FLP: Factor lattice pattern-based automated detection of Parkinson's disease and specific language impairment using recorded speech.

BACKGROUND: Timely detection of neurodevelopmental and neurological conditions is crucial for early intervention. Specific Language Impairment (SLI) in children and Parkinson's disease (PD) manifests in speech disturbances that may be exploited for diagnostic screening using recorded speech signals. We were motivated to develop an accurate yet computationally lightweight model for speech-based detection of SLI and PD, employing novel feature engineering techniques to mimic the adaptable dynamic weight assignment network capability of deep learning architectures. MATERIALS AND METHODS: In this research, we have introduced an advanced feature engineering model incorporating a novel feature extraction function, the Factor Lattice Pattern (FLP), which is a quantum-inspired method and uses a superposition-like mechanism, making it dynamic in nature. The FLP encompasses eight distinct patterns, from which the most appropriate pattern was discerned based on the data structure. Through the implementation of the FLP, we automatically extracted signal-specific textural features. Additionally, we developed a new feature engineering model to assess the efficacy of the FLP. This model is self-organizing, producing nine potential results and subsequently choosing the optimal one. Our speech classification framework consists of (1) feature extraction using the proposed FLP and a statistical feature extractor; (2) feature selection employing iterative neighborhood component analysis and an intersection-based feature selector; (3) classification via support vector machine and k-nearest neighbors; and (4) outcome determination using combinational majority voting to select the most favorable results. RESULTS: To validate the classification capabilities of our proposed feature engineering model, designed to automatically detect PD and SLI, we employed three speech datasets of PD and SLI patients. Our presented FLP-centric model achieved classification accuracy of more than 95% and 99.79% for all PD and SLI datasets, respectively. CONCLUSIONS: Our results indicate that the proposed model is an accurate alternative to deep learning models in classifying neurological conditions using speech signals.

Phonological awareness training and phonological therapy approaches for specific language impairment children with speech sound disorders: a comparative outcome study.

PURPOSE: Children with specific language impairment (SLI) might present with speech sound disorder (SSD) and phonological awareness (PA) deficits which put them at risk of potential reading problems. This work aimed to organize an intervention program in Arabic for phonological training and to assess the effect of PA training versus the phonological therapy (PT) for children with SLI and SSD. METHODS: The study was carried out on 60 children with comorbid SLI and SSD, aged 5-7 years. Children were equally divided into two groups; each group received language therapy combined with (PT or PA training). Measures of language development, phonological output, and PA were taken before therapy and at 4 month post-therapy for all children. RESULTS: The two therapy groups made nearly the same amount of progress in the development of language and phonological production, with no significant differences regarding language age and percent of consonants correct (PCC). The PA training group progressed more on the PA skills than children who received PT over the same time. CONCLUSIONS: PA training could facilitate the development of phonological skills by targeting the child's awareness of phonemes and improving the production of sound patterns.

Perfil de atos comunicativos de crianças com transtorno do desenvolvimento de linguagem / Profile of communicative acts of children with developmental language disorder

RESUMO Objetivo Caracterizar os atos comunicativos de crianças com transtorno do desenvolvimento da linguagem, verificando a quantidade de atos comunicativos, atos comunicativos interativos e sua relação com a idade cronológica. Métodos Foram participantes 40 crianças de ambos os gêneros com diagnóstico de transtorno do desenvolvimento da linguagem com idades entre 3 anos e 2 meses e 7 anos e 11 meses. Todos os sujeitos foram avaliados com a Prova de Pragmática ABFW - Teste de Linguagem Infantil, em sua avaliação inicial. Especificamente para este estudo, focou-se na verificação da quantidade de atos comunicativos, atos comunicativos por minuto, atos comunicativos interativos e número de iniciativas comunicativas. Resultados Os dados indicaram que crianças com transtorno do desenvolvimento da linguagem apresentam alterações importantes em relação aos atos comunicativos e interações comunicativas e há correlação dessas variáveis com a idade cronológica. Conclusão Crianças com transtorno do desenvolvimento da linguagem apresentam diminuição no número de atos comunicativos, atos comunicativos interativos e interações comunicativas, quando comparadas aos valores de referência de crianças típicas, independentemente da idade.

