Production of relative clauses in Cantonese-speaking children with and without Developmental Language Disorder.

Developmental Language Disorder (DLD) has been explained as either a deficit deriving from an abstract representational deficit or as emerging from difficulties in acquiring and coordinating multiple interacting cues guiding learning. These competing explanations are often difficult to decide between when tested on European languages. This paper reports an experimental study of relative clause (RC) production in Cantonese-speaking children with and without DLD, which enabled us to test multiple developmental predictions derived from one prominent theory - emergentism. Children with DLD (N = 22; aged 6;6-9;7) were compared with age-matched typically-developing peers (N = 23) and language-matched, typically-developing children (N = 21; aged 4;7-7;6) on a sentence repetition task. Results showed that children's production across multiple RC types was influenced by structural frequency, general semantic complexity, and the linear order of constituents, with the DLD group performing worse than their age-matched and language-matched peers. The results are consistent with the emergentist explanation of DLD.

Assessing students with dyslexia and other reading difficulties through multiple diagnostic assessments.

This article aims to assist practitioners in understanding dyslexia and other reading difficulties and assessing students' learning needs. We describe the essential components of language and literacy, universal screening, diagnostic assessments, curriculum-based measurement and eligibility determination. We then introduce four diagnostic assessments as examples, including norm-referenced assessments (i.e. the Comprehensive Test of Phonological Processing second edition and the Woodcock-Johnson IV Tests of Achievement) and criterion-referenced assessments (i.e. the Gallistel-Ellis Test of Coding Skills and the Dynamic Indicators of Basic Early Literacy Skills). Finally, We use a makeup case as a concrete example to illustrate how multiple diagnostic assessments are recorded and how the results can be used to inform intervention and eligibility for special education services.

Automated Analysis of Fluency Behaviors in Aphasia.

PURPOSE: This study explored the use of an automated language analysis tool, FLUCALC, for measuring fluency in aphasia. The purpose was to determine whether CLAN's FLUCALC command could produce efficient, objective outcome measures for salient aspects of fluency in aphasia. METHOD: The FLUCALC command was used on CHAT transcripts of Cinderella stories from people with aphasia (PWA; n = 281) and controls (n = 257) in the AphasiaBank database. RESULTS: PWA produced significantly fewer total words, fewer words per minute, more pausing, more repetitions, more revisions, and more phonological fragments than controls, with only one exception: The Wernicke's group was similar to the control group in percentage of filled pauses. Individuals with Broca's aphasia had significantly longer inter-utterance pauses and fewer total words than all other aphasia groups. Both the Broca's and conduction aphasia groups had higher percentages of phrase repetitions than the NABW (NotAphasicByWAB) group. The conduction aphasia group also had a higher percentage of phrase revisions than the NABW and the anomic aphasia groups. Principal components analysis revealed two principal components that accounted for around 60% of the variance and related to quantity of output, rate of speech, and quality of output. The Gaussian mixture models showed that the participants clustered in three groups, which corresponded predominantly to the controls, the nonfluent aphasia group, and the remaining aphasia groups (all classically fluent aphasia types). CONCLUSIONS: FLUCALC is an efficient way to measure objective fluency behaviors in language samples in aphasia. Automated analyses of objective fluency behaviors on large samples of adults with and without aphasia can produce measures that can be used by researchers and clinicians to better understand and track salient aspects of fluency in aphasia. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25979863.

Association of domain-general speed of information processing with spoken language outcomes in prelingually-deaf children with cochlear implants.

Spoken language development after pediatric cochlear implantation requires rapid and efficient processing of novel, degraded auditory signals and linguistic information. These demands for rapid adaptation tax the information processing speed ability of children who receive cochlear implants. This study investigated the association of speed of information processing ability with spoken language outcomes after cochlear implantation in prelingually deaf children aged 4-6 years. Two domain-general (visual, non-linguistic) speed of information processing measures were administered to 21 preschool-aged children with cochlear implants and 23 normal-hearing peers. Measures of speech recognition, language (vocabulary and comprehension), nonverbal intelligence, and executive functioning skills were also obtained from each participant. Speed of information processing was positively associated with speech recognition and language skills in preschool-aged children with cochlear implants but not in normal-hearing peers. This association remained significant after controlling for hearing group, age, nonverbal intelligence, and executive functioning skills. These findings are consistent with models suggesting that domain-general, fast-efficient information processing speed underlies adaptation to speech perception and language learning following implantation. Assessment and intervention strategies targeting speed of information processing may provide better understanding and development of speech-language skills after cochlear implantation.

Vocabulary and expressive morpho-syntax in individuals with Down syndrome: Links to narration.

BACKGROUND: Narrative ability is crucial for social participation in everyday and school life but involves different language abilities such as vocabulary and morpho-syntax. This is particularly difficult for individuals who display both language and cognitive impairments. Previous research has identified productive vocabulary as a possible key factor for narrative performance in individuals with Down syndrome. Considering a close connection between lexical and morpho-syntactic performance within language acquisition and the distinct impairments that individuals with Down syndrome display concerning their morpho-syntactic skills, the nature of a relation between vocabulary and narrative skills under the influence of grammatical deficits requires further investigation. METHODS: Narrations were obtained from 28 children and adolescents with Down syndrome (aged 10;0-20;1) using a non-verbal picture book. Narrative abilities were rated using the Narrative Scoring Scheme across seven narrative aspects (including macro- and microstructure). Vocabulary analyses and morpho-lexical context analyses including verb and conjunction enumerations, evaluation of verb position and MLU were conducted. Findings from the transcript analysis have been supplemented with data from standardized language measures evaluating expressive lexical and morpho-syntactic development. A multiple regression analysis was conducted to identify significant predictors for narrative outcome in the participants with Down syndrome. RESULTS: Lexical analyses revealed a high heterogeneity in production of subordinating conjunctions as a link between lexical and morpho-syntactic abilities. Comparisons of standardized and narrative data demonstrated differences in subordinate clause production depending on the elicitation setting. A multiple regression analysis identified the number of different verbs in the narrative task as the most significant predictor for narrative performance in individuals with Down syndrome. DISCUSSION AND IMPLICATIONS: The findings of this study contribute to the knowledge regarding factors that influence narrative performance in individuals with language impairment. A differentiated verb lexicon can be identified as the key ability for reaching advanced narrative skills in participants with Down syndrome. These findings are of clinical relevance for therapeutic and educational support and contribute to an understanding of the relation between strengths in vocabulary and morpho-syntactic weaknesses in individuals with Down syndrome within communicative participation.

Should We Stop Using Lexical Diversity Measures in Children's Language Sample Analysis?

PURPOSE: Prior work has identified weaknesses in commonly used indices of lexical diversity in spoken language samples, such as type-token ratio (TTR) due to sample size and elicitation variation, we explored whether TTR and other diversity measures, such as number of different words/100 (NDW), vocabulary diversity (VocD), and the moving average TTR would be more sensitive to child age and clinical status (typically developing [TD] or developmental language disorder [DLD]) if samples were obtained from standardized prompts. METHOD: We utilized archival data from the norming samples of the Test of Narrative Language and the Edmonton Narrative Norms Instrument. We examined lexical diversity and other linguistic properties of the samples, from a total of 1,048 children, ages 4-11 years; 798 of these were considered TD, whereas 250 were categorized as having a language learning disorder. RESULTS: TTR was the least sensitive to child age or diagnostic group, with good potential to misidentify children with DLD as TD and TD children as having DLD. Growth slopes of NDW were shallow and not very sensitive to diagnostic grouping. The strongest performing measure was VocD. Mean length of utterance, TNW, and verbs/utterance did show both good growth trajectories and ability to distinguish between clinical and typical samples. CONCLUSIONS: This study, the largest and best controlled to date, re-affirms that TTR should not be used in clinical decision making with children. A second popular measure, NDW, is not measurably stronger in terms of its psychometric properties. Because the most sensitive measure of lexical diversity, VocD, is unlikely to gain popularity because of reliance on computer-assisted analysis, we suggest alternatives for the appraisal of children's expressive vocabulary skill.

Identifying and Addressing Functional Communication Challenges in Patients With Behavioral Variant Frontotemporal Dementia.

PURPOSE: We describe the communication challenges of four patients with a neurodegenerative disorder consistent with behavioral variant frontotemporal dementia (bvFTD), characterized by early behavioral and personality changes. By describing their clinical profiles, we identify common barriers to functional communication in this population and provide recommendations for how speech-language pathologists (SLPs) might contribute to minimizing them. METHOD: Four patients with bvFTD were selected from a cohort of patients with progressive communication impairments. Three of them returned for at least one follow-up visit. Case histories are presented along with the results of comprehensive speech and language, neuropsychological, and neurological testing. RESULTS: At the time of initial evaluation, patients were between the ages of 54 and 66 years and had been experiencing symptoms for 1.5-6 years. Consistent with their bvFTD diagnoses, all patients had prominent behavioral and personality changes that impacted communication. Patients 1 and 2 also had mild aphasia at enrollment, primarily characterized by anomia and loss of word meaning. Patients 3 and 4 both had apraxia of speech and moderate-to-severe aphasia at enrollment with prominent anomia and agrammatism. All four patients had impaired executive functioning and relative sparing of visuospatial skills; episodic memory was also impaired for Patients 2 and 4. Even though functional communication was progressively limited for all patients, none of them received regular support from an SLP. CONCLUSIONS: This case series adds to a scant, but growing, literature demonstrating that patients with bvFTD have communication impairments. SLPs are uniquely positioned to identify barriers to functional communication and to provide tailored strategy training to the patients and their care partners over the course of their disease. Systematic evaluation of the efficacy of treatment in this population would be valuable. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25933762.

Response to intervention as an identification strategy of the risk for dyslexia. / Resposta à intervenção como estratégia de identificação do risco para dislexia.

PURPOSE: To develop on intervention process to identify children at risk of dyslexia, based on the Response to Intervention model. Specifically, to identify the pattern of changes in post-intervention performance in tasks of phonological awareness, working memory, lexical access, reading and writing; and to analyze which cognitive functions had a significant effect on the discriminating students at risk of dyslexia. METHOD: Sample of 30 participants with Reading and writing difficulties, aged 8-11, from public/private schools, students from 3rd to 5th grade. Participants were submitted to a battery of cognitive-linguistic tests, before and after 12 intervention sessions. To monitor their performance, five reading and writing lists of words and pseudowords were applied. We qualitatively and quantitatively analyzed the differences in pre- and post-intervention performance of each participant; and among participants in the post-assessment, to understand the patterns of dyslexia vs non-dyslexia groups. RESULTS: There were statistically significant changes in: rapid automatized naming, narrative text comprehension, phonological awareness, rate and typology of hits/misses in reading and writing, and reading speed. Being the last three variables the most sensitive to discriminate the two groups, all with less post-intervention gains for the dyslexia group. CONCLUSIONS: The intervention focused on the stimulation of phonological skills and explicit and systematic teaching of graphophonemic correspondences contributed positively to the evolution of the group's participants. The intervention response approach favored the identification of children with a profile at risk for dyslexia, as distinct from children with other learning difficulties.

OBJETIVO: desenvolver um processo de intervenção para identificação de crianças em risco para dislexia, baseado no modelo de resposta à intervenção. Especificamente, identificar o perfil de mudança no desempenho pós-intervenção em tarefas de consciência fonológica, memória operacional, acesso lexical, leitura, escrita; e analisar quais funções cognitivas tiveram efeito significativo para discriminação de estudantes em risco para dislexia. MÉTODO: amostra composta por 30 participantes com dificuldades na leitura e escrita, entre 8 e 11 anos, de escola pública ou particular, estudantes do 3º ao 5º ano. Todos foram submetidos a uma bateria de testes cognitivo-linguísticos, antes e após a realização de 12 sessões de intervenção. Para monitoramento do desempenho foram aplicadas cinco listas de leitura e escrita de palavras/pseudopalavras. Foram realizadas análises, qualitativas e quantitativas, das diferenças de desempenho pré e pós-intervenção; e entre os participantes na pós avaliação, para compreensão de grupos perfil em risco para dislexia vs não-dislexia. RESULTADOS: ocorreram mudanças estatisticamente significativas em nomeação automática rápida, compreensão de texto, consciência fonológica, taxa e tipologia de acertos/erros na leitura/escrita e velocidade de leitura. Sendo essas três últimas variáveis as que se mostraram mais discriminativas dos grupos, todas com menos ganhos na pós-intervenção para o grupo com perfil em risco de dislexia. CONCLUSÃO: a intervenção com foco na estimulação das habilidades fonológicas e ensino explícito das correspondências grafofonêmicas contribuiu para a evolução dos participantes. A abordagem de resposta à intervenção favoreceu a identificação de crianças com perfil em risco para dislexia, as diferenciando de crianças com outras dificuldades de aprendizagem.

Language impairments in Alzheimer´s disease: What changes can be found between mild and moderate stages of the disease?

OBJECTIVE: To investigate how language deteriorates over the Alzheimer's Disease course. METHODS: A cross-sectional, observational study was carried out. 35 patients diagnosed with dementia due to AD using the NINCDS-ARDRA criteria and undergoing treatment for AD with a therapeutic dose of acetylcholinesterase inhibitors were assessed by the Boston Diagnostic Aphasia Examination (BDAE). The sample comprised 15 patients with mild AD (MMSE > 23, CDR = 0 or 0.5‒1.0) and 20 patients with moderate AD (MMSE = 13‒23, CDR = 2). The results for the 2 groups on all language tasks were compared. RESULTS: A statistically significant difference was found between the mild and moderate AD groups for total score on the BDAE (95% CI 47.10‒114.08, t = 5.0, DF = 21, p = 0.000*), as well as on several tasks involving oral and writing comprehension, language oral expression and writing. CONCLUSION: The study results showed major changes in the moderate stage. Also, the decline in language performance correlated with the worsening of dementia syndrome, independently of sociodemographic variables.

La Rana or El Rana: Dual Language Learners' Grammatical Variability in Narrative Retells.

PURPOSE: This longitudinal study investigated the trajectory of Spanish article accuracy in Spanish-English dual language learners (DLLs) from preschool to first grade, addressing the need for longitudinal data on the variability of Spanish grammatical skills in DLLs in English immersion classrooms. METHOD: Language sample analysis was conducted on 336 Spanish and English narrative retells elicited from 31 Spanish-English DLLs (range: 45-85 months). Growth curve models captured within- and between-individual change in article accuracy from the beginning of preschool to the end of first grade. RESULTS: As a group, DLLs did not exhibit significant positive or negative growth in Spanish article accuracy over time. On average, article accuracy remained stable at 76% from preschool throughout first grade. Participants exhibited significant variability in article accuracy that was partly explained by changes in Spanish proficiency. Spanish article accuracy was lower for DLLs with lower Spanish proficiency indexed by measures from the Spanish language samples, while English proficiency indexed by the English language samples did not affect Spanish article accuracy. CONCLUSIONS: These findings suggest that expectations for Spanish grammatical performance in DLLs need to be adjusted to account for the possible impact of not receiving Spanish support in English immersion school settings. DLLs in these instructional programs do not exhibit article accuracy at a level expected for monolingual Spanish speakers. Significant individual differences in both individual status and growth rates of Spanish article accuracy highlight the broad variability in Spanish language skills of DLLs in the United States.

African American Preschoolers' Performance on Norm-Referenced Language Assessments: Examining the Effect of Dialect Density and the Use of Scoring Modifications.

PURPOSE: We investigated and compared the outcomes from two standardized, norm-referenced screening assessments of language (i.e., Clinical Evaluation of Language Fundamentals Preschool-Second Edition [CELFP-2], Diagnostic Evaluation of Language Variation-Screening Test [DELV-ST]) with African American preschoolers whose spoken dialect differed from that of General American English (GAE). We (a) described preschoolers' performance on the CELFP-2 Core Language Index (CLI) and its subtests with consideration of degree of dialect variation (DVAR) observed, (b) investigated how the application of dialect-sensitive scoring modifications to the expressive morphology and syntax Word Structure (WS) subtest affected CELFP-2 CLI scores, and (c) evaluated the screening classification agreement rates between the DELV-ST and the CELFP-2 CLI. METHOD: African American preschoolers (N = 284) completed the CELFP-2 CLI subtests (i.e., Sentence Structure, WS, Expressive Vocabulary) and the DELV-ST. Density of spoken dialect use was estimated with the DELV-ST Part I Language Variation Status, and percentage of DVAR was calculated. The CELFP-2 WS subtest was scored with and without dialect-sensitive scoring modifications. RESULTS: Planned comparisons of CELFP-2 CLI performance indicated statistically significant differences in performance based on DELV-ST-determined degree of language variation groupings. Scoring modifications applied to the WS subtest increased subtest scaled scores and CLI composite standard scores. However, preschoolers who demonstrated strong variation from GAE continued to demonstrate significantly lower performance than preschoolers who demonstrated little to no language variation. Affected-status agreement rates between assessments (modified and unmodified CELFP-2 CLI scores and DELV-ST Part II Diagnostic Risk Status) were extremely low. CONCLUSIONS: The application of dialect-specific scoring modifications to standardized, norm-referenced assessments of language must be simultaneously viewed through the lenses of equity, practicality, and psychometry. The results of our multistage study reiterate the need for reliable methods of identifying risk for developmental language disorder within children who speak American English dialects other than GAE. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26017978.

The Effectiveness of Individualized Morphosyntactic Target Identification and Explicit Intervention Using the SHAPE CODING System for Children With Developmental Language Disorder and the Impact of Within-Session Dosage.

PURPOSE: We investigated the effectiveness of a highly individualized morphosyntactic intervention using the SHAPE CODING™ system delivered at different dosages. METHOD: Eight children with developmental language disorder aged 8;0-10;10 (years;months) received 10 hr of explicit individualized intervention for morphosyntax delivered in 30-min individual sessions once per week for 20 weeks. Following at least four baseline probe tests, two grammatical targets per session received explicit instruction until they reached criterion (90%), when the next target was introduced. To control for session length and teaching episode density, either both targets received 20 teaching episodes per session or one target received 10 teaching episodes and the other 30. Maintenance testing of completed targets was also carried out. RESULTS: Scores on probe tests post-intervention were significantly higher than during the baseline phase (d = 1.6) with no change during the baseline or maintenance phases. However, progress during the intervention phase was highly significant. One participant showed significantly faster progress with intervention, while one (with the lowest attention score) made little progress. When considering progress relative to cumulative intervention sessions, progress was faster with 30 teaching episodes per session and slower with 10. However, when cumulative teaching episodes were used as the predictor, all three within-session dosages showed very similar rates of progress, with the odds of a correct response increasing by 3.9% for each teaching episode. The targets that were achieved required an average of 40-60 teaching episodes. CONCLUSIONS: With the exception of one participant, the individualized intervention was highly effective and efficient. Thus, the individualized target identification process and intervention method merit further research in a larger group of children. The cumulative number of teaching episodes per target provided across sessions appeared to be key. Thus, clinicians should aim for high teaching episode rates, particularly if the number of sessions is constrained. Otherwise, intervention scheduling can be flexible. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25996168.

Validation of a Cantonese Version of the Amsterdam-Nijmegen Everyday Language Test (CANELT): A functional approach.

BACKGROUND: The current study aimed to validate the Cantonese version of the Amsterdam-Nijmegen Everyday Language Test (CANELT), a functional communication assessment tool for Cantonese speakers with aphasia. A quantitative scoring method was adopted to examine the pragmatics and informativeness of the production of people with aphasia (PWA). METHOD: CANELT was translated from its English version with cultural adaptations. The performance on the 20-item CANELT collected from 56 PWA and 100 neurologically healthy Cantonese-speaