Phenome risk classification enables phenotypic imputation and gene discovery in developmental stuttering.

Developmental stuttering is a speech disorder characterized by disruption in the forward movement of speech. This disruption includes part-word and single-syllable repetitions, prolongations, and involuntary tension that blocks syllables and words, and the disorder has a life-time prevalence of 6-12%. Within Vanderbilt's electronic health record (EHR)-linked biorepository (BioVU), only 142 individuals out of 92,762 participants (0.15%) are identified with diagnostic ICD9/10 codes, suggesting a large portion of people who stutter do not have a record of diagnosis within the EHR. To identify individuals affected by stuttering within our EHR, we built a PheCode-driven Gini impurity-based classification and regression tree model, PheML, by using comorbidities enriched in individuals affected by stuttering as predicting features and imputing stuttering status as the outcome variable. Applying PheML in BioVU identified 9,239 genotyped affected individuals (a clinical prevalence of ∼10%) for downstream genetic analysis. Ancestry-stratified GWAS of PheML-imputed affected individuals and matched control individuals identified rs12613255, a variant near CYRIA on chromosome 2 (B = 0.323; p value = 1.31 × 10-8) in European-ancestry analysis and rs7837758 (B = 0.518; p value = 5.07 × 10-8), an intronic variant found within the ZMAT4 gene on chromosome 8, in African-ancestry analysis. Polygenic-risk prediction and concordance analysis in an independent clinically ascertained sample of developmental stuttering cases validate our GWAS findings in PheML-imputed affected and control individuals and demonstrate the clinical relevance of our population-based analysis for stuttering risk.

How We Fail Children With Developmental Language Disorder.

Purpose For over two decades, we have known that children with developmental language disorder (DLD) are underserved. We have also known that DLD does not attract the research attention that it merits given its prevalence and impact. The purposes of this clinical focus article are to present evidence that these failures continue, explore the reasons behind these failures, and propose solutions. Method I reviewed the literature and applied bibliometric analysis procedures from Bishop (2010) to quantify research efforts aimed at DLD compared to other neurodevelopmental disorders. Results The percentage of children who are deemed eligible for clinical services because of DLD continues to fall well short of estimates based on the prevalence of DLD in community samples. The amount of research conducted on DLD relative to other neurodevelopmental disorders remains low. Contributing factors include a lack of awareness of DLD, the hidden nature of DLD, entrenched policies, and the dissonance created when speech-language pathologists must diagnose DLD in school settings. Conclusions Expanded approaches to supporting children with DLD are required. These might include engagement in advocacy and awareness campaigns; clearer communication with the families we serve and enhanced collaborations with classroom teachers; the implementation of school-based language screenings; participation in policymaking; and the development of service delivery models that operate alongside those that exist in our schools and complement their function. Supplemental Material https://doi.org/10.23641/asha.12743273.

Speech and Language Therapy Services for Multilingual Children with Migration Background: A Cross-Sectional Survey in Germany.

Speech, language, and communication needs are particularly common among multilingual and migrant children. More than every third child in Germany has a migrant background. In the city of Bremen, this figure is even higher, including refugee children. The availability of comprehensive data on the provision and uptake of speech and language therapy (SLT) services is still inadequate, especially for multilingual children. However, health-monitoring programs report that migrants differ in many health-related areas from the majority population, mainly in barriers in health care. This study examines the current provision of SLT services for multilingual children following a medical prescription for the specific case of suspected language disorder. Information was obtained from speech-language pathologists (SLPs) representing 28 practices in different districts across one of the moderately largest cities affected by sociospatial polarization. The SLT practices were clustered according to the proportion of minor migrants and minor welfare recipients in the district. The survey included the number and proportion of multilingual children on the SLT caseloads, as well as the age of children by time of referral, physician and SLP diagnoses, application and type of assessment materials, intervention goals, and sociodemographic data of practicing SLPs. Questionnaire responses were analyzed using descriptive statistics and an explanatory interpretive approach. Findings suggest that multilingual children experience later referral compared to monolingual German-speaking children, with approximately half of the multilingual children demonstrating a developmental language disorder (DLD). The SLP's level of experience determines the accuracy of differential diagnosis between communication disorders and typical linguistic variations. Consequently, participation in continuing education focusing on service provision of the multilingual and multicultural clientele is essential. This study highlights the obstacles and the needs for increased multiprofessional awareness and an enhanced professional knowledge to provide effective and swift diagnosis earlier to allow multilingual children with a DLD to access relevant services on equal terms with native resident children.

