Prevalence, co-occurring difficulties, and risk factors of developmental language disorder: first evidence for Mandarin-speaking children in a population-based study.

Background: Developmental language disorder (DLD) is a condition that significantly affects children's achievement but has been understudied. We aim to estimate the prevalence of DLD in Shanghai, compare the co-occurrence of difficulties between children with DLD and those with typical development (TD), and investigate the early risk factors for DLD. Methods: We estimated DLD prevalence using data from a population-based survey with a cluster random sampling design in Shanghai, China. A subsample of children (aged 5-6 years) received an onsite evaluation, and each child was categorized as TD or DLD. The proportions of children with socio-emotional behavior (SEB) difficulties, low non-verbal IQ (NVIQ), and poor school readiness were calculated among children with TD and DLD. We used multiple imputation to address the missing values of risk factors. Univariate and multivariate regression models adjusted with sampling weights were used to estimate the correlation of each risk factor with DLD. Findings: Of 1082 children who were approached for the onsite evaluation, 974 (90.0%) completed the language ability assessments, of whom 74 met the criteria for DLD, resulting in a prevalence of 8.5% (95% CI 6.3-11.5) when adjusted with sampling weights. Compared with TD children, children with DLD had higher rates of concurrent difficulties, including SEB (total difficulties score at-risk: 156 [17.3%] of 900 TD vs. 28 [37.8%] of 74 DLD, p < 0.0001), low NVIQ (3 [0.3%] of 900 TD vs. 8 [10.8%] of 74 DLD, p < 0.0001), and poor school readiness (71 [7.9%] of 900 TD vs. 13 [17.6%] of 74 DLD, p = 0.0040). After accounting for all other risk factors, a higher risk of DLD was associated with a lack of parent-child interaction diversity (adjusted odds ratio [aOR] = 3.08, 95% CI = 1.29-7.37; p = 0.012) and lower kindergarten levels (compared to demonstration and first level: third level (aOR = 6.15, 95% CI = 1.92-19.63; p = 0.0020)). Interpretation: The prevalence of DLD and its co-occurrence with other difficulties suggest the need for further attention. Family and kindergarten factors were found to contribute to DLD, suggesting that multi-sector coordinated efforts are needed to better identify and serve DLD populations at home, in schools, and in clinical settings. Funding: The study was supported by Shanghai Municipal Education Commission (No. 2022you1-2, D1502), the Innovative Research Team of High-level Local Universities in Shanghai (No. SHSMU-ZDCX20211900), Shanghai Municipal Health Commission (No.GWV-10.1-XK07), and the National Key Research and Development Program of China (No. 2022YFC2705201).

Assessing the language of 2 year-olds: From theory to practice.

Early screening for language problems is a priority given the importance of language for success in school and interpersonal relationships. The paucity of reliable behavioral instruments for this age group prompted the development of a new touchscreen language screener for 2-year-olds that relies on language comprehension. Developmental literature guided selection of age-appropriate markers of language disorder risk that are culturally and dialectally neutral and could be reliably assessed. Items extend beyond products of linguistic knowledge (vocabulary and syntax) and tap the process by which children learn language, also known as fast mapping. After piloting an extensive set of items (139), two phases of testing with over 500 children aged 2; 0-2; 11 were conducted to choose the final 40-item set. Rasch analysis was used to select the best fitting and least redundant items. Norms were created based on 270 children. Sufficient test-retest reliability, Cronbach's alpha, and convergent validity with the MB-CDI and PPVT are reported. This quick behavioral measure of language capabilities could support research studies and facilitate the early detection of language problems.

Classification accuracy of the Quick Interactive Language Screener for preschool children with and without developmental language disorder.

