Identifying developmental language disorder (DLD) in multilingual children: A case study tutorial.

PURPOSE: A long-standing issue in identifying developmental language disorder (DLD) in multilingual children is differentiating between effects of language experience and genuine impairment when clinicians often lack suitable norm-referenced assessments. In this tutorial we demonstrate, via a case study, that it is feasible to identify DLD in a multilingual child using the CATALISE diagnostic criteria, Language Impairment Testing in Multilingual Settings (LITMUS) assessment tools, and telepractice. METHOD: This tutorial features a case study of one 6-year-old Urdu-Cantonese multilingual ethnic minority child, and seven age- and grade-matched multilinguals. They were tested via Zoom using Urdu versions of the Multilingual Assessment Instrument for Narratives (LITMUS-MAIN), the Crosslinguistic Lexical Task (LITMUS-CLT), the Crosslinguistic Nonword Repetition Test (LITMUS-CL-NWR), and the Sentence Repetition Task (LITMUS-SRep). RESULT: The child scored significantly lower in the LITMUS tests compared to her peers in her best/first language of Urdu. Together with the presence of negative functional impact and poor prognostic features, and absence of associated biomedical conditions, the findings suggest this participant could be identified as having DLD using the CATALISE diagnostic criteria. CONCLUSION: The result demonstrates the promise of this approach to collect reference data and identify DLD in multilingual children. The online LITMUS battery has the potential to support identification of multilingual DLD in any target language.

Nonword Repetition in Children With Developmental Language Disorder: Revisiting the Case of Cantonese.

PURPOSE: Nonword repetition (NWR) has been described as a clinical marker of developmental language disorder (DLD), as NWR tasks consistently discriminate between DLD and typical development (TD) cross-linguistically, with Cantonese as the only reported exception. This study reexamines whether NWR is able to generate TD/DLD group differences in Cantonese-speaking children by reporting on a novel set of NWR stimuli that take into account factors known to affect NWR performance and group differentiation, including lexicality, sublexicality, length, and syllable complexity. METHOD: Sixteen Cantonese-speaking children with DLD and 16 age-matched children with TD repeated two sets of high-lexicality nonwords, where all constituent syllables are morphemic in Cantonese but meaningless when combined, and one set of low-lexicality nonwords, where all constituent syllables are nonmorphemic. Low-lexicality nonwords were further classified on sublexicality in terms of consonant-vowel (CV) combination attestedness (whether or not CV combinations in nonword syllables occur in real Cantonese words). RESULTS: Children with DLD scored significantly below their peers with TD. Effect sizes showed that high-lexicality nonwords and nonword syllables with attested CV combinations offered the greatest TD/DLD group differentiation. Nonword length and syllable complexity did not affect TD/DLD group differentiation. CONCLUSIONS: NWR can capture TD/DLD group differences in Cantonese-speaking children. Lexicality and sublexicality effects must be considered in designing NWR stimuli for TD/DLD group differentiation. Future studies should replicate the present study on a larger sample size and a younger population as well as examine the diagnostic accuracy of this NWR test. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25529371.

A Short and Engaging Adaptive Working-Memory Intervention for Children with Developmental Language Disorder: Effects on Language and Working Memory.

Recent research has suggested that working-memory training interventions may benefit children with developmental language disorder (DLD). The current study investigated a short and engaging adaptive working-memory intervention that targeted executive skills and aimed to improve both language comprehension and working-memory abilities in children with DLD. Forty-seven 6- to 10-year-old children with DLD were randomly allocated to an executive working-memory training intervention (n = 24) or an active control group (n = 23). A pre-test/intervention/post-test/9-month-follow-up design was used. Outcome measures included assessments of language (to evaluate far transfer of the training) and working memory (to evaluate near transfer of the training). Hierarchical multiple regression analyses controlling for pre-intervention performance and age found the group to be a significant predictor of sentence comprehension and of performance on six untrained working-memory measures at post-intervention and 9-month follow-up. Children in the intervention group showed significantly higher language comprehension and working-memory scores at both time points than children in the active control group. The intervention programme showed the potential to improve working memory and language comprehension in children with DLD and demonstrated several advantages: it involved short sessions over a short period, caused little disruption in the school day, and was enjoyed by children.

