Standardized Language Measures Research Articles

Vocabulary and expressive morpho-syntax in individuals with Down syndrome: Links to narration

BackgroundNarrative ability is crucial for social participation in everyday and school life but involves different language abilities such as vocabulary and morpho-syntax. This is particularly difficult for individuals who display both language and cognitive impairments. Previous research has identified productive vocabulary as a possible key factor for narrative performance in individuals with Down syndrome. Considering a close connection between lexical and morpho-syntactic performance within language acquisition and the distinct impairments that individuals with Down syndrome display concerning their morpho-syntactic skills, the nature of a relation between vocabulary and narrative skills under the influence of grammatical deficits requires further investigation. MethodsNarrations were obtained from 28 children and adolescents with Down syndrome (aged 10;0–20;1) using a non-verbal picture book. Narrative abilities were rated using the Narrative Scoring Scheme across seven narrative aspects (including macro- and microstructure). Vocabulary analyses and morpho-lexical context analyses including verb and conjunction enumerations, evaluation of verb position and MLU were conducted. Findings from the transcript analysis have been supplemented with data from standardized language measures evaluating expressive lexical and morpho-syntactic development. A multiple regression analysis was conducted to identify significant predictors for narrative outcome in the participants with Down syndrome. ResultsLexical analyses revealed a high heterogeneity in production of subordinating conjunctions as a link between lexical and morpho-syntactic abilities. Comparisons of standardized and narrative data demonstrated differences in subordinate clause production depending on the elicitation setting. A multiple regression analysis identified the number of different verbs in the narrative task as the most significant predictor for narrative performance in individuals with Down syndrome. Discussion and implicationsThe findings of this study contribute to the knowledge regarding factors that influence narrative performance in individuals with language impairment. A differentiated verb lexicon can be identified as the key ability for reaching advanced narrative skills in participants with Down syndrome. These findings are of clinical relevance for therapeutic and educational support and contribute to an understanding of the relation between strengths in vocabulary and morpho-syntactic weaknesses in individuals with Down syndrome within communicative participation.

Reading Instruction for Students with Autism Spectrum Disorder: Comparing Observations of Instruction to Student Reading Profiles

AbstractDespite a marked increase in the volume of research investigating issues about reading interventions for students with ASD (e.g., Bailey and Arciuli, Rev J Autism Dev Disord 7(2):127–150, 2020; Chiang and Lin, Focus Autism Other Dev Disab 22(4):259–267, 2007), very few studies have examined the current reading practices experienced by children with ASD in the schools. This mixed-method study reports on the observed reading instruction and reading performance of students (N = 39) with autism spectrum disorder (ASD) in grades 4–8 (ages 9–14 years.) across two separate geographic regions of the USA. Data collection included systematic observations of tier 1 and tier 2/3 reading instruction. Students were also assessed with standardized measures of word recognition, language, and reading comprehension. The purpose of this investigation was to contribute to the limited corpus of observation research on reading instruction for students with ASD within the context of describing student performance on battery of standardized measures. A total of 168 lesson sessions totaling 7497 min of observed class time were completed and the battery of measures were administered to students. Results of the observations indicated that 44–48% of instructional time across different tiers of instruction were dedicated to comprehension monitoring consisting of answering teacher directed questions. Minimal amounts of time were dedicated to word recognition instruction. According to findings from the assessment battery, approximately 46% of students had below average scores on word recognition and reading comprehension measures. Study findings suggest a mismatch between student needs and the manner in which they were addressed.

A Feasibility Study in Virtual Assessment Procedures of a Sentence-Writing Probe for Use With Intermediate-Grade Students

This article reports on the development and initial feasibility of virtual assessment procedures for a sentence-writing probe for remote instructional purposes with intermediate-grade students. The study included a sample of 15 intermediate-grade children. The sentence-writing probe was administered through video conferencing software, an innovation of the times, across three sessions separated by 2 weeks. Scores derived from sentence probes included total number of words, a sentence accuracy score, and a word accuracy score, which were compared across time points. Results indicated no statistically significant differences across time points for the entire sample for all measures except the total number of words at Time 2. Measures obtained from the sentence-writing probe were significantly correlated with standardized measures of oral language. Findings from this study support the proof of concept that virtual assessment procedures can be used to assess sentence-level writing in intermediate-grade students. Future directions are provided regarding the utility of remote instruction for assessment purposes, the types of scores derived from measures, and future plans to scale up the assessment for use in research studies and as a curriculum-based evaluation tool.

