Standardized Language Measures Research Articles

Exploring writing products in students with language impairments and autism spectrum disorders

Oral language skills scaffold written text production; students with oral language difficulties often experience writing problems. The current study examines the ways in which oral language problems experienced by students with language impairment (LI) and students with autism spectrum disorders (ASD) impact on their production of written text. One hundred and fifty seven participants (Mage = 10;2) with LI or ASD completed standardized measures of oral language, transcription, working memory, and nonverbal ability and produced a written narrative text assessed for productivity, grammatical accuracy, and quality. Measures of transcription, productivity, and grammatical accuracy, but not text quality, were poorer for students with LI. Transcription skills accounted for the majority of variance in the writing of the LI cohort. For the ASD cohort, handwriting, oral language and autism symptomatology were significant predictors. When students with ASD also experienced language problems, their performance was equivalent to that observed in the LI cohort.

Speech and Language Outcomes of Cochlear Implantation in Children With Isolated Auditory Neuropathy Versus Cochlear Hearing Loss

Children with auditory neuropathy (AN) have variable hearing on pure tone testing, and the presence of speech and language delays often play a major role in the decision to offer cochlear implantation (CI) in this population. Despite this fact, the speech and language outcomes in this group after CI are not well described. This study compares speech and language outcomes after CI in a subset of the pediatric AN population that does not have a confounding cognitive disorder with those of their peers with cochlear hearing loss (CoHL). Retrospective chart review. Tertiary referral center. Seventeen pediatric patients with AN who received a CI and a group of children with CoHL who received a CI were the subjects of this study. The 2 groups demonstrated similar ages at implant. Children with cognitive delays were excluded from each group. Cochlear implantation. All subjects were evaluated preoperatively and postoperatively with standardized age appropriate speech and language measures, including the Expressive Vocabulary Test (EVT), Peabody Picture Vocabulary Test (PPVT), and Preschool Language Scale (PLS). There was no significant difference between the groups on age of activation of the CI. Children with a diagnosis of AN had a significantly lower unaided pure tone average preoperatively as compared with children with cochlear hearing loss; however, there was no significant difference between the groups on either their preimplantation or postimplantation speech and language scores. Children with a diagnosis of AN without associated cognitive or developmental disorders have speech and language outcomes comparable to other children who received a CI.

Spoken English Language Development Among Native Signing Children With Cochlear Implants

Bilingualism is common throughout the world, and bilingual children regularly develop into fluently bilingual adults. In contrast, children with cochlear implants (CIs) are frequently encouraged to focus on a spoken language to the exclusion of sign language. Here, we investigate the spoken English language skills of 5 children with CIs who also have deaf signing parents, and so receive exposure to a full natural sign language (American Sign Language, ASL) from birth, in addition to spoken English after implantation. We compare their language skills with hearing ASL/English bilingual children of deaf parents. Our results show comparable English scores for the CI and hearing groups on a variety of standardized language measures, exceeding previously reported scores for children with CIs with the same age of implantation and years of CI use. We conclude that natural sign language input does no harm and may mitigate negative effects of early auditory deprivation for spoken language development.

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia

Transcranial magnetic stimulation (TMS) has been shown to significantly improve language function in patients with non-fluent aphasia(1). In this experiment, we demonstrate the administration of low-frequency repetitive TMS (rTMS) to an optimal stimulation site in the right hemisphere in patients with chronic non-fluent aphasia. A battery of standardized language measures is administered in order to assess baseline performance. Patients are subsequently randomized to either receive real rTMS or initial sham stimulation. Patients in the real stimulation undergo a site-finding phase, comprised of a series of six rTMS sessions administered over five days; stimulation is delivered to a different site in the right frontal lobe during each of these sessions. Each site-finding session consists of 600 pulses of 1 Hz rTMS, preceded and followed by a picture-naming task. By comparing the degree of transient change in naming ability elicited by stimulation of candidate sites, we are able to locate the area of optimal response for each individual patient. We then administer rTMS to this site during the treatment phase. During treatment, patients undergo a total of ten days of stimulation over the span of two weeks; each session is comprised of 20 min of 1 Hz rTMS delivered at 90% resting motor threshold. Stimulation is paired with an fMRI-naming task on the first and last days of treatment. After the treatment phase is complete, the language battery obtained at baseline is repeated two and six months following stimulation in order to identify rTMS-induced changes in performance. The fMRI-naming task is also repeated two and six months following treatment. Patients who are randomized to the sham arm of the study undergo sham site-finding, sham treatment, fMRI-naming studies, and repeat language testing two months after completing sham treatment. Sham patients then cross over into the real stimulation arm, completing real site-finding, real treatment, fMRI, and two- and six-month post-stimulation language testing.

