 9 years of age in a population-based sample of children with hearing loss who participated in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. The developmental outcomes of 81 children with hearing loss were evaluated at 5 and 9 years of age. Hearing loss ranged from mild to severe degrees, and all participants used hearing aids. They all used spoken language as the primary mode of communication and education. Nine-year-old language was assessed using the Clinical Evaluation of Language Fundamentals – 4th edition (CELF-4), the Peabody Picture Vocabulary Test – 4th edition (PPVT-4), and the Expressive Vocabulary Test – 2nd edition (EVT-2). Multiple regression analyses were conducted to examine the extent to which children’s scores on these standardized assessments were predicted by their cognitive ability (non-verbal IQ and verbal working memory) measured at 5 years of age. The influence of early language scores at 5 years and a range of demographic characteristics on language scores at 9 years of age was evaluated. We found that 5-year-old digit span score was a significant predictor of receptive and expressive language, but not receptive or expressive vocabulary, at 9 years of age. Also, 5-year-old non-word repetition test score was a significant predictor of only expressive language and vocabulary, but not receptive language or vocabulary at 9 years of age. After allowing for the effects of non-verbal IQ and 5-year-old receptive vocabulary, early digit span score (but not non-word repetition score) was a significant predictor of expressive and receptive language scores at 9 years of age. The findings shed light on the unique role of early verbal working memory in predicting the development of receptive and expressive language skills and vocabulary skills in children who use hearing aids.

Improving ASR Systems for Children with Autism and Language Impairment Using Domain-Focused DNN Transfer Techniques.

This study explores building and improving an automatic speech recognition (ASR) system for children aged 6-9 years and diagnosed with autism spectrum disorder (ASD), language impairment (LI), or both. Working with only 1.5 hours of target data in which children perform the Clinical Evaluation of Language Fundamentals Recalling Sentences task, we apply deep neural network (DNN) weight transfer techniques to adapt a large DNN model trained on the LibriSpeech corpus of adult speech. To begin, we aim to find the best proportional training rates of the DNN layers. Our best configuration yields a 29.38% word error rate (WER). Using this configuration, we explore the effects of quantity and similarity of data augmentation in transfer learning. We augment our training with portions of the OGI Kids' Corpus, adding 4.6 hours of typically developing speakers aged kindergarten through 3rd grade. We find that 2nd grade data alone - approximately the mean age of the target data - outperforms other grades and all the sets combined. Doubling the data for 1st, 2nd, and 3rd grade, we again compare each grade as well as pairs of grades. We find the combination of 1st and 2nd grade performs best at a 26.21% WER.

The Contribution of Bilingualism, Parental Education, and School Characteristics to Performance on the Clinical Evaluation of Language Fundamentals: Fourth Edition, Swedish.

Assessment of bilingual children in only one language fails to acknowledge their distributed linguistic competence and has been shown to overidentify language disorder in bilingual populations. However, other factors, sometimes associated with bilingualism, may also contribute to low results in language assessments. Our aim was to examine the impact of these factors on language abilities. We used the Clinical Evaluation of Language Fundamentals – Fourth Edition, Swedish (CELF-4) to investigate core language abilities of 224 7- to 8-year-old children. Results showed 30 and 80% of monolinguals and bilinguals, respectively, performing more than 1 SD below the normative sample mean, calling into question the clinical utility of the test. However, participant and school characteristics provided a deeper understanding of the skewed results. In isolation, bilingualism predicted 38% of the variance in the CELF-4 Core scores. With level of parental education entered the variance explained by the model increased to 52%, but the unique contribution of bilingualism was reduced to 20%. Finally, with information added on school characteristics and enrollment in the school’s recreation center the model explained an additional two percent, with the unique contribution of bilingualism further reduced to 9%. The results indicate an increased risk for low results on the CELF-4 Core when children present with multiple risk factors. This highlights the need to look beyond bilingualism in language assessment of bilingual children and adolescents and to consider other explanations to academic struggle. Available interventions must be considered and applied proportionately to their respective impact on the individual’s development.

The Effect of Cochlear Implant Interval on Spoken Language Skills of Pediatric Bilateral Cochlear Implant Users.