Associations between rapid auditory processing of speech sounds and specific verbal communication skills in autism.

The ability to rapidly process speech sounds is integral not only for processing other's speech, but also for auditory processing of one's own speech, which allows for maintenance of speech accuracy. Deficits in rapid auditory processing have been demonstrated in autistic individuals, particularly those with language impairment. We examined rapid auditory processing for speech sounds in relation to performance on a battery of verbal communication measures to determine which aspects of verbal communication were associated with cortical auditory processing in a sample of individuals with autism. Participants were 57 children and adolescents (40 male and 17 female) ages 5-18 who were diagnosed with an Autism Spectrum Disorder (ASD). Rapid auditory processing of speech sounds was measured via a magnetoencephalographic (MEG) index of the quality of the auditory evoked response to the second of two differing speech sounds ("Ga" / "Da") presented in rapid succession. Verbal communication abilities were assessed on standardized clinical measures of overall expressive and receptive language, vocabulary, articulation, and phonological processing. Associations between cortical measures of left- and right-hemisphere rapid auditory processing and verbal communication measures were examined. Rapid auditory processing of speech sounds was significantly associated with speech articulation bilaterally (r = 0.463, p = 0.001 for left hemisphere and r = 0.328, p = 0.020 for right hemisphere). In addition, rapid auditory processing in the left hemisphere was significantly associated with overall expressive language abilities (r = 0.354, p = 0.013); expressive (r = 0.384, p = 0.005) vocabulary; and phonological memory (r = 0.325, p = 0.024). Phonological memory was found to mediate the relationship between rapid cortical processing and receptive language. These results demonstrate that impaired rapid auditory processing for speech sounds is associated with dysfunction in verbal communication in ASD. The data also indicate that intact rapid auditory processing may be necessary for even basic communication skills that support speech production, such as phonological memory and articulatory control.

The Language Environment at Home of Children With (a Suspicion of) a Developmental Language Disorder and Relations With Standardized Language Measures.

This study compares the home language environments of children with (a suspicion of) developmental language disorder (DLD) with that of children with typical development (TD). It does so by adopting new technology that automatically provides metrics about children's language environment (Language ENvironment Analysis [LENA]). In addition, relationships between LENA metrics and standardized language tests are explored in the DLD group. Ninety-nine 2- to 4-year-old toddlers participated: 59 with (a suspicion of) DLD and 40 with TD. LENA metrics on adult word count, conversational turn count, and child vocalization count were obtained. For all children, data on parental education and multilingualism were available. In the DLD group, data were collected on receptive and expressive vocabulary and grammar, and on nonverbal intelligence, using standardized tests. We found lower adult word count, conversational turn count, and child vocalization count in the DLD group, independent of multilingualism but not of parental education. In the DLD group, receptive vocabulary was related to conversational turn count and child vocalization count, but not to adult word count. Expressive vocabulary, receptive grammar, and expressive grammar were not related to LENA metrics. Toddlers with (a suspicion of) DLD vocalize less at home than children with TD. They also hear fewer adult words and experience fewer conversational turns. Children with DLD's language outcomes are to a limited extent related to language environment at home. Conversational turns and child vocalizations are in this respect more important than adult words, in line with findings for TD populations.

Standardized Measures Used Regularly by Speech-Language Pathologists when Assessing the Language Abilities of School-Aged Children: A Survey

Introduction: This study examined speech-language pathologist (SLP)'s use of standardized language measures when assessing school-aged children. Method: A total of 335 SLPs provided information in a web-based survey regarding the standardized language measures they use for school-aged children. SLPs were asked to identify the domains targeted, purposes of use, and reasons for which regularly used standardized measures were chosen for use. Results: Findings indicated that SLPs collectively use many standardized measures, although only a small number are used regularly. SLPs reported using standardized measures to assess domains that measures are not ideally designed for and for purposes that the measures are not ideally suited to assessing. SLPs reported selecting diagnostic measures based on psychometric properties but not for screening measures. Reasons for choice varied depending on the particular measure. Conclusion: Overall, findings indicated that SLPs need to place greater focus on evidence-based practice recommendations when selecting standardized measures for use with school-aged children. Implications for clinical practice and future directions are discussed.