ABSTRACT Purpose To characterize the communicative acts of children with Developmental Language Disorder, verifying the number of communicative acts, interactive communicative acts, and their relationship with chronological age. Methods Forty children of both sexes with a diagnosis of Developmental Language Disorder aged between 3 years and seven years and 11 months were subjects. All subjects were assessed with the ABFW Pragmatics Test - Child Language Test in their initial assessment. Specifically, this study focused on verifying the number of communicative acts, communicative acts per minute, interactive communicative acts, and the number of communicative initiatives. Results The data indicate that children with Developmental Language Disorder present significant alterations concerning communicative acts and communicative interactions, and there is a correlation between these variables and chronological age. Conclusion Children with Developmental Language Disorder show a decrease in the number of communicative acts, interactive communicative acts, and communicative interactions when compared to the reference values of typical children, regardless of age.

Alterações pragmáticas em crianças com Transtorno Fonológico: uma revisão sistemática / Pragmatic disorders in children with Phonological Disorder: a systematic review / Alteraciones pragmáticas en niños con Trastorno Fonológico: una revisión sistemática

Introdução: A pragmática é definida como o uso social da linguagem e a fonologia diz respeito à organização fonêmica e silábica. No Transtorno Fonológico são observadas alterações nessa organização, sendo possível também afetar a pragmática. Objetivo: Compreender e demonstrar se há alterações pragmáticas em crianças com Transtorno Fonológico. Metodologia: A busca por estudos foi realizada utilizando as bases de dados eletrônicas: Embase, Google Scholar, Portal Biblioteca Virtual em Saúde (BVS) - (LILACS), PubMed, SciELO, Scopus, Web of Science, e Base de Dados de Teses e Dissertações. Foram utilizados os descritores: "child", "speech sound disorder", "language tests", "verbal behavior", "social communication disorder" e "observational studies as topic" e seus sinônimos. Os artigos selecionados atendiam aos seguintes critérios: amostra composta por crianças de 4 a 10 anos com Transtorno Fonológico e dentro do desenvolvimento padrão, apresentar avaliações da pragmática dessas crianças, e delineamento observacional. A análise dos artigos foi feita pela leitura na íntegra e os dados foram extraídos para a avaliação da qualidade metodológica e dos achados. Resultados: Foram encontrados seis artigos, sendo quatro nacionais e dois internacionais. Discussão: Cinco estudos demonstraram haver alterações pragmáticas em crianças com Transtorno Fonológico, enquanto um concluiu que não havia relação. Considerações finais: A presente revisão sistemática revelou que estudos evidenciam alterações pragmáticas em crianças com Transtorno Fonológico, especialmente acerca da inteligibilidade de fala e de como isso afeta as iniciativas de comunicação. Todavia, devido ao baixo número de estudos, são necessárias futuras pesquisas na temática para dados com evidências mais robustas. (AU)

Introduction: Pragmatics is defined as the social use of language while phonology looks to phonemic and syllabic organization. In the phonological disorder, problems are observed in this organization being possible to affect the pragmatics too. Objective: To understand and demonstrate if there are pragmatic alterations in children with Phonological Disorder. Methodology: The search for studies was carried out using electronic databases: Embase, Google Scholar, BVS - (LILACS), PubMed, SciELO, Scopus, Web of Science and The Theses and Dissertations Database. The descriptors used were: "child", "speech sound disorder", "language tests", "verbal behavior", "social communication disorder" and "observational studies as topic" and their synonyms. The selected articles met the following criteria: sample composed of children aged 4 to 10 with phonological disorder and within standard development, evaluations of the pragmatics of these children, and observational design. The articles were analyzed by reading them in their entirety and the data were extracted to evaluate the methodological quality and the findings. Results: Six articles were found, four national and two international. Discussion: Five studies showed that there were pragmatic alterations in children with phonological disorder and one concluded that there was no relationship. Final considerations: The present systematic review revealed that the studies show pragmatic alterations in children with phonological disorder, especially regarding the intelligibility of their speech and how this may affect communication initiatives. However, due to the low number of studies, there seems to be a need for future research relating the two subjects for such evidence to be more robust. (AU)

