Language Rehabilitation Research Articles

Advancing Neuropsychological Rehabilitation in Primary Progressive Aphasia Based on Principles of Cognitive Neuroscience: A Scoping Review and Systematic Analysis of the Data

Background/Objectives: This systematic review of neuropsychological rehabilitation strategies for primary progressive aphasia will consider recent developments in cognitive neuroscience, especially neuroimaging techniques such as EEG and fMRI, to outline how these tools might be integrated into clinical practice to maximize treatment outcomes. Methods: A systematic search of peer-reviewed literature from the last decade was performed following the PRISMA guidelines across multiple databases. A total of 63 studies were included, guided by predefined inclusion and exclusion criteria, with a focus on cognitive and language rehabilitation in PPA, interventions guided by neuroimaging, and mechanisms of neuroplasticity. Results: Integration of neuroimaging techniques contributes to the increase in the efficacy of interventions with critical information about the neural mechanisms underlying language deficits in the aphasias. Traditional rehabilitation strategies, technology-assisted interventions, and non-invasive brain stimulation techniques hold considerable promise for language improvement. Neuroimaging was also found to be necessary in subtype-specific differentiation toward tailoring therapeutic intervention. Evidence also shows that directed and sustained interventions using neuroplasticity can have long-term effects in managing the symptoms of PPA. Conclusions: The present review underlines the necessity of including cognitive neuroscience techniques within neuropsychological rehabilitation to enhance therapeutic outcomes in PPA. In addition, neuroimaging modalities such as EEG and fMRI are also of great importance in understanding the underlying neurobiology of language disturbances and guiding tailored interventions. Long-term benefits of these approaches should be evaluated, including their applicability in routine clinical practice.

The impact of early speech and language cognitive training care on the developmental quotient of children with language impairments: A retrospective study.

This study aims to investigate the effects of early speech and language cognitive training on the nursing outcomes of children with language impairments and their impact on developmental quotient. From October 2018 to October 2023, the data of 80 children with language impairments treated at our hospital were selected. They were divided into an observation group (n = 40) and a control group (n = 40) based on the treatment plan. The control group received routine rehabilitation training, while the observation group received early cognitive language rehabilitation training. The treatment efficacy of the 2 groups, as well as differences in Gesell Developmental Schedule scores and serum indicators before and after treatment, were observed and analyzed. The treatment efficacy in the observation group was superior to that in the control group (P < .05), with a total effective rate of 92.50% in the observation group. After 6 months of treatment, the scores for adaptability, gross motor skills, fine motor skills, personal-social behavior, and language development quotient in the observation group were (77.41 ± 10.21), (77.15 ± 10.43), (80.43 ± 11.19), (71.14 ± 10.42), and (81.21 ± 12.03), respectively, significantly higher than those in the control group (P < .05). After 6 months of treatment, the mental development index and psychomotor development index in the observation group were (107.28 ± 10.43) and (96.60 ± 9.03), respectively, which were markedly higher than those in the control group (P < .05). After 6 months of treatment, the serum levels of insulin-like growth factor-1, 25-hydroxyvitamin D [25(OH)D3], and gamma-aminobutyric acid in the observation group were (52.43 ± 9.44) ng/mL, (31.45 ± 4.82) ng/mL, and (76.65 ± 10.54) µmol/mL, respectively. These levels were not significantly different from those in the control group (P > .05). The blood flow velocities of the middle cerebral artery, anterior cerebral artery, basal artery, and vertebral artery in the observation group and control group were compared after 6 months of treatment (P > .05). Early speech and cognitive training have shown promising efficacy in the treatment of language disorders, as it can improve developmental quotient in affected children and increase serum levels of insulin-like growth factor-1, 25(OH)D3, and gamma-aminobutyric acid.

Elucidating a statistical learning brain network: Coordinate-based meta-analyses and functional connectivity profiles of artificial grammar learning in healthy adults

Abstract Language rehabilitation centers on modifying its use through experience-based neuroplasticity. Statistical learning of language is essential to its acquisition and likely its rehabilitation following brain injury, but its corresponding brain networks remain elusive. Coordinate-based meta-analyses were conducted to identify common and distinct brain activity across 25 studies coded for meta-data and experimental contrasts (Grammatical and Ungrammatical). The resultant brain regions served as seeds for profiling functional connectivity in large task-independent and task-dependent data sets. Hierarchical clustering of these profiles grouped brain regions into three subnetworks associated with statistical learning processes. Functional decoding clarified the mental operations associated with those subnetworks. Results support a left-dominant language sub-network and two cognitive control networks as scaffolds for language rule identification, maintenance, and application in healthy adults. These data suggest that cognitive control is necessary to track regularities across stimuli and imperative for rule identification and application of grammar. Future empirical investigation of these brain networks in language learning in individuals with brain injury will clarify their prognostic role in language recovery.