Preliminary data on the development of emotion vocabulary in typically developing children (5-13 years) using an experimental psycholinguistic measure.

Vocabulary of emotion is integral to emotional development and emotional intelligence is associated with improved mental health outcomes. Many language disordered groups experience emotional difficulties; Developmental Language Disorders, Attention Deficit Hyperactivity Disorder and autism. However, (as in the case of autism) research tends to focus on assessing recognition of emotional states, rather than exploring labeling skills. Where labeling is assessed, measures have focused on early-acquired vocabulary (happy, sad, angry) or self/parent reporting. To date, no objective assessment has been made of vocabulary of emotion across childhood. This study uses an experimental psycholinguistic measure, The Emotion Vocabulary: Expressive and Receptive ability measure (EVER) which includes two tasks (receptive vocabulary and word generation/expressive vocabulary). This measure has capacity to demonstrate vocabulary growth across age groups. 171 participants (5.0-13.11 years) completed The EVER Measure, alongside two closely matched standardized measures of basic language: BPVS (receptive vocabulary task) and CELF (word-association task). Assessments were completed online and en vivo (COVID testing restrictions dependent). As predicted, children's accuracy increased on both receptive and expressive emotion vocabulary tasks, in line with age at time of testing. EVER scores were significantly predicted by age and correlated with matched basic language scores. Secondary analysis provided preliminary findings on age of acquisition for specific emotion vocabulary items. The findings consequently demonstrate proof of concept for the use of The EVER Measure in assessing emotional vocabulary across childhood. This study provides important preliminary data on generating and recognizing emotion labels across typical child development. Critically, it extends current knowledge on emotion vocabulary acquisition into middle childhood, where linguistic ability is relatively mature. As such, findings have implications for research with potential clinical application in the assessment of older children, with either language or emotional differences or both. Findings demonstrate the need for a standardized tool, and its potential application in research and clinical practice is explored. A large-scale study offering proof of concept and reliability of The EVER Measure is indicated.

Effectiveness of Constraint-Induced Language Therapy for Aphasia: Evidence From Systematic Reviews and Meta-Analyses.

Constraint-induced language therapy (CILT) is an aphasia treatment that incorporates neuroplasticity principles of forced verbal use and high-intensity training to facilitate language recovery in individuals with stroke-induced aphasia (Pulvermüller et al., 2001). The burgeoning CILT literature has led to systematic reviews (SRs) that summarize treatment results. In this project, we appraised the quality and examined findings reported in several SRs to draw conclusions about the effectiveness of CILT. We searched multiple databases for SRs that summarized CILT research for poststroke aphasia. We identified six SRs, among which three summarized findings qualitatively and three included meta-analysis (MA) to quantify results. We rated each SR for methodologic quality using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR 2; Shea et al., 2017) and extracted findings across the six SRs. Two reviewers reliably applied the AMSTAR 2 to the six SRs. Although the six SRs generally were conducted with satisfactory rigor, each was lacking two or more critical domains. Descriptive summaries in SRs reported positive effects of CILT for language and communication measures. However, the three MAs showed that effects of CILT often did not surpass those of comparison treatments for naming, comprehension, and repetition measures. MA findings were positive in a review that included all research designs and evaluated treatment effects for trained naming items. Generalized CILT effects for standardized language measures were limited in two other MAs. CILT led to improvements in a variety of language and communication measures. When compared with intensive multimodality treatments, CILT effects were similar, suggesting that training intensity may be the potent factor in CILT outcomes. Future SRs should be implemented with increased rigor across quality rating scale domains to increase confidence in conclusions.

