Language-impaired Children Research Articles

The Szenario-Kids: Psychometric properties of a novel, participation-oriented language assessment as determined in children and youth without communication deficits

Background: Creating a holistic picture of children and youth who suffer from acquired aphasia or another (developmental) language disorders is very difficult due to missing diagnostic instruments covering participation. Szenario-Kids is a new diagnostic instrument to measure multimodal communication abilities in everyday life situations of children and youth aged 6 to 16 years. Aims: We aimed to examine feasibility and psychometric properties of the model-based Szenario-Kids in the healthy population, to build the basis for later test evaluation in the language-impaired patient group. Method: Szenario-Kids was administered to n = 57 children and youth without communication deficits (mean age 9.16 years; German as native language). The diagnostic instrument was presented twice within two weeks, complemented by standardized diagnostic instruments to cover all communication modalities and enable correlation of performance between tests. Results: Data analysis showed good practicability, satisfying parallelism of test versions A and B ( p = .098-.845), acceptable to excellent reliability (Cronbach's α = .781-.920) and high interrater reliability ( ICC = .733-.960), very strong test-retest correlation ( r = .736-.893) and moderate to strong concurrent validity ( r = -.475-.611; p ≤ .01). Conclusions: The analysis of feasibility and psychometric properties revealed promising results for the group without communication deficits. Neurolinguistic underpinnings can be explained within our Multimodal Communication Model (MCM). Thus, the evaluation of Szenario-Kids in language-impaired children and youth is a next step.

The co-occurrence of motor and language impairments in children evaluated for autism spectrum disorder. An explorative study from Norway.

BackgroundCurrent research suggest that motor and language impairments are common and closely related in infants with autism spectrum disorder (ASD). In older children, less is known about how these impairments are related to each other. AimsThe current study explored the co-occurrence and potential impact of motor and language impairments in a sample of school-aged children evaluated for ASD by Norwegian specialist health services. MethodsBesides clinical evaluation for ASD, all participants (N = 20, mean age 10.7 (SD = 3.4) years) underwent a standardized test of motor performance (MABC-2), parent report measures of current motor (DCDQ’07), language (CCC-2), and social (SRS) skills, and a caregiver interview on everyday functioning, providing an overall impairment score (DD-CGAS). ResultsThe majority (85%) had motor and/or structural language deficits in addition to their social impairment. All children identified with motor impairment on both measures (39%) also had structural language deficits. Better motor performance was strongly correlated with better structural language skills (r = .618, p = .006). ConclusionsOur findings suggest that co-occurring motor and structural language deficits should be anticipated and assessed when evaluating children for ASD. These deficits may need specific interventions that complement those targeting social skills deficits and other ASD core symptoms.

Türkiye'de Çocukluk Çağı Dil Bozukluğuna İlişkin Toplumsal Farkındalık: Betimsel Çalışma

Objective: Childhood language impairment (CLI), also known as developmental language disorder, adversely affects children's expressive and/or receptive language development. Although relatively significant action has been taken to raise public awareness about other developmental disorders in Turkey, limited attention has been paid to CLI. Moreover, no previous study has been conducted about awareness of the Turkish population about CLI. Material and Methods: We carried out the Turkish version of a survey developed by Working Group 3 of COST Action IS1406 to estimate public awareness of CLI regarding its nature, causes and the problems associated with it. Data were collected in the form of face-to-face interviews. The sample included 87 participants from socio-economically diverse districts of İstanbul, Turkey, determined on the basis of the Human Development Index. Results: A significantly lower number of the participants reported having heard of CLI compared to autism, attention-deficit/hyperactivity disorder and speech disorder. Another finding was that women with children reported having heard of CLI significantly more than those without children. It was also observed that the participants had inadequate knowledge of the problems that individuals with CLI have and of its causes. Conclusion: The current findings highlight the need to take more action to raise public awareness about CLI in Turkey.