Acoustic and Semantic Enhancements for Children With Cochlear Implants

In this study, the authors examined how signal clarity interacts with the use of sentence context information in determining speech-in-noise recognition for children with cochlear implants and children with normal hearing. One hundred and twenty sentences in which the final word varied in predictability (high vs. low semantic context) were produced in conversational and clear speech. Nine children with cochlear implants and 9 children with normal hearing completed the sentence-in-noise listening tests and a standardized language measure. Word recognition in noise improved significantly for both groups of children for high-predictability sentences in clear speech. Children with normal hearing benefited more from each source of information compared with children with cochlear implants. There was a significant correlation between more developed language skills and the ability to use contextual enhancements. The smaller context gain in clear speech for children with cochlear implants is in accord with the effortfulness hypothesis (McCoy et al., 2005) and points to the cumulative effects of noise throughout the processing system. Modifications of the speech signal and the context of the utterances through changes in the talker output hold substantial promise as a communication enhancement technique for both children with cochlear implants and children with normal hearing.

Promotion of syntactical development and oral comprehension: Development and initial evaluation of a small-group intervention

This article reports on the development and preliminary implementation trials of a modular small-group intervention targeting syntax and vocabulary for children at high risk for reading comprehension difficulties in grades prekindergarten through first. The intervention, delivered by trained paraprofessionals, included 12 weeks of 20-minute lessons that included hands-on activities promoting receptive and expressive acquisition of grade-specific targeted syntax and semantic features such as prepositions, passive sentence structure, and adverbial clauses. Children ( n = 354) ranging in age from 40–101 months were screened for inclusion on several standardized language measures and those included in the intervention (64–68 per grade, scoring below the 30th percentile on several measures) were assessed on two proximal measures of intervention-linked syntax and listening-comprehension. Results from the repeated implementation trials in each grade indicate that the intervention shows substantial promise as a method of supporting syntax growth and ultimately improving comprehension skills in young children.

An Exploration of Imitation Recognition in Young Children With Autism Spectrum Disorders

The ability to recognize when one is being imitated has been hypothesized to be an important developmental process related to the emergence of more advanced social-cognitive skills. While a series of behaviors indicating progressively more mature imitation recognition (IR) skills has been assessed in typically developing children, empirical work with children with autism spectrum disorders (ASDs) has largely focused on basic social responses to an imitative adult (e.g. increases in eye contact). Limited work has explored more mature IR behaviors in this population. This study compared the degree to which children with ASD engage in different behaviors thought to be indicative of IR during a naturalistic imitation task and the relationship between different types of IR behaviors and social-cognitive skills (i.e. imitation, language, social reciprocity, and joint attention). Thirty children with ASD were administered standardized measures of cognitive level, language, joint attention, social reciprocity, and imitation. IR behaviors were observed during periods of contingent imitation by an adult. Participants engaged more frequently in less mature (e.g. looking at the experimenter's toy or face) than more mature IR behaviors (e.g. testing the experimenter's intent to imitate). After controlling for developmental level, social reciprocity, object imitation, and gesture imitation were positively correlated with more mature IR. These findings suggest that the development of more mature IR skills is related to the development of other social-cognitive skills in children with ASD and provide additional empirical support for reports of more mature IR observed in this population. , Inc.