Constraint-Induced Language Therapy for Aphasia: Evidence from Systematic Reviews and Meta-Analyses

<h3>Objective(s)</h3> Constraint induced language therapy (CILT) is an aphasia treatment that incorporates use-dependent principles to facilitate language recovery in stroke-induced aphasia (Pulvermuller et al., 2001). Several systematic reviews (SR) have been conducted to summarize the growing CILT literature. The purpose of this project was to appraise the quality and examine the weight of treatment evidence reported in CILT SRs. <h3>Data Sources</h3> PsychInfo, PubMed, SpeechBite, ASHA Compendium of Systematic Reviews. <h3>Study Selection</h3> We identified six SRs that examined CILT for post-stroke aphasia in the English literature, three that included meta-analysis (MA). <h3>Data Extraction</h3> Two reviewers rated each SR for methodologic quality using the AMSTAR2 (Shea et al., 2017) and extracted findings across the six reviews. Coding reliability for the AMSTAR2 showed 94.8% agreement. <h3>Data Synthesis</h3> The quality of SRs varied on the AMSTAR2 scale (range 1.5-9.5, mean 7/16). Five SRs addressed more than half of the appraisal criteria. The number of original studies included in the SRs ranged from 5 to 24, as some reviews included only RCTs and others included all designs. CILT SRs that included all designs reported positive CILT outcomes, particularly for trained naming stimuli. Two MAs that analyzed RCTs reported limited positive outcomes for standardized language measures. <h3>Conclusions</h3> Conclusions varied as descriptive SR summaries reported positive effects of CILT studies, yet MA showed that effects often did not surpass comparison treatments for naming, comprehension, and repetition. Early enthusiasm has given way to measured caution in recent MAs that have summarized CILT outcomes relative to control treatments of similar intensity, suggesting that the intensity effect may be the more potent factor than verbal constraint in the reported CILT results. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to report.

Say that again: Quantifying patterns of production for children with autism using recurrence analysis.

The current research study characterized syntactic productivity across a range of 5-year-old children with autism and explored the degree to which this productivity was associated with standardized measures of language and autism symptomatology. Natural language samples were transcribed from play-based interactions between a clinician and participants with an autism diagnosis. Speech samples were parsed for grammatical morphemes and were used to generate measures of MLU and total number of utterances. We applied categorical recurrence quantification analysis, a technique used to quantify patterns of repetition in behaviors, to the children's noun-related and verb-related speech. Recurrence metrics captured the degree to which children repeated specific lexical/grammatical units (i.e., recurrence rate) and the degree to which children repeated combinations of lexical/grammatical units (i.e., percent determinism). Findings indicated that beyond capturing patterns shown in traditional linguistic analysis, recurrence can reveal differences in the speech productions of children with autism spectrum disorder at the lexical and grammatical levels. We also found that the degree of repeating noun-related units and grammatical units was related to MLU and ADOS Severity Score, while the degree of repeating unit combinations (e.g., saying "the big fluffy dog" or the determiner-adjective-adjective-noun construction multiple times), in general, was only related to MLU.

Predicting Language in Children with ASD Using Spontaneous Language Samples and Standardized Measures.

This longitudinal study examined the degree to which standardized measures of language and natural language samples predicted later language usage in a heterogeneous sample of children with autism spectrum disorder (ASD), and how this relationship is impacted by ASD severity and interventions. Participants with a diagnosis of ASD (N = 54, 41 males) completed standardized assessments of language and social functioning; natural language samples were transcribed from play-based interactions. Findings indicated that standardized language measures, natural language measures, and ADOS severity were each unique predictors of later lexical use. Intervention types also appeared to impact later language; in particular, participation in mainstream inclusion accounted for significant amounts of variance in children's mean length of utterance at T3.

