Linguistic profiles of children with CI as compared with children with hearing or specific language impairment.

BACKGROUND: The spoken language difficulties of children with moderate or severe to profound hearing loss are mainly related to limited auditory speech perception. However, degraded or filtered auditory input as evidenced in children with cochlear implants (CIs) may result in less efficient or slower language processing as well. To provide insight into the underlying nature of the spoken language difficulties in children with CIs, linguistic profiles of children with CIs are compared with those of hard-of-hearing (HoH) children with conventional hearing aids and children with specific language impairment (SLI). AIMS: To examine differences in linguistic abilities and profiles of children with CIs as compared with HoH children and children with SLI, and whether the spoken language difficulties of children with CIs mainly lie in limited auditory perception or in language processing problems. METHODS & PROCEDURE: Differences in linguistic abilities and differential linguistic profiles of 47 children with CI, 66 HoH children with moderate to severe hearing loss, and 127 children with SLI are compared, divided into two age cohorts. Standardized Dutch tests were administered. Factor analyses and cluster analyses were conducted to find homogeneous linguistic profiles of the children. OUTCOMES & RESULTS: The children with CIs were outperformed by their HoH peers and peers with SLI on most linguistic abilities. Concerning the linguistic profiles, the largest group of children with CIs and HoH children shared similar profiles. The profiles observed for most of the children with SLI were different from those of their peers with hearing loss in both age cohorts. CONCLUSIONS & IMPLICATIONS: Results suggest that the underlying nature of spoken language problems in most children with CIs manifests in limited auditory perception instead of language processing difficulties. However, there appears to be a subgroup of children with CIs whose linguistic profiles resemble those of children with SLI.

'MetaTaal': enhancing complex syntax in children with specific language impairment--a metalinguistic and multimodal approach.

BACKGROUND: Currently, most research on the effective treatment of morphosyntax in children with specific language impairment (SLI) pertains to younger children. In the last two decades, several studies have provided evidence that intervention for older school-age children with SLI can be effective. These metalinguistic intervention approaches teach grammatical rules explicitly and use shapes and colours as two-dimensional visual support. Reading or writing activities form a substantial part of these interventions. However, some children with SLI are poor readers and might benefit more from an approach that is less dependent on literacy skills. AIMS: To examine the effectiveness of a combined metalinguistic and multimodal approach in older school-age children with SLI. The intervention was adapted to suit poor readers and targeted the improvement of relative clause production, because relative clauses still pose difficulties for older children with SLI. METHODS & PROCEDURES: Participants were 12 monolingual Dutch children with SLI (mean age 11;2). All children visited a special school for children with speech and language disorders in the Netherlands. A quasi-experimental multiple-baseline design was chosen to evaluate the effectiveness of the intervention. A set of tasks was constructed to test relative clause production and comprehension. Two balanced versions were alternated in order to suppress a possible learning effect from multiple presentations of the tasks. After 3 monthly baseline measurements, the children received individual treatment with a protocolled intervention programme twice a week during 5 weeks. The tests were repeated directly post-therapy and at a retention measurement 3 months later. During the intervention programme, the speech therapist delivering the treatment remained blind to the test results. OUTCOMES & RESULTS: No significant changes were found during the baseline measurements. However, measurement directly post-therapy showed that 5 h of intervention produced significant improvement on the relative clause production tasks, but not on the relative clause comprehension task. The gains were also maintained 3 months later. CONCLUSIONS & IMPLICATIONS: The motor and tactile/kinesthetic dimensions of the 'MetaTaal' metalinguistic intervention approach are a valuable addition to the existing metalinguistic approaches. This study supports the evidence that grammatical skills in older school-age children with SLI can be remediated with direct intervention using a metalinguistic approach. The current tendency to diminish direct intervention for older children with SLI should be reconsidered.

Conversational behaviour of children with Developmental Language Delay and their caretakers.

BACKGROUND: A subset of children with Developmental Language Delay (DLD) encountered difficulties with the regulation of spoken discourse. In the conversations of caretakers with DLD children, several studies report difficulties with turn-taking, a proneness to use the non-verbal register, child and caretaker problems with topic management. Longitudinal research has yet to be conducted on the conversational behaviour of young DLD children and their caretakers. AIMS: The study investigates the development of style and structure of conversations between preschool-aged DLD children and their caretakers. METHOD & PROCEDURES: In a longitudinal design, language samples from twelve DLD children and six Normal Language-Acquiring (NLA) children and their caretakers were recorded in semi-structured play situations at two-month intervals across a period of 18 months. The children were between 2 and 3 years of age at the start of the study. OUTCOMES & RESULTS: The data show that the DLD children predominantly use restricted linguistic forms, non-verbal register and experience difficulties with turn-taking, topic initiation and topic maintenance. The conversational style of the caretakers in dialogue with their DLD children consistently showed more attention-gathering turns, formulaic corrections, self-repetitions and re-introductions of topics when compared with the conversational style of caretakers in dialogue with their NLA children across the 18 months. CONCLUSIONS & IMPLICATIONS: Caretakers in DLD dyads appear to develop a less facilitative conversational style and a decrease of contingencies in initiations and responses over time. The result is little opportunity for the conversational and linguistic skills of the DLD children to develop. Parental guidance in the form of conversational training, child-adjusted register, contingent response behaviour and the provision of language materials which can help the child discover his or her role as a conversational partner and recognize the different perspectives of conversational partners is emphasized.