A comparison of formal and informal methods for assessing language and cognition in children with Rett syndrome.

BACKGROUND: Opinions about the cognitive and receptive language skills of people with Rett syndrome (RTT) range from severe intellectual impairment to near-normal development. Assessment is challenging because most are non-verbal, with no purposeful hand use. Clarkson et al. (2017) adapted the Mullen Scales of Early Learning for use with eye gaze technology (MSEL-A/ET) for people with RTT. AIMS: To investigate and compare the performance of children with RTT on formal and newly-designed informal assessments of language and cognition using eye gaze/tracking technology. METHODS AND PROCEDURES: Ten children with RTT aged 4:0-6:8 were assessed on the MSEL-A/ET for Visual Reception (VR) and Receptive Language (RL), and standard MSEL for Expressive Language (EL). Informal assessments of the same skills were embedded in activities such as reading and cake-decorating. OUTCOMES AND RESULTS: Standard scores on MSEL-A/ET VR and RL subtests ranged from 'very low' to 'above average'. All children scored 'very low' on standard EL assessment. Informal assessments added information about EL, with children producing 1-3 word utterances and a range of communicative functions through an eye gaze device. CONCLUSIONS AND IMPLICATIONS: Combining low-tech augmentative and alternative communication, eye gaze technology, informal activities and formal assessment, yields greater insight into children's abilities. This is important in informing suitable support and education for the individual.

Effects of semantic plausibility, syntactic complexity and n-gram frequency on children's sentence repetition.

Theories of language processing differ with respect to the role of abstract syntax and semantics vs surface-level lexical co-occurrence (n-gram) frequency. The contribution of each of these factors has been demonstrated in previous studies of children and adults, but none have investigated them jointly. This study evaluated the role of all three factors in a sentence repetition task performed by children aged 4-7 and 11-12 years. It was found that semantic plausibility benefitted performance in both age groups; syntactic complexity disadvantaged the younger group but benefitted the older group; while contrary to previous findings, n-gram frequency did not facilitate, and in a post-hoc analysis even hampered, performance. This new evidence suggests that n-gram frequency effects might be restricted to the highly constrained and frequent n-grams used in previous investigations, and that semantics and morphosyntax play a more powerful role than n-gram frequency, supporting the role of abstract linguistic knowledge in children's sentence processing.

The Early Sociocognitive Battery: a clinical tool for early identification of children at risk for social communication difficulties and ASD?

BACKGROUND: A substantial proportion of preschool children referred to speech and language therapy (SLT) services have social communication difficulties and/or autistic spectrum disorders (SC&/ASD) that are not identified until late childhood. These 'late' diagnosed children miss opportunities to benefit from earlier targeted interventions. Prior evidence from a follow-up clinical sample showed that preschool performance on the Early Sociocognitive Battery (ESB) was a good predictor of children with social communication difficulties 7-8 years later. AIMS: The aims were three-fold: (1) to determine the impact of child/demographic factors on ESB performance in a community sample of young children; (2) to assess the ESB's concurrent validity and test-retest reliability; and (3) to use cut-offs for 'low' ESB performance derived from the community sample data to evaluate in a clinical sample the predictiveness of the ESB at 2-4 years for outcomes at 9-11 years, including parent-reported SC&/ASD diagnosis. METHODS & PROCEDURES: A community sample of 205 children aged 2-4 years was assessed on the ESB and a receptive vocabulary test. A subsample (n = 20) was retested on the ESB within 2 weeks. Parents completed a questionnaire providing background child/demographic information. The clinical sample from our previous study comprised 93 children assessed on the ESB at 2;6 to < 4;0 whose parents completed the Social Responsiveness Scale (SRS), our measure of social communication, when the children were 9-11 years. Cut-offs for 'low' ESB performance derived from the community sample were used to determine the predictive validity of 'low' ESB scores for social communication outcomes and parent-reported SC&/ASD diagnosis according to age of ESB assessment. OUTCOME & RESULTS: Findings from the community sample confirmed the ESB as psychometrically robust, sensitive to age and language delay, and, in contrast to the receptive vocabulary measure, unaffected by bilingualism. While overall associations between ESB performance and later social communication difficulties in the clinical sample were particularly strong for the youngest age group (2;6 to < 3;0; r = .71, p < .001), 'low' ESB performance was equally predictive across age groups and overall identified 89% of children with 'late' SC&/ASD diagnoses (sensitivity), and 75% of those without (specificity). CONCLUSIONS & IMPLICATIONS: Results indicate that the ESB is a valid preschool assessment suitable for use with children from diverse language backgrounds. It identifies deficits in key sociocognitive skills and is predictive of social communication difficulties in school-age children that had not been identified in preschool clinical assessment, supporting earlier targeted interventions for these children.

