Risk For Language Impairment Research Articles

A cross-linguistic study of the acquisition of clitic and pronoun production

ABSTRACTThis study develops a single elicitation method to test the acquisition of third-person pronominal objects in 5-year-olds for 16 languages. This methodology allows us to compare the acquisition of pronominals in languages that lack object clitics (“pronoun languages”) with languages that employ clitics in the relevant context (“clitic languages”), thus establishing a robust cross-linguistic baseline in the domain of clitic and pronoun production for 5-year-olds. High rates of pronominal production are found in our results, indicating that children have the relevant pragmatic knowledge required to select a pronominal in the discourse setting involved in the experiment as well as the relevant morphosyntactic knowledge involved in the production of pronominals. It is legitimate to conclude from our data that a child who at age 5 is not able to produce any or few pronominals is a child at risk for language impairment. In this way, pronominal production can be taken as a developmental marker, provided that one takes into account certain cross-linguistic differences discussed in the article.

Dual language intervention for bilinguals at risk for language impairment.

Selecting the initial language of intervention for bilingual children at risk for language impairment is challenging for clinicians, as both the home and academic languages are important for children's successful communication. In this project, six Spanish-English bilingual first graders at risk for language impairment participated in an 8-week intervention program targeting vocabulary, morphosyntax, narrative, and literacy skills in both Spanish and English. Children completed 24 small-group sessions (three times a week). One group received Spanish intervention first, then English, and another group received English first, then Spanish. The systematic use of both languages in intervention resulted in overall gains in vocabulary and narrative skills in this short-term intervention. Language condition groups differed in performance on oral narratives and semantics. Clinical recommendations for selecting the initial language of intervention are discussed.

Language evaluation protocol for children aged 2 months to 23 months: analysis of sensitivity and specificity.

To establish cutoff points for the analysis of the Behavior Observation Form (BOF) of children in the ages of 2 to 23 months and evaluate the sensitivity and specificity by age group and domains (Emission, Reception, and Cognitive Aspects of Language). The sample consisted of 752 children who underwent BOF. Each child was classified as having appropriate language development for the age or having possible risk of language impairment. Performance Indicators (PI) were calculated in each domain as well as the overall PI in all domains. The values for sensitivity and specificity were also calculated. The cutoff points for possible risk of language impairment for each domain and each age group were obtained using the receiver operating characteristics curve. The results of the study revealed that one-third of the assessed children have a risk of language impairment in the first two years of life. The analysis of BOF showed high sensitivity (>90%) in all categories and in all age groups; however, the chance of false-positive results was higher than 20% in the majority of aspects evaluated. It was possible to establish the cutoff points for all categories and age groups with good correlation between sensitivity and specificity, except for the age group of 2 to 6 months. This study provides important contributions to the discussion on the evaluation of the language development of children younger than 2 years.

Early Language Learning and the Social Brain.

Explaining how every typically developing child acquires language is one of the grand challenges of cognitive neuroscience. Historically, language learning provoked classic debates about the contributions of innately specialized as opposed to general learning mechanisms. Now, new data are being brought to bear from studies that employ magnetoencephalograph (MEG), electroencephalograph (EEG), magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI) studies on young children. These studies examine the patterns of association between brain and behavioral measures. The resulting data offer both expected results and surprises that are altering theory. As we uncover what it means to be human through the lens of young children, and their ability to speak, what we learn will not only inform theories of human development, but also lead to the discovery of neural biomarkers, early in life, that indicate risk for language impairment and allow early intervention for children with developmental disabilities involving language.

Predictors of Language Outcome for Children Born Preterm: Implications for Early Intervention

There is ample evidence that children who are born preterm are at risk for language impairment [1-3]. However, not all children who are born preterm will experience difficulty developing language. Why some children have a language impairment and others do not may be owed to the presence of certain risk factors, as well as the absence of particular protective factors. It is possible that different combinations of risk and protective factors may result in negative or positive outcomes for the child born preterm.

Fine motor skill predicts expressive language in infant siblings of children with autism.

We investigated whether fine motor and expressive language skills are related in the later-born siblings of children with autism (heightened-risk, HR infants) who are at increased risk for language delays. We observed 34 HR infants longitudinally from 12 to 36 months. We used parent report and standardized observation measures to assess fine motor skill from 12 to 24 months in HR infants (Study 1) and its relation to later expressive vocabulary at 36 months in HR infants (Study 2). In Study 1, we also included 25 infants without a family history of autism to serve as a normative comparison group for a parent-report fine motor measure. We found that HR infants exhibited fine motor delays between 12 and 24 months and expressive vocabulary delays at 36 months. Further, fine motor skill significantly predicted expressive language at 36 months. Fine motor and expressive language skills are related early in development in HR infants, who, as a group, exhibit risk for delays in both. Our findings highlight the importance of considering fine motor skill in children at risk for language impairments and may have implications for early identification of expressive language difficulties.