To examine the effects of cochlear implant (CI) interval (time between CI surgeries) on receptive vocabulary and receptive language skills for children with bilateral CIs. A prospective cross-sectional study design. Participants were recruited from, and tested at, oral schools for the deaf and pediatric audiology clinics across the United States. Eighty-eight children, 4 to 9 years of age, with bilateral CIs and known hearing histories. Twenty-three participants received CIs simultaneously and 65 received CIs sequentially. Of those implanted sequentially, 86% wore a hearing aid (HA) on the non-implanted ear during the CI interval. Bilateral cochlear implantation. Receptive vocabulary was measured via the Peabody Picture Vocabulary Test (PPVT). Receptive language skills were measured via the Clinical Evaluation of Language Fundamentals (CELF). Multiple linear regression models indicate better receptive vocabulary and receptive language skills are associated with earlier ages at first CI (CI 1), but not with shorter CI intervals. Early cochlear implantation (i.e., age at CI 1) is critical for better receptive vocabulary and receptive language skills. Shorter CI intervals are not associated with better receptive vocabulary and receptive language skills for these 88 children, who nearly all used bimodal hearing during the interval. Use of a HA at the non-implanted ear, before receipt of a second CI (CI 2), may mitigate the effects of early bilateral auditory deprivation.

Phonological Awareness Assessment and Intervention Practices for Children Who Are D/deaf or Hard of Hearing

There is not general consensus on best practice for assessment and intervention of phonological awareness (PA) for children who are D/deaf or hard of hearing (D/dhh). The current study surveyed the PA practices of teachers of the deaf and speech-language pathologists to explore perceptions of PA importance, familiarity, and helpfulness related to assessment and intervention approaches used when working with children who are D/dhh. Survey responses from speech-language pathologists ( n = 80) and teachers of the deaf ( n = 94) indicated that the majority of respondents perceive PA to be important to literacy instruction with children who are deaf or hard of hearing. Notably there was a significantly higher average PA importance rating for literacy instruction with children with typical hearing than the PA importance rating for children who were D/dhh. There was wide variability in reported PA assessment and intervention practices. Participants reported using some assessments that included explicit items or subtests for PA including the following: Clinical Evaluation of Language Fundamentals, Comprehensive Test of Phonological Processing, and the Dynamic Indicators of Basic Early Literacy Skills. There was not general consensus on a particular instructional method or approach to support literacy development.

Narrative language skills of maltreated children living in out-of-home care

Purpose: Children’s narrative accounts of their experiences are central to the prosecution of perpetrators of alleged maltreatment. We describe the narrative language skills of children who were placed in out-of-home care (OOHC) following substantiated maltreatment. It was hypothesised that (i) children with such histories would display narrative language skills that fall significantly below published age-expected norms, (ii) narrative language skills and core language skills would be positively correlated and (iii) narrative language skills would be associated with measures of socio-economic disadvantage.Method: Eighty-three children (40 males and 43 females) aged 5;3 to 12;10 (M = 7.9, SD = 2.3) from English-speaking home backgrounds were assessed using the Test of Narrative Language and the Clinical Evaluation of Language Fundamentals (CELF-4) Core Language Score. The Raven’s Coloured Progressive Matrices, a measure of nonverbal intelligence, was employed as a covariate.Result: Forty-two percent of children scored in the below-average range on the Narrative Language Index Ability Index. The same proportion scored at/above age-expected levels on the Narrative Comprehension subtest, and 19% scored at/above age-expected levels on Oral Narration. There was a significant correlation between CELF-4 Core Language Scores and the Narrative Language Index Ability Index. Female carers’ education was significantly positively associated with overall narrative language scores; however, household income and index of socio-economic disadvantage were not significantly associated with narrative language scores.Conclusion: Children who are victims of substantiated maltreatment should be considered at-risk for compromised ability to provide a narrative account of their experiences. The heterogeneity and often scant oral narrative language skills of these children highlights the importance of police/human services training on best-practice forensic interviewing. Policy and practice implications for speech-language pathology early intervention to support the needs of at-risk children are also discussed.

The Functional Communication Classification System: extended reliability and concurrent validity for children with cerebral palsy aged 5 to 18 years.

To examine psychometric properties and clinical utility of the Functional Communication Classification System (FCCS) for classifying observable communication function in children with cerebral palsy (CP) aged 5 to 18 years. Eighty-two children (38 males, 44 females) with CP in six age groups (5y [n=15], 8y [n=14], 10y [n=14], 12y [n=14], 15y [n=11], and 17y [n=14]) were assessed by a speech-language pathologist (SLP) and parent for FCCS ratings. Data were compared with: (1) everyday communication function, assessed using the Clinical Evaluation of Language Fundamentals - Fourth Edition Pragmatics Profile (CELF-4 PP) for familiar and unfamiliar partners; (2) motor speech, gross and fine motor function; and (3) associated impairments, including epilepsy, intelligence, hearing, and vision. Interrater agreement was calculated for FCCS ratings using kappa (κ) statistics. Relationships between FCCS ratings and other measures were examined using Spearman's correlation coefficient. Almost perfect interrater agreement was demonstrated between SLP and parent FCCS ratings (κw =0.96). Correlations were excellent between FCCS ratings with CELF-4 PP ratings, motor speech, and intellect; moderate with gross and fine motor function; and fair with other associated impairments (hearing, visual, and epilepsy). There was no correlation between age and FCCS. The FCCS is a reliable and valid communication classification system for children with CP aged 5 to 18 years, and highly suitable for surveillance, research, and clinical purposes. The Functional Communication Classification System (FCCS) is valid and reliable for communication classification in children with cerebral palsy. Excellent agreement is present between speech language pathologists and parents. The FCCS shows excellent correlation with pragmatics, motor speech, and intelligence. The FCCS is moderately correlated with gross and fine motor function. The FCCS has fair correlation with epilepsy, hearing, and vision.