What Our Hands Tell Us: A Two-Year Follow-Up Investigating Outcomes in Subgroups of Children With Language Delay.

Purpose This study followed up children identified with expressive language delay (ELD) or receptive/expressive language delay (R/ELD) at 2 years of age, Time 1 (T1), in order to identify their language profiles at 4-5 years, Time 2 (T2), and explore relationships to T1 language, gesture use, and symbolic comprehension. Method Nineteen of 22 children were seen at follow-up (9 of 10 from R/ELD group, 10 of 12 from ELD group). T1 measures assessed receptive and expressive language, gesture use, and symbolic comprehension. At T2, we assessed receptive and expressive language, sentence repetition, and expressive phonology. Results Outcomes for the R/ELD group were significantly poorer, with all children continuing to have delay in receptive and/or expressive language compared to just 20% of the ELD group. Expressive phonology delay was common in both groups. T1 receptive language showed the most pervasive correlations with T2 language measures, but categorical performance on all three T1 measures correctly predicted language outcomes in 16-17 of the 19 children. Conclusion Findings add to evidence that receptive language is a strong predictor of outcomes. Gesture use and symbolic comprehension are also strong predictors and clinically valuable as part of play-based assessments with implications for theoretical understanding and intervention planning.

Nonword repetition depends on the frequency of sublexical representations at different grain sizes: Evidence from a multi-factorial analysis.

The nonword repetition task (NWR) has been widely used in basic cognitive and clinical research, as well as in clinical assessment, and has been proposed as a clinical marker for Specific Language Impairment (SLI). Yet the mechanisms underlying performance on this task are not clear. This study offers insights into these mechanisms through a comprehensive examination of item-related variables identified in previous research as possibly contributing to NWR scores and through testing the predictive power of each in relation to the others. A unique feature of the study is that all factors are considered simultaneously. Fifty-seven typically developing children were tested with a NWR task containing 150 nonwords differing in length, phonotactic probability, lexical neighbourhood and phonological complexity. The results indicate that phonological processing of novel words draws on sublexical representations at all grain sizes and that these representations are phonological, unstructured and insensitive to morphemehood. We propose a novel index - mean ngram frequency of all phonemes - that best captures the extent to which a nonword draws on sublexical representations. The study demonstrates the primacy of sublexical representations in NWR performance with implications for the nature of the deficit in SLI.

Noun and verb knowledge in monolingual preschool children across 17 languages: Data from Cross-linguistic Lexical Tasks (LITMUS-CLT).

This article investigates the cross-linguistic comparability of the newly developed lexical assessment tool Cross-linguistic Lexical Tasks (LITMUS-CLT). LITMUS-CLT is a part the Language Impairment Testing in Multilingual Settings (LITMUS) battery (Armon-Lotem, de Jong & Meir, 2015). Here we analyse results on receptive and expressive word knowledge tasks for nouns and verbs across 17 languages from eight different language families: Baltic (Lithuanian), Bantu (isiXhosa), Finnic (Finnish), Germanic (Afrikaans, British English, South African English, German, Luxembourgish, Norwegian, Swedish), Romance (Catalan, Italian), Semitic (Hebrew), Slavic (Polish, Serbian, Slovak) and Turkic (Turkish). The participants were 639 monolingual children aged 3;0-6;11 living in 15 different countries. Differences in vocabulary size were small between 16 of the languages; but isiXhosa-speaking children knew significantly fewer words than speakers of the other languages. There was a robust effect of word class: accuracy was higher for nouns than verbs. Furthermore, comprehension was more advanced than production. Results are discussed in the context of cross-linguistic comparisons of lexical development in monolingual and bilingual populations.