A Decade of Disproportionality: A State-Level Analysis of African American Students Enrolled in the Primary Disability Category of Speech or Language Impairment.

Purpose This study aimed to determine if African American students were disproportionately represented between the years of 2004 and 2014 in the primary disability category of Speech or Language Impairment (S/LI) under the 2004 reauthorized Individuals with Disabilities Education Improvement Act. Method S/LI enrollment data from the Office of Special Education Programs and general enrollment data from the National Center for Education Statistics were analyzed to compare the risk of primary S/LI category enrollment of African American students to that of all other students. Risk ratios with 99% confidence intervals were calculated for each state across the 10 years studied. Results An average of 75% of states disproportionately represented African American students in the S/LI category each year; on average, 62% underrepresented African American students, and 14% overrepresented them. A post hoc analysis of the relationship between African American student representation and population densities revealed that states with high African American population densities almost exclusively underrepresented African American students and states with low densities tended toward a proportionate representation. Conclusions African American students were largely underrepresented in the category of S/LI in the years studied. These findings, alongside historic and chronic overrepresentation in other categories of special education, are discussed in the context of the fragmented harm theory ( Payne, 1984 ; Voulgarides, 2018 ; Voulgarides, Zwerger, & Noguera, 2013 ) and the disability rights and critical race theory ( Annamma, Connor, & Ferri, 2013 ). Supplemental Material https://doi.org/10.23641/asha.7967024.

Identifying risk for language impairment in children from linguistically diverse low-income schools.

PURPOSE: To improve screening procedures for children in a linguistically diverse context, we combined tasks known to reveal grammatical deficits in children with language impairment (LI) with training to facilitate performance on a verb elicitation task. METHOD: Sixty-four first grade children participated. The objective grammatical measures included elicitation of 12 past tense regular verbs preceded by a teaching phase (teach-test), the sentence recall (SR) subtest of the Clinical evaluation of language fundamentals (CELF-4), and a tally of all conjugated verbs from a narrative retell task. Given the widespread reliance on teacher observation for the referral of children suspected of having LI, we compared our results to the spoken language portion of the CELF-4 teacher observational rating scale (ORS). RESULT: Using teacher observation as a reference for comparison, the past tense elicitation task and the SR task yielded strong discriminating power, but the verb tally was relatively weak. However, combining the three tasks yielded the highest levels of sensitivity (75%) and specificity (92%) than any single measure on its own. CONCLUSION: This study contributes to alternative assessment practices by highlighting the potential utility of adding a teaching component prior to administering informal grammatical probes.

Identifiers of Language Impairment for Spanish-English Dual Language Learners.

Purpose The purpose of this study was to determine if a standardized assessment developed for Spanish-English dual language learners (SEDLLs) differentiates SEDLLs with language impairment (LI) from children with typical language better than the translated/adapted Spanish and/or English version of a standardized assessment and to determine if adding informal measure/s to the standardized assessment increases the classification accuracy. Method Standardized and informal language assessment measures were administered to 30 Mexican American 4- to 5-year-old SEDLLs to determine the predictive value of each measure and the group of measures that best identified children with LI and typical language. Discriminant analyses were performed on the data set. Results The Morphosyntax and Semantics subtests of the Bilingual English-Spanish Assessment ( Peña, Gutierrez-Clellen, Iglesias, Golstein, & Bedore, 2014 ) resulted in the largest effect size of the individual assessments with a sensitivity of 93.3% and a specificity of 86.7%. Combining these subtests with mean length of utterance in words from the child's better language sample (English or Spanish) was most accurate in identifying LI and can be used with above 90% confidence. Conclusion The Bilingual English-Spanish Assessment Morphosyntax and Semantics subtests were shown to comprise an effective measure for identifying LI; however, including a language sample is suggested to identify LI with greater accuracy.