Introducción: La pragmática se define como el uso social del lenguaje y la fonología como la organización fonémica y silábica. En el Trastorno Fonológico, hay cambios en esta organización, y es posible afectar la pragmática. Objetivo: Comprender y demostrar si existen cambios pragmáticos en niños con Trastorno Fonológico. Metodología: Búsqueda de estudios realizados en bases de datos electrónicas: Embase, Google Scholar, Portal Biblioteca Virtual en Salud (BVS) - (LILACS), PubMed, SciELO, Scopus, Web of Science y Banco de Tesis y Disertaciones. Fueron utilizados los siguientes descriptores: "niño", "trastorno de los sonidos del habla", "pruebas de lenguaje", "conducta verbal", "trastorno de la comunicación social" y "estudios observacionales como tema" y sus sinónimos. Los artículos seleccionados cumplieron con los siguientes criterios: muestra compuesta por niños de 4 a 10 años con Trastorno Fonológico y dentro del desarrollo estándar, valoraciones de la pragmática de estos niños y diseño observacional. Los artículos fueron analizados mediante lectura comprensiva y se extrajeron datos para evaluar la calidad metodológica de los hallazgos. Resultados: Se encontraron seis artículos, cuatro nacionales y dos internacionales. Discusión: Cinco estudios mostraron cambios pragmáticos en niños con Trastorno Fonológico y uno concluyó que no había relación. Consideraciones finales: Esta revisión sistemática reveló que los estudios muestran alteraciones pragmáticas en niños con Trastorno Fonológico, especialmente en cuanto a la inteligibilidad de su habla y cómo esto puede afectar las iniciativas de comunicación. Sin embargo, debido al bajo número de estudios, se necesita más investigación sobre el tema para que la evidencia sea más sólida. (AU)

Resting-state EEG alpha rhythm spectral power in children with specific language impairment: a cross-sectional study.

PURPOSE: This study investigated EEG alpha rhythm spectral power in children with Specific Language Impairment (SLI) and compared it to typically developing children to better understand the electrophysiological characteristics of this disorder. Specifically, we explored resting-state EEG, because there are studies that point to it being linked to speech and language development. METHODS: EEG recordings of 30 children diagnosed with specific language impairment and 30 typically developing children, aged 4.0-6.11 years, were carried out under eyes closed and eyes open conditions. Differences in alpha rhythm spectral power in relation to brain topography and experimental conditions were calculated. RESULTS: In the eyes closed condition, alpha rhythm spectral power was statistically significantly lower in children with specific language impairment in the left temporal (T5) and occipital electrodes (O1, O2) than in typically developing children. In the eyes open condition, children with SLI showed significantly lower alpha rhythm spectral power in the left temporal (T3, T5), parietal (P3, Pz), and occipital electrodes (O1, O2). There were no statistically significant differences between the groups in relation to the relative change (the difference between average alpha rhythm spectral power during eyes closed condition and average alpha rhythm spectral power during eyes open condition divided by average alpha rhythm spectral power during eyes closed condition) in the alpha rhythm spectral power between the conditions. CONCLUSION: Lower alpha rhythm spectral power in the left temporal, left, midline parietal, and occipital brain regions could be a valuable electrophysiological marker in children with SLI. Further investigation is needed to examine the connection between EEG alpha spectral power and general processing and memory deficits in patients with SLI.

Longitudinal Grammaticality Judgments of Tense Marking in Complex Questions in Children With and Without Specific Language Impairment, Ages 5-18 Years.

PURPOSE: Identification of children with specific language impairment (SLI) can be difficult even though their language can lag that of age peers throughout childhood. A clinical grammar marker featuring tense marking in simple clauses is valid and reliable for young children but is limited by ceiling effects around the age of 8 years. This study evaluated a new, more grammatically challenging complex sentence task in children affected or unaffected with SLI in longitudinal data, ages 5-18 years. METHOD: Four hundred eighty-three children (213 unaffected, 270 affected) between 5 and 18 years of age participated, following a rolling recruitment longitudinal design encompassing a total of 4,148 observations. The new experimental grammaticality judgment task followed linguistic concepts of syntactic sites for finiteness and movement within complex clauses. Growth modeling methods evaluated group differences over time for four different outcomes; three were hypothesized to evaluate optional omissions of overt finiteness forms in authorized sentence sites, and one evaluated an overt error of tense marking. RESULTS: As in earlier studies of younger children, growth models for the SLI group were consistently lower than the unaffected group, although the growth trajectories across groups did not differ. The results replicated across four item types defined by omissions with minor differences for an item with an overt error of tense marking. Covariates of child nonverbal IQ, mother's education, and child sex did not significantly moderate these effects. CONCLUSION: The outcomes support the task as having potential screening value for identification of children with SLI and are consistent with linguistic interpretations of task demands.