Dyslexie font does not benefit reading in children with or without dyslexia.

In two experiments, the claim was tested that the font "Dyslexie", specifically designed for people with dyslexia, eases reading performance of children with (and without) dyslexia. Three questions were investigated. (1) Does the Dyslexie font lead to faster and/or more accurate reading? (2) Do children have a preference for the Dyslexie font? And, (3) is font preference related to reading performance? In Experiment 1, children with dyslexia (n = 170) did not read text written in Dyslexie font faster or more accurately than in Arial font. The majority preferred reading in Arial and preference was not related to reading performance. In Experiment 2, children with (n = 102) and without dyslexia (n = 45) read word lists in three different font types (Dyslexie, Arial, Times New Roman). Words written in Dyslexie font were not read faster or more accurately. Moreover, participants showed a preference for the fonts Arial and Times New Roman rather than Dyslexie, and again, preference was not related to reading performance. These experiments clearly justify the conclusion that the Dyslexie font neither benefits nor impedes the reading process of children with and without dyslexia.

Semantic Processing of Sentences in Preschoolers With Specific Language Impairment: Evidence From the N400 Effect.

Purpose: Given the complexity of sentence processing and the specific problems that children with specific language impairment (SLI) experience, we investigated the time course and characteristics of semantic processing at the sentence level in Dutch preschoolers with SLI. Method: We measured N400 responses to semantically congruent and incongruent spoken sentences (e.g., "My father is eating an apple/*blanket") in a group of 37 Dutch preschoolers with SLI and in a group of 25 typically developing (TD) peers. We compared the time course and amplitude of the N400 effect between the two groups. Results: The TD group showed a strong posterior N400 effect in time windows 300-500 ms and 500-800 ms. In contrast, the SLI group demonstrated only a reliable N400 effect in the later time window, 500-800 ms, and did not show a stronger presence at posterior electrodes. Conclusion: The findings suggest that the neuronal processing of semantic information at sentence level is atypical in preschoolers with SLI compared with TD children.

Auditory and verbal memory predictors of spoken language skills in children with cochlear implants.

BACKGROUND: Large variability in individual spoken language outcomes remains a persistent finding in the group of children with cochlear implants (CIs), particularly in their grammatical development. AIMS: In the present study, we examined the extent of delay in lexical and morphosyntactic spoken language levels of children with CIs as compared to those of a normative sample of age-matched children with normal hearing. Furthermore, the predictive value of auditory and verbal memory factors in the spoken language performance of implanted children was analyzed. METHODS & PROCEDURES: Thirty-nine profoundly deaf children with CIs were assessed using a test battery including measures of lexical, grammatical, auditory and verbal memory tests. Furthermore, child-related demographic characteristics were taken into account. OUTCOMES & RESULTS: The majority of the children with CIs did not reach age-equivalent lexical and morphosyntactic language skills. Multiple linear regression analyses revealed that lexical spoken language performance in children with CIs was best predicted by age at testing, phoneme perception, and auditory word closure. The morphosyntactic language outcomes of the CI group were best predicted by lexicon, auditory word closure, and auditory memory for words. CONCLUSIONS: Qualitatively good speech perception skills appear to be crucial for lexical and grammatical development in children with CIs. Furthermore, strongly developed vocabulary skills and verbal memory abilities predict morphosyntactic language skills.

Development of Morphosyntactic Accuracy and Grammatical Complexity in Dutch School-Age Children With SLI.

PURPOSE: The purpose of this study was to identify the development of morphosyntactic accuracy and grammatical complexity in Dutch school-age children with specific language impairment (SLI). METHOD: Morphosyntactic accuracy, the use of dummy auxiliaries, and complex syntax were assessed using a narrative task that was administered at three points in time (T1, T2, T3) with 12-month intervals during a 2-year period. Participants were 30 monolingual Dutch children with SLI, age 6;5 (years;months) at T1; 30 typically developing peers, age 6;6 at T1; and 30 typically developing language-matched children, age 4;7 at T1. RESULTS: On the morphosyntactic accuracy measures, the group with SLI performed more poorly than both control groups. Error rates in the group with SLI were much higher than expected on the basis of mean length of T-units and scores on standardized language tests. Percentages of dummy auxiliaries remained high over time. No group differences were found for grammatical complexity, except at T3, when the group with SLI used fewer relative clauses than the typically developing peer group. CONCLUSIONS: The narrative analysis demonstrates different developmental trajectories for morphosyntactic accuracy and grammatical complexity in children with SLI and typically developing peer and language-matched children. In the group with SLI, grammatical skills continue to develop.

Lexical access in children with hearing loss or specific language impairment, using the cross-modal picture-word interference paradigm.