The relationships between language, working memory and rapid naming in children with mild to moderate hearing loss

ObjectiveHearing loss is associated with reduced quality and quantity of auditory input, and difficulty in cognitive and language skills. This study aimed to investigate the relationship between language, working memory, and rapid naming skills in children with mild to moderate sensorineural hearing loss (MMHL). MethodsTwenty children with MMHL with the same auditory experience and demographical conditions using bilateral hearing aids were included. Verbal memory subscale of the Working Memory Scale (WMS), consisting of verbal short-term memory (V-STM) and verbal working memory (V-WM) subtests, was administered to all participants. They also completed rapid automatized naming tasks and standardized language measures. ResultsThe language score showed a moderate and significant correlation with verbal memory (VM) score (p = 0.03, r = 0.48) and a moderate and negative correlation with rapid automatized naming (RAN) duration (p = 0.06, r = −0.61). The VM score showed a moderate and significant negative correlation with RAN duration (p = 0.01, r = −0.67). The language level has a strong and significant positive correlation with V-STM (p = 0.007, r = 0.60), V-WM (p = 0.009, r = 0.58), and VM level (p = 0.003, r = 0.65). VM subtests levels have a strong and significant positive correlation with each other (p = 0.017, r = 0.53). RAN level has a strong and significant negative correlation with VM (p = 0.001, r = −0.70), V-WM (p = 0.001, r = −0.76), V-STM (p = 0.001, r = −0.69), and language level (p = 0.001, r = −0.77). ConclusionThe results suggest that the language, verbal working memory, and rapid naming skills of children with MMHL are closely related. It is recommended that the relationship between verbal short-term memory, verbal working memory, rapid naming skills, and language skills should be considered in therapeutic and educational settings. To the best of our knowledge, this is the first study to examine the relationships between verbal-short-term -working memory, duration of rapid automatized naming, and language skills in children with MMHL.

Sources of variability in the prospective relation of language to social, emotional, and behavior problem symptoms: Implications for developmental language disorder.

Children with developmental language disorder (DLD) are at risk for social, emotional, and behavioral (SEB) maladjustment throughout development, though it is unclear if poor language proficiency per se can account for this risk as associations between language and SEB appear more variable among typical-language children. This study investigated whether the relationship between language and SEB problems is stronger at very low levels of language and considered confounders including socioeconomic status, sex, and nonverbal intelligence. These were examined using a population-based survey design, including children with a wide range of language and cognitive profiles, and assessed using the Strengths and Difficulties Questionnaire and six standardized language measures (n = 363, weighted n = 6,451). Structural equation models adjusted for prior levels of SEB revealed that the relationship of language at age 5–6 years to SEB at 7–9 years was nonlinear. Language more strongly predicted all clusters of SEB at disordered language levels relative to typical language levels, with standardized betas of −.25 versus .03 for behavioral, −.31 versus −.04 for peer, and .27 versus .03 for prosocial problems. Wald tests between these pairs of betas yielded p values from .049 to .014. Sex moderated the nonlinear association between language and emotional symptoms. These findings indicate a clinical need to support language development in order to mitigate against problems of SEB and to carefully monitor the mental health needs of children with DLD, particularly in the context of multiple, and potentially sex-specific, risks.

Parental Reports of Preschoolers' Lexical and Syntactic Development: Validation of the CDI-III for European Portuguese.

This study presents the validation analysis of the European Portuguese version of the MacArthur-Bates Communicative Development Inventory III (CDI-III-PT). The CDI-III-PT is a parental report measure allowing researchers to assess expressive vocabulary and the syntactic abilities of children aged 2;6–4;0. In this study, we present a version comprising a lexical subscale which follows the Swedish adaptation and an original syntactic subscale allowing us to include language-specific structures. The reports of 739 children were collected; in addition, a standardized measure of language was also administered to a sub-sample of these children and the reports of preschool teachers were collected for another sub-sample. The results indicate a high internal consistency of the lexical and syntactic subscales. As for sociodemographic variables often found to be predictors of language development, as measured by this type of instrument, the results indicate that age and maternal education are significant predictors of the scores, and that first-born children attain higher scores in vocabulary than later born children, but no significant gender differences were found. The scores of the CDI-III-PT are positively correlated with the ones obtained in the standardized language measure, thus supporting their validity. A high agreement between the reports of parents and teachers was also found. These findings indicate that the CDI-III-PT has adequate psychometric properties and that it can be a useful tool for research and clinical practice. The age-based norms that are now provided can be used to evaluate whether a child is performing poorly compared to their peers.