The comprehension of relative clauses in Mandarin Children with suspected specific language impairment.

This paper investigates the comprehension of Relative Clauses (RCs) in 15 Mandarin children with suspected Specific Language Impairment (SLI) (aged between 4; 5 and 6; 0) and 29 typically developing (TD) controls. Results from a Character Picture Matching Task indicate that (i) the subject RC was better understood than the object RC in children with SLI, but there was no asymmetry in the comprehension of the two RCs in TD children; (ii) the performance of children with SLI was significantly worse than that of their TD peers; (iii) children with SLI were prone to committing thematic role reversal errors and middle errors. In order to overcome the shortcomings of previous accounts, we therefore put forward the Edge Feature Underspecification Hypothesis, which can not only explain the asymmetry of comprehension seen in children with SLI but also shed light on the nature of errors committed by them in the task.

Procesamiento sensorial en menores de seis años con trastorno específico del lenguaje / Sensory processing in children under six years of age with specific language disorder

Introducción: El procesamiento sensorial determina e influencia el nivel de desarrollo que presentan los individuos en la infancia y cuando se afecta alguno de los sistemas que lo integran, se alteran dominios del desarrollo que impiden a los niños desenvolverse de manera adecuada en su entorno. Objetivos: Describir y comparar el procesamiento sensorial de los niños con trastorno específico del lenguaje y con desarrollo típico del lenguaje. Métodos: La muestra estuvo conformada por 60 niños con edades de 4 a 5 años de la escuela especial de lenguaje San Clemente, asignados a dos grupos de acuerdo con la presencia o ausencia de trastorno específico del lenguaje. El procesamiento sensorial se evaluó mediante la escala de procesamiento sensorial. Se evaluó el tipo de distribución de las variables de la escala para su posterior análisis. Resultados: Los niños con trastorno específico del lenguaje obtuvieron 275 puntos y se ubicaron por debajo del puntaje de corte, en cambio los menores con desarrollo típico obtuvieron 309 puntos y se situaron por sobre el puntaje de corte. Es decir, los niños con trastorno específico del lenguaje presentaron un procesamiento sensorial más bajo en comparación con los niños que poseen desarrollo típico del lenguaje con diferencias significativas en el sistema auditivo y propioceptivo. Conclusiones: Los niños con trastorno específico del lenguaje exhiben un desempeño más bajo en tareas de procesamiento sensorial, es por ello, que este último debe ser considerado en la evaluación y diagnóstico de niños con este trastorno para generar un abordaje más integral(AU)

Introduction: Sensory processing determines and influences the level of development presented by individuals in childhood and when any of the systems that integrate it are affected. Developmental domains are altered and they prevent children from developing adequately in their environment. Objectives: To describe and compare sensory processing in children with specific language impairment and typical language development. Methods: The sample consisted of 60 children aged 4 to 5 years from the San Clemente Special Language School, whom were assigned to two groups according to the presence or absence of specific language disorder. Sensory processing was assessed using the sensory processing scale. The type of distribution of the scale variables was evaluated for further analysis. Results: Children with specific language disorder obtained 275 points and were below the cut-off score, while children with typical development obtained 309 points and were above the cut-off score. That is, children with specific language disorder have lower sensory processing compared to children with typical language development with significant differences in the auditory and proprioceptive system. Conclusions: Children with specific language disorder show lower performance in sensory processing tasks, which is why the latter should be considered in the evaluation and diagnosis of children with this disorder to generate a more comprehensive approach(AU)

Experiencias de fonoaudiólogos/as al realizar telerehabilitación a niños preescolares con trastorno del desarrollo del lenguaje en contexto de pandemia / Experiences of speech-language therapists providing teletherapy to preschoolers during the COVID-19 pandemic