EVALUATION OF AN ALLIED HEALTH PROFESSIONAL PREHABILITATION SERVICE IN NEURO-ONCOLOGY

Abstract AIMS The evidence base for the benefits of prehabilitation in the cancer population is increasing. So far, the focus has been on colorectal, breast and lung cancer sites with no current research into the effects in patients with primary or secondary brain tumours. It is hypothesised that patients with brain cancer would benefit from prehabilitation as current evidence demonstrates the positive effects of exercise, cognitive and language rehabilitation in this patient group. The aim of this project is to demonstrate the feasibility and impact of a two-year prehabilitation pilot service. The service comprises physiotherapy, occupational therapy and speech and language therapy for patients with brain cancer in the pre-operative phase. METHOD A pilot study was carried out at a tertiary UK neurosurgery centre. Patients over the age of 17 with a diagnosis of primary or secondary brain tumour awaiting surgery were eligible for the prehabilitation service. The impact was measured through Length of Stay, Quality of Life (EQ-5D-5L), emergency department attendances and admission rates 90 days post-surgery. RESULTS 128 patients were seen in prehabilitation from 01/11/2022 to 31/01/2024. Length of hospital stay post-surgery was lower for the prehabilitation group (0.9 days with 95% confidence interval) compared to control group. A mean improvement in the EQ-5D-5L Index from pre-operative assessment to post-surgery follow up was demonstrated CONCLUSION This study reveals data demonstrating the benefits of prehabilitaiton for patients with brain tumours. Prehabilitation for this patient group appears to improve clinical outcomes alongside patients’ quality of life. Future directions for the service will focus on expanding the provision to patients with spinal and benign tumours, where this is also a possibility of therapeutic need in the pre and post-operative phase.

Community-based interventions for mitigating cognitive-linguistic decline in older adults.

This study focuses on exploring the effectiveness of interventions in two community-based language rehabilitation care centers located in an economically underdeveloped region of northwest China. The research focuses on 35 older adults with cognitive-linguistic decline enrolled in both centers. The interventions provided to the participants include auditory training, sign language use enhancement, second language interest classes, and the promotion of elderly-mode applications on smartphones. The interventions were particularly effective in enhancing auditory processing and language comprehension skills. Additionally, the promotion of elderly-mode applications on smartphones proved to be a valuable tool in improving participants' language cognition. The study underscores the importance of tailored community-based interventions in improving language skills and cognition and provides a basis for further research in this area.

Lexical retrieval difficulties in post-COVID-19 syndrome: Insights from verbal fluency and naming tasks.

Although considerable research has been conducted on post-COVID-19 syndrome (PCS), cognitive symptoms, particularly those related to language, are still not well understood. To provide a detailed quantitative and qualitative analysis of language performance in PCS patients using a comprehensive set of semantic and verbal production tasks. The study involved 195 PCS patients aged 26-64 years and 50 healthy controls aged 25-61 years. Participants were assessed using two semantic tasks, three naming tasks and four types of verbal fluency tasks, designed to evaluate different aspects of language processing. PCS patients demonstrated significantly poorer performance compared with controls across all verbal fluency tasks. This was evident in both the total number of words generated and their types, with patients tending to choose more easily accessible words. In naming tasks, the pattern of errors was similar in both groups, although patients showed a higher number of non-responses and made more errors, reflecting difficulties in word retrieval. The analysis highlighted the impact of factors such as stimulus availability, educational level and cognitive reserve on performance. Notably, younger patients performed worse than older, a paradoxical trend also observed in previous research. These findings reveal significant word retrieval difficulties in PCS patients, suggesting that cognitive impairment related to language may be more pronounced than previously understood. The results underscore the need for a thorough evaluation of language functions in PCS patients and the development of more targeted and individualized language rehabilitation strategies to address these specific challenges. What is already known on the subject Studies on the cognitive characteristics of CPS have focused mainly on broad-spectrum neuropsychological assessments covering all cognitive functions. However, there are very few studies analysing oral production with specific lexical and semantic system tasks. Furthermore, no work has specifically included tasks assessing semantic processing or conducted qualitative analyses of the psycholinguistic variables affecting performance. Such analyses could undoubtedly help clarify the nature of the language impairments in patients with PCS. What this paper adds to the existing knowledge This study explores in depth the evaluation and analysis of the oral production of patients with PCS using several lexical and semantic tasks. In addition, psycholinguistic variables are analysed that could undoubtedly help clarify the nature of the language impairments in patients with PCS. What are the potential or actual clinical implications of this work? The study allows the identification of specific lexical-semantic deficits in the spoken language in patients with this PCS. A more detailed assessment of the oral language of these patients, keeping in mind the psycholinguistic variables that may affect the performance, will facilitate the design of more efficient and individualized rehabilitation programmes.