A Framework for Crosslinguistic Nonword Repetition Tests: Effects of Bilingualism and Socioeconomic Status on Children's Performance.

Purpose: As a recognized indicator of language impairment, nonword repetition has unique potential for distinguishing language impairment from difficulties due to limited experience and knowledge of a language. This study focused on a new Crosslinguistic Nonword Repetition framework, comprising 3 tests that vary the phonological characteristics of nonwords, in the quest for an assessment that minimizes effects of language experience and knowledge and thereby maximizes potential for assessing children with diverse linguistic experience. Method: The English version of the new framework was administered, with a test of receptive vocabulary, to 4- to 7-year-old monolingual and bilingual children with typical development (n = 21 per group) from neighborhoods with midhigh and low socioeconomic status (SES). Results: Receptive vocabulary was affected by both bilingualism and neighborhood SES. In contrast, no effects of bilingualism or neighborhood SES were found on 2 of our nonword repetition tests, whereas the most language-specific test yielded a borderline effect of neighborhood SES but no effect of bilingualism. Conclusions: The findings support the potential of the new tests for assessing children regardless of lingual or socioeconomic background. They also highlight the importance of considering the characteristics of nonword targets and investigating the compound influence of bilingualism and SES on different language assessments.

Ratings of age of acquisition of 299 words across 25 languages: Is there a cross-linguistic order of words?

We present a new set of subjective age-of-acquisition (AoA) ratings for 299 words (158 nouns, 141 verbs) in 25 languages from five language families (Afro-Asiatic: Semitic languages; Altaic: one Turkic language: Indo-European: Baltic, Celtic, Germanic, Hellenic, Slavic, and Romance languages; Niger-Congo: one Bantu language; Uralic: Finnic and Ugric languages). Adult native speakers reported the age at which they had learned each word. We present a comparison of the AoA ratings across all languages by contrasting them in pairs. This comparison shows a consistency in the orders of ratings across the 25 languages. The data were then analyzed (1) to ascertain how the demographic characteristics of the participants influenced AoA estimations and (2) to assess differences caused by the exact form of the target question (when did you learn vs. when do children learn this word); (3) to compare the ratings obtained in our study to those of previous studies; and (4) to assess the validity of our study by comparison with quasi-objective AoA norms derived from the MacArthur-Bates Communicative Development Inventories (MB-CDI). All 299 words were judged as being acquired early (mostly before the age of 6 years). AoA ratings were associated with the raters' social or language status, but not with the raters' age or education. Parents reported words as being learned earlier, and bilinguals reported learning them later. Estimations of the age at which children learn the words revealed significantly lower ratings of AoA. Finally, comparisons with previous AoA and MB-CDI norms support the validity of the present estimations. Our AoA ratings are available for research or other purposes.

A Quasi-Universal Nonword Repetition Task as a Diagnostic Tool for Bilingual Children Learning Dutch as a Second Language.

PURPOSE: This study evaluated a newly developed quasi-universal nonword repetition task (Q-U NWRT) as a diagnostic tool for bilingual children with language impairment (LI) who have Dutch as a 2nd language. The Q-U NWRT was designed to be minimally influenced by knowledge of 1 specific language in contrast to a language-specific NWRT with which it was compared. METHOD: One hundred twenty monolingual and bilingual children with and without LI participated (30 per group). A mixed-design analysis of variance was used to investigate the effects of LI and bilingualism on the NWRTs. Receiver operating characteristic analyses were conducted to evaluate the instruments' diagnostic value. RESULTS: Large negative effects of LI were found on both NWRTs, whereas negative effects of bilingualism only occurred on the language-specific NWRT. Both instruments had high clinical accuracy in the monolingual group, but only the Q-U NWRT had high clinical accuracy in the bilingual group. CONCLUSIONS: This study indicates that the Q-U NWRT is a promising diagnostic tool to help identify LI in bilingual children learning Dutch as a 2nd language. The instrument was clinically accurate in both a monolingual and bilingual group of children and seems better able to disentangle LI from language disadvantage than more language-specific measures.