Dynamic Assessment of Narratives Among Navajo Preschoolers.

Purpose: This study examined whether the Predictive Early Assessment of Reading and Language (PEARL), a dynamic assessment of narratives that measures language comprehension and production, accurately classifies Navajo preschoolers with typically developing (TD) language or with language impairment (LI). Method: Ninety 4- and 5-year-old Navajo preschoolers were identified as having LI or are TD (n = 45 each) via a 5-measure battery: parent report, teacher report, English narrative, independent educational plan, and the Clinical Evaluation of Language Fundamental Preschool-Second Edition (Wiig, Secord, & Semel, 2004). Children completed a PEARL pretest, a narrative mediation phase providing principles of narrative structure, and a PEARL posttest. A modifiability score reflected responsiveness to mediation. Results: The PEARL pretest and posttest each distinguished children with LI versus TD children with 89% accuracy; modifiability scores identified children with 100% accuracy. The PEARL story grammar subtest at pretest and posttest best distinguished LI versus TD. A revised cutoff score on the PEARL pretest decreased the diagnosis of TD children as having LI; the standard PEARL posttest cutoff was retained. Conclusion: The PEARL is a promising assessment for accurately differentiating Navajo preschool children with LI from those with TD language, particularly with a revised pretest cutoff score.

Effects of Specific Language Impairment on a Contrastive Dialect Structure: The Case of Infinitival TO Across Various Nonmainstream Dialects of English.

Purpose: Using data from children who spoke various nonmainstream dialects of English and who were classified as either children with specific language impairment (SLI) or typically developing (TD) children, we examined children's marking of infinitival TO by their dialect and clinical status. Method: The data came from 180 kindergartners (91 speakers of African American English, 60 speakers of Southern White English, 29 speakers of +Cajun); 53 were children with SLI, and 127 were TD children. Data included 4,537 infinitival TO contexts extracted from language samples; each was coded as zero or overtly marked and by preceding verb context (i.e., verbs of motion vs. other). Results: Across dialects, overall rates of zero marking differed by the children's clinical status (SLI > TD), and other verb contexts accounted for this result. Across the TD and SLI groups, dialect variation was evident for verbs of motion contexts, and the effect was stronger for the TD than for the SLI groups, particularly if the TD children's dialects were classified as +Cajun. Conclusion: Children's marking of infinitival TO can be affected by both their dialect and clinical status. Results support language assessments that include context-specific rate-based measures of infinitival TO and other contrastive structures when they prove useful for understanding the linguistic profile of SLI within a dialect.

Family aggregation of language impairment in an isolated Chilean population from Robinson Crusoe Island.

BACKGROUND: It has been reported that the inhabitants of the Chilean Robinson Crusoe Island have an increased frequency of specific language impairment (SLI) or developmental language disorder (DLD). AIMS: To explore the familial aggregation of DLD in this community. METHODS & PROCEDURES: We assessed the frequency of DLD amongst colonial children between the ages of 3 and 8;11 years (50 individuals from 45 nuclear families). Familial aggregation rates of language disorder were calculated by assessing all available first-degree relatives (n = 107, 77 parents, 25 siblings, five half-siblings) of the probands. OUTCOMES & RESULTS: We found that 71% of the child population performed significantly below expected in measures of phonological production or expressive and receptive morphology. The majority of these children presented with severe expressive and/or receptive language difficulties. One-quarter of language-disordered probands primarily had phonological difficulties. Family members of affected probands experienced a higher risk of language disorder than those of typically developing probands. This increased risk was apparent regardless of non-verbal IQ. CONCLUSIONS & IMPLICATIONS: The study substantiates the existence of a familial form of speech and language disorder on Robinson Crusoe Island. Furthermore, we find that the familiarity is stable regardless of non-verbal IQ, supporting the recent movement to reduce the importance of non-verbal IQ criterion in DLD diagnoses.

