Language Disorders Research Articles

Exploring the need for dynamic assessment in the diagnosis of children with suspected language disorders

This study investigates the familiarity with and application of Dynamic Assessment (DA) among Speech and Language Pathologists (SLPs) in Sweden, focusing on its use in diagnosing language disorders in children. Using a mixed-methods approach, survey data were collected from 565 SLPs, revealing that 72% were familiar with DA. However, a significant proportion rarely applied it in practice, although DA was more prevalent in areas predominantly characterized by low socioeconomic status and a high proportion of multilingual assessments. The findings underscore a gap between international guidelines from experts in the field, which recognize the potential of DA for more accurate diagnosis, particularly in children from culturally and linguistically diverse backgrounds, and its actual utilization. Despite the evident need (92% of the respondents rated the need for DA as very or quite large), only a minority of the respondents had received formal DA training. These results call for enhanced training and resources to increase the integration of DA into clinical practice, aiming to bridge the gap between current practices and the benefits of utilizing DA in language assessments of children with suspected language disorders.

Enhancing Early Language Disorder Detection in Preschools: Evaluation and Future Directions for the Gades Platform.

Language acquisition is a critical developmental milestone, with notable variability during the first 4 years of life. Developmental language disorder (DLD) often overlaps with other neurodevelopmental disorders or simple language delay (SLD), making early detection challenging, especially for primary caregivers. We aimed to evaluate the effectiveness of the Gades platform, an adaptive screening tool that enables preschool teachers to identify potential language disorders without direct support from nursery school language therapists (NSLTs). The study took place in a nursery school and an early childhood educational and psychopedagogical center in Madrid, Spain, involving 218 children aged 6 to 36 months, 24 preschool teachers, and 2 NSLTs. Initially, NSLTs conducted informational sessions to familiarize teachers with DLDs and how to identify them. Following this, the teachers used the Gades platform to conduct language screenings independently, without ongoing support from NSLTs. The Gades platform was enhanced to collect detailed profiles of each child and implemented an adaptive screening model tailored to account for variability in language development. This setup allowed preschool teachers, who are not language experts, to observe and assess language development effectively in natural, unsupervised educational environments. The study assessed the platform's utility in guiding teachers through these observations and its effectiveness in such settings. Gades identified language difficulties in 19.7% (43/218) of the children, with a higher prevalence in boys (29/218, 13.3%) than in girls (14/218, 6.4%). These challenges were most frequently observed in children aged 15 to 27 months. The platform demonstrated a high accuracy rate of 97.41%, with evaluators largely agreeing with its recommendations. Teachers also found Gades to be user friendly and a valuable tool for supporting language development observations in everyday educational settings. Gades demonstrates potential as a reliable and accessible tool for early detection of language disorders, empowering educators to identify DLD and SLD in the absence of NSLTs. However, further refinement of the platform is required to effectively differentiate between DLD and SLD. By integrating Gades into routine preschool assessments, educators can facilitate timely interventions, bridging gaps in early childhood education and therapy. Pan-African Clinical Trial Registry (PACTR) PACTR202210657553944; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24051.

Depression and quality of life in patients with Broca’s and subcortical stroke-related aphasia: A comparative study

Aim Aphasia, primarily recognized as a language disorder following stroke, often is presented with concurrent emotional and social difficulties, including depression. This study investigated whether the type of aphasia—Broca’s or subcortical—may be related to the prevalence of depression and overall quality of life (QOL) in affected individuals. Methods The present study involved 46 individuals with chronic aphasia resulting from left hemisphere strokes. Participants were divided into two groups: those with Broca’s aphasia and those with subcortical aphasia. Several assessment tools were utilized, including the Persian versions of Mini-Mental State Examination (MMSE), Western Aphasia Battery (P-WAB-1), the Beck Depression Inventory-II (BDI-II), and the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39). Results The results indicated that the average severity of aphasia was significantly lower in the Broca’s aphasia group (36.48 ± 8.05) compared to the subcortical aphasia group (62.83 ± 19.88). However, both groups demonstrated similar depression severity scores and their quality of life was largely comparable to each other. Conclusion This study underscores that living with aphasia, regardless of type, involves emotional and social challenges that may be extended beyond language difficulties, emphasizing the need to address these issues to improve the well-being of stroke survivors.