El confinamiento como medida sanitaria a causa del COVID-19 ha obligado la adopción de la modalidad virtual en los sistemas escolares del mundo. Los fonoaudiólogos/as que trabajan con niños/as preescolares que presentan alteraciones del lenguaje han debido modificar su metodología de trabajo usual para lograr los objetivos terapéuticos y educativos de los planes de intervención que aplican. En esta investigación se buscó describir la percepción que tienen los fonoaudiólogos/as acerca de la experiencia de realizar telerehabilitación a niños/as preescolares con trastorno del desarrollo del lenguaje en contexto de pandemia. Se diseñó un estudio cualitativo, con enfoque fenomenológico. A la muestra de 10 fonoaudiólogas, reclutadas por conveniencia, se les realizó entrevistas focalizadas semiestructuradas. El análisis fenomenológico de los datos obtenidos se realizó mediante la obtención de subcódigos, códigos y categorías, de forma manual. Del análisis surgen las siguientes categorías temáticas: valoración de la experiencia,efectividad de la intervención virtual, preparación de las sesiones y participación de los padres. Las vivencias expuestas en las entrevistas realizadas permiten señalar elementos críticos relacionados con el improvisado y repentino cambio de modalidad, la escasa formación y/o preparación de las terapeutas para implementar la telepráctica, la administración de recursos y la sensación de infectividad de la intervención. Si bien las intervenciones virtuales se han establecido como una alternativa a lo presencial, se concluye que esta fue poco aceptada entre las fonoaudiólogas entrevistadas, ya que se las considera demandantes y poco efectivas para niños/as tan pequeños/as. Se resalta que el compromiso de los padres, madres y/o cuidadores/as es fundamental para lograr un proceso exitoso.

Confinement, as a sanitary measure due to the COVID-19 pandemic, has forced school systems around the world to adapt their lessons to the virtual modality. Speech-language therapists working with preschool children who present language disorders have had to modify their usual work methodology to achieve their therapeutic and educational goals. This research sought to describe the perception speech-language therapists had of their experience providing telerehabilitation to preschool children with developmental language disorder during the pandemic. The study design was qualitative with a phenomenological approach. The sample was made up of 10 female speech-language therapists, recruited through convenience sampling, who were interviewed using semi-structured interviews. The data were analyzed phenomenologically, obtaining subcodes, codes, and categories manually. The following thematic categories emerged from the analysis: evaluation of the experience, effectiveness of the virtual intervention, session preparation, and parental participation. The experiences shared during the interviews allowed us to detect critical elements related to the improvised and sudden modality change, the lack of training and/or preparation of the therapists to implement telepractice, resource administration, and a perception of ineffectiveness regarding the intervention. Although virtual interventions have been established as an alternative to in-person intervention, it is concluded that it was not widely accepted among the speech-language therapists interviewed in this research, who deemed this modality demanding and ineffective for such young children. We emphasize the importance of parental and/or caregiver commitment to achieve success during the process of teletherapy.

Electroen cephalography correlates of word and non-word listening in children with specific language impairment: An observational study20F0.

Auditory processing in children diagnosed with speech and language impairment (SLI) is atypical and characterized by reduced brain activation compared to typically developing (TD) children. In typical speech and language development processes, frontal, temporal, and posterior regions are engaged during single-word listening, while for non-word listening, it is highly unlikely that perceiving or speaking them is not followed by frequent neurones' activation enough to form stable network connections. This study aimed to investigate the electrophysiological cortical activity of alpha rhythm while listening words and non-words in children with SLI compared to TD children. The participants were 50 children with SLI, aged 4 to 6, and 50 age-related TD children. Groups were divided into 2 subgroups: first subgroup - children aged 4.0 to 5.0 years old (E = 25, C = 25) and second subgroup - children aged 5.0 to 6.0 years old (E = 25, C = 25). The younger children's group did not show statistically significant differences in alpha spectral power in word or non-word listening. In contrast, in the older age group for word and non-word listening, differences were present in the prefrontal, temporal, and parieto-occipital regions bilaterally. Children with SLI showed a certain lack of alpha desynchronization in word and non-word listening compared with TD children. Non-word perception arouses more brain regions because of the unknown presence of the word stimuli. The lack of adequate alpha desynchronization is consistent with established difficulties in lexical and phonological processing at the behavioral level in children with SLI.