Apresentação do Programa de intervenção em equoterapia “Passo a passo na comunicação” para crianças com autismo

ABSTRACT The objective of this paper is to present the “Step-by-step in communication” equine-assisted speech-language-hearing rehabilitation program to treat language impairment in children. The program was developed in three stages: literature analysis, pilot application, and clinical analysis. The literature was analyzed by searching, reading, and discussing articles and books on the topic, published up to 2018. After this stage, the first version of the program was developed. This version addressed: participants’ language assessment, application of 10 sessions, monitoring and record of activities in each session, participants’ reassessment, and adjustment of techniques and activities. The clinical analysis took place after the pilot application with the following procedures: analysis by three judges, revision of the approach by the authors, and development of the final version of the “Step-by-step in communication” program, comprising eight theme modules with 24 sessions, and based on four main pillars, which are applied in equine-assisted therapy activities. Each pillar has specific objectives and strategies. The activities aim at formal (semantic and morphosyntactic) and pragmatic aspects of language. Their theoretical/practical framework is grounded on functional grammar, and the strategies are based on equine-assisted therapy experiences that open the way for communication.

Методы и подходы к оценке различных уровней организации речи в современных зарубежных исследованиях на примере расстройств аутистического спектра

<p>The article presents an overview of studies on the problem of speech evaluation in childhood. We analyzed the material based on the model that describes 4 levels of language: phonetics and phonology, morphosyntax, semantics and pragmatics. The article contains the analysis of studies describing each level of language as well as existing approaches to its assessment, and reviews studies on language impairments in children with autism spectrum disorders. Additionally, the article contains a detailed analysis of existing foreign and Russian standardized methods for assessing speech development, showing which level of language organization (among each of the mentioned above methods) allows us to assess. It also describes the assessment procedures and evaluation. The review systematizes the available data on the approaches to atypical speech development in children with autism spectrum disorders.</p>

Determinants of Language Impairment in Turkish-Persian Bilingual Children

Background and Aims: Bilingual children are sometimes over-identified with language impairment and sometimes their language impairment under-identified that in either case, proper intervention is not possible. Accurate measurement of bilingual child language development involves assessing both of their languages. The purpose of this study was to identify a set of measures that would discriminate language impairment in bilingual Turkish-Persian children aged 5 to 7 years in Tehran. Materials and Methods: In this descriptive-analytical study, the language sample of 24 bilingual children with no language impairment and 8 bilingual children with language impairment was analyzed according to the linguistic measures of mean length of Terminable-unit, number of total words, number of different words, and number of grammatical errors per Terminable-unit. Children without language impairment were selected from kindergartens and schools by multi-stage cluster sampling method. Language-impaired children were selected by the Speech-Language Pathologist with at least three years of bilingual speech and language pathology services from Tehran-based speech therapy clinics in an accessible manner. There was no significant difference between the groups in terms of nonverbal intelligence, age of exposure and duration of exposure to Persian. Parents responded to questions about their perceptions of their children’s speech and language skills and family history of speech and language problems. Results: Diagnostic analysis indicated that 3 measures discriminated the groups of children with sensitivity 87.5%: the Parent Report Questionnaire, number of total words, and mean length of T-unit. Conclusion: According to the results, Indicators of parental reports and language criteria in identifying the language damage of Turkish-Persian bilingual children can be of diagnostic use for speech and language pathologists.

One-dimensional convolutional neural network and hybrid deep-learning paradigm for classification of specific language impaired children using their speech

Background and objectiveScreening children for communicational disorders such as specific language impairment (SLI) is always challenging as it requires clinicians to follow a series of steps to evaluate the subjects. Artificial intelligence and computer-aided diagnosis have supported health professionals in making swift and error-free decisions about the neurodevelopmental state of children vis-à-vis language comprehension and production. Past studies have claimed that typical developing (TD) and SLI children show distinct vocal characteristics that can serve as discriminating facets between them. The objective of this study is to group children in SLI or TD categories by processing their raw speech signals using two proposed approaches: a customized convolutional neural network (CNN) model and a hybrid deep-learning framework where CNN is combined with long-short-term-memory (LSTM). MethodWe considered a publicly available speech database of SLI and typical children of Czech accents for this study. The convolution filters in both the proposed CNN and hybrid models (CNN-LSTM) estimated fuzzy-automated features from the speech utterance. We performed the experiments in five separate sessions. Data augmentations were performed in each of those sessions to enhance the training strength. ResultsOur hybrid model exhibited a perfect 100% accuracy and F-measure for almost all the session-trials compared to CNN alone which achieved an average accuracy close to 90% and F-measure ≥ 92%. The models have further illustrated their robust classification essences by securing values of reliability indexes over 90%. ConclusionThe results confirm the effectiveness of proposed approaches for the detection of SLI in children using their raw speech signals. Both the models do not require any dedicated feature extraction unit for their operations. The models may also be suitable for screening SLI and other neurodevelopmental disorders in children of different linguistic accents.