Developmental Language Disorder at Adolescence: Links Between Communication Skills and Self-Efficacy Ratings

Developmental Language Disorder (DLD) has a prevalence of 7%, making it one of the important yet little known neurodevelopmental disorders. Often identified in kindergarten, children with DLD have language learning difficulties severe enough to impact their schooling and socialization. During adolescence, there is a high risk of academic, vocational, and mental health difficulties. However, for adults with DLD, a positive perception of self-efficacy may act as a protective factor. This led us to explore how communications skills and self-efficacy are related in adolescents with DLD. The participants were 49 teenagers, aged 12 to 15, who have DLD. Communication was measured using the Children’s Communication Checklist, completed by the teenagers’ parents, while perception of self-efficacy was reported by the teenagers as well as by their parents using the Generalized Self-Efficacy Scale. A significant correlation was found between communication and self-efficacy with three domains of communication being the most important in this association, i.e., coherence (r = 0.716, p < 0.001), initiation (r = 0.581, p < 0.001), and use of context (r = 0.649, p < 0.001). These results highlight the crucial role of social communication in the profile of teenagers living with DLD. They further suggest that it may be relevant to examine whether supporting language development may foster positive perception of self-efficacy in teenagers living with DLD.

Parental Input and Its Relationship With Language Outcomes in Children With (Suspected) Developmental Language Disorder: A Systematic Review.

It is widely acknowledged that parental input plays an important role in typical language development. Less is known about the input provided to children with (suspected) developmental language disorder (DLD) or those at risk for DLD. These children may not benefit from parental input in the same way as their typically developing peers, and different aspects of parental input may be more important for them. The present systematic literature review aimed to uncover (a) how parental input has been assessed in the context of DLD, (b) which aspects of parental input have been studied, and (c) what the reported associations are with language outcomes in children with DLD (age 0-6 years). A systematic literature review of 67 articles was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Parental input was coded based on Rowe and Snow's (2020) categorization of input, divided into interactive, linguistic, and conceptual aspects of parental input. The majority of studies used audio or video recordings of naturalistic parent-child interaction during play. Aspects within the interactive dimension (parental responsiveness and turn-taking) were most often assessed, followed by the linguistic and conceptual dimensions. Thirty-eight studies investigated the relationship between parental input and child language outcomes. Findings show that aspects within the interactive dimension are positively associated with language outcomes in children with DLD. Additionally, the sheer quantity of language input was not associated with language outcomes, although replication of this observation is necessary. The results of this review highlight the importance of parents' responsive behaviors as well as the child's involvement in parent-child interaction. The findings also signal gaps in the existing literature and provide associated directions for future research on effects of parental input in children with DLD.

Examining Potential Mediators of the Relationship Between Developmental Language Disorder and Executive Function Performance in Preschoolers

Purpose: The goal of this study was to examine potential mediators of the relationship between developmental language disorder (DLD) status and executive function performance. Method: Participants included preschoolers, of whom 80 met the diagnostic criteria for DLD and 103 were categorized as having typical language abilities. Participants' nonverbal IQ and receptive vocabulary were assessed via standardized tests, and their executive function was tested using the Dimensional Change Card Sort. Maternal education was collected via caregiver report and served as a measure of socioeconomic status (SES). Results: Group comparisons confirmed that participants with DLD had lower language scores, nonverbal IQ scores, executive function scores, and SES relative to peers with typical language. Additionally, these variables were significantly positively correlated. Multiple mediation analyses indicated that both nonverbal IQ and receptive vocabulary were significant partial mediators of the effect of DLD status on executive function scores. However, a direct effect of DLD status on executive function remained significant in a model that included the mediators and covaried maternal education. Conclusions: Group differences in nonverbal IQ and receptive vocabulary can partially explain why children with DLD tend to have lower executive function scores relative to peers with typical language. However, even after accounting for these mediators, there is a significant, large direct effect of DLD status on executive function performance, which suggests that the groups' difference in executive functioning is not fully explained by other variables.