Adversity Exposure, Syntax, and Specific Language Impairment: An Exploratory Study.

PURPOSE: Children exposed to adversity (e.g., chronic poverty, traumatic events, and maltreatment) are at increased risk for performing below age expectations on norm-referenced language assessments, but it is unknown whether the risk is higher for specific language impairment (SLI). This exploratory study investigated whether adversity exposure is associated with reduced grammar knowledge and SLI. METHOD: The syntax subtest of the Diagnostic Evaluation of Language Variation-Norm-Referenced (DELV-NR) assessment was administered to 30 school-age children with known histories of adversity exposure. Their primary caregiver also completed a comprehensive adversity exposure measure, which captured adverse event type, frequency, chronicity, and severity. Analyses included t tests, correlations, Mann-Whitney U tests, and chi-square. RESULTS: Overall, the sample performed below age expectations on the DELV-NR Syntax subtest, and a higher percentage of participants (20%) met diagnostic criteria for SLI than expected. The SLI and typical language (TL) groups did not significantly differ in adversity dosage, frequency, chronicity, or severity; however, participants in the SLI group were 1.46 times more likely to have experienced physical trauma than the participants in the TL group. CONCLUSIONS: Children with known histories of adversity exposure presented with grammatical deficits and SLI more often than expected based on the DELV-NR normative sample; however, features of the adverse event did not associate with SLI status except for exposure to physical trauma (e.g., physical abuse and victimization). Future research is needed to investigate the prevalence and potential causal pathways of SLI in this population. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20483706.

Characterizing macro- and micro-structures of narrative skills for Mandarin-speaking school-age children with specific language impairment.

INTRODUCTION: Little is known about the narrative skills of Mandarin-speaking children with specific language impairment (SLI). This study was aimed to capture the features of narratives for school-age Mandarin-speaking children with SLI. METHODS: Oral narrative samples by 55 Mandarin-speaking children with SLI [higher grades, recruited from Grade 4-5, n = 26, Mage = 11.00 years, SD = 0.56; lower grades, recruited from Grade 1-3, n = 29, Mage = 8.05 years, SD = 0.89] were compared with typically developing (TD) children on macro- and micro-structures of narratives. RESULTS: The results revealed that across grades, for macrostructure, children with SLI lagged behind TD children in narrative pattern scores. For microstructure, children with SLI were constrained in the total number of words, the total number of different words, and the mean length of utterance. They also used fewer serial verb constructions, clausal objects, and temporality conjunctions. They were less adequate in the three referential functions of introduction, maintenance, and switch. Furthermore, the results showed that older children demonstrated higher narrative pattern scores, longer MLU, and higher proportions of conjunctions and referential forms of switch. CONCLUSIONS: These results suggest that both macro- and micro-structure measures in narratives are sensitive to linguistic difficulties for children with SLI and that some of these measures are sensitive to grade growth. The findings shed light on the assessment and developmental changes of school-age Mandarin-speaking children with SLI and TD children.

Teacher Educational Decision Making for Children With Specific Language Impairment.

PURPOSE: Children with specific language impairment (SLI) are underidentified, despite a robust literature on their language abilities and a clinical grammar marker. Adlof and Hogan (2019) call for school systems to assess oral language and provide supports through response to intervention (RTI), with the aim of identifying and supporting children with SLI and other language impairments. However, it is unknown how teachers make educational decisions for children with SLI. METHOD: A web-based survey was distributed to public school teachers nationwide (N = 304). In this observational study, teachers read six vignettes featuring profiles of children systematically varying in the linguistic characteristics relevant to SLI (e.g., difficulty with verb tense) and responded to items on the educational decisions that they would make in the absence of workplace constraints. RESULTS: Teachers were likely to identify that the children in the vignettes needed language for classroom success and to indicate that they would provide in-class intervention. However, teachers were unlikely to recommend speech-language pathology services. These outcomes were mostly consistent across all child characteristics and teacher characteristics. CONCLUSIONS: Findings show that teachers were sensitive to the language-based needs of children with SLI and elected to provide in-class intervention. Future work is needed to understand how workplace characteristics, including opportunities for interprofessional collaboration, and the heterogeneity of children with SLI, inform teacher educational decision making.