Home literacy practices that support language and literacy development in bilingual children: a longitudinal case study

ABSTRACT In the past few decades, literature has consistently suggested that bilingual children are at risk for academic failure due to their limited language skills. However, many of these studies included underprivileged bilingual children, and few of them attempted to disentangle the effects of bilingualism from the effects of socio-economic status. Critically, it is not clear how the language and literacy skills of bilingual children develop when they benefit from home support. This paper presents the case study of a child who emigrated from Romania to the United States at the age of 4.8 and enrolled in preschool with no prior knowledge of English. With support from his family, by the end of the 4th grade, his English vocabulary was 2.5 standard deviations above national norms (11th grade level equivalent), and all other standardized language and reading comprehension measures placed him between the 82nd and the 99th percentile. This study suggests that the socio-economic status (in general) and the home language and literacy environment (in particular) has the potential to play an important role in the language and literacy development of bilingual children.

Non-linguistic cognitive measures as predictors of functionally defined developmental language disorder in monolingual and bilingual children.

Given that standardized language measures alone are inadequate for identifying functionally defined developmental language disorder (fDLD), this study investigated whether non-linguistic cognitive abilities (procedural learning, motor functions, executive attention, processing speed) can increase the prediction accuracy of fDLD in children in linguistically diverse settings. We examined non-linguistic cognitive abilities in mono- and bilingual school-aged children (ages 8-12) with and without fDLD. Typically developing (TD) children (14 monolinguals, 12 bilinguals) and children with fDLD (28 monolinguals, 12 bilinguals) completed tasks measuring motor functions, procedural learning, executive attention and processing speed. Children were assigned as fDLD based on parental or professional concerns regarding children's daily language functioning. If no concerns were present, children were assigned as TD. Standardized English scores, non-verbal IQ scores and years of maternal education were also obtained. Likelihood ratios were used to examine how well each measure separated the fDLD versus TD groups. A binary logistic regression was used to test whether combined measures enhanced the prediction of identifying fDLD status. A combination of linguistic and non-linguistic measures provided the best distinction between fDLD and TD for both mono- and bilingual groups. For monolingual children, the combined measures include English language scores, functional motor abilities and processing speed, whereas for bilinguals, the combined measures include English language scores and procedural learning. A combination of non-linguistic and linguistic measures significantly improved the distinction between fDLD and TD for both mono- and bilingual groups. This study supports the possibility of using non-linguistic cognitive measures to identify fDLD in linguistically diverse settings. What is already known on the subject Given that standardized English language measures may fail to identify functional language disorder, we examined whether supplementing English language measures with non-linguistic cognitive tasks could resolve the problem. Our study is based on the hypothesis that non-linguistic cognitive abilities contribute to language processing and learning. This is further supported by previous findings that children with language disorder exhibit non-linguistic cognitive deficits. What this paper adds to existing knowledge The results indicated that a combination of linguistic and non-linguistic cognitive abilities increased the prediction of functional language disorder in both mono- and bilingual children. What are the potential or actual clinical implications of this work? This study supports the possibility of using non-linguistic cognitive measures to identify the risk of language disorder in linguistically diverse settings.

Measuring social-communication difficulties in school-age siblings of children with autism spectrum disorder: Standardized versus naturalistic assessment.

Younger siblings of children with autism spectrum disorder (ASD; high-risk siblings) are at elevated risk for developing the broader autism phenotype (BAP), which consists of subclinical features of ASD. We examined conversational skills in a naturalistic context and standardized assessments of pragmatic language and communication skills in high-risk and low-risk school-age children with BAP (n=22) and ASD (n=18) outcomes, as well as comparison children without ASD or BAP (n=135). Children with BAP characteristics exhibited lower conversational skills than comparison children, but did not differ on any of three standardized measures. Only the conversational ratings significantly predicted membership in the BAP versus Comparison group. This suggests that naturalistic tasks are crucial when assessing social-communication difficulties in children with a family history of ASD. LAY SUMMARY: The broader autism phenotype (BAP) consists of subclinical features of autism spectrum disorder (ASD) and is more common among family members of those with ASD. School-age children with BAP characteristics exhibited lower conversational skills than comparison children, but did not differ on standardized language measures tapping similar abilities. This suggests that naturalistic tasks may be more sensitive to the social-communication difficulties seen in some children with a family history of ASD than the standardized language tests used in most evaluations.