The Progression of Developmental Language Disorder Terminology: A Scoping Review of American Speech-Language-Hearing Association Journals

Purpose: A 2017 CATALISE project resulted in consensus on using the term “developmental language disorder” (DLD) to describe children with unexplained language impairment. Since then, it is unclear how researchers have identified DLD and implemented DLD terminology. The current study is a scoping review to better understand the implementation of DLD terminology. Method: We identified studies ( N = 265) published in American Speech-Language-Hearing Association (ASHA) journals between 2017 and 2024 that included individuals with communication difficulties in the area of language not secondary to another etiology. We extracted key information regarding study purpose and participant identification from each publication. Results: Across all publications, 58% included the term “DLD” to describe their participant(s), 22% included “specific language impairment” (SLI), 12% included “language impairment” (LI), and 8% included other terms. The majority of publications served to better understand the profile of individuals with DLD, evaluate an intervention, or report on a measurement tool related to identification of the condition. There was significant variation in the developmental domains (e.g., cognitive, social, sensory) considered when diagnosing DLD across research publications. Conclusions: This scoping review demonstrates the adoption and implementation of the term “DLD” in ASHA publications. Future efforts should prioritize increasing the consistency of identification of DLD in research, advocating for use of DLD terminology in clinical contexts, and supporting clinicians' knowledge, identification, assessment, intervention, and advocacy related to DLD. Supplemental Material: https://doi.org/10.23641/asha.28508936

Neural tracking of natural speech: an effective marker for post-stroke aphasia.

After a stroke, approximately one-third of patients suffer from aphasia, a language disorder that impairs communication ability. Behavioural tests are the current standard to detect aphasia, but they are time-consuming, have limited ecological validity and require active patient cooperation. To address these limitations, we tested the potential of EEG-based neural envelope tracking of natural speech. The technique investigates the neural response to the temporal envelope of speech, which is critical for speech understanding by encompassing cues for detecting and segmenting linguistic units (e.g. phrases, words and phonemes). We recorded EEG from 26 individuals with aphasia in the chronic phase after stroke (>6 months post-stroke) and 22 healthy controls while they listened to a 25-min story. We quantified neural envelope tracking in a broadband frequency range as well as in the delta, theta, alpha, beta and gamma frequency bands using mutual information analyses. Besides group differences in neural tracking measures, we also tested its suitability for detecting aphasia at the individual level using a support vector machine classifier. We further investigated the reliability of neural envelope tracking and the required recording length for accurate aphasia detection. Our results showed that individuals with aphasia had decreased encoding of the envelope compared to controls in the broad, delta, theta and gamma bands, which aligns with the assumed role of these bands in auditory and linguistic processing of speech. Neural tracking in these frequency bands effectively captured aphasia at the individual level, with a classification accuracy of 83.33% and an area under the curve of 89.16%. Moreover, we demonstrated that high-accuracy detection of aphasia can be achieved in a time-efficient (5-7 min) and highly reliable manner (split-half reliability correlations between R = 0.61 and R = 0.96 across frequency bands). In this study, we identified specific neural response characteristics to natural speech that are impaired in individuals with aphasia, holding promise as a potential biomarker for the condition. Furthermore, we demonstrate that the neural tracking technique can discriminate aphasia from healthy controls at the individual level with high accuracy, and in a reliable and time-efficient manner. Our findings represent a significant advance towards more automated, objective and ecologically valid assessments of language impairments in aphasia.

Visual treatment with AR for children with dysphasia

The language disorder known as dysphasia significantly affects the ability to communicate effectively, presenting challenges in both comprehension and expression of language. To address this issue, the development of a visual treatment using augmented reality (AR) specifically designed for children with dysphasia has been proposed. The methodology selected for this project is analysis, design, development, implementation, and evaluation (ADDIE), an innovative methodology that encompasses analysis, design, development, implementation and evaluation. This methodology is perfectly adapted to the needs of the project, allowing a systematic and complete approach at all stages of the process of creating the visual treatment. The results obtained show that the visual treatment with AR has been positively evaluated by development experts and dysphasia specialists. Its innovative capacity to assist children with this disorder in health and educational settings is highlighted. This approach provides an effective tool to improve the communication and language development of children affected by dysphasia, offering new opportunities for their learning and growth. Its implementation in healthcare and educational settings could have a significant impact on the quality of life and development of these children.