In this study we compared lexical access to spoken words in 25 deaf children with cochlear implants (CIs), 13 hard-of-hearing (HoH) children and 20 children with specific language impairment (SLI). Twenty-one age-matched typically developing children served as controls. The children with CIs and the HoH children in the present study had good speech perception abilities. We used a cross-modal picture-word interference paradigm to examine lexical access. Results showed that children with SLI revealed overall slower reaction times and produced more errors than the children with CIs, the HoH children, and the control children. Reaction times of children with CIs and the HoH children did not differ from those of the control children. Thus, problems with spoken language processing, as is the case in children with SLI, seem to affect lexical access more than limitations in auditory perception, as is the fundamental problem in children with hearing loss. We recommend that improvement of lexical access in children with SLI deserves specific attention in therapy and education.

Progress in reading and spelling of dyslexic children is not affected by executive functioning.

Although poor reading and spelling skills have been associated with weak skills of executive functioning (EF), its role in literacy is not undisputed. Because EF has different theoretical underpinnings, methods of analysis and of assessing, it has led to varying and often contrasting results in its effects in children with dyslexia. The present study has two goals. The first goal is to establish the relationship between a large number of EF tasks and reading and spelling skills in a large number of Dutch dyslexic children (n = 229). More interesting, however, is the second aim. To what extent do EF skills predict progress in reading and spelling in dyslexic children who attended a remediation programme? The results revealed small, but significant relationships between EF and reading and spelling skills, but no relationships between EF and progress in reading and spelling. It is concluded that training EF skills is unlikely to enhance reading and spelling skills.

Predicting word decoding and word spelling development in children with Specific Language Impairment.

UNLABELLED: This longitudinal investigation on Dutch children with Specific Language Impairment (SLI) aimed at determining the predictive value of statistically uncorrelated language proficiencies on later reading and spelling skills in Dutch. Language abilities, tested with an extensive test battery at the onset of formal reading instruction, were represented by four statistically uncorrelated factors: lexical-semantic abilities, auditory perception, verbal-sequential processing, and speech production. All factors contributed significantly to the prediction of word reading and spelling development seven months later. Verbal-sequential processing was the strongest predictor for both word decoding and spelling. Furthermore, autoregression effects of word decoding and spelling were strong and verbal-sequential processing had predictive value on word spelling nineteen months later when pre-existing spelling abilities were accounted for. Children with SLI and normal literacy skills performed better on most of the language and language-related measures than children with SLI and poor literacy skills. LEARNING OUTCOMES: As a result of this activity, readers will describe four language domains that are related to later literacy skills in children with Specific Language Impairment (SLI). As a result of this activity, readers will recognize the predictive value of each of these language domains and the important role of verbal-sequential processing in learning to decode and writing words for children with SLI. As a result of this activity, readers will recall the differences in language proficiencies between children with SLI who develop normal literacy skills and those who encounter literacy problems.

Assessment of second language proficiency in bilingual children with specific language impairment: a clinical perspective.

The goal of this study was to examine to what extent the conditions of restricted input of L2 and SLI have an additive impact on language acquisition. Therefore, the Dutch language achievement of 6-, 7-, and 8-year-old bilingual children with SLI was compared with that of typically developing monolingual Dutch children, typically developing bilingual children, and monolingual Dutch children with SLI. Assuming that speaking a language in varying environments involves distinct subskills that can be acquired in differential patterns, the achievement of phonological, lexical, morphosyntactic and textual abilities were assessed separately. For each of these abilities, it was determined to what extent the conditions of restricted input (first vs. second language) and language deficit (typically developing vs. SLI) cause stagnation or a delay in language acquisition. Bilingual children with SLI perform at a lower level than the other groups in almost all aspects of achievement in Dutch. For language tasks related to the mental lexicon and grammar, an additional disadvantage was evidenced as a result of the combination of learning Dutch as second language and having SLI.

Towards a typology of specific language impairment.

BACKGROUND: The population of children with specific language impairments (SLI) is heterogeneous. The present study was conducted to examine this heterogeneity more closely, by identifying and describing subgroups within the population of children with SLI in the Netherlands. METHOD: A broad battery of language tests and language-related cognitive tests were administered to 147 six-year-old and 136 eight-year-old children with SLI. RESULTS: Factor analyses revealed 4 factors indicating 4 distinctive linguistic domains for both age samples: 1) lexical-semantic abilities, 2) auditory conceptualization, 3) verbal sequential memory and 4) speech production. These empirical findings were further validated by the positive correlations found between the language factors and the judgments of teachers and speech therapists. Finally, a cluster analysis revealed 4 distinct clusters of SLI children for each sample with specific language profiles based on the 4 factors. Results were nearly the same for both age samples. CONCLUSIONS: The language problems that emerged from the two samples of children with SLI could be described as falling into four types. Based on these language types, four subgroups of children with SLI could be distinguished, each with a specific profile. Some subgroups had severe problems on one specific type of language problem; others had severe problems in more than one type of language problem when compared to the other subgroups of the same age sample. The different profiles may indicate that a more dynamic approach is needed in intervention, considering the presence of both compensating and restricting factors within each child with SLI.