INTRODUCTION: This research examined the classification accuracy of the Quick Interactive Language Screener (QUILS) for identifying preschool-aged children (3;0 to 6;9) with developmental language disorder (DLD). We present data from two independent samples that varied in prevalence and diagnostic reference standard. METHODS: Study 1 included a clinical sample of children (54 with DLD; 13 without) who completed the QUILS and a standardized assessment of expressive grammar (Syntax subtest from the Diagnostic Evaluation of Language Variation-Norm Referenced; Structured Photographic Expressive Language Test-Preschool 2nd Edition; or Structured Photographic Expressive Language Test-3 rd Edition). Study 2 included a community sample of children (25 with DLD; 101 without) who completed the QUILS and the Auditory Comprehension subtest of the Preschool Language Scales-5th Edition (PLS-5; Zimmerman et al., 2011). Discriminant analyses were conducted to compare classification accuracy (i.e., sensitivity and specificity) using the normreferenced cut score (< 25th percentile) with empirically derived cut scores. RESULTS: In Study 1, the QUILS led to low fail rates (i.e., high specificity) in children without impairment and statistically significant group differences as a function of children's clinical status; however, only 65% of children with DLD were accurately identified using the norm-referenced cutoff. In Study 2, 76% of children with DLD were accurately identified at the 25th percentile cutoff and accuracy improved to 84% when an empirically derived cutoff (<32nd percentile) was applied. CONCLUSIONS: Findings support the clinical application of the QUILS as a component of the screening process for identifying the presence or absence of DLD in community samples of preschool-aged children.

Across demographics and recent history, most parents sing to their infants and toddlers daily.

Music is universally prevalent in human society and is a salient component of the lives of young families. Here, we studied the frequency of singing and playing recorded music in the home using surveys of parents with infants (N = 945). We found that most parents sing to their infant on a daily basis and the frequency of infant-directed singing is unrelated to parents' income or ethnicity. Two reliable individual differences emerged, however: (i) fathers sing less than mothers and (ii) as infants grow older, parents sing less. Moreover, the latter effect of child age was specific to singing and was not reflected in reports of the frequency of playing recorded music. Last, we meta-analysed reports of the frequency of infant-directed singing and found little change in its frequency over the past 30 years, despite substantial changes in the technological environment in the home. These findings, consistent with theories of the psychological functions of music, in general, and infant-directed singing, in particular, demonstrate the everyday nature of music in infancy. This article is part of the theme issue 'Voice modulation: from origin and mechanism to social impact (Part I)'.

The role of language in building abstract, generalized conceptual representations of one- and two-place predicates: A comparison between adults and infants.

Theories of relations between language and conceptual development benefit from empirical evidence for concepts available in infancy, but such evidence is comparatively scarce. Here, we examine early representations of specific concepts, namely, sets of dynamic events corresponding either to predicates involving two variables with a reversible, asymmetric relation between them (such as the set of all events that correspond to a linguistic phrase like "a dog is pushing a car,") or to comparatively simpler, one-variable predicates (such as the set of events corresponding to a phrase like "a dog is jumping."). We develop a non-linguistic, anticipatory eye-tracking task that can be administered to both infants and adults, and we use this task to gather evidence for the formation and use of such one-and two-place-predicate classes (which we refer to as event sortals) in 12-24-mo-old infants, and in adults with and without concurrent verbal prose shadowing. Using visually similar stimuli for both the simpler (one-place) and the more complex (reversible, asymmetric, two-place) concepts, we find that infants only show evidence for forming and generalizing one-place event sortals, and, while adults succeed with both kinds in the absence of verbal shadowing, shadowing hampers their ability to form and use the asymmetric two-place event sortals. In a subsequent experiment with adults, we find that if the shadowing material is grammatically impoverished, adults now succeed in forming and using both one- and two-place event sortals. We discuss implications of these results for theories of concept acquisition, and the role of language in this process.

Within and Across Language Predictors of Word Learning Processes in Dual Language Learners.