Word association analysis of children with disabilities

Purpose: This study aimed to compare the types of response words for stimuli in children with language impairment and normal children through the word association task.Methods: For this study, 60 children with language impairment aged 9-11 years old and 60 normal children of the same language age as them were selected. The list of stimulus words for the word association task consisted of 25 nouns, 6 verbs and 6 adjectives.Results: The research results were as follows. First, it was found that the appearance rate of association words in the form and syntax among the intra-linguistic association was higher in the children with language impairment than in the normal children, and the appearance rate of association words in the meaning and pragmatics was lower than that of the normal children. Second, in children with language impairment, the appearance rate of verb response words was high in the noun stimulus words, and the noun response words appeared high in the verb and adjective stimulus words.Conclusions: In conclusion, compared to the normal children, the form and syntax-oriented syntagmatic associative responses were higher than the semantic-oriented paradigmatic associative responses, indicating that the stimulus and response words were used side by side in sentences.

Model Selection Reveals the Butyrate-Producing Gut Bacterium Coprococcus eutactus as Predictor for Language Development in 3-Year-Old Rural Ugandan Children.

IntroductionThe metabolic activity of the gut microbiota plays a pivotal role in the gut-brain axis through the effects of bacterial metabolites on brain function and development. In this study we investigated the association of gut microbiota composition with language development of 3-year-old rural Ugandan children.MethodsWe studied the language ability in 139 children of 36 months in our controlled maternal education intervention trial to stimulate children’s growth and development. The dataset includes 1170 potential predictors, including anthropometric and cognitive parameters at 24 months, 542 composition parameters of the children’s gut microbiota at 24 months and 621 of these parameters at 36 months. We applied a novel computationally efficient version of the all-subsets regression methodology and identified predictors of language ability of 36-months-old children scored according to the Bayley Scales of Infant and Toddler Development (BSID-III).ResultsThe best three-term model, selected from more than 266 million models, includes the predictors Coprococcus eutactus at 24 months of age, Bifidobacterium at 36 months of age, and language development at 24 months. The top 20 four-term models, selected from more than 77 billion models, consistently include C. eutactus abundance at 24 months, while 14 of these models include the other two predictors as well. Mann–Whitney U tests suggest that the abundance of gut bacteria in language non-impaired children (n = 78) differs from that in language impaired children (n = 61). While anaerobic butyrate-producers, including C. eutactus, Faecalibacterium prausnitzii, Holdemanella biformis, Roseburia hominis are less abundant, facultative anaerobic bacteria, including Granulicatella elegans, Escherichia/Shigella and Campylobacter coli, are more abundant in language impaired children. The overall predominance of oxygen tolerant species in the gut microbiota was slightly higher in the language impaired group than in the non-impaired group (P = 0.09).ConclusionApplication of the all-subsets regression methodology to microbiota data established a correlation between the relative abundance of the anaerobic butyrate-producing gut bacterium C. eutactus and language development in Ugandan children. We propose that the gut redox potential and the overall bacterial butyrate-producing capacity in the gut are important factors for language development.

Reduced brain activation during spoken language processing in children with developmental language disorder and children with 22q11.2 deletion syndrome

Language difficulties of children with Developmental Language Disorder (DLD) have been associated with multiple underlying factors and are still poorly understood. One way of investigating the mechanisms of DLD language problems is to compare language-related brain activation patterns of children with DLD to those of a population with similar language difficulties and a uniform etiology. Children with 22q11.2 deletion syndrome (22q11DS) constitute such a population. Here, we conducted an fMRI study, in which children (6-10yo) with DLD and 22q11DS listened to speech alternated with reversed speech. We compared language laterality and language-related brain activation levels with those of typically developing (TD) children who performed the same task. The data revealed no significant differences between groups in language lateralization, but task-related activation levels were lower in children with language impairment than in TD children in several nodes of the language network. We conclude that language impairment in children with DLD and in children with 22q11DS may involve (partially) overlapping cortical areas.