Neurobehavioral Outcomes of Children with Antenatal Exposure to Antiseizure Medications.

To evaluate the effect of antiepileptic medications prescribed to mothers during pregnancy on the development and behavior of children. From the Kerala Registry of Epilepsy and Pregnancy, 98 children between the ages of 1½ to 2½ y were consecutively chosen. Children of mothers who did not have epilepsy during pregnancy and not exposed to antiseizure medications (ASMs) antenatally were selected as comparator group. Developmental assessment of the children was performed using Developmental Assessment Scale for Indian Infants (DASII) and Receptive-Expressive Emergent Language Scale (REELS). Behavior outcomes were assessed using Child Behavior Checklist. A significant delay in expressive language skills was seen in children exposed to antiseizure medication with an odds ratio of 2.539 (95% CI 1.10,5.85, P = 0.026). A delay in expressive language skills was seen in polytherapy with clobazam (odds ratio 6.83; 95% CI 2.17, 21.56, P < 0.001). Also, delay was seen in receptive language skills in the same polytherapy group (odds ratio of 7.333; 95% CI 2.16, 24.92, P < 0.001). There were no statistically significant differences between study and comparative groups in motor and mental quotient domains and behavioral outcomes. The finding of speech delay in children exposed to ASMs is significant since individuals with a history of childhood speech or language disorders may experience long-term difficulties in mental health, social well-being, and academic outcomes.

Is there any room for ChatGPT AI bot in speech-language pathology?

This study investigates the potential of the ChatGPT-4.0 artificial intelligence bot to assist speech-language pathologists (SLPs) by assessing its accuracy, comprehensiveness, and relevance in various tasks related to speech, language, and swallowing disorders. In this cross-sectional descriptive study, 15 practicing SLPs evaluated ChatGPT-4.0's responses to task-specific queries across six core areas: report writing, assessment material generation, clinical decision support, therapy stimulus generation, therapy planning, and client/family training material generation. English prompts were created in seven areas: speech sound disorders, motor speech disorders, aphasia, stuttering, childhood language disorders, voice disorders, and swallowing disorders. These prompts were entered into ChatGPT-4.0, and its responses were evaluated. Using a three-point Likert-type scale, participants rated each response for accuracy, relevance, and comprehensiveness based on clinical expectations and their professional judgment. The study revealed that ChatGPT-4.0 performed with predominantly high accuracy, comprehensiveness, and relevance in tasks related to speech and language disorders. High accuracy, comprehensiveness, and relevance levels were observed in report writing, clinical decision support, and creating education material. However, tasks such as creating therapy stimuli and therapy planning showed more variation with medium and high accuracy levels. ChatGPT-4.0 shows promise in assisting SLPs with various professional tasks, particularly report writing, clinical decision support, and education material creation. However, further research is needed to address its limitations in therapy stimulus generation and therapy planning to improve its usability in clinical practice. Integrating AI technologies such as ChatGPT could improve the efficiency and effectiveness of therapeutic processes in speech-language pathology.

A Mutation in the ANK2 Gene Causing ASD and a Review of the Literature.

To investigate the clinical and genetic characteristics of patients with ANK2(HGNC:493)-associated autism spectrum disorders (ASDs) and epilepsy (EP). We identified a novel ANK2 variant in a patient with ASD and EP and summarized the clinical and genetic characteristics of ANK2 gene variants in this patient and those in previous reports. A novel nonsense variant, ANK2 (NM_001148.6):c.3007C>T/p.R1003* in exon 27, was identified in one patient. We described the clinical features and molecular genetics of this patient and previously reported patients. This was discovered at a follow-up visit to the pediatric neurology department where genetic testing based on condition identified this rare genetic variant. He mainly presents with language delay, intellectual disability, limited learning, and communication skills, and later develops seizures, combined with common childhood neurological disorders such as hyperactivity, behavioral abnormalities, and even self-injury. The patient cohort included 16 patients with a complex array of neurological disabilities: ASD (9 patients); EP (10 patients); ASD with EP (4 patients); intellectual disability and developmental delay (5 patients); poor language communication (11 patients); language and learning impairment (11 patients); anxiety/agitation mood disorder (6 patients); attention-deficit/hyperactivity disorder (5 patients); cognitive, memory, and adaptability deficits (1 patient); tic disorder (1 patient); electrocardiogram and cardiac damage (1 patient); and abnormal electroencephalography (EEG) (9 patients). For the first time, we identified a novel variant of the ANK2 gene in China, broadening the genetic spectrum of the ANK2 gene. ANK2 gene mutations can cause ASD, EP, ASD with EP, developmental delay and intellectual disability, poor language communication skills, language and learning disorders, anxiety/agitation mood disorder, and attention-deficit/hyperactivity disorder. Clinical ASD, EP, common EP should consider the ANK2 gene mutation.