Effects of background noise, talker’s voice, and speechreading on speech understanding by primary school children in simulated classroom listening situations

In the primary school classroom, children are exposed to multiple factors that combine to create adverse conditions for listening to and understanding what the teacher is saying. Four experiments were conducted to investigate the combined effects of background babble noise (quiet vs. noise), voice quality (normal vs. dysphonic), and speechreading (audio-only vs. audio-visual cues) on speech understanding in 245 eight-year old children. Comprehension was tested using narratives from the test of Clinical Evaluation of Language Fundamentals. Background babble noise was composed of several children talking. Visual speech cues were presented using a digitally animated talker. Vocal loading was used to induce a dysphonic (hoarse) voice. Speech understanding was reduced by even low levels of babble noise, but compensated by visual cues. Dysphonia did not significantly reduce comprehension scores, but it was considered unpleasant. There was some evidence that performance in adverse conditions was positively associated with individual differences in cognitive executive function. Overall, these results suggest that multiple factors combine to influence speech understanding and listening effort for child listeners in the primary school classroom. The constellation of these room, talker, modality, and listener factors should be taken into account in the planning and design of educational and learning activities.

Predicting Language Difficulties in Middle Childhood From Early Developmental Milestones: A Comparison of Traditional Regression and Machine Learning Techniques

The current study aimed to compare traditional logistic regression models with machine learning algorithms to investigate the predictive ability of (a) communication performance at 3 years old on language outcomes at 10 years old and (b) broader developmental skills (motor, social, and adaptive) at 3 years old on language outcomes at 10 years old. Participants (N = 1,322) were drawn from the Western Australian Pregnancy Cohort (Raine) Study (Straker et al., 2017). A general developmental screener, the Infant Monitoring Questionnaire (Squires, Bricker, & Potter, 1990), was completed by caregivers at the 3-year follow-up. Language ability at 10 years old was assessed using the Clinical Evaluation of Language Fundamentals-Third Edition (Semel, Wiig, & Secord, 1995). Logistic regression models and interpretable machine learning algorithms were used to assess predictive abilities of early developmental milestones for later language outcomes. Overall, the findings showed that prediction accuracies were comparable between logistic regression and machine learning models using communication-only performance as well as performance on communication and broader developmental domains to predict language performance at 10 years old. Decision trees are incorporated to visually present these findings but must be interpreted with caution because of the poor accuracy of the models overall. The current study provides preliminary evidence that machine learning algorithms provide equivalent predictive accuracy to traditional methods. Furthermore, the inclusion of broader developmental skills did not improve predictive capability. Assessment of language at more than 1 time point is necessary to ensure children whose language delays emerge later are identified and supported. https://doi.org/10.23641/asha.6879719.

Receptive and expressive language characteristics of school-aged children with non-syndromic cleft lip and/or palate.

Research investigating language skills in school-aged children with non-syndromic cleft lip and/or palate is sparse. Past studies focus on younger populations, lack key comparisons to demographically matched control cohorts or explore language as a component of broader academic skills. Trends of existing studies suggest that affected children may perform at a lower level compared with typically developing peers. To examine the receptive and expressive language skills of middle-school-aged children with non-syndromic cleft lip and palate (CLP) and cleft palate only (CP). Additionally, to explore the language skills of children with clefts compared with a non-cleft control group. Thirty-seven participants with orofacial clefts (aged 7;1-14;1 years) participated in the study: 19 with CLP (10 males; 9 females) and 18 with CP (8 males; 10 females). A non-cleft comparison group consisted of 129 individuals matched on age, sex and maternal education level. Participants completed formal language (Clinical Evaluation of Language Fundamentals, Fourth Edition) and non-verbal intellectual measurements (Wechsler Abbreviated Scale of Intelligence-WASI). Demographic and developmental information was obtained via parental interview. Further clinical details (e.g., surgery; hearing status) were extracted from patient medical files. Cleft and non-cleft language and non-verbal IQ outcomes were reported separately. Language outcomes were then compared between groups. Participants with clefts achieved core (mean = 103.31, standard deviation (SD) = 10.31), receptive (mean = 102.51, SD = 11.60) and expressive (mean = 102.89, SD = 12.17) language index scores within the normative average range. A total of 14.1% and 17.8% of the cleft and non-cleft groups respectively had impairment (i.e., ≥ 1.25 SD below the mean) in one or more language domains. No significant differences were found in the three language index scores between cleft and non-cleft groups. This study is the first formally to examine language skills alongside non-verbal IQ in school-aged children with clefts compared with a large matched non-cleft population. Results suggest that health professionals should evaluate each child as they present and not assume that a child with non-syndromic CLP or CP will also have co-occurring language difficulties. Where language falls in the average range, these skills can be harnessed to support areas of difficulty often associated with orofacial clefting, such as speech.

