Identifying children at risk for language impairment: screening of communication at 18 months.

AIM: To investigate the possibility of identifying children at risk for language impairment based on a new screening instrument to assess communication and language skills at 18 mo of age. METHODS: At 18 mo, 58 children were assessed with a screening instrument for communication and language consisting of a professional assessment and a parents' questionnaire. Students of speech and language pathology, well trained in child language assessment, carried out the professional assessment, which was based on observations of play behaviour, interaction and expressive and receptive language skills. Of the 58 children, 43 attended a follow-up assessment of language skills at 54 mo of age. RESULTS: Nine children were considered to be at risk for language impairment at 18 mo and 10 children were evaluated as being at risk at 54 mo. A significant positive correlation was found between the professional evaluations at 18 mo and the language tests at 54 mo. Verbal comprehension and pretend play correlated significantly with the results on the language tests. CONCLUSION: A professional screening of communication and language at 18 mo of age is worthwhile for predicting problems in language development. The results further show that language comprehension and pretend play rather than expressive skills should be emphasized.

Language impairment in Swedish bilingual children: a comparison between bilingual and monolingual children in Malmö.

UNLABELLED: In this study two groups of children were compared, 192 bilingual and 246 monolingual, referred over a 12-mo period to University Hospital in Malmö for suspected language impairment. Compared with monolingual children, bilingual children ran a significantly lower risk (RR = 0.76, p < 0.0001) of being referred by a child health centre, and a significantly higher risk (RR= 1.54, p < 0.0103) of being referred after 5 y of age. In the bilingual group there was also a significantly higher risk of parental refusal of assessment (RR = 2.35, p < 0.0016) and of the children being diagnosed with a severe language impairment (RR = 1.87, p < 0.0009). The risk for bilingual children with severe language impairment being discharged owing to non-attendance was high (RR = 6.20, p < 0.0002) compared to monolingual children. The risk increased with severity of language impairment. CONCLUSION: Bilingual children displayed a higher risk of a diagnosis of severe language impairment and of being discharged for non-attendance. The problem of low compliance among bilingual parents, despite strong indications of parental distress, must be addressed.

Risk factors for language impairment in Swedish bilingual and monolingual children relative to severity.

AIM: To explore potential risk factors for language impairment (LI) relative to degree of severity in bilingual and monolingual children. METHODS: Two groups of clinically assessed children were compared, 252 bilinguals whose parents were both non-Swedish and 446 monolinguals, who were referred over a period of 24 mo to the University Hospital in Malmö for suspected LI. RESULTS: A multivariate linear regression for both groups showed that two risk factors were the same: parental distress (p < 0.0001 in both groups) and short attention span (p < 0.0001 in both groups). Male gender (p < 0.0001) was an additional predictor for LI relative to degree of severity in the monolingual group. Specific risk factors for LI relative to degree of severity in the bilingual children were maternal arrival within 1 y in relation to birth (p < 0.002) and parental need for an interpreter after > 5 y in Sweden (p < 0.040). CONCLUSION: Most risk factors for LI relative to degree of severity in this study seemed to apply to both groups, although they sometimes appeared in another form in the bilingual group. Gender and possibly also hereditary factors seemed to need to interact with environmental factors to appear as risk factors for the bilingual children in this study.

Giving the crucial information: performance on a referential communication task in Swedish children with language impairment.

The study focused on the performance of a group of Swedish children with language impairment (LI) on a referential communication task as a step in the investigation of their pragmatic skills. The task entailed choosing a single card from a selection of 16 depicting a face and describing it well enough for the opponent in order for him/her to pick the correct one from his/her identical array of cards laid out behind a barrier. To give an adequate description, the player had to understand that four dimensions had to be described in order for the other person to choose the correct card. The participating children had been part of a previous study on narrative skills in children with LI. A few of them with rather poor language comprehension had shown utterances during story generation judged to be irrelevant to both the listener and the task. In the present study, language comprehension did not significantly correlate to performance on the referential communication task. The participants performed at the level of their peers without LI and there was no significant difference between the amount of relevant or irrelevant information when the children with LI interacted with an adult or with a friend. The results are discussed in relation to recent research.

Contextual influence on the language production of children with speech/language impairment.

To investigate the possible contextual variability of language and interaction, data from 10 children with speech/language impairment and three different types of conversational partners (a parent, a peer and a clinician) were collected. The dialogues were analyzed with respect to the characteristics of the dialogues as whole, to the dominance and the productivity of the three types of conversational partners, and to the productivity, fluency and grammatical structure of the language production of the children with speech/language impairment. Productivity was measured as mean length of utterance (MLU) in words, number of utterances, number of different words and proportion of complete and intelligible utterances. Fluency was measured as the proportion of utterances containing a maze. Grammatical structure was analysed with respect to the use of grammatical morphemes, word order patterns, the occurrence of expansions and the complexity of verb forms. Significant differences, in particular between child-child and adult-child dialogues were found. The adult-child dialogues were asymmetrical, where the adults dominated through asking many questions and talking much. The peer dialogues were more dynamic and equal. In these dialogues the children with speech/language impairment took a more active role as a conversational partner. The children produced more utterances and different words with the adult partners, but variables related to fluency and grammatical structure did not vary as a function of the conversational partner. The results imply that children with speech/language impairment practise different aspects of their communicative ability with different types of conversational partners. In particular, it is important to provide them with opportunities to interact with peers, in order for them to develop their skills as independent conversational partners.

Conversation versus narration in pre-school children with language impairment.

The study focuses on two elicitation methods for language sampling in children with language impairment: conversation and narration. It has been noted in other studies on different clinical groups that language elicited in different speaking contexts varies in aspects such as MLU, fluency and syntactic complexity. The purpose of this study was to compare genre effects on different aspects of language production in a group of pre-school children with language impairment. The results show that there are differences in language production during conversation compared with narration. Intelligibility and fluency were found to be higher in conversation than in narration, whereas MLU in words was higher in narration. The narrative task elicited more phrasal expansions and grammatical morphemes per utterance than the conversation. However, the children used more complex verb forms in conversation than in narration. The results are discussed in relation to recent research.

Specific language impairment in Swedish: the status of verb morphology and word order.

Several competing proposals have been offered to explain the grammatical difficulties experienced by children with specific language impairment (SLI). In this study, the grammatical abilities of Swedish-speaking children with SLI were examined for the purpose of evaluating these proposals and offering new findings that might be used in the development of alternative accounts. A group of preschoolers with SLI showed lower percentages of use of present tense copula forms and regular past tense inflections than normally developing peers matched for age and younger normally developing children matched for mean length of utterance (MLU). Word order errors, too, were more frequent in the speech of the children with SLI. However, these children performed as well as MLU-matched children in the use of present tense inflections and irregular past forms. In addition, the majority of their sentences containing word order errors showed appropriate use of verb morphology. None of the competing accounts of SLI could accommodate all of the findings. In particular, these accounts--or new alternatives-must develop provisions to explain both the earlier acquisition of present tense inflections than past tense inflections and word order errors that seem unrelated to verb morphology.

Non-word repetition in children with language impairment--pitfalls and possibilities.

Specific language impairment has, although not without controversy, been considered as a consequence of a phonological memory deficit. Non-word repetition has been proposed as a reliable index of phonological memory and also as predictive of lexical and grammatical development in normally developing and language-impaired children. The main aim was to study the relationship between repetition of words and non-words and expressive language skills (phonology and grammar) in 27 5-year-old children with language impairment. The authors also wanted to explore the influence of lexical stress on repetition skills. The results showed that words were significantly easier to repeat than non-words and that non-word repetition skills were significantly correlated to phonological and grammatical development. The most important predictor of non-word repetition skills was output phonology. The conclusion is that non-word repetition is not a single, reliable index of phonological memory in preschool children with language impairment. Also, the influence of prosodic variables on segmental aspects of speech production should not be overlooked in non-word construction, since it was found that unstressed syllables were omitted six times more often in prestressed than in post-stressed positions of the words and non-words.

The acquisition of Swedish as second language in a group of Arabic-speaking pre-school children: word order patterns and phrasal morphology.

Children with Swedish as a second language (L2) and Swedish children with specific language impairment (SLI) have displayed interesting similarities in their linguistic development. A group of 18 normally developed Arabic-speaking children, five and six years old, were tested with respect to their development of word order patterns and phrasal morphology in the noun phrase. The results were in accordance with Pienemann's processability theory, that predicts the order of acquisition of both morphological and syntactical structures. The results on word order patterns showed similarities between L2 and SLI children. Processability theory could be a powerful tool in analyzing the grammar in children with SLI.

Grammatical characteristics of Swedish children with SLI.

Spontaneous speech samples from 10 Swedish children were collected and analyzed grammatically. The subjects consisted of 5 children with SLI and 5 MLU matched controls with normal grammatical development. The children with SLI differed significantly from the controls in their more restricted usage of word order patterns and in number of grammatical errors. As in studies on English-speaking children with SLI, the Swedish children with SLI had a large number of omissions of grammatical morphemes. Verb-related errors were more common than noun-related errors. Contrary to reports on children with SLI acquiring other languages, however, word order errors were also very common in the Swedish children with SLI. A restricted usage of word order pattern in combination with errors of word order indicates that not only morphological deficits but also syntactic difficulties can be found in children with SLI relative to MLU controls, depending on the target language. The findings show the importance of cross-linguistic comparisons of children with SLI.

Language development in children with recurrent acute otitis media during the first three years of life. Follow-up study from birth to seven years of age.

From a cohort of 113 children, followed prospectively from birth during the first three years of life regarding different aspects of acute otitis media (AOM), two study groups were selected for the present investigation: 13 children with recurrent AOM (rAOM, i.e. at least six episodes of AOM during a 12-month period), and 29 children without any AOM episode. The purpose of this study was to analyse the possible effects of early onset rAOM on language development as assessed at four and seven years of age at phoniatric and linguistic examinations performed blindly. There were no differences between the two groups on any of the linguistic analyses performed, although the rAOM group manifested a somewhat better performance on auditory discrimination tests at four years of age. The results of the present study show that rAOM during the first three years of life, in otherwise healthy children, does not cause a detectable delay of language development at four and seven years of age.

Context and comprehension: a neurolinguistic and interactional approach to the understanding of semantic-pragmatic disorder.

In the present study we provide thorough descriptions of two children with a semantic-pragmatic disorder, a subgroup within the group of specific and severe developmental language disorders, from a neurolinguistic and interactional perspective. We argue that the pragmatic problems, at least in these two girls, are most probably secondary to their semantic/conceptual deficit. If sufficient contextual cues are provided comprehension is improved and, as a consequence, the pragmatic problems are reduced.