Relationships between executive functions and vocabulary knowledge in Spanish-speaking children with and without developmental language disorder.

Relationships between executive functions and vocabulary knowledge in Spanish-speaking children with and without developmental language disorder.

"It's not that bad but it's not so fun either"- A qualitative study on school-aged children's perceptions of speech and language therapy for developmental language disorders.

"It's not that bad but it's not so fun either"- A qualitative study on school-aged children's perceptions of speech and language therapy for developmental language disorders.

Efficacy of a novel narrative intervention program for children with developmental language disorder: A pilot randomized controlled trial.

Efficacy of a novel narrative intervention program for children with developmental language disorder: A pilot randomized controlled trial.

Current practices of Portuguese speech-language pathologists with preschool-age children with pragmatic impairment: A cross-sectional survey.

This study aims to investigate the practice patterns used by Portuguese speech-language pathologists (SLPs) with preschool-age children with pragmatic impairment and to identify the actual need(s) perceived by SLPs in this field. A total of 351 SLPs responded. The results reveal that 81.5 per cent of the respondents (n=286) reported working or had previously worked with preschool-age children with pragmatic impairment arising from autism spectrum disorder, developmental language disorder, or both. Considering the clinical practice, similarities and differences were found, many of which are due not to the inherent characteristics of each disorder but to the scarcity of research in clinical pragmatics. These results are also reflected in the needs perceived by SLPs and the degree of confidence with which they work with these children. Implications for clinical practice and directions for future research are discussed.

Word spelling in monolingual and bilingual children with developmental language disorder

Word spelling in monolingual and bilingual children with developmental language disorder

Culturally Responsive Practices for Improved Speech-language Pathology and Audiology Interventions in South Africa

Cultural and linguistic diversity poses significant challenges in diagnosing and treating speech, language, and hearing disorders. This short communication underscores the necessity of integrating culturally responsive practices within the South African National Health Insurance (NHI) framework, utilizing implementation science to promote equitable care. We outline a framework for developing and implementing culturally sensitive interventions, training programs for healthcare providers, and strategies to ensure inclusivity in patient care. Insights from pilot programs and the implications for health policy and practice within the NHI context are also discussed.

Evaluation of Language Disorder in Children - A Case Study of Gboko Central Primary School Pupils, Benue State, Nigeria

Language disorders or language impairments are disorders that involve the processing of linguistic information. Problems that may be experienced can involve grammar (syntax and/or morphology), semantics (meaning), or other aspects of language. These problems may be receptive (involving impaired language comprehension), expressive (involving language production), or a combination of both. The fact that some children fail to acquire language abilities is the central concern of this research and is being identified as the major problem and subject of investigation in this study. The study adopts Chomsky’s theory of Universal Grammar. The interesting principle of this theory that makes it suitable for being a framework for this study is that it posits that children go through stages of language development, and the “mistakes” they make during this time only reveal their development stage, but during their maturation, they are resistant to correction. The evaluation was done in the semantic phonological and syntactic areas of language, including stuttering analysis. The information gathered shows that children are affected by various language disorders and degrees. The research suggests that parents should be sensitized to examine the language acquisition stages of their children so as to identify any disorder early as this is important for intervention and remedy. Although this school is not a special kind for this defect, the study is carried out to ascertain language disorder among these pupils.

Assessing childhood impact: Virtual and in-person counseling for children's language development challenges.

Assessing childhood impact: Virtual and in-person counseling for children's language development challenges.