Neural patterns elicited by lexical processing in adolescents with specific language impairment: support for the procedural deficit hypothesis?

BACKGROUND: Deficits in procedural memory have been proposed to account for the language deficits in specific language impairment (SLI). A key aspect of the procedural deficit hypothesis (PDH) account of SLI is that declarative memory is intact and functions as a compensatory mechanism in the acquisition of language in individuals with SLI. The current study examined the neural correlates of lexical-phonological and lexical-semantic processing with respect to these predictions in a group of adolescents with SLI with procedural memory impairment and a group of chronologically age-matched (CA) normal controls. METHODS: Participants completed tasks designed to measure procedural and declarative memory and two ERP tasks designed to assess lexical-semantic and lexical-phonological processing in the auditory modality. Procedural memory was assessed using a statistical learning task. Lexical-semantic processing was assessed using a sentence judgment task modulating semantic congruency and lexical-phonological processing was assessed using a word/nonword decision task modulating word frequency. Behavioral performance on the tasks, mean amplitude of the cortical response, and animated topographs were examined. RESULTS: Performance on the statistical word-learning task was at chance for the adolescents with SLI, whereas declarative memory was no different from the CA controls. Behavioral accuracy on the lexical-semantic task was the same for the adolescents with SLI and CA controls but accuracy on the lexical-phonological task was significantly poorer for the adolescents with SLI as compared to the CA controls. An N400 component was elicited in response to semantic congruency on the lexical-semantic task for both groups but differences were noted in both the location and time course of the cortical response for the SLI and CA groups. An N400 component was elicited by word frequency on the lexical-phonological task for the CA controls not for the adolescents with SLI. In contrast, post hoc analysis revealed a cortical response based on imageability for the adolescents with SLI, but not CA controls. Statistical word learning was significantly correlated with speed of processing on the lexical decision task for the CA controls but not for the adolescents with SLI. In contrast, statistical word learning ability was not correlated with the modulation of the N400 on either task for either group. CONCLUSION: The behavioral data suggests intact semantic conceptual knowledge, but impaired lexical phonological processing for the adolescents with SLI, consistent with the PDH. The pattern of cortical activation in response to semantic congruency and word frequency suggests, however, that the processing of lexical-semantic and lexical-phonological information by adolescents with a history of SLI may be supported by both overlapping and nonoverlapping neural generators to those of CA controls, and a greater reliance on declarative memory strategies. Taken together, the findings from this study suggest that the underlying representations of words in the lexicons of adolescents with a history of SLI may differ qualitatively from those of their typical peers, but these differences may only be evident when behavioral data and neural cortical patterns of activation are examined together.

Work Setting Effects on Speech-Language Pathology Practice: Implications for Identification of Children With Specific Language Impairment.

PURPOSE: Most research on language acquisition and impairments is neutral to work setting; however, work settings (e.g., schools, health care) are expected to differ in alignment with overlaid workplace models (e.g., education, medical). These differences may affect clinical service provision for individuals with specific language impairment (SLI). This article evaluates potential effects of work setting on top-down advocacy initiatives and clinical service provision for children with symptoms of SLI. METHOD: Speech-language pathologists serving pediatric populations in health care-based (n = 140) and school-based (n = 423) work settings completed a three-part survey: (a) participant demographics, (b) report of case/workload and practice patterns, and (c) clinical vignettes and eligibility belief. Data analysis included descriptives and chi-square tests. RESULTS: The work setting groups reported differences in eligibility terminology, eligibility criteria, and practice patterns from the point of referral through discharge. The reported differences aligned with overlaid workplace models. As compared to the school-based group, health care-based participants reported fewer eligibility restrictions in the workplace, agreed more often with a belief in less restrictive eligibility criteria, and reported more sensitive clinical decisions when operating under neutral workplace circumstances. Despite these findings, health care-based participants reported a smaller proportion of individuals with language impairment only on their caseload. DISCUSSION: Work setting variations influence the underidentification of individuals with SLI for speech-language pathology services. Differences in responses by workplace indicate the need for unique and targeted advocacy efforts. Shifting diagnostic terminology and criteria will be insufficient in closing the gap unless advocacy efforts also address speech-language pathologists' workplace realities.