This study investigated the relation between Dual Language Learners' (N = 90) vocabulary and grammar comprehension and word learning processes in preschool (aged 3-through-5 years). Of interest was whether: (a) performance in Spanish correlated with performance in English within each domain; and (b) comprehension predicted novel word learning within and across languages. Dual-language experience was evaluated as a potential moderator. Hierarchical linear modeling revealed stronger predictive associations within each language than across languages. Across languages, results varied by experience and domain. Structural sensitivity theory suggests exposure to two languages heightens awareness of parameters along which languages vary and provides a framework for interpreting complex associations within and across languages. Knowledge from one language may influence learning in both.

The Impact of Grammar on Mentalizing: A Training Study Including Children With Autism Spectrum Disorder and Developmental Language Disorder.

Training on complements in English, German, and Mandarin has been reported to trigger improvements on both complements and Theory of Mind (ToM), with typically developing (TD) pre-schoolers on the verge of developing these skills (Hale and Tager-Flusberg, 2003; Lohmann and Tomasello, 2003; Shuliang et al., 2014). In the current study, we build on the idea that increasing mastery of complementation holds the promise of enhancing ToM, and seek (i) to replicate the positive effects observed in previous work for this effect in French-speaking TD children, and (ii) to pilot extending this to clinical children, more specifically those with Autism Spectrum Disorder (ASD) and Developmental Language Disorder (DLD), through exploring whether improvement in the latter, clinical groups follows that of the TD group. Sixty children with ToM difficulties, 16 with ASD (aged 5;6-11;8), 20 with DLD (aged 4;8-9;0) and 24 typically developing children aged (2;9-5;3 years), participated in a 4-week training program. Half received training targeting sentential complements and half received a control training targeting lexical skills. Complementation training, but not lexical training, led to a significant direct increase in complements, and also had the indirect effect of significantly boosting belief reasoning. TD and clinical groups followed the same patterns of performance. These results confirm previous findings in other languages for TD, and further suggest promising new directions for therapeutic programs addressing ToM delays in populations of different aetiologies, namely the incorporation of a motivating training on complementation.

The Acquisition of Exhaustive Pairing in Multiple Wh-Questions in Mandarin.

The comprehension of paired wh-questions is examined in child Mandarin, to compare the age of acquisition with that of children speaking European languages like English and German. In Study 1, participants were 734 Mandarin speakers aged 2;6-7;11, drawn from four regions of China. Results reveal a striking parallel between the acquisition of exhaustive answers in Mandarin and that in languages with wh-movement. The significant correlation with children's exhaustive interpretations of the universal quantifier every (dou) also parallels findings in English. In Study 2, the performance of children (N = 100) identified as having language impairment is compared to that of non-impaired children (N = 130), and the results support the idea that answering these paired wh-questions is a potential semantic deficit in language-delayed children.

Fast mapping word meanings across trials: Young children forget all but their first guess.

Do children learn a new word by tracking co-occurrences between words and referents across multiple instances ("cross-situational learning" models), or is word-learning a "one-track" process, where learners maintain a single hypothesis about the possible referent, which may be verified or falsified in future occurrences ("propose-but-verify" models)? Using a novel word-learning task, we ask which learning procedure is utilized by preschool-aged children. We report on findings from three studies comparing the word-learning strategies across different populations of child learners: monolingual English learners, Spanish - English dual language learners, and learners at risk for language-delay. In all three studies, we ask what, if anything, is retained from prior exposures and whether the amount of information retained changes as children get older. The ability to make a good initial hypothesis was a function of various factors, including language ability and experience, but across-the-board, children were no better than chance after a wrong initial hypothesis. This suggests that children do not retain multiple meaning hypotheses across learning instances, lending support to the propose-but-verify models.

A Narrative Evaluation of Mandarin-Speaking Children With Language Impairment.