Literacy-related skills among children after left or right hemispherectomy

ObjectiveFollowing hemispherectomy surgery, children’s educational outcomes are of great importance but are understudied. The study goal was to investigate reading, language, and nonverbal cognitive skills in children obligatorily relying on a left versus right hemisphere using a cross-sectional design. MethodsParticipants (ages 6–18) who had undergone left hemispherectomy (LH; n = 10) or right hemispherectomy (RH; n = 14) completed standardized measures of reading, language, and nonverbal cognition. ResultsLH and RH groups were balanced for socioeconomic status, sex, and age. Both groups scored below the population mean across standardized measures (RH: −0.79 to −1.95 SDs; LH: −0.97 to −2.32 SDs). Compared to the LH group, the group retaining a functional left hemisphere (RH group) learned to read sooner (p = .011) despite no significant differences for surgery age, and scored higher on untimed real word and pseudoword reading measures (p < .05). Effect sizes were medium (r = 0.34–0.46) for the LH and RH comparison on measures of phonological awareness and both untimed and timed word and pseudoword reading. In examining the association between clinical variables and reading-related outcomes, younger age of post-hemispherectomy reading acquisition and shorter duration between seizure onset and hemispherectomy surgery were associated with higher standardized reading and language test scores (p < .05). SignificanceInvestigations of psychoeducational skills in reading, language, and nonverbal cognition among children who have undergone hemispherectomy can offer important insights into compensatory potential for left and right hemispheres as well as inform educational programming for children following medical stabilization.

Processing of Code-Switched Sentences in Noise by Bilingual Children

Purpose The purpose of the current study was to examine the effects of code-switching on bilingual children's online processing and offline comprehension of sentences in the presence of noise. In addition, the study examined individual differences in language ability and cognitive control skills as moderators of children's ability to process code-switched sentences in noise. Method The participants were 50 Spanish-English bilingual children, ages 7;0-11;8 (years;months). Children completed an auditory moving window task to examine whether they processed sentences with code-switching more slowly and less accurately than single-language sentences in the presence of noise. They completed the Dimensional Change Card Sort task to index cognitive control and standardized language measures in English and Spanish to index relative language dominance and overall language ability. Results Children were significantly less accurate in answering offline comprehension questions about code-switched sentences presented in noise compared to single-language sentences, especially for their dominant language. They also tended to exhibit slower processing speed, but costs did not reach significance. Language ability had an overall effect on offline comprehension but did not moderate the effects of code-switching. Cognitive control moderated the extent to which offline comprehension costs were affected by language dominance. Conclusions The findings of the current study suggest that code-switching, especially in the presence of background noise, may place additional demands on children's ability to comprehend sentences. However, it may be the processing of the nondominant language, rather than code-switching per se, that is especially difficult in the presence of noise.

Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial.

Transcranial direct current stimulation (tDCS) may enhance speech and language treatment (SLT) for stroke survivors with aphasia; however, to date, there is no standard protocol for the application of tDCS in post-stroke aphasia. We explored the safety and efficacy of fMRI-guided tDCS on functional language and cortical activity when delivered to the lesioned left hemisphere concurrently with SLT across an extended, six-week treatment period. Twelve persons with chronic, nonfluent aphasia following a single left-hemisphere stroke participated in the three-arm (anodal vs. cathodal vs. sham) single-blind, parallel, pilot trial. No serious adverse events occurred during 30 treatment sessions or in the following six weeks. All groups demonstrated functional language gains following intensive treatment; however, active tDCS resulted in greater gains in standardized, probe, and caregiver-reported measures of functional language than sham. Evidence declaring one polarity as superior for inducing language recovery was mixed. However, cathodal stimulation to the lesioned left hemisphere, expected to have a down-regulating effect, resulted in increased areas of cortical activation across both hemispheres, and specifically perilesionally. Generalization of these preliminary findings is limited; however, results are nevertheless compelling that tDCS combined with SLT can be safely applied across extended durations, with the potential to enhance functional language and cortical activation for persons with aphasia.