Theory of Mind Development in Italian Children with Specific Language Impairment and Autism Spectrum Disorder: Delay, Deficit, or Neither?

Some studies report delayed theory of mind (ToM) development in children with specific language impairment (SLI), while others do not. A ToM delay is acknowledged in children with autism spectrum disorder (ASD), while whether these children also display a deficit is still under debate. In the current study, we drew on a developmental trajectory approach to assess whether children with SLI or ASD displayed delays or deficits in their ToM performance. Forty-three children with SLI (age 4-10 years), 44 children with ASD (age 5-12 years), and 227 typically developing children (age 3-11 years) completed the ToM Storybooks. Children with SLI were not found to display either a delay or a deficit in ToM, while children with ASD were found to display a deficit.

The role of age and timing in bilingual assessment: non-word repetition, subject-verb agreement and case marking in L1 and eL2 children with and without SLI.

Diagnostics in bilingual children is challenging, due to an overlap of production patterns in typically developing (TD) bilingual children and monolingual children with specific language impairment (SLI). To screen bilingual children effectively, the Language Impairment Testing in Multilingual Settings (LITMUS) tools were developed in an international project. The present study tests three of these tools for their suitability and diagnostic accuracy for early second language learners (eL2) of German, aged six to eight years. The study focuses on the timing in first language (L1) TD acquisition, investigating early and late acquisition phenomena of the morphosyntactic domain (subject-verb agreement [SVA], and case marking), combined with a non-word repetition (NWR) task targeting phonological complexity. The study aims at evaluating these three LITMUS-tools regarding their diagnostic accuracy, compared to a standardised assessment tool (LiSe-DaZ).To this end, forty-two children were tested using the LITMUS-tools, namely, contrastive case marking (CCM), supplemented by an elicitation task for the prepositional case, SVA and NWR. Four groups of children participated: eL2 children with SLI (mean age 7;6, mean age of onset 3;1), eL2 children with TD (mean age 7;10, mean age of onset 2;11), L1 TD children (mean age 7;3) and L1 SLI children (mean age 7;2). Results show NWR and SVA as suitable markers and the LITMUS-tools as suitable screenings. Conversely, CCM does not disentangle SLI from TD in the investigated bilingual population by this age.

Efectividad de la rehabilitación basada en la comunidad en preescolares con retraso del lenguaje expresivo / Effectiveness of community based rehabilitation in preschool children with language speech delay

Antecedentes: En Honduras, 28% de los niños con discapacidad presenta alguna alteración en la función relacionada con la voz y el habla. La Rehabilitación Basada en la Comunidad (RBC) es una estrategia para mejorar el acceso a los servicios de rehabilitación. Objetivo: Comparar la efectividad de terapias de lenguaje con enfoque RBC versus terapia convencional en niños con Retraso en el Lenguaje Expresivo (RLE) en el Centro Especializado de Medicina Física y Rehabilitación, Instituto Hondureño de Seguridad Social, (IHSS), Honduras, junio 2019 - enero 2020. Metodología: Estudio ensayo clínico aleatorizado. Se diagnosticaron niños de 2-5 años con RLE aleatorizados en grupo de intervención (RBC) y en grupo control; 28 niños participaron en terapias RBC y 20 en terapia convencional. La intervención consistió en capacitar a los padres para que realizaran terapias con sus hijos en casa. Se caracterizó la población y se realizaron modelos de regresión de Cox. Resultados: 48 pacientes completaron dos evaluaciones. La mediana de edad fue 3 años, 77.1% entre 2-3 años, sexo masculino predominó con 79.2%, procedencia urbana con 82.9%, madres con nivel educativo superior 47.9%. Los niños en RBC tuvieron 4.7% más probabilidad de mejorar Hazard Ratio (HR) crudo (1.047, p=0.889; IC 95% 0.5434 ­ 2.0194); al ajustar la probabilidad de mejorar fue de 10.2% (HR ajustado 1.1016, p= 0.783; IC95% 0.55­2.1966). Ninguno de los modelos alcanzó significancia estadística. Discusión: No se identificó diferencia en la efectividad entre los grupos del estudio; utilizar terapias RBC puede disminuir costos para el derechohabiente y para el IHSS...(AU)