Atypical language characteristics and trajectories in children with 22q11.2 deletion syndrome

Background22q11.2 deletion syndrome (22q11.2DS) is a genetic condition associated with a highly variable phenotypic expression. During childhood speech and language deficits are commonly observed. Findings of cross-sectional studies suggest syndrome-specific and changing language profiles, but a longitudinal approach to identify developmental changes is still lacking to date. AimsThe present study aimed to delineate language characteristics and trajectories by comparing the performance of Dutch-speaking school-aged children with 22q11.2DS (n = 18) to those of peers with idiopathic intellectual disability (IID, n = 19) and to those of children with IID and comorbid autism spectrum disorder (IID + ASD, n = 23). The literature shows contradictory findings regarding language comprehension difficulties in children with 22q11.2DS, we focused on the receptive-expressive language discrepancy. Given their relative strength for verbal short-term memory (VSTM) tasks, a fine-grained error categorization was included to elucidate a possible influence of VSTM on the expressive language outcomes. Finally, we suggested that the inability of children with 22q11.2DS to use contextual information could interfere with morphosyntactic measures. MethodsAll groups (22q11.2DS, IID, and IID + ASD) were matched for nonverbal fluid reasoning (Gf) using the Analogies and Categories subtests of the Snijders-Oomen Nonverbal Intelligence Test or the Matrix Reasoning and Picture Concepts subtests of the Wechsler Preschool and Primary Scale of Intelligence. Several structural language skills were measured using the Clinical Evaluation of Language Fundamentals and Peabody Picture Vocabulary Test. The same instruments were re-administered after 18 to 24 months. A fine-grained error analysis of the Formulating and Recalling Sentences subtests, both measuring expressive syntax, explored factors contributing to expressive language deficits. ResultsIn children with 22q11.2DS the relative advantage of receptive over expressive language had decreased compared to children with IID. For children with 22q11.2DS, complex sentence comprehension remained very challenging over time. Expressive language skills seemed less limited compared to children with IID, and were accompanied by less VSTM difficulties. In children with 22q11.2DS and children with IID + ASD, variable patterns of strengths and weaknesses were demonstrated, resulting in subtle differences between these groups. Error analyses indicated disregard of content-contextual cues and use of vague and elliptic language as being typical for children with 22q11.2DS. ConclusionsWe recommend that in children with 22q11.2DS the impact of the receptive language impairment should be comprehensively examined and followed-up since it can have a negative effect on their social communication skills, adaptive functioning and academic achievement. Error analysis underscores that multiple measures should be used to evaluate the child’s expressive language ability. Further research should focus on developmental trajectories of social communication skills and on the use of intervention strategies to improve language comprehension and pragmatics in school-aged children with 22q11.2DS.

Screening Tests Reveal High Risk Among Adjudicated Adolescents of Auditory Processing and Language Disorders.

The study investigated the prevalence of risk factors for auditory processing and language disorders among adolescents residing at a local juvenile detention center. A total of 782 adjudicated adolescents with normal hearing were screened with the Randomized Dichotic Digits Test (Strouse & Wilson, 1999) and the Dichotic Words Test (Moncrieff, 2015). A subset of 420 of those adolescents was also screened with the Clinical Evaluation of Language Fundamentals (CELF; Semel, Wiig, & Secord, 2003). More than 70% of the adolescents produced weakness on at least 1 dichotic listening test. One third of those produced weakness across both dichotic listening tests, consistent with a binaural integration deficit pattern. Nearly 48% of the subgroup of adolescents produced CELF scores that fell below the criterion for age. Dichotic listening and language scores were more associated in participants with poor performance in both ears during dichotic tests, who also produced the lowest scores on the CELF. There was no main effect of race, but 17- and 18-year-old Black adolescents produced lower CELF scores than White adolescents of the same age. School-age children referred for disciplinary action may have undiagnosed deficits in auditory processing and/or language. Efforts to screen, diagnose, and remediate these deficits could lead to improvements in communication, learning, and language skills in this population.