An Innovative Approach To Increasing Speech And Language Therapy Intensity For Stroke Patients

Abstract Background Different national guidelines exist for the provision of Speech and Language Therapy (SLT) intensity for stroke patients. The National Institute for Health and Care Excellence (NICE) guidelines on stroke rehabilitation in Adults (2023) advises 3 hours of multidisciplinary therapy a day, five days a week. The National Clinical guideline for Stroke for the UK and Ireland (2023) does not include SLT in this 3-hour provision of motor therapy, but advises 45 minutes of SLT a day, 5 days a week. Poor SLT staffing levels are commonplace, more recently exacerbated by the HSE recruitment embargo, posing significant challenges to rehabilitation provision. Methods A Speech and Language Therapist in a stroke service assessed whether the use of Therapy assistants could add to the delivery of the targeted 45 minutes of SLT. Training was provided in the execution of speech, language and swallow rehabilitation exercises, using patient specific exercise packs. A month of data collection started on 8 patients. Intensity was measured in 3 percentage groups: Results When rehabilitation was provided by SLT alone, 7 patients received insufficient therapy intensity. One patient scored in the moderate group. With the added input of stroke assistants, 4 patients received sufficient therapy time, 3 patients scored in the moderate group and only one patient received insufficient therapy. Conclusion Use of Stroke assistants for the provision of SLT rehabilitation exercises, can be an effective tool in increasing SLT intensity. Training is time intensive, but essential to make assistants knowledgeable and competent in their abilities. All rehabilitation should be under direct supervision of SLT. However, we should not use stroke assistants to mask or minimise the need for adequate SLT resourcing, as specified in international standards.

Brain tumor patient perceptions toward repetitive transcranial magnetic stimulation for rehabilitation after surgery

Abstract Background Repetitive transcranial magnetic stimulation (rTMS) is established for depression and rehabilitation after stroke and is emerging for cognitive rehabilitation. We sought to evaluate patient and carer perceptions toward rTMS for rehabilitation after neurosurgery. Methods Two surveys were undertaken. Group 1: Patients who received 7 days of rTMS for motor or language rehabilitation for severe postoperative deficits following lesional resection were prospectively surveyed on the last day of their rTMS treatment, as well as their next of kin. Group 2: Patients who had previously been diagnosed with glioma but did not receive rTMS were retrospectively surveyed through two brain tumor charities, including next of kin. Results Group 1: Twenty-one responses. Eleven patients, 10 next of kin. The commonest pathology was WHO Grade 4 glioma (n = 3). Group 2: 24 responses. Sixteen patients, 8 next of kin. The commonest pathology was WHO Grade 2 glioma (n = 7). Most Group 1 respondents reported a positive experience of rTMS (15/21). Patients experienced subjective improvements in gross motor functions of arm and leg weakness and purposeful movement (9/11). Lack of subjective motor improvement was associated with adverse symptoms (e.g., headaches; p = .01). Group 2 respondents were supportive of rTMS. Key priorities included motor and cognitive rehabilitation. They were accepting of longer and more frequent rTMS sessions than Group 1 (p = .028 and &amp;lt;.001, respectively). Commonest concerns pertained to side effects are seizures and headaches. Conclusions rTMS for rehabilitation was well-tolerated by patients with side effects being commoner in those with no subjective motor improvements. Nontreated patients and their next of kin would find longer and more sessions acceptable but have concerns about potential side effects.

Moving Toward Anti-Ableist Practices in Aphasia Rehabilitation and Research: A Viewpoint.