Accurately Predicting Future Reading Difficulty for Bilingual Latino Children at Risk for Language Impairment

Sixty-three bilingual Latino children who were at risk for language impairment were administered reading-related measures in English and Spanish (letter identification, phonological awareness, rapid automatized naming, and sentence repetition) and descriptive measures including English language proficiency, language ability, SES, and preschool attendance at kindergarten. At the end of first grade, English word-level reading and reading comprehension were measured. Results indicated that the Spanish predictor measures did not account for significant variance over and above the English predictor measures for any of the first grade outcome measures. Of the descriptive predictor measures, only English language proficiency and language ability were significantly predictive, accounting for unique variance in first grade reading comprehension. Sensitivity ranged from .67 to .86 and specificity ranged from .82 to .93 across the four first grade outcome measures.

Predicting Reading Ability for Bilingual Latino Children Using Dynamic Assessment

This study investigated the predictive validity of a dynamic assessment designed to evaluate later risk for reading difficulty in bilingual Latino children at risk for language impairment. During kindergarten, 63 bilingual Latino children completed a dynamic assessment nonsense-word recoding task that yielded pretest to posttest gain scores, residuum gain scores, and modifiability scores. At the end of first grade, the same participants completed criterion reading measures of word identification, decoding, and reading fluency. The dynamic assessment yielded high classification accuracy, with sensitivity and specificity at or above 80% for all three criterion reading measures, including 100% sensitivity for two out of the three first-grade measures. The dynamic assessment used in this study has promise as a means for predicting first-grade word-level reading ability in Latino, bilingual children.

Early lexical expression in typically developing Maltese children: implications for the identification of language delay

Limited word production may be the first indicator of impaired language development. The unavailability of normative data and standardized assessments for young Maltese children hinders the identification of early language delays. This study aimed to document Maltese children's expressive vocabulary growth and accompanying range of variation, to assist identification of children at risk for language impairment. The expressive vocabularies of 44 typically developing children aged 12–30 months were measured through caregiver report. Mean scores at each age point were characterized by substantial individual variation. Gender was not related to mean growth in vocabulary production. Minimum scores were compared to clinical thresholds for English-speaking children. Results emphasized the assessment- and language-specific nature of identification criteria. Nevertheless, established thresholds may be referred to when normative data for particular languages/language pairs are limited. In such contexts, the consideration of other risk markers gains importance in supplementing findings on lexical expression.

It Depends

The current study examined the association between frequency of storybook reading and emergent literacy in 212 children at risk for language impairment, assessed during the fall semester of kindergarten. Measures included parent-reported storybook reading, as well as direct assessments of print knowledge, letter awareness, and expressive vocabulary. Results suggested nonsignificant to moderate (r = .11 to .25) correlations between frequency of storybook reading and child emergent literacy across the entire range of environment and ability. Quantile regression results suggested that the association was highest at low frequency of storybook reading, particularly for print knowledge, approaching r = .50. Moreover, the association between frequency of storybook reading and emergent literacy was highest at higher levels of emergent literacy for print knowledge, but particularly for letter naming, approaching r = .80. These results suggest that in children with language difficulties, the relationship between aspects of the home environment and emergent literacy is conditional on the quality of the home environment as well as the child’s proficiency in emergent literacy skills.

Extending Use of the NRT to Preschool-Age Children With and Without Specific Language Impairment

The purpose of this study was to assess the diagnostic accuracy of the Nonword Repetition Test (NRT; Dollaghan & Campbell, 1998) using a sample of 4- and 5-year-olds with and without specific language impairment (SLI) and to evaluate its feasibility for use in universal screening. The NRT was administered to 29 children with SLI and 47 age-matched children with typical development. Diagnostic accuracy was computed using alternative scoring methods, which treated out-of-inventory phonemes either as errors or as unscorable. To estimate accuracy in a universal screening context, the probability of identifying a child at risk for language impairment was computed using the prevalence of SLI (7%) as the base rate. Diagnostic accuracy was acceptable using both scoring methods. The resulting likelihood ratios (LR+ = 22.66, 19.43; LR- = .05, .05) were similar to those reported for older children. The probability of accurate detection of children with SLI in the general population increased from 7% to 61%. However, this value suggests that many false positives could be expected. The NRT yielded results similar to those reported for older children. However, despite its strengths, the NRT is not sufficient for screening the general population of 4- and 5-year-olds.

The Academic and Functional Academic Skills of Youth Who Are at Risk for Language Impairment in Residential Care

Undiagnosed language impairment (LI) for youth in residential care is a concern as similar populations have shown elevated levels of language delays. Therefore, the purposes of this study were to identify the percentage of youth in residential care who are at risk for LI and to compare the demographic, academic achievement, and functional academic skills of youth with or without possible LI. Participants were 80 youth in residential care. Risk for LI was determined using the Clinical Evaluation of Language Fundamentals-4 Screening Test (E. Semel, E. H. Wiig, & W. A. Secord, 2004). Independent-samples t tests and chi-square analyses were conducted to assess the differences between groups. Measures used included the Woodcock-Johnson Test of Achievement (R. W. Woodcock, K. S. McGrew, & N. Mather, 2001) and the Kaufman Functional Academic Skills Test (A. S. Kaufman & N. L. Kaufman, 1994). More than half of the sample (54%) were identified as being at risk for LI. Statistically significant differences between youth with and without LI were found on academic variables. Specifically, youth who were at risk for LI presented academic achievement and functional academic scores in the low to low-average ranges. Findings suggest that there is a need to screen youth entering residential programs for possible LI. Implications for treatment and program planning are discussed.

Teacher identification of children at risk for language impairment in the first year of school

While the first 3 years of formal schooling have obvious importance for the transition to literacy, it must be remembered that learning to read is a linguistically-based task that draws heavily on mastery of key oral-language skills such as phonemic and morphological awareness, vocabulary development, and early syntax. In order to support the transition to literacy, and because oral language competence is important in its own right, it is vital that early-years teachers are skilled at identifying children who may be at risk of oral language impairment. In this study, 15 teachers completed the Children's Communication Checklist (second edition) on children in their first year of school (n = 149), and ratings were compared with results of screening using the Clinical Examination of Language Fundamentals Screening Test (fourth edition). Teacher ratings showed poor sensitivity and specificity in identifying children whose oral language skills require further investigation. Results are discussed in the light of recommendations for teacher pre-service education, SLP advocacy for oral language competence as a life-long determinant of health, issues in screening during the early years of school, and implications for further research.

Language profiles of monolingual and bilingual Finnish preschool children at risk for language impairment

A large proportion of children are exposed to more than one language, yet research on simultaneous bilingualism has been relatively sparse. Traditionally, there has been concern that bilingualism may aggravate language difficulties of children with language impairment. However, recent studies have not found specific language impairment (SLI) or language-related problems to be increased by bilingualism. The topic of bilingualism and its effects has high actuality in Finland, where increasing numbers of children in the country's 6% Swedish-speaking minority grow up in bilingual families, where one parent's primary language is Swedish and the other's Finnish. The present study aimed at exploring the influence of such bilingualism on the language profiles of children from this population at risk for language impairment (LI). Participants were recruited from a language screening of 339 children from kindergartens with instruction only in Swedish, from the Swedish-speaking parts of Finland. Of these children, 33 (9.7%) were defined as a Risk Group for LI, whereas 48 non-risk children were randomly selected to form a control group. When subdividing the children according to home language, 35 were found to be monolingual, Swedish-speaking, and 46 were Swedish-Finnish bilingual. The children underwent neuropsychological assessment during their preschool year. Assessment methods included subtests from the Wechsler Primary and Preschool Scale of Intelligence - Revised and the NEPSY Developmental Neuropsychological Assessment. A repeated-measures multiple analysis of covariance (MANCOVA) showed a significant effect of risk of LI on the NEPSY language scores. The effect of home language was not significant and there was no interaction between home language and risk for LI. Non-verbal IQ was controlled for. Across groups, bilingual children scored lower than monolingual children only on measures of vocabulary and sentence repetition. Although a slight general cost of bilingualism was found in the language profile of the six-year olds in this study, a bilingual background was not associated with more severe language problems in the LI Risk Group. Thus, there would seem to be no need to shield language-impaired children from opportunities for dual language learning.

Early Language Delay and Risk for Language Impairment

AbstractClinicians are often faced with the difficult task of deciding whether a late talker shows normal variability or has a clinically significant language disorder. This article provides an overview of research investigating identification, characteristics, outcomes, and predictors of late talkers. Clinical implications for speech-language pathologists in the identification and treatment of children who are late talkers are discussed.

Early cognitive and language skills are linked to resting frontal gamma power across the first 3 years

High-frequency cortical activity in humans and animals has been linked to a wide variety of higher cognitive processes. This research suggests that specific changes in neuronal synchrony occur during cognitive processing, distinguished by emergence of fast oscillations in the gamma frequency range. To determine whether the development of high-frequency brain oscillations can be related to the development of cognitive abilities, we studied the power spectra of resting EEG in children 16, 24 and 36 months of age. Individual differences in the distribution of frontal gamma power during rest were highly correlated with concurrent language and cognitive skills at all ages. Gamma power was also associated with attention measures; children who were observed as having better inhibitory control and more mature attention shifting abilities had higher gamma power density functions. We included a group of children with a family history of language impairment (FH+) and thus at higher risk for language disorders. FH+ children, as a group, showed consistently lower gamma over frontal regions than the well-matched FH− controls with no such family history (FH−). We suggest that the emergence of high-frequency neural synchrony may be critical for cognitive and linguistic development, and that children at risk for language impairments may lag in this process.