Classification Accuracy of Nonword Repetition When Used With Preschool-Age Spanish-Speaking Children

The purpose of the present study was to (a) describe and compare the nonword repetition (NWR) performance of preschool-age Spanish-speaking children (3- to 5-year-olds) with and without language impairment (LI) across 2 scoring approaches and (b) to contrast the classification accuracy of a Spanish NWR task when item-level and percentage of phonemes correct (PPC) scoring methods are applied. Forty-four Spanish-speaking children participated. Twenty-one children had LI and 23 had typically developing (TD) language. Children were administered a Spanish NWR task and a standardized Spanish language measure. A developmental pattern in NWR performance was observed, and the children with LI had NWR scores that were significantly lower than those of the TD children. Whereas item-level scoring of NWR items indicated acceptable levels of sensitivity and specificity and suggested positive and negative likelihood ratios, PPC scoring of NWR items resulted in less than desirable levels of sensitivity and adequate specificity. Item-level scoring of 3- to 5-syllable Spanish NWR items may be useful as part of an assessment battery for preschool-age Spanish-speaking children.

Language Processing in Autism Spectrum Disorders: Insights from Neuroscience

Language is an area of difficulty even for verbal, high-functioning individuals with autism spectrum disorders (ASD). Behavioral measures have provided limited understanding of the bases for these differences, as verbal individuals with ASD frequently score within the average range on standardized language measures, even as they have difficulty with the comprehension and use of language in daily life. Positron emission tomography (PET) scanning has yielded some insight into the neurofunctional basis of linguistic processing in ASD but has limited application due to the need for intravenous injection of a chemical radiotracer. Functional magnetic resonance imaging (fMRI) is a noninvasive methodology that has provided an unprecedented opportunity to examine the underlying neural processing while an individual performs a cognitive task. FMRI studies have been completed with young children, adolescents, and adults with ASD using a variety of language tasks. These studies have revealed differences in the way individuals with ASD process language even without differences in behavioral performance. Although still preliminary, these results provide speech-language pathologists with valuable insight into the cognitive processing challenges associated with ASD that can inform the design of interventions to address the problems individuals with ASD have in the comprehension and production of language.

Non‐word repetition in adolescents with specific language impairment (SLI)

Non-word repetition (NWR) difficulties are common, but not universal, among children with specific language impairment (SLI). However, older children and adolescents with SLI have rarely been studied. Studies disagree on the relationship between NWR difficulties and difficulties with other areas of language and literacy. There is also no consensus about the underlying reason for the difficulties (some) children with SLI have with NWR. Some scholars argue that difficulties with phonological short-term memory or storage cause NWR and other language difficulties, whereas others argue that difficulties with NWR may be due more to difficulties with phonological representations. To investigate NWR abilities and their relationship to other language and literacy abilities in a group of older children with SLI and typically developing controls. To investigate the relative effects of increasing phonological complexity and the number of syllables on the ability of the participants to repeat non-words. An NWR test (The Test of Phonological Structure; TOPhS), which systematically varies phonological complexity, was administered to 15 participants with SLI (aged 11-15 years), 30 language and 15 age controls. Standardized language and literacy tests and a specific test of verb agreement and tense marking (Verb Agreement and Tense Test; VATT) were also administered. The participants with SLI showed a bimodal distribution: half achieved age-appropriate NWR, while half scored significantly below language and age controls (d > 7). The two groups of participants with SLI (high versus low scorers) only differed in NWR (d > 5) and agreement (d > 3) and tense marking (d > 2.5), not on the standardized language and literacy measures administered. NWR was also highly correlated with verb agreement (r= 0.97) and tense marking (r= 0.89) among participants with SLI, but not among controls (r= 0.16 and 0.30 respectively). Phonological complexity was related to NWR accuracy, particularly among participants with SLI. The number of syllables had no independent effect on NWR performance for any group. Some children with SLI (who have good NWR) have language difficulties unrelated to any of the factors underlying NWR. Others have a (probably additional) deficit which affects NWR and also leads to greater difficulties with verb agreement and tense marking. The results indicate that difficulties with this particular NWR test are more likely to be due to a deficit with phonology per se, rather than with phonological short-term memory or storage.