Ableism is a pervasive set of beliefs that regard nondisabled bodies and minds as ideal and necessary to live a full life. Ableism manifests for people with aphasia as stigma and discrimination based on their language ability. We assert that ableism contributes to decreased quality of life for people with aphasia and should be actively challenged and disrupted by clinicians and researchers in the field. We applied the Health Stigma and Discrimination Framework (HSDF) to outline how stigma and discrimination are perpetuated against people with aphasia on the basis of language ability and their downstream health and social consequences. We presented this framework at the Clinical Aphasiology Conference in 2023 and share themes and challenges that arose from this discussion and from our ongoing learning. Applying the HSDF to aphasia outlined potential sequelae of ableism. We identified preliminary foci of future initiatives aimed at challenging ableist beliefs and practices and means to monitor the effectiveness of such interventions. Furthermore, we draw attention to the seeming tension between anti-ableist practices and traditional language rehabilitation goals. We assert that this tension may be a catalyst for fruitful discourse on how clinicians and researchers can resist ableism while honoring the lived experiences of people with aphasia and their goals for language rehabilitation. These discussions may be facilitated by existing models in disability studies (e.g., the political/relational model). Clinicians and researchers are well positioned to challenge ableism and minimize the resultant health and social impacts for people living with aphasia. Anti-ableist practices are not antithetical to aphasia rehabilitation and can be thoughtfully integrated into rehabilitation practices and discourse.

Cost-effectiveness of neuropsychological rehabilitation for acquired brain injuries: Update of Stolwyk etal.'s (2019) review.

Acquired brain injuries (ABI), resulting from stroke or traumatic brain injury, cause a range of neuropsychological impairments and many patients continue to experience neuropsychological deficits years after onset. The increasing average age of the population highlights the importance of effective management strategies for the consequences of ABI. Despite the well-documented impact of rehabilitation interventions, the cost-effectiveness of neuropsychological rehabilitation remains largely unknown. This study conducted a scoping review to update the findings of Stolwyk etal. (Neuropsychological Rehabilitation, 2021, 31, 316), focusing on the economic evaluations of neuropsychological rehabilitation for individuals with ABI. Following the PIO framework, PRISMA ScR guidelines, and systematic review reporting checklist, the review screened 1027 articles and included eight studies published between 2019 and 2024. The studies encompassed either language rehabilitation or general neuropsychological programs, including neuropsychological interventions. The economic analyses, including two cost-effectiveness, five cost-utility, and one cost-benefit study, mostly adhered to CHEERS guidelines, enhancing the transparency and methodological rigour of their reporting. These studies demonstrated varying degrees of cost-effectiveness for interventions targeting post-stroke language disorders and neuropsychological rehabilitation for ABI, with significant cost savings and health benefits observed, particularly for home-based rehabilitation interventions. The included studies suffered from a short time horizon, limiting the ability to capture the long-term economic impacts and effectiveness of the interventions. Future research should focus on longer-term follow-up data and include broader search strategies to enhance understanding and optimise health care interventions. A comprehensive implementation of these economic analyses is crucial for informing policymakers, enabling them to introduce rehabilitative interventions based on solid evidence.

A Case Report on Infant Aural Rehabilitation Using Korean Auditory, Language, and Cognitive Rehabilitation for Infants

The purpose of this paper is to report the effectiveness and significance of aural rehabilitation using the Korean Auditory, language, and cognitive Rehabilitation for Infants (KARI) program. The KARI program was administered to an infant diagnosed with hearing loss at 9 months of age. A total of 45 KARI sessions were conducted for 13 months. Four developmental areas, auditory, language and social communication, overall and vocal and articulatory were evaluated at 10, 15, and 18 months of age for initial, progress, and final tests. After aural rehabilitation with KARI, in the area of auditory development, the infant showed normal range. In the area of language and social communication, the infant exhibited normal receptive language and non-verbal communication skills but showed significant delays in speech due to the diagnosed submucous cleft palate. In the area of overall developmental screening, Korean Developmental Screening Test for Infants &amp; Children scores were at peer level in cognition and social skills. However, gross motor, fine motor, language, and self-help skills were in the range of needing further testing. In the areas of vocalization and articulation, vocalization showed normal range, but articulation development showed delayed development. Although development of expressive language and articulation was delayed due to submucous cleft palate, the overall results showed good progression with KARI in other areas. Therefore, it is hoped that the KARI would be used to promote aural rehabilitation for the infants with hearing impaired.

Aberrant neural oscillations in poststroke aphasia.

Neural oscillations are electrophysiological indicators of synchronous neuronal activity in the brain. Recent work suggests aberrant patterns of neuronal activity in patients with poststroke aphasia. Yet, there is a lack of systematic explorations of neural oscillations in poststroke aphasia. Investigating changes in the dynamics of neuronal activity after stroke may be helpful to identify neural markers of aphasia and language recovery and increase the current understanding of successful language rehabilitation. This review summarizes research on neural oscillations in poststroke aphasia and evaluates their potential as biomarkers for specific linguistic processes. We searched the literature through PubMed, Web of Science, and EBSCO, and selected 31 studies that met the inclusion criteria. Our analyses focused on neural oscillation activity in each frequency band, brain connectivity, and therapy-induced changes during language recovery. Our review highlights potential neurophysiological markers; however, the literature remains confounded, casting doubt on the reliability of these findings. Future research must address these confounds to confirm the robustness of cross-study findings on neural oscillations in poststroke aphasia.

TABLET TOSCANA to Develop Innovative Organizational Models for Tele-Rehabilitation in Subjects with Congenital and Acquired Developmental Disabilities: A Wait-List Control Group Trial Protocol.

Background/Objectives: In recent years, the advent of new technologies has fostered their application in neuro-psychomotor and language rehabilitation, particularly since the COVID-19 pandemic. Tele-rehabilitation has emerged as an innovative and timely solution, enabling personalized interventions monitored by clinicians. TABLET TOSCANA project aims to develop innovative tele-rehabilitation organizational models in children, adolescents and young adults with congenital and acquired developmental disabilities, using the Virtual Reality Rehabilitation System (VRRS) Home Kit and the MedicoAmico APP. Methods: The trial is designed according to the CONSORT statement guidelines. The project encompasses three phases: adapting the technologies for pediatric use, validating them through a wait-list study, and analyzing feasibility and effectiveness data to define new organizational models. A randomized wait-list-control study with 100 subjects aged 6 to 30 years will compare tele-rehabilitation versus prosecution of standard care. Discussion: Although literature highlights tele-rehabilitation benefits such as improved access, cost savings, and enhanced treatment adherence, practical implementation remains limited (i.e., the definition of standardized procedures). TABLET TOSCANA project seeks to address these gaps by focusing on multi-domain treatments for neurodevelopmental disabilities and emphasizing the integration of tele-rehabilitation into local health services. Conclusion: The project aims to improve the continuity and intensity of care through innovative models that integrate tele-rehabilitation into local health services. The results could inform healthcare policies and promote the development of innovative and collaborative models of care, paving the way for more effective and widespread tele-rehabilitation solutions and fostering collaborative networks among professionals.

A novel case of Takenouchi-Kosaki syndrome: Focus on hearing and language rehabilitation

Abstract Takenouchi-Kosaki syndrome (TKS) is a rare congenital condition, caused by a mutation in the cell division cycle 42 gene. This gene typo impacts various physiological processes, including hearing, hematopoiesis, immunologic functioning, and neurodevelopment. Despite the high prevalence of hearing impairment in TKS, existing literature has concentrated primarily on pharmacological treatments for hematoimmunologic diseases. This case report presents a novel case of TKS, highlighting the importance of audiological assessment and rehabilitating interventions in children with TKS. We discuss the case of a prematurely born boy who was diagnosed with TKS and who presented with profound bilateral sensorineural hearing loss and associated developmental delays. Following comprehensive audiological evaluation and intervention – including hearing aids, sign language, and alternative augmentative communication systems – a multidisciplinary approach was adopted to enhance his communicative abilities. From this study, it emerges the increasing need for tailored rehabilitation strategies for TKS patients to improve communication skills and overall quality of life. Further researches are needed to develop standardized protocols for assessment and treatment in patients with TKS.

Working memory in deaf children with cochlear implants using different language rehabilitation approaches

Working memory in deaf children with cochlear implants using different language rehabilitation approaches

Language profile of children with cochlear implants: comparative study about the effect of age of cochlear implantation and the duration of rehabilitation

PurposeThe analysis of different language domains and exploration of variables that affect the outcomes of cochlear implantation would help to document the efficacy of cochlear implantation and intervention programs. The aim of this work was to examine the language profile of children with Cochlear Implants (CI) and to assess the effect of age at the time of cochlear implantation and the impact of duration of rehabilitation on the development of linguistic abilities for cochlear implanted children.MethodsThe study was conducted on 46 Arabic speaking children using unilateral CI who are receiving regular post-cochlear auditory and language rehabilitation in the phoniatrics unit, Kasr Alaini hospital. A Proficient Preschooler Language Evaluation (APPEL TOOL) was applied for the assessment of different language domains.ResultsChildren who received post implant rehabilitation for ≥ 2 years showed significant improvement in all subtests' scores of APPEL tool than children who received same rehabilitation for ≤ 1 year. There was no significant difference of language scores between children who have received CI before age of 3 years and those who have been implanted after age of 3 years.ConclusionThis study showed that the language profile of CI children was beneficially affected by the longer duration of therapy post implantation.

Under pressure: the interplay of hypertension and white matter hyperintensities with cognition in chronic stroke aphasia.

While converging research suggests that increased white matter hyperintensity load is associated with poorer cognition, and the presence of hypertension is associated with increased white matter hyperintensity load, the relationship among hypertension, cognition and white matter hyperintensities is not well understood. We sought to determine the effect of white matter hyperintensity burden on the relationship between hypertension and cognition in individuals with post-stroke aphasia, with the hypothesis that white matter hyperintensity load moderates the relationship between history of hypertension and cognitive function. Health history, Fazekas scores for white matter hyperintensities and Wechsler Adult Intelligence Scale Matrix Reasoning subtest scores for 79 people with aphasia collected as part of the Predicting Outcomes of Language Rehabilitation study at the Center for the Study of Aphasia Recovery at the University of South Carolina and the Medical University of South Carolina were analysed retrospectively. We found that participants with a history of hypertension had increased deep white matter hyperintensity severity (P < 0.001), but not periventricular white matter hyperintensity severity (P = 0.116). Moderation analysis revealed that deep white matter hyperintensity load moderates the relationship between high blood pressure and Wechsler Adult Intelligence Scale scores when controlling for age, education, aphasia severity and lesion volume. The interaction is significant, showing that a history of high blood pressure and severe deep white matter hyperintensities together are associated with poorer Matrix Reasoning scores. The overall model explains 41.85% of the overall variation in Matrix Reasoning score in this group of participants. These findings underscore the importance of considering cardiovascular risk factors in aphasia treatment, specifically hypertension and its relationship to brain health in post-stroke cognitive function.

Large variations in intensive speech– language rehabilitation post-stroke

Background: Intensive rehabilitation of aphasia is recommended in the national guidelines for stroke care, but is far from implemented in Swedish healthcare. Aim: To explore current practice and detect barriers and enablers for intensive aphasia rehabilitation among Speech Language Pathologists (SLPs) before they were enrolled in a national intervention study.Method: Thirty-six SLPs in 26 clinics answered a web-based questionnaire. Responses were processed using descriptive statistics and thematic analysis.Result: Treatment intensity, duration and delivery format varied widely, and two-thirds offered intensive rehabilitation rarely or never. Thematic analysis generated the following five barriers: understaffing, patient factors, teamwork/scheduling, prioritization, and accessibility, and three enablers: increased staffing, planned intervention programmes, and comprehensive delivery formats.Conclusions: Compliance with Swedish stroke guidelines for intensive aphasia rehabilitation is low, and the current practice varies widely between different clinics. Increasing SLPs in primary care and restructuring care by using planned and comprehensive intervention approaches are suggested to stimulate implementation.

Language and Communication Interventions in People with Alzheimer's Disease: A Systematic Review.

Although language impairment is frequently observed in patients with Alzheimer's disease (pwAD), targeted language rehabilitation is often overlooked. The present study reviews published evidence on the impact of language training, either alone or in combination with cognitive training, on cognitive outcomes in pwAD. A systematic search of PubMed, Google Scholar, and Cochrane was carried out, including studies published from inception to November 2023. A total of eight research articles (four randomized controlled trials and four observational studies) met the inclusion criteria: six assessed language training combined with cognitive training and two evaluated language rehabilitation alone. Regarding language and non-language (mainly memory, attention, and executive functions) outcomes, there was a consensus among studies that language rehabilitation (alone or in combination with cognitive training) yields positive results. Some of the articles also explored the impact on patients' and their caregivers' quality of life, with all but one showing improvement. Consequently, the combination of language and cognitive training leads to improvements across various cognitive domains. However, limited evidence supports the value of sole language rehabilitation. This conclusion is influenced by heterogeneity among studies (different types and duration of interventions, small participant sets, various assessment tools), and, thus, further research is warranted.

Clinical practice guideline: Interventions for Developmental Language Delay and Disorders.

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