What Our Hands Say: Exploring Gesture Use in Subgroups of Children With Language Delay.

PURPOSE: The aim of this study was to investigate whether children with receptive-expressive language delay (R/ELD) and expressive-only language delay (ELD) differ in their use of gesture; to examine relationships between their use of gesture, symbolic comprehension, and language; to consider implications for assessment and for the nature of problems underlying different profiles of early language delay. METHOD: Twelve children with ELD (8 boys, 4 girls) and 10 children with R/ELD (8 boys, 2 girls), aged 2-3 years, were assessed on measures of gesture use and symbolic comprehension. RESULTS: Performance of the R/ELD group was significantly poorer than performance of the ELD group on measures of gesture and symbolic comprehension. Gesture use and symbolic comprehension were significantly associated with receptive language, but associations with expressive language were not significant. CONCLUSIONS: Findings of this study support previous research pointing to links between gesture and language development, and more specifically, between delays in gesture, symbolic understanding, and receptive rather than expressive language. Given potentially important implications for the nature of problems underlying ELD and R/ELD, and for assessment of children with language delay, this preliminary study invites further investigation comparing the use of different gesture types in samples of children matched on age and nonverbal IQ.

Sentence repetition: what does the task measure?

BACKGROUND: Sentence repetition is gaining increasing attention as a source of information about children's sentence-level abilities in clinical assessment, and as a clinical marker of specific language impairment. However, it is widely debated what the task is testing and therefore how informative it is. AIMS: (1) To evaluate the effects of different types of long-term linguistic knowledge on immediate recall, (2) to assess age sensitivity of repetition tasks designed to evaluate these effects, and (3) to establish if the effects are similar across typologically different languages. The study also considers the implications of the findings for the use of sentence repetition as a research and clinical assessment tool. METHODS & PROCEDURES: Participants were 50 English-speaking and 50 Czech-speaking typically developing 4-5-year-olds. Children's ability to recall sequences of items was compared in seven linguistic conditions ranging from fully well-formed sentences to sequences of non-words. In each condition, children repeated blocks of successively longer stimuli to establish their span. OUTCOMES & RESULTS: Results showed significant but differential effects of all linguistic factors in both languages. While syntactic violations and presence of non-words dramatically reduced children's span, semantic implausibility and the removal of sentence prosody played a significant but much smaller role. Familiarity of function words was more important than familiarity of content words. The effects of different linguistic factors on spans were the same for both languages and did not change between 4 and 5 years, although average spans increased over this age range. CONCLUSIONS & IMPLICATIONS: Children's ability to repeat sentences is more dependent on their familiarity with morphosyntax and lexical phonology than semantics or prosody, with function words of particular importance. Findings have implications for the use of recall in clinical assessment and as a research tool.

Semantic effects in sentence recall: the contribution of immediate vs delayed recall in language assessment.

UNLABELLED: Sentence recall is increasingly used to assess language. It is widely debated what the task is actually testing, but one rarely explored aspect is the contribution of semantics to sentence recall. The few studies that have examined the role of semantics in sentence recall have employed an 'intrusion paradigm', following Potter and Lombardi (1990), and their paradigm relies on interference errors with conclusions based on an analysis of error patterns. We have instead manipulated the semantic plausibility of whole sentences to investigate the effects of semantics on immediate and delayed sentence recall. In Study 1, adults recalled semantically plausible and implausible sentences either immediately or after distracter tasks varying in lexical retrieval demands (backward counting and picture naming). Results revealed significant effects of plausibility, delay, and a significant interaction indicating increasing reliance on semantics as the demands of the distracter tasks increased. Study 2, conducted with 6-year-old children, employed delay conditions that were modified to avoid floor effects (delay with silence and forward counting) and a similar pattern of results emerged. This novel methodology provided robust evidence showing the effectiveness of delayed recall in the assessment of semantics and the effectiveness of immediate recall in the assessment of morphosyntax. The findings from our study clarify the linguistic mechanisms involved in immediate and delayed sentence recall, with implications for the use of recall tasks in language assessment. LEARNING OUTCOMES: The reader will be able to: (i) define the difference between immediate and delayed sentence recall and different types of distractors, (ii) explain the utility of immediate and delayed recall sentence recall in language assessment, (iii) discuss suitability of delayed recall for the assessment of semantics.