Components and Context

Drawing on the cognitive and ecological domains within the componential model of reading, this longitudinal study explores heterogeneity in the sources of reading difficulties for language minority learners and native English speakers in urban schools. Students (N = 150) were followed from first through third grade and assessed annually on standardized English language and reading measures. Structural equation modeling was used to investigate the relative contributions of code-related and linguistic comprehension skills in first and second grade to third grade reading comprehension. Linguistic comprehension and the interaction between linguistic comprehension and code-related skills each explained substantial variation in reading comprehension. Among students with low reading comprehension, more than 80% demonstrated weaknesses in linguistic comprehension alone, whereas approximately 15% demonstrated weaknesses in both linguistic comprehension and code-related skills. Results were remarkably similar for the language minority learners and native English speakers, suggesting the importance of their shared socioeconomic backgrounds and schooling contexts.

Profiles of receptive and expressive language abilities in boys with comorbid fragile X syndrome and autism.

Abstract The authors examined receptive and expressive language profiles for a group of verbal male children and adolescents who had fragile X syndrome along with varying degrees of autism symptoms. A categorical approach for assigning autism diagnostic classification, based on the combined use of the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule (ADOS), and a continuous approach for representing autism symptom severity, based on ADOS severity scores, were used in 2 separate sets of analyses. All analyses controlled for nonverbal IQ and chronological age. Nonverbal IQ accounted for significant variance in all language outcomes with large effect sizes. Results of the categorical analyses failed to reveal an effect of diagnostic group (fragile X syndrome-autism, fragile X syndrome-no autism) on standardized language test performance. Results of the continuous analyses revealed a negative relationship between autism symptom severity and all of the standardized language measures. Implications for representing autism symptoms in fragile X syndrome research are considered.

Influence of DFNB1 Status on Expressive Language in Deaf Children With Cochlear Implants

The objective of this study was to compare the language growth of children with connexin-related deafness (DFNB1) who received cochlear implants versus the language growth of implanted children with non-DFNB1 deafness. A prospective longitudinal observational study and analysis. Two tertiary referral centers. There were 37 children with severe-to-profound hearing loss who received cochlear implants before the age of 5 years. A standardized language measure, the section for expressive language of the Reynell Developmental Language Scale was used to assess expressive language skills at 2 times postimplantation (14 and 57 mo postimplantation). Molecular screening for DFNB1 gene variants. Language quotient (LQ) scores (i.e., age-equivalent score obtained on the Reynell Developmental Language Scale divided by the child's chronological age), results of genotyping. The mean language age at the second time interval (mean ± standard deviation, 51.8 ± 13 mo) was greater than at the first testing session (mean ± standard deviation, 19 ± 8 mo, p < 0.001, Wilcoxon signed rank test). When divided by genotype, DFNB1 children exhibited a higher LQ and less variability in scores than non-DFNB1 children at the second testing interval (Wilcoxon sign rank test, p = 0.0034). A regression analysis (linear-fit by least squares) conducted on 26 children with preimplantation audiometric data showed that DFNB1 status was the independent variable with greater predictive effect on LQ at the second testing interval, followed by age at implantation (R2 = 0.35, p = 0.0479). Deaf children who received cochlear implants before the age of 5 years and use oral communication show substantial improvement in language abilities. In this study, DFNB1 children who use cochlear implants show greater gains in expressive language than non-DFNB1 children, independent of residual hearing, age at implantation, and duration of implant use.

Evaluating Language Assessments with Members of the Travelling Community

Background and objective: The Irish Travelling Community is a cultural group using a unique dialect – Traveller English. It has been established that some standardized, norm-referenced language measures are biased against culturally and linguistically diverse populations. In this study, the achievement of Traveller children on standardized language measures and on processing-dependent measures is compared with achievement of children from the Settled community on the same measures. Method: Twenty children aged 6–10 years, 10 each from Travelling and Settled communities, were assessed using the CELF-3 UK, and two processing-dependent measures to assess aspects of language development. Results and conclusions: Results indicate that Traveller children scored significantly lower than Settled children on the standardized language measures. In contrast, the use of processing-dependent measures showed few inter-group differences. The recommendation is that processing-dependent measures be used in addition to standardized measures to increase the validity of language assessment of Traveller children.