Longitudinal vocabulary development in Australian urban Aboriginal children: Protective and risk factors.

BACKGROUND: Vocabulary is a key component of language that can impact on children's future literacy and communication. The gap between Australian Aboriginal and non-Aboriginal children's reading and academic outcomes is well reported and similar to Indigenous/non-Indigenous gaps in other nations. Determining factors that influence vocabulary acquisition over time and may be responsive to treatment is important for improving Aboriginal children's communication and academic outcomes. AIM: To determine what factors influence Australian urban Aboriginal children's receptive vocabulary acquisition and whether any of these are risks or protective for vocabulary development. METHOD: One hundred thirteen Aboriginal children in South Western Sydney from the longitudinal birth cohort Gudaga study were assessed on The Peabody Picture Vocabulary Test multiple times: 3 years, just prior to school entry, at the end of the first and second years of formal schooling. Multilevel models were used to determine the effects of 13 fixed and manipulable maternal, child, and family variables drawn from previous research. RESULTS: Higher maternal education was found to be protective at 3 years and over time. The number of children in urban Australian Aboriginal households made an impact on vocabulary development and this varied over time. From 3 to 6 years, those with early poor non-verbal cognitive skills had vocabulary skills that remained below those with stronger non-verbal skills at 3 years. Girls exhibit an earlier advantage in vocabulary acquisition, but this difference is not sustained after 4 years of age. CONCLUSIONS: The risk and protective factors for vocabulary development in Australian Aboriginal children are similar to those identified in other studies with some variation related to the number of children in the home. In this limited set of predictors, maternal education, gender, non-verbal cognitive skills, and the number of children in households were all shown to impact on the acquisition of vocabulary to 3 years and or the developmental trajectory over time.

Language Assessment With Children Who Speak Nonmainstream Dialects: Examining the Effects of Scoring Modifications in Norm-Referenced Assessment.

Purpose: We compared outcomes from 2 measures of language ability in children who displayed a range of dialect variation: 1 using features that do not contrast between mainstream American English (MAE) and nonmainstream dialects (NMAE), and 1 using contrastive features. We investigated how modified scoring procedures affected the diagnostic accuracy of the measure with contrastive features. Method: Second-grade students (N = 299; 167 White, 106 African American, 26 other) completed measures of language variation and ability (the Diagnostic Evaluation of Language Variation-Screening Test and the Clinical Evaluation of Language Fundamentals-Fourth Edition [CELF-4]). The CELF-4 was scored with and without the recommended scoring modifications for children who spoke African American English. Results: Partial correlations controlling for socioeconomic status revealed small to moderate correlations between measures of language ability and the use of NMAE features. Modified scoring yielded higher scores for children who spoke African American English and a reduced association between the use of NMAE features and CELF-4 scores. Modified scoring also affected the diagnostic accuracy of the CELF-4, resulting in a lower positive likelihood ratio and a higher negative likelihood ratio. Conclusions: The decision to apply scoring modifications affects both the false positive and false negative rates. Implications for language assessment for children who speak NMAE dialects are discussed, including the need for further investigation.

Language development, delay and intervention-the views of parents from communities that speech and language therapy managers in England consider to be under-served.