Early predictors of language and social communication impairments at ages 9-11 years: a follow-up study of early-referred children.

PURPOSE: In this study, the authors aimed to evaluate hypotheses that early sociocognition will predict later social communication and early phonology will predict later morphosyntax in clinically referred preschoolers. METHOD: Participants were 108 children ages 9-11 years who had been referred to clinical services with concerns about language at age 2½-3½ years. Predictors at Time 1 (T1) were measures of sociocognition, word/nonword repetition, and receptive language. Outcome measures at Time 3 (T3) included a social communication questionnaire completed by parents and tests of nonword repetition, morphosyntax, and receptive language. RESULTS: Group- and case-level analyses revealed early sociocognition to be the strongest predictor of social communication problems, which by T3 affected almost one third of the sample. At the group level, early phonology, which was a significant problem for the majority of children at T1, was a weak predictor of morphosyntax at T3. However, at the case level the majority of children with poor morphosyntax and nonword repetition at outcome had had very low repetition scores at T1. CONCLUSIONS: In early language referrals, it is important to identify and address sociocognitive problems, a considerable risk for later social communication and autism spectrum disorders. The majority of early-referred children had phonological problems, often severe, but these require further investigation to determine their longer term significance for language.

Nonverbal imitation skills in children with specific language delay.

Research in children with language problems has focussed on verbal deficits, and we have less understanding of children's deficits with nonverbal sociocognitive skills which have been proposed to be important for language acquisition. This study was designed to investigate elicited nonverbal imitation in children with specific language delay (SLD). It is argued that difficulties in nonverbal imitation, which do not involve the processing of structural aspects of language, may be indicative of sociocognitive deficits. Participants were German-speaking typically developing children (n=60) and children with SLD (n=45) aged 2-3 ½ years. A novel battery of tasks measured their ability to imitate a range of nonverbal target acts that to a greater or lesser extent involve sociocognitive skills (body movements, instrumental acts on objects, pretend acts). Significant group differences were found for all body movement and pretend act tasks, but not for the instrumental act tasks. The poorer imitative performance of the SLD sample was not explained by motor or nonverbal cognitive skills. Thus, it appeared that the nature of the task affected children's imitation performance. It is argued that the ability to establish a sense of connectedness with the demonstrator was at the core of children's imitation difficulty in the SLD sample.

'A place where I can be me': a role for social and leisure provision to support young people with language impairment.

BACKGROUND: The long-term well-being of children with language impairment is an area of increasing interest to families, educators and employers as language impairment is often life-long. Furthermore, language impairment and psychiatric difficulty are known to overlap in both populations originally diagnosed as having language impairment and those receiving mental health services. However, there are currently little data available about the wider quality of life for people with language impairment, especially from the perspective of the young people themselves. There is a dearth of information about community-based activities provided for the support and leisure of this population. The Afasic Youth Project meets once a week and is one of only a handful of such groups across the United Kingdom. METHODS & PROCEDURES: This study reports the experiences and views of 19 young people aged 13-23 years attending a leisure provision for young people with primary communication needs. The views of 20 parents were also gained. Interviews with young people and parents were based on items used in the Manchester Language Study in which a large group of young people with a history of language difficulties (n= 130) and typically developing 16-year-olds (n= 109) expressed their views on a range of quality of life measures. This allows a context against which to evaluate the responses of the young people in the study. An additional section of the interview was designed to address the young people's views on the Afasic Youth Project specifically. OUTCOMES & RESULTS: Social patterns of the young people were very similar to those reported by the Manchester Language Study indicating that they are a group relatively representative of the language impairment population. A number of positive themes emerged in relation to the club, which included freedom to be true to self, and meeting similar individuals. Interestingly, parents expressed some similar themes, but also had additional thoughts about the group, including the need to meet other parents in similar situations and the belief that the group was aiding social development. CONCLUSIONS & IMPLICATIONS: The analysis suggests that community-based social and leisure provision is an important 'missing' service for young people with language impairment, providing an alternative to school-based activities and support older teenagers beyond compulsory education. There is a pressing need to investigate the potential role of such facilities given that recent research into language impairment has clearly shown associations with long-term and wide-ranging social and emotional risk.