The profile of pragmatic language impairments in children with ADHD: A systematic review.

This systematic review synthesizes the empirical literature examining pragmatic language in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Using a taxonomy of pragmatic language, we compared the pragmatic language profiles of children with ADHD to those of typically developing (TD) children and children with autism. Three databases were searched up to October 2019: PsychInfo; PubMed; and CSA Linguistics and Language Behavior Abstracts. We included 34 studies reporting on 2,845 children (ADHD = 1,407; TD = 1,058; autism = 380). Quality and risk of bias assessments included sample size and representativeness; measure reliability and validity; and missing data management. Children with ADHD were found to have higher rates of pragmatic difficulties than their TD peers. Specific difficulties were identified with inappropriate initiation, presupposition, social discourse, and narrative coherence. Children with ADHD appear to differ from those with autism in the degree of their pragmatic language impairments. General language skills contribute to, but do not explain, pragmatic difficulties in samples of children with ADHD. Though the extant evidence is limited, a preliminary profile of the pragmatic language impairments in children with ADHD is indicated. This supports a call for evidence-based interventions that include pragmatic language skills training.

Prediction of baseline expressive and receptive language function in children with focal epilepsy using diffusion tractography-based deep learning network

PurposeFocal epilepsy is a risk factor for language impairment in children. We investigated whether the current state-of-the-art deep learning network on diffusion tractography connectome can accurately predict expressive and receptive language scores of children with epilepsy. MethodsWe studied 37 children with a diagnosis of drug-resistant focal epilepsy (age: 11.8 ± 3.1 years) using 3 T MRI and diffusion tractography connectome: G = (S, Ω), where S is an adjacency matrix of edges representing the connectivity strength (number of white-matter tract streamlines) between each pair of brain regions, and Ω reflects a set of brain regions. A convolutional neural network (CNN) was trained to learn the nonlinear relationship between ‘S (input)’ and ‘language score (output)’. Repeated hold-out validation was then employed to measure the Pearson correlation and mean absolute error (MAE) between CNN-predicted and actual language scores. ResultsWe found that CNN-predicted and actual scores were significantly correlated (i.e., Pearson’s R/p-value: 0.82/<0.001 and 0.75/<0.001), yielding MAE: 7.77 and 7.40 for expressive and receptive scores, respectively. Specifically, sparse connectivity not only within the left cortico-cortical network but also involving the right subcortical structures was predictive of language impairment of expressive or receptive domain. Subsequent subgroup analyses inferred that the effectiveness of diffusion tractography-based prediction of language outcome was independent of clinical variables. Intrinsic diffusion tractography connectome properties may be useful for predicting the severity of baseline language dysfunction and possibly provide a better understanding of the biological mechanisms of epilepsy-related language impairment in children.

Structural and Pragmatic Language Impairments in Children Evaluated for Autism Spectrum Disorder (ASD)

Pragmatic language impairments are common in neurodevelopmental disorders, especially in autism spectrum disorder (ASD). The relationship between structural language skills and pragmatic competence in children with autistic symptoms, however, is largely unknown. We investigated this relationship based on the Children’s Communication Checklist-2 and early language delay among children (N = 177, 19% females) clinically evaluated for ASD, differentiated into ASD (n = 148) and non-ASD (n = 29). Structural language deficits were common and associated with reduced pragmatic competence in both groups. Pragmatic language impairments were most profound in children with ASD. Early language delay and structural language deficits were less common in females. Our findings suggest that assessment of structural language skills should be included in the evaluation of children with suspected ASD.

The Revised Children's Communication Checklist-2 (CCC-R): Factor Structure and Psychometric Evaluation.