Purpose: We aimed to study narrative skills in Mandarin-speaking children with language impairment (LI) to compare with children with LI speaking Indo-European languages. Method: Eighteen Mandarin-speaking children with LI (mean age 6;2 [years;months]) and 18 typically developing (TD) age controls told 3 stories elicited using the Mandarin Expressive Narrative Test (de Villiers & Liu, 2014). We compared macrostructure-evaluating descriptions of characters, settings, initiating events, internal responses,plans, actions, and consequences. We also studied general microstructure, including productivity, lexical diversity, syntactic complexity, and grammaticality. In addition, we compared the use of 6 fine-grained microstructure elements that evaluate particular Mandarin linguistic features. Results: Children with LI exhibited weaknesses in 5 macrostructure elements, lexical diversity, syntactic complexity, and 3 Mandarin-specific, fine-grained microstructure elements. Children with LI and TD controls demonstrated comparable performance on 2 macrostructure elements, productivity, grammaticality, and the remaining 3 fine-grained microstructure features. Conclusions: Similarities and differences are noted in narrative profiles of children with LI who speak Mandarin versus those who speak Indo-European languages. The results are consistent with the view that profiles of linguistic deficits are shaped by the ambient language. Clinical implications are discussed.

Research to Establish the Validity, Reliability, and Clinical Utility of a Comprehensive Language Assessment of Mandarin.

Purpose: With no existing gold standard for comparison, challenges arise for establishing the validity of a new standardized Mandarin language assessment normed in mainland China. Method: A new assessment, Diagnostic Receptive and Expressive Assessment of Mandarin (DREAM), was normed with a stratified sample of 969 children ages 2;6 (years;months) to 7;11 in multiple urban and nonurban regions in northern and southern China. In this study of 230 children, the sensitivity and specificity of DREAM were examined against an a priori judgment of disorders. External validity was assessed using 2 indices of language production for different age groups. Results: External validity was assessed against spontaneous language indices (correlation range: r = .6-.7; all ps < .01) and narrative indices (overall: r = .45, p < .01). Sensitivity (.73) and specificity (.82) of DREAM are moderate to good using a priori judgment as the standard. The values improved to .95 and .82 when spontaneous language and narratives were added to a priori judgment to define typicality. Divergent validity was moderate with nonlinguistic indices. Conclusion: DREAM holds promise as a diagnostic test of Mandarin language impairment for children aged 2;6 to 7;11.

Parenting Predictors of Delay Inhibition in Socioeconomically Disadvantaged Preschoolers.

This study examined longitudinal associations between specific parenting factors and delay inhibition in socioeconomically disadvantaged preschoolers. At Time 1, parents and 2- to 4-year-old children (mean age = 3.21 years; N = 247) participated in a videotaped parent-child free play session, and children completed delay inhibition tasks (gift delay-wrap, gift delay-bow, and snack delay tasks). Three months later, at Time 2, children completed the same set of tasks. Parental responsiveness was coded from the parent-child free play sessions, and parental directive language was coded from transcripts of a subset of 127 of these sessions. Structural equation modeling was used, and covariates included age, gender, language skills, parental education, and Time 1 delay inhibition. Results indicated that in separate models, Time 1 parental directive language was significantly negatively associated with Time 2 delay inhibition, and Time 1 parental responsiveness was significantly positively associated with Time 2 delay inhibition. When these parenting factors were entered simultaneously, Time 1 parental directive language significantly predicted Time 2 delay inhibition whereas Time 1 parental responsiveness was no longer significant. Findings suggest that parental language that modulates the amount of autonomy allotted the child may be an important predictor of early delay inhibition skills.

New language outcome measures for Mandarin speaking children with hearing loss.

OBJECTIVE: The paper discusses recent evidence on the assessment of language outcomes in children with hearing loss acquiring oral language. METHODS: Research emphasizes that language tests must be specific enough to capture subtle deficits in vocabulary and grammar learning at different developmental ages. The Diagnostic Receptive and Expressive Assessment of Mandarin (DREAM) was carefully designed to be a comprehensive standardized Mandarin assessment normed in Mainland China. RESULTS: This paper summarizes the evidence-based item design process and validity and reliability results of DREAM. A pilot study reported here shows that DREAM provided detailed information about hearing impaired children's language abilities and can be used to aid intervention planning to maximize progress. CONCLUSION: DREAM represents an example of translational science, transferring methods from empirical studies of language acquisition in research environments into applied domains such as assessment and intervention. Research on outcomes in China will advance significantly with the availability of evidence-based comprehensive language tests that measure a sufficient age range of skills, are normed on Mandarin speaking children in mainland China, and are designed to capture features central to Mandarin language acquisition.