Sentence imitation as a tool in identifying expressive morphosyntactic difficulties in children with severe speech difficulties.

BACKGROUND: Sentence imitation has been identified as a good indicator of children's language skills, with performance differentiating children with specific language impairment and showing relationships with other language measures. It has a number of advantages over other methods of assessment. The assessment of morphosyntax in children who have severe speech difficulties presents unique challenges which currently available sentence imitation assessments do not address. AIMS: This paper presents a new sentence imitation test (The Sentence Imitation Test (SIT-61)) and reports on an investigation which sets out to determine whether this test (1) reveals differences in performance between a group of children diagnosed with specific language impairment and a group of typically developing children (2) reveals distinct profiles of performance amongst children with different speech difficulties, and (3) provides information about morphosyntactic strengths and difficulties. METHODS & PROCEDURES: SIT-61 is a finely graded sentence imitation test in which the phonotactic structure, segmental phonology and length of words were kept as developmentally simple as possible. Responses are scored for number of content words, function words and inflections correct. A novel scoring system was devised to credit a child where there was evidence of targeting a morpheme even if it was mispronounced. The test was administered to four groups of children between the ages of 4 and 6 years: 33 children with typical development, 13 children with known expressive morphosyntactic difficulties (specific language impairment), and two groups of 14 children with different types of speech disorder: a group with consistent phonological disorder, who used atypical phonological error patterns consistently; and a group with inconsistent phonological disorder, who produced atypical phonological errors inconsistently. OUTCOMES & RESULTS: SIT-61 found differences in performance between the group of typically developing participants and the three clinic groups. While the consistent phonological disorder group obtained extremely high scores for content and function words, they obtained lower inflection scores reflective of their speech difficulties. The scores of the specific language impairment and inconsistent phonological disorder groups were comparable for content and function words, but the groups were differentiated through an analysis of their errors. Further analyses confirmed that low scores obtained by some children in the inconsistent phonological disorder group were due to morphosyntactic difficulties and not speech difficulties. CONCLUSIONS & IMPLICATIONS: A new sentence imitation test, the SIT-61, is shown to be valuable tool for identifying expressive morphosyntactic difficulties in children. It is informative about the morphosyntactic abilities of children with speech disorders and raises questions as to the nature of their difficulties.

Evaluation of speech and language therapy interventions for pre-school children with specific language impairment: a comparison of outcomes following specialist intensive, nursery-based and no intervention.

BACKGROUND: Clinical services in the UK are increasingly delivering 'consultative' methods of intervention rather than 'direct' intensive input for children with receptive and expressive language difficulties, yet there has been little systematic evaluation of these different intervention models. AIMS: To investigate the effectiveness of different models of therapy provision for children with specific language impairment between the ages of 4;00 and 4;06 years. METHODS & PROCEDURES: Twenty-four children were selected from a specialist waiting list in the London Borough of Lambeth. They were assessed on a range of verbal and non-verbal skills, and randomly assigned to three different intervention groups. Group 1 received direct intensive speech and language therapy weekly over an 8-month period at a child development centre; Group 2 received a nursery-based model of intervention; and Group 3 received review sessions at their local clinic. OUTCOME & RESULTS: Statistical analysis before the intervention phase revealed no significant differences in scores between the three groups on a range of clinical and parental measures of language, non-verbal skills, play and behaviour. At the end of the intervention period the Intensive group showed significantly greater improvement than the No Intervention group on all clinical and parental measures, and significantly greater improvement than the Nursery-based group on all clinical and parental measures except for expressive grammar. CONCLUSIONS & IMPLICATIONS: The results of this small-scale study demonstrate that intensive direct speech and language therapy delivered by speech and language therapists was a more effective model of intervention for this clinical group with severe speech and language impairment.