The Children's Communication Checklist-2 (CCC-2) is often applied to assess pragmatic language impairment which is highly prevalent in autism spectrum disorder (ASD) and several mental health conditions. We replicated previous findings on the limited applicability of the CCC-2 in clinical samples and the inconsistent findings concerning the factor structure. The aim of the present study was, thus, to develop a concise, simplified, and revised version of the CCC-2 in a large German-speaking sample. Four groups of children and adolescents aged 4 to 17 years were included: ASD (n = 195), intellectual disability (ID, n = 83), diverse mental health conditions (MHC, n = 144) and a typically developing control group (TD, n = 417). We reduced the original number of items from 70 to 39, based on item analysis, exploratory factor analysis and the exclusion of communication-unrelated items. The revised version, CCC-R (α = 0.96), consists of two empirically derived factors: a pragmatic-language (α = 0.96) and a grammatical-semantic-language factor (α = 0.93). All clinical groups (ASD, ID, and MHC) had significantly increased CCC-R total scores, with the highest scores being in the neurodevelopmental disorder groups (ASD and ID). In addition, we found group-specific patterns of elevated pragmatic-language scores in the ASD group and grammatical-semantic scores in the ID group. The CCC-R was comparable to the CCC-2 in distinguishing ASD from the other groups. The CCC-R is proposed as a simplified and easily applied, clinical questionnaire for caregivers, assessing pragmatic language impairments across neurodevelopmental disorders and mental health conditions. LAY SUMMARY: The CCC-2 is a questionnaire designed to identify children who have problems in the social use of language, however, it is limited in its clinical application and exhibits inconsistent factors. We have created a shorter and simpler version of the CCC-2 that we have called the CCC-R which overcomes the previous limitations of the CCC-2. It consists of two subscales: pragmatic language and grammatical-semantic language. The CCC-R can be used as a short and clinically relevant caregiver questionnaire which assesses pragmatic language impairments in children and adolescents. Autism Res 2021, 14: 759-772. © 2021 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals LLC.

English foreign language teachers’ awareness of childhood language impairment

ABSTRACT The increasing number of children with Language Impairment (LI) globally, and practitioners’ limited knowledge and specialized training can have a serious effect on foreign language learning and development. The present study proposes useful and meaningful practices in the area of raising awareness and alerting a wide range of stakeholders in the field of language education. More specifically, the study concentrates on foreign language secondary school pre-service teacher trainees and their knowledge regarding a) students’ problems in language understanding, b) why LI occurs and, c) LI intervention. This work aims to encourage collaboration among speech therapists and teachers, to foster a better understanding of each other’s expertise, and create communication-friendly classrooms that will enhance foreign language development in a supportive and inclusive learning environment.

How aware is the public of the existence, characteristics and causes of language impairment in childhood and where have they heard about it? A European survey

Public awareness of language impairment in childhood (Developmental Language Disorder (DLD)) has been identified as an important determiner of research and clinical service delivery, yet studies directly assessing public awareness are lacking. This study surveyed awareness across 18 countries of Europe. MethodA questionnaire developed by an international team asked whether respondents had heard of language impairment affecting children, what they thought its manifestations and causes were and where they had heard of it. Respondents were also asked whether they had heard of autism, dyslexia, ADD/ADHD and speech disorder. The questionnaire was administered to members of the public in 18 European countries. A total of 1519 responses were obtained, spanning 6 age groups, 4 educational level groups and 3 income level groups. ResultsAcross all but one country, significantly fewer people had heard of language impairment than any of the other disorders (or 60 % compared to over 90 % for autism). Awareness tended to be lowest in Eastern Europe and greatest in North-Western Europe, and was influenced by education level, age and income level. People in countries with overall low and overall high awareness differed in their views on manifestations and causes. People had heard of language impairment and autism the same way - most frequently through the media, including Internet, and less frequently through their child’s school or a medical professional. DiscussionThe study confirms that awareness of language impairment and knowledge of the breadth of its manifestations are low. It also suggests opportunities for how to increase awareness, including greater media coverage of language impairment and more efficient use of venues such as schools and healthcare. Ways in which cultural and linguistic differences may influence public awareness efforts are discussed, including the translatability of clinical labels and scientific terms. These may impact the acceptance of a common term and definition across all countries. As awareness campaigns are gaining momentum, the findings of this study can serve as a baseline against which to compare future findings.

Causal Pathways for Specific Language Impairment: Lessons From Studies of Twins.

PurposeThis review article summarizes a program of longitudinal investigation of twins' language acquisition with a focus on causal pathways for specific language impairment (SLI) and nonspecific language impairment in children at 4 and 6 years with known history at 2 years.MethodThe context of the overview is established by legacy scientific papers in genetics, language, and SLI. Five recent studies of twins are summarized, from 2 to 16 years of age, with a longitudinal perspective of heritability over multiple speech, language, and cognitive phenotypes.ResultsReplicated moderate-to-high heritability is reported across ages, phenotypes, full population estimates, and estimates for clinical groups. Key outcomes are documentation of a twinning effect of risk for late language acquisition in twins that persists through 6 years of age, greater for monozygotic than dizygotic twins (although zygosity effects disappear at 6 years); heritability is greater for grammar and morphosyntax than other linguistic dimensions, from age 2 years through age 16 years, replicated within twin samples at subsequent age levels and across twin samples at age 16 years.ConclusionThere is consistent support for legacy models of genetic influences on language acquisition, updated with a more precise growth signaling disruption model supported by twin data, as well as singleton data of children with SLI and nonspecific language impairment.Presentation Video https://doi.org/10.23641/asha.13063727

Diagnostic Accuracy of the Photographic Expressive Persian Grammar Test to Identify 4-6 Years Old Children With Developmental Language Disorder

Objectives: Accurate diagnosis of Persian children with Developmental Language Disorder (DLD) is regarded as a challenge for Speech and Language Pathologists (SLPs) in Iran because of the lack of formal linguistic tests that can reliably distinguish language-impaired children from Typically-Developing (TD) children. This study aimed to investigate the diagnostic accuracy of the photographic expressive Persian Grammar Test (PEGT). Methods: The participants were forty 4-6 years old monolingual Persian speakers who were categorized into two groups of DLD (n=20) and TD (n=20) children based on the MLU (mean length of utterance) scores as the reference standard and clinical judgment of an experienced speech-language pathologist. PEGT was administered to all participants, and the results were analyzed using the Mann-Whitney test and Rock Chart (ROC) to estimate the ability of the PEGT to differentiate between children with DLD and TD and to determine its sensitivity, specificity, and the optimal cutoff point. Results: The results revealed that children with DLD performed significantly lower than their TD peers in the PEGT (P&lt;0.05). Both sensitivity and specificity measures of PEGT were estimated as 100% at the optimal cut-off point of 12.5. Discussion: The data provide empirical support for the use of the PEGT for accurate diagnosis of preschool children with DLD from their TD peers.

Adapting the Multilingual Assessment Instrument for Narratives (MAIN) to Scottish Gaelic

&#x0D; &#x0D; &#x0D; This paper describes the rationale for the adaptation of the Multilingual Assessment Instrument for Narratives (LITMUS-MAIN) (Gagarina et al., 2012, 2015, 2019) to Scottish Gaelic (Gaelic) and presents some preliminary results from the macrostructure measures. Gaelic is a heritage minority language in Scotland being revitalised through immersion education, which spans across all levels of compulsory education (preschool, primary and secondary level). MAIN was adapted to Gaelic for two reasons: (i) to gauge the language abilities of children attending Gaelic immersion schools using an ecologically valid test, and (ii) to help identify areas of language impairment in children with Developmental Language Disorders within a broader battery of language tasks. Preliminary results from the macrostructure component indicate a wider range of Gaelic language abilities in six- to eight-year-old typically developing children in Gaelic- medium education. These results set the stage for future use of the tool within this context.&#x0D; &#x0D; &#x0D;

Commentary on special issue: Syntax and verbal short term memory

Short term memory (STM) and working memory (WM) performance consistently predict language abilities in children with developmental language disorders. However, causality is not fully established. Moreover, evidence from the fine-grained analysis of STM/WM tasks and comprehension of complex sentences, suggests that long term memory (LTM) representations play an important role. Critical assessment of the articles in the special edition focuses on Zebib et al. and Stanford and Delage. Zebib et al. find that sentence repetition by bilingual language-impaired children more strongly reflects WM than overall linguistic ability. This suggests a dependence on WM when linguistic representations are impoverished. However, the process of ranking predictors is problematic. Stanford and Delage find that STM/WM difficulties affect the processing of complex sentences by individuals with Specific Learning Disabilities. Yet, LTM-based explanations focusing on input frequency may also explain this phenomenon. To make progress we need a combination of experimental studies and large-scale longitudinal studies.