Impact on Parents of Receiving Individualized Feedback of Psychological Testing Conducted with Children as Part of a Research Study

While many researchers accept the principle that participants have a right to receive information learned from their participation in research, there are few studies examining the impact of receiving results on participants. This study was developed to examine the impact on parents of the receipt of individual results of research-based psychological testing of their children. A summary of the child's individual results of standardized measures of language and development was sent by mail with the questionnaire designed to assess the impact of receiving results. Response rate from the mailed questionnaire was 55.6% (n = 74/133). Most parents reported the results as helpful and positive. The majority would receive results again. Overall, the sharing of individualized feedback from psychological testing conducted as part of a research study was well accepted by parents. This practice appears ethically permissible with appropriate support options for addressing participant concerns upon receiving the results as well options for clinical follow-up for the child.

Language abilities in children with autism and language impairment: using narrative as a additional source of clinical information

Autistic Spectrum Disorder (ASD) and Specific Language Impairment (SLI) are disorders of communication that are sometimes thought to show similar structural language difficulties. Recent research has even suggested that they might be aetiologically related. However, it may be that standardized language tasks are not sensitive enough to detect similarities and differences accurately. This study involved 26 Greek children with either ASD or SLI and compared them on standardized measures of structural and pragmatic language as well as using a structured narrative task. Children with ASD were more impaired on receptive but not expressive scores from standardized language tests. In contrast, narrative measures showed significantly poorer ASD performance in expressive skills involving wider story-telling skill and in some sentence-level skills, in particular referencing, compared to peers with SLI. ASD and SLI groups also showed different relationships between structural language and other measures. The data suggests that narrative is a useful tool for revealing qualitative differences in language between overlapping communication disorders both at the clinical and theoretical level, since it provides information that is lost in more formalized testing. This may be particularly true where norms are not available or testing is difficult.

Sensitivity and Specificity of French Language and Processing Measures for the Identification of Primary Language Impairment at Age 5

Research on the diagnostic accuracy of different language measures has focused primarily on English. This study examined the sensitivity and specificity of a range of measures of language knowledge and language processing for the identification of primary language impairment (PLI) in French-speaking children. Because of the lack of well-documented language measures in French, it is difficult to accurately identify affected children, and thus research in this area is impeded. The performance of 14 monolingual French-speaking children with confirmed, clinically identified PLI (M = 61.4 months of age, SD = 7.2 months) on a range of language and language processing measures was compared with the performance of 78 children with confirmed typical language development (M age = 58.9 months, SD = 5.7). These included evaluations of receptive vocabulary, receptive grammar, spontaneous language, narrative production, nonword repetition, sentence imitation, following directions, rapid automatized naming, and digit span. Sensitivity, specificity, and likelihood ratios were determined at 3 cutoff points: (a) -1 SD, (b) -1.28 SD, and (b) -2 SD below mean values. Receiver operator characteristic curves were used to identify the most accurate cutoff for each measure. Significant differences between the PLI and typical language development groups were found for the majority of the language measures, with moderate to large effect sizes. The measures differed in their sensitivity and specificity, as well as in which cutoff point provided the most accurate decision. Ideal cutoff points were in most cases between the mean and -1 SD. Sentence imitation and following directions appeared to be the most accurate measures. This study provides evidence that standardized measures of language and language processing provide accurate identification of PLI in French. The results are strikingly similar to previous results for English, suggesting that in spite of structural differences between the languages, PLI in both languages involves a generalized language delay across linguistic domains, which can be identified in a similar way using existing standardized measures.

Longitudinal development of phonology and morphology in children with late-identified mild-moderate sensorineural hearing loss.

Studies of language development in children with mild-moderate hearing loss are relatively rare. Longitudinal studies of children with late-identified hearing loss are relevant for determining how a period of unaided mild-moderate hearing loss impacts development. In recent years, newborn hearing screening programs have effectively reduced the ages of identification for most children with permanent hearing loss. However, some children continue to be identified late, and research is needed to guide management decisions. Furthermore, studies of this group may help to discern whether language normalizes after intervention and/or whether certain aspects of language might be vulnerable to persistent delays. The current study examines the impact of late identification and reduced audibility on speech and language outcomes via a longitudinal study of four children with mild-moderate sensorineural hearing loss. Longitudinal outcomes of four children with late-identified mild-moderate sensorineural hearing loss were studied using standardized measures and language sampling procedures from at or near the point of identification (28 to 41 mos) through 84 mos of age. The children with hearing loss were compared with 10 age-matched children with normal hearing on a majority of the measures through 60 mos of age. Spontaneous language samples were collected from mother-child interaction sessions recorded at consistent intervals in a laboratory-based play setting. Transcripts were analyzed using computer-based procedures (Systematic Analysis of Language Transcripts) and the Index of Productive Syntax. Possible influences of audibility were explored by examining the onset and productive use of a set of verb tense markers and by monitoring the children's accuracy in the use of morphological endings. Phonological samples at baseline were transcribed and analyzed using Computerized Profiling. At entry to the study, the four children with hearing loss demonstrated language delays with pronounced delays in phonological development. Three of the four children demonstrated rapid progress with development and interventions and performed within the average range on standardized speech and language measures compared with age-matched children by 60 mos of age. However, persistent differences from children with normal hearing were observed in the areas of morphosyntax, speech intelligibility in conversation, and production of fricatives. Children with mild-moderate hearing loss demonstrated later than typical emergence of certain verb tense markers, which may be related to reduced or inconsistent audibility. The results of this study suggest that early communication delays will resolve for children with late-identified, mild-moderate hearing loss, given appropriate amplification and intervention services. A positive result is that three of four children demonstrated normalization of broad language behaviors by 60 mos of age, despite significant delays at baseline. However, these children are at risk for persistent delays in phonology at the conversational level and for accuracy in use of morphological markers. The ways in which reduced auditory experiences and audibility may contribute to these delays are explored along with implications for evaluation of outcomes.

The co-emergence of cognition, language, and speech motor control in early development: A longitudinal correlation study

Although the development of spoken language is dependent on the emergence of cognitive, language, and speech motor skills, knowledge about how these domains interact during the early stages of communication development is currently limited. This exploratory investigation examines the strength of associations between longitudinal changes in articulatory kinematics and development of skills in multiple domains thought to support early communication development. Twenty-four children were investigated every 3 months between the ages of 9 and 21 months. Movements of the upper lip, lower lip, and jaw were transduced using a three-dimensional motion capture system to obtain age-related changes in movement speed and range of movement. Standardized measures of cognition and language from the Battelle Developmental Inventory, 2nd edition and the MacArthur-Bates Communicative Development Inventory were also collected. Significant associations were identified between orofacial kinematic and the standardized measures of language and cognitive skills, even when age served as covariate.These findings provide preliminary evidence of interactions between cognition, language, and speech motor skills during early communication development. Further work is needed to identify and quantify causal relations among these co-emerging skills.Learning outcomes: The reader will be able to: (1) describe how cognition, language, and speech motor control may interact during speech development, (2) describe the associations between speech kinematic characteristics and measures of cognition and language.

Early and late talkers: school-age language, literacy and neurolinguistic differences

Early language development sets the stage for a lifetime of competence in language and literacy. However, the neural mechanisms associated with the relative advantages of early communication success, or the disadvantages of having delayed language development, are not well explored. In this study, 174 elementary school-age children whose parents reported that they started forming sentences 'early', 'on-time' or 'late' were evaluated with standardized measures of language, reading and spelling. All oral and written language measures revealed consistent patterns for 'early' talkers to have the highest level of performance and 'late' talkers to have the lowest level of performance. We report functional magnetic resonance imaging data from a subset of early, on-time and late talkers matched for age, gender and performance intelligence quotient that allows evaluation of neural activation patterns produced while listening to and reading real words and pronounceable non-words. Activation in bilateral thalamus and putamen, and left insula and superior temporal gyrus during these tasks was significantly lower in late talkers, demonstrating that residual effects of being a late talker are found not only in behavioural tests of oral and written language, but also in distributed cortical-subcortical neural circuits underlying speech and print processing. Moreover, these findings suggest that the age of functional language acquisition can have long-reaching effects on reading and language behaviour, and on the corresponding neurocircuitry that supports linguistic function into the school-age years.