BACKGROUND: Evidence-based practice includes research evidence, clinical expertise and stakeholder perspectives. Stakeholder perspectives are important and include parental ethno-theories, which embrace views about many aspects of speech, language and communication, language development, and interventions. The Developmental Niche Framework provides a useful theory to understand parental beliefs. Ethnotheories, including those about language development, delay and interventions, may vary cross culturally and are less well understood in relation to families who may be considered 'under-served' or 'hard-to-reach' by speech and language therapy services. Who is considered to be under-served and the reasons why some families are under-served are complex. AIM: To describe beliefs and reported practices, in relation to speech and language development, delay and intervention, of parents and carers from a small number of groups in England who were perceived to be under-served in relation to SLT services. METHODS & PROCEDURES: As part of a wider National Institute for Health Research (NIHR)-funded study (Child Talk), seven focus groups (with a total of 52 participants) were held with parents from three communities in England. Topics addressed included beliefs about language development, language delay and parents' reported responses to language delay. Data were transcribed and analysed using adapted framework analysis, which also drew on directed content analysis. OUTCOMES & RESULTS: Four themes resulted that broadly matched the topics addressed in the focus groups: language development and the environment; causes and signs of speech and language delay; responses to concerns about speech, language and communication; and improving SLT. These produced some previously unreported ideas, e.g., about how language develops and the causes of delay. CONCLUSIONS & IMPLICATIONS: The findings are discussed in relation to previous literature and the Developmental Niche Framework. Clinical implications include ideas about issues for SLTs to discuss with families and the need to recognize that parents may see themselves as competent facilitators of language. Suggestions are made for future research, including: expanded investigation of a wider range of under-served groups, an exploration of who parents consult when concerned about their child's language, and how key community figures advise parents in relation to language delay.

Lexical and grammatical development in trilingual speakers of isiXhosa, English and Afrikaans.

BACKGROUND: There is a dearth of normative data on linguistic development among child speakers of Southern African languages, especially in the case of the multilingual children who constitute the largest part of this population. This inevitably impacts on the accuracy of developmental assessments of such speakers. Already negative lay opinion on the effect of early multilingualism on language development rates could be exacerbated by the lack of developmental data, ultimately affecting choices regarding home and school language policies. OBJECTIVES: To establish whether trilinguals necessarily exhibit developmental delay when compared to monolinguals and, if so, whether this delay (1) occurs in terms of both lexical and grammatical development; and (2) in all three the trilinguals' languages, regardless of input quantity. METHOD: Focusing on isiXhosa, South African English and Afrikaans, the study involved a comparison of 11 four-year-old developing trilinguals' acquisition of vocabulary and passive constructions with that of 10 age-matched monolingual speakers of each language. RESULTS: The trilinguals proved to be monolingual-like in their lexical development in the language to which, on average, they had been exposed most over time, that is, isiXhosa. No developmental delay was found in the trilinguals' acquisition of passive constructions, regardless of the language of testing. CONCLUSION: As previously found for bilingual development, necessarily reduced quantity of exposure does not hinder lexical development in the trilinguals' input dominant language. The overall lack of delay in their acquisition of the passive is interpreted as possible evidence of cross-linguistic bootstrapping and support for early multilingual exposure.

Comparison of African American Children's Performances on a Minimal Competence Core for Morphosyntax and the Index of Productive Syntax.

PURPOSE: This study is a response to the need for evidence-based measures of spontaneous oral language to assess African American children under the age of 4 years. We determined if pass/fail status on a minimal competence core for morphosyntax (MCC-MS) was more highly related to scores on the Index of Productive Syntax (IPSyn)-the measure of convergent criterion validity-than to scores on 3 measures of divergent validity: number of different words (Watkins, Kelly, Harbers, & Hollis, 1995), Percentage of Consonants Correct-Revised (Shriberg, Austin, Lewis, McSweeney, & Wilson, 1997), and the Leiter International Performance Scale-Revised (Roid & Miller, 1997). METHOD: Archival language samples for 68 African American 3-year-olds were analyzed to determine MCC-MS pass/fail status and the scores on measures of convergent and divergent validity. RESULTS: Higher IPSyn scores were observed for 60 children who passed the MCC-MS than for 8 children who did not. A significant positive correlation, rpb = .73, between MCC-MS pass/fail status and IPSyn scores was observed. This coefficient was higher than MCC-MS correlations with measures of divergent validity: rpb = .13 (Leiter International Performance Scale-Revised), rpb = .42 (number of different words in 100 utterances), and rpb = .46 (Percentage of Consonants Correct-Revised). CONCLUSION: The MCC-MS has convergent criterion validity with the IPSyn. Although more research is warranted, both measures can be potentially used in oral language assessments of African American 3-year-olds.

Ramathibodi Language Development Questionnaire: A Newly Developed Screening Tool for Detection of Delayed Language Development in Children Aged 18-30 Months.

OBJECTIVE: To develop a parental questionnaire for screening children with delayed language development in primary care settings. MATERIAL AND METHOD: Ramathibodi Language Development (RLD) questionnaire was developed and completed by groups of 40 typically developing children age 18 to 30 months old and 30 children with delayed language development. RESULTS: The mean score was significantly lower in the delay language group (6.7 ± 1.9), comparing with the typically developing group (9.6 ± 0.7). The optimal ROC curve cut-off score was 8 with corresponding sensitivity and specificity were 98% and 72%, respectively. The corresponding area under the curve was 0.96 (95% CI = 0.92-0.99). CONCLUSION: The RLD questionnaire was the promising language developmental screening instrument that easily utilized in well-child examination settings.

Impacts of parent-implemented early-literacy intervention for Spanish-speaking children with language impairment.

BACKGROUND: Children with language impairment (LI) often have lags in development of print knowledge, an important early-literacy skill. This study explores impacts of a print-focused intervention for Spanish-speaking children with LI in Southeastern Mexico. AIMS: Aims were twofold. First, we sought to describe the print knowledge (print-concept knowledge, alphabet knowledge) of Spanish-speaking children with LI. Second, we determined the extent to which print-referencing intervention delivered by children's parents could improve print knowledge. METHODS & PROCEDURES: Using a pre-test-post-test delayed treatment research design, 13 parent-child dyads were assigned to an intervention (n = 8) versus control (n = 5) condition. Children were drawn from a speech-language clinic and all were receiving services for LI. Caregivers in the intervention group implemented an 8-week home-reading programme following a systematic scope and sequence for improving children's print knowledge. OUTCOMES & RESULTS: Children showed individual differences in their print knowledge based on three baseline measures examining print-concept knowledge, alphabet knowledge and letter-sound knowledge. Those whose caregivers implemented the 8-week programme showed statistically and practically significant gains on two of the three measures over the intervention period. CONCLUSIONS & IMPLICATIONS: The results presented here may stimulate future research on the print knowledge of Spanish-speaking children with LI. Sources of individual differences are important to determine. Caregivers may use the intervention presented here as a potential avenue for improving children's print knowledge.

Utility of a Language Screening Measure for Predicting Risk for Language Impairment in Bilinguals.

PURPOSE: This study evaluated the accuracy of an experimental version of the Bilingual English Spanish Oral Screener (BESOS; Peña, Bedore, Iglesias, Gutiérrez-Clellen, & Goldstein, 2008) for predicting the long-term risk for language impairment (LI) for a matched group of preschool-aged Spanish-English bilingual children with and without LI. METHOD: A total of 1,029 Spanish-English bilingual children completed the BESOS before entering kindergarten. A subset of 167 participants completed a follow-up language evaluation in 1st grade. Twenty-one of these children were identified as having LI and were matched to a group of 21 typically developing peers from the larger sample. A series of discriminant analyses were used to determine the combination of scores on the BESOS that most accurately predicted 2 years later which children presented with and without LI. RESULTS: The linear combination of the semantics and morphosyntax scores in the best language resulted in predictive sensitivity of 95.2% and predictive specificity of 71.4%, with an overall accuracy of 81% for predicting risk for LI. CONCLUSION: A bilingual language screener administered before kindergarten can be useful for predicting risk for LI in bilingual children in 1st grade.

Rates of auxiliary is and are in African American English speaking children with specific language impairment following language treatment.