Models and determinants of vocabulary growth from kindergarten to adulthood

Increasing evidence suggests that childhood language problems persist into early adulthood. Nevertheless, little is known about how individual and environmental characteristics influence the language growth of individuals identified with speech/language problems. Individual growth curve models were utilised to examine how speech/language impairment and environmental variables (socioeconomic status, family separation, and maternal factors) influence vocabulary development from age 5 to 25. Participants were taken from a community sample of children initially diagnosed with speech/language problems at age 5 and their sex- and age-matched controls. The language impaired group had significantly poorer receptive vocabulary than the speech impaired and control groups throughout the 20-year period. Family income was a significant predictor of vocabulary growth when considered separately, but ceased to be a predictor when language impairment status was taken into account. Maternal education and family separation were determinants of vocabulary at age 5, over and above language impairment status. Language impairment is a significant risk factor for vocabulary development from childhood to adulthood. Individuals with speech impairment were less impaired on receptive vocabulary than individuals with language impairment. Further investigation into maternal and familial risk factors may provide targets for early intervention with children at risk for language impairment.

Early Communication Skills; Important in Screening for Language Impairment and Neuropsychiatric Disorders

Communication skills during social interaction at 18 months age, such as comprehension of instructions and play behaviour, have been shown to predict the results on language tests three years later. Accordingly, children with weak communication skills are at risk for persistent problems of language and communication. Problems of communication in social interaction are also common in children with neuropsychiatric disorders, such as ADHD (attention deficit hyperactivity disorder) and ASD (autism spectrum disorder). For different reasons, it is important to identify children who are at risk for language impairment and neuropsychiatric disorders at as an early age as possible. First, early identification allows early intervention, which may increase the chances of a positive outcome for the child. Second, early identification may decrease the risk of secondary problems with behaviour, and social and emotional wellbeing, which are frequently occurring in children with neuropsychiatric disorders. This paper is an overview of the literature focusing on the importance of early communication skills, i.e. language use in a social interaction context. Conclusion: Early communication skills in social interaction are a possible predictor of language impairment and neuropsychiatric disorders, and should therefore be included in early screening procedures. Furthermore, social interaction enhances language development, and can therefore be regarded as a tool in language intervention. Keywords: Social interaction, communication skills, language development, early screening, prediction, language impairment, neuropsychiatric disorders, intervention

First steps toward developing tools for language assessment in multilingual urban pre-schoolers

The development of language and communication skills in young children is directly related to future academic success. Young children who are at risk for language impairment should, therefore, be identified as early as possible. Multilingualism, which has become a universal phenomenon, may mask the presence of language impairment. In South African urban multilingual pre-school contexts, the teacher or speech-language therapist is not always proficient in the young multilingual learner's primary language. Assessment of learners' language behaviour is usually conducted in English, which is generally the language of mutual understanding. The aim of this study was to determine the feasibility of constructing a profile of typical English language behaviours for pre-school (English Additional Language) EAL learners in a circumscribed urban area. The profile is intended to provide speech-language therapists and pre-school teachers in collaborative practice with a dual-purpose tool: (i) an instrument for identifying those learners who are at risk for language impairment/language learning disabilities, and (ii) a means of obtaining guidelines for the development of an appropriate programme for facilitating language development. The results show that it was possible to construct a profile of typical English language behaviours for nine aspects of language form, one aspect of language content, and six aspects of language use.

Distinct genetic influences on grammar and phonological short‐term memory deficits: evidence from 6‐year‐old twins

Children with language impairments have limitations of phonological short-term memory (STM) and have distinctive problems with certain aspects of grammar. Both deficits have been proposed as phenotypic markers of heritable language impairment. We studied 173 twin pairs, selected to be over-representative of children with risk of developmental language impairment, using a battery of standardized language and intelligence tests, a test of nonword repetition to index phonological STM and two elicitation tasks to assess use of verb tense marking. As predicted, the phonological STM and the verb tense measures both discriminated children with risk of language impairment from low risk children, and DeFries-Fulker analysis showed that impairments on both tasks were significantly heritable. However, there was minimal phenotypic and etiological overlap between the two deficits, suggesting that different genes are implicated in causing these two kinds of language difficulty. From an evolutionary perspective, these data are consistent with the view that language is a complex function that depends on multiple underlying skills with distinct genetic origins.