When does speech sound disorder matter for literacy? The role of disordered speech errors, co-occurring language impairment and family risk of dyslexia.

BACKGROUND: This study considers the role of early speech difficulties in literacy development, in the context of additional risk factors. METHOD: Children were identified with speech sound disorder (SSD) at the age of 3½ years, on the basis of performance on the Diagnostic Evaluation of Articulation and Phonology. Their literacy skills were assessed at the start of formal reading instruction (age 5½), using measures of phoneme awareness, word-level reading and spelling; and 3 years later (age 8), using measures of word-level reading, spelling and reading comprehension. RESULTS: The presence of early SSD conferred a small but significant risk of poor phonemic skills and spelling at the age of 5½ and of poor word reading at the age of 8. Furthermore, within the group with SSD, the persistence of speech difficulties to the point of school entry was associated with poorer emergent literacy skills, and children with 'disordered' speech errors had poorer word reading skills than children whose speech errors indicated 'delay'. In contrast, the initial severity of SSD was not a significant predictor of reading development. Beyond the domain of speech, the presence of a co-occurring language impairment was strongly predictive of literacy skills and having a family risk of dyslexia predicted additional variance in literacy at both time-points. CONCLUSIONS: Early SSD alone has only modest effects on literacy development but when additional risk factors are present, these can have serious negative consequences, consistent with the view that multiple risks accumulate to predict reading disorders.

Am I dyslexic? Parental self-report of literacy difficulties.

In the absence of criteria for the diagnosis of dyslexia, considerable weight is given to self-report, in particular in studies of children at family risk of dyslexia. The present paper uses secondary data from a previous study to compare parents who self-report as dyslexic and those who do not, in relation to objectively determined levels of ability. In general, adults are more likely to self-report as 'dyslexic' if they have poorer reading and spelling skills and also if there is a discrepancy between IQ and measured literacy. However, parents of higher social status who have mild literacy difficulties are more likely to self-report as dyslexic than parents who have weaker literacy skills but are less socially advantaged. Together the findings suggest that the judgement as to whether or not a parent considers themselves 'dyslexic' is made relative to others in the same social sphere. Those who are socially disadvantaged may, in turn, be less likely to seek support for their children.

Evaluating the GAPS test as a screener for language impairment in young children.

BACKGROUND: The early identification of children is one of five themes identified by the Bercow review of 2008. The review also notes that there is a wide range in the methods used to identify children and it goes on to recommend that there needs to be a more systematic approach. One such approach would be to screen children before, or shortly after, school entry. The GAPS test has been designed as a screening tool to identify young children with language impairment and is reported to be of value in identifying children with language difficulties. However, the test has previously only been evaluated by its authors and the sensitivity of the test for identifying children from an unselected sample has not been evaluated. AIMS: This study evaluated the ability of the GAPS test to identify language-impaired children in an unselected sample. In addition, the effect of tester status (a trained researcher and a teaching assistant) was investigated. METHODS & PROCEDURES: A total of 106 children aged 3-6 years completed the GAPS test, the Early Repetition Battery (ERB) and the core language scales from the Clinical Evaluation of Language Fundamentals-Preschool 2 with a trained researcher. Half the children completed the GAPS test a second time with a teaching assistant. OUTCOMES & RESULTS: There was a significant effect of tester only for the non-word repetition subtest of the GAPS test in the nursery age group; the teaching assistants awarded higher scores than trained researchers. Of the 106 children, ten were language impaired according to the CELF-Preschool 2 core language score. The GAPS test identified two of these children at the 10th percentile cut-off, resulting in a low sensitivity estimate of 20%. However, the GAPS test only identified four of the 96 remaining unimpaired children resulting in a high specificity value of 96%. These values were similar when the 15th percentile cut-off was used and when parental concern or a family history of reading difficulties were used as the criterion measure. CONCLUSIONS & IMPLICATIONS: These data show that although the GAPS test can be used by a range of people who work with young children, it is not a sensitive screener for language impairment when used by trained researchers.

Copy Number Variation Screen Identifies a Rare De Novo Deletion at Chromosome 15q13.1-13.3 in a Child with Language Impairment.

A significant proportion of children (up to 7% in the UK) present with pronounced language difficulties that cannot be explained by obvious causes like other neurological and medical conditions. A substantial genetic component is predicted to underlie such language problems. Copy number variants (CNVs) have been implicated in neurodevelopmental and psychiatric conditions, such as autism and schizophrenia, but it is not fully established to what extent they might contribute to language disorders. We conducted a CNV screen in a longitudinal cohort of young children with language-related difficulties (n = 85), focusing on single events at candidate loci. We detected a de novo deletion on chromosome 15q13.1-13.3. The adjacent 15q11-13.1 locus is disrupted in Prader-Willi and Angelman syndromes, while disruptions across the breakpoints (BP1-BP6) have previously been implicated in different neurodevelopmental phenotypes including autism, intellectual disability (ID), seizures and developmental delay (DD). This is the first report of a deletion at BP3-BP5 being linked to a deficit confined to language impairment, in the absence of ID, expanding the range of phenotypes that implicate the chromosome 15q13 locus.