The purpose of this exploratory study is to examine rates of auxiliary is and are across dialect patterns produced by African American English with specific language impairment (AAE-SLI) children following language treatment. The following research question is asked: Do AAE-SLI children exhibit rates of auxiliary is and are across dialect patterns consistent with previous reports of typically developing children and adult AAE speakers? A pre-/post-test design was used to identify patterns in which auxiliary is and are were produced at significant levels. Individual performance was included to examine variable rates of use across patterns. Group and individual results suggest children used auxiliary is and are in dialect patterns at rates consistent with typically developing child and adult AAE speakers. We conclude that rates of use may contribute to evidence-based guidelines for morphological intervention with AAE-SLI children.

Specific language impairment in language-minority children from low-income families.

BACKGROUND: Recent evidence suggests that specific language impairment (SLI) might be secondary to general cognitive processing limitations in the domain of executive functioning. Previous research has focused almost exclusively on monolingual children with SLI and offers little evidence-based guidance on executive functioning in bilingual children with SLI. Studying bilinguals with SLI is important, especially in the light of increasing evidence that bilingualism can bring advantages in certain domains of executive functioning. AIMS: To determine whether executive functioning represents an area of difficulty for bilingual language-minority children with SLI and, if so, which specific executive processes are affected. METHODS & PROCEDURES: This cross-cultural research was conducted with bilingual children from Luxembourg and monolingual children from Portugal who all had Portuguese as their first language. The data from 81 eight-year-olds from the following three groups were analysed: (1) 15 Portuguese-Luxembourgish bilinguals from Luxembourg with an SLI diagnosis; (2) 33 typically developing Portuguese-Luxembourgish bilinguals from Luxembourg; and (3) 33 typically developing Portuguese-speaking monolinguals from Portugal. Groups were matched on first language, ethnicity, chronological age and socioeconomic status, and they did not differ in nonverbal intelligence. Children completed a battery of tests tapping: expressive and receptive vocabulary, syntactic comprehension, verbal and visuospatial working memory, selective attention and interference suppression. OUTCOMES & RESULTS: The bilingual SLI group performed equally well compared with their typically developing peers on measures of visuospatial working memory, but had lower scores than both control groups on tasks of verbal working memory. On measures of selective attention and interference suppression, typically developing children who were bilingual outperformed their monolingual counterparts. For selective attention, performance of the bilingual SLI group did not differ significantly from the controls. For interference suppression the bilingual SLI group performed significantly less well than typically developing bilinguals but not monolinguals. CONCLUSIONS & IMPLICATIONS: This research provides further support to the position that SLI is not a language-specific disorder. The study indicates that although bilingual children with SLI do not demonstrate the same advantages in selective attention and interference suppression as typically developing bilinguals, they do not lag behind typically developing monolinguals in these domains of executive functioning. This finding raises the possibility that bilingualism might represent a protective factor against some of the cognitive limitations that are associated with SLI in monolinguals.

Variability in the language input to children enhances learning in a treatment context.

PURPOSE: Artificial language learning studies have demonstrated that learners exposed to many different nonword combinations representing a grammatical form demonstrate rapid learning of that form without explicit instruction. However, learners presented with few exemplars, even when they are repeated frequently, fail to learn the underlying grammar. This study translated this experimental finding in a therapeutic context. METHOD: Eighteen preschool children with language impairment received conversational recast treatment for morpheme errors. Over a 6-week period, half heard 12 unique verbs twice each during recasts (low-variability condition), and half heard 24 unique verbs (high-variability condition). Children's use of trained and untrained morphemes on generalization probes as well as spontaneous use of trained morphemes was tracked throughout treatment. RESULTS: The high-variability condition only produced significant change in children's use of trained morphemes, but not untrained morphemes. Data from individual children confirmed that more children in the high- than the low-variability condition showed a strong treatment effect. Children in the high-variability condition also produced significantly more unique utterances containing their trained morpheme than children in the low-variability condition. CONCLUSION: The results support the use of highly variable input in a therapeutic context to facilitate grammatical morpheme learning.