Impacts of a Comprehensive School Readiness Curriculum for Preschool Children at Risk for Educational Difficulties.

This article reports findings from a cluster-randomized study of an integrated literacy- and math-focused preschool curriculum, comparing versions with and without an explicit socioemotional lesson component to a business-as-usual condition. Participants included 110 classroom teachers from randomized classrooms and approximately eight students from each classroom (N = 760) who averaged 4.48 (SD = 0.44) years of age at the start of the school year. There were positive impacts of the two versions of the curriculum on language, phonological awareness, math, and socioemotional outcomes, but there were no added benefits to academic or socioemotional outcomes for the children receiving explicit socioemotional instruction. Results are discussed with relevance to early childhood theory, policy, and goals of closing the school readiness gap.

Taking account of both languages in the assessment of dual language learners.

This article addresses the issue of "adjusted" assessment of bilingual children, a practice that acknowledges that children who know two languages have distributed knowledge of those languages. In recent work, at least three procedures have become common for taking into account this distributed knowledge: a conceptual score, in which children are given credit for knowing some feature of language in either language; a combined or total score, which adds units of knowledge from each language together; and a best score, in which the performance in the better language is taken as the most appropriate measure. The article begins with a discussion of the rationale behind the varied scores. After reviewing a sample of studies that used each type, I will argue that vocabulary and morphosyntax are fundamentally different types of knowledge that may need distinct kinds of adjusted measurement. The value of each kind of adjusted assessment must be considered relative to its purpose: is it to gauge the child's readiness for schooling? Or is it to detect language disorders? Finally, a plea is made for more basic research to answer the many questions that are raised.

Parenting predictors of cognitive skills and emotion knowledge in socioeconomically disadvantaged preschoolers.

This study examined the concurrent and longitudinal associations of parental responsiveness and inferential language input with cognitive skills and emotion knowledge among socioeconomically disadvantaged preschoolers. Parents and 2- to 4-year-old children (mean age=3.21 years, N=284) participated in a parent-child free play session, and children completed cognitive (language, early literacy, early mathematics) and emotion knowledge assessments. Approximately 1 year later, children completed the same assessment battery. Parental responsiveness was coded from the videotaped parent-child free play sessions, and parental inferential language input was coded from transcripts of a subset of 127 of these sessions. All analyses controlled for child age, gender, and parental education, and longitudinal analyses controlled for initial skill level. Parental responsiveness significantly predicted all concurrent cognitive skills as well as literacy, math, and emotion knowledge 1 year later. Parental inferential language input was significantly positively associated with children's concurrent emotion knowledge. In longitudinal analyses, an interaction was found such that for children with stronger initial language skills, higher levels of parental inferential language input facilitated greater vocabulary development, whereas for children with weaker initial language skills, there was no association between parental inferential language input and change in children's vocabulary skills. These findings further our understanding of the roles of parental responsiveness and inferential language input in promoting children's school readiness skills.

Enhancing early child care quality and learning for toddlers at risk: the responsive early childhood program.

Despite reports of positive effects of high-quality child care, few experimental studies have examined the process of improving low-quality center-based care for toddler-age children. In this article, we report intervention effects on child care teachers' behaviors and children's social, emotional, behavioral, early literacy, language, and math outcomes as well as the teacher-child relationship. The intervention targeted the use of a set of responsive teacher practices, derived from attachment and sociocultural theories, and a comprehensive curriculum. Sixty-five childcare classrooms serving low-income 2- and 3-year-old children were randomized into 3 conditions: business-as-usual control, Responsive Early Childhood Curriculum (RECC), and RECC plus explicit social-emotional classroom activities (RECC+). Classroom observations showed greater gains for RECC and RECC+ teachers' responsive practices including helping children manage their behavior, establishing a predictable schedule, and use of cognitively stimulating activities (e.g., shared book reading) compared with controls; however, teacher behaviors did not differ for focal areas such as sensitivity and positive discipline supports. Child assessments demonstrated that children in the interventions outperformed controls in areas of social and emotional development, although children's performance in control and intervention groups was similar for cognitive skills (language, literacy, and math). Results support the positive impact of responsive teachers and environments providing appropriate support for toddlers' social and emotional development. Possible explanations for the absence of systematic differences in children's cognitive skills are considered, including implications for practice and future research targeting low-income toddlers.

Deception dissociates from false belief reasoning in deaf children: implications for the implicit versus explicit theory of mind distinction.

Deception is a controversial aspect of theory of mind, and researchers disagree about whether it entails an understanding of the false beliefs of one's opponent. The present study asks whether children with delayed language and delayed explicit false belief reasoning can succeed on explicit deception tasks. Participants were 45 orally taught deaf children with varying language delays aged 4.5-8 years and 45 hearing children aged 3.5-6 years. Participants received a battery of language, executive function, deception, and both verbal and low-verbal false belief tasks. The result reveal a dissociation of deception and false belief tasks: the deaf children are on par with their hearing peers on deception games, but show significant delays in false belief tasks even when the language demands are made minimal. Furthermore, different skills are predictors of success for the two types of task in the deaf children: language, and in particular complement syntax, is the best predictor of false belief reasoning; but executive function skills, especially inhibitory control, are the best predictors of deception. It is argued that deception at this level can be handled by behaviour rules without reference to mental states.

Wh-questions: Moving beyond the first Phase.

The paper presents a feature-checking theory of wh-movement that attempts to accommodate both adult grammar and the path of acquisition by which children handle long distance movement, indirect questions and partial movement. Partial movement is not a grammatical option in English but it is adopted as an option in development. The account makes several predictions about the performance of children with Specific Language impairment (SLI), and also predicts a particular advantage for children who speak African American English (AAE) over those who speak Mainstream American English (MAE). The empirical data are taken from a study of 590 children, both typically-developing and language-impaired, and both AAE and MAE speaking, aged four to nine years. The tasks involved answering wh-questions after stories as part of the field-testing of a new language assessment instrument. The questions included multi-clause questions with or without medial wh-complementizers. The predictions are borne out that children with language impairment have prolonged difficulty with real long distance movement and medial questions, and that children who speak AAE are at an advantage in avoiding certain errors (partial movement) because of the dialect's characteristic marking of indirect questions via inversion in the lower clause.

Assessment of language acquisition.

This review addresses questions of what should be assessed in language acquisition, and how to do it. The design of a language assessment is crucially connected to its purpose, whether for diagnosis, development of an intervention plan, or for research. Precise profiles of language strengths and weaknesses are required for clear definitions of the phenotypes of particular language and neurodevelopmental disorders. The benefits and costs of formal tests versus language sampling assessments are reviewed. Content validity, theoretically and empirically grounded in child language acquisition, is claimed to be centrally important for appropriate assessment. Without this grounding, links between phenomena can be missed, and interpretations of underlying difficulties can be compromised. Sensitivity and specificity of assessment instruments are often assessed using a gold standard of existing tests and diagnostic practices, but problems arise if that standard is biased against particular groups or dialects. The paper addresses the issues raised by the goal of unbiased assessment of children from diverse linguistic and cultural backgrounds, especially speakers of non-mainstream dialects or bilingual children. A variety of new approaches are discussed for language assessment, including dynamic assessment, experimental tools such as intermodal preferential looking, and training studies that assess generalization. Stress is placed on the need for measures of the process of acquisition rather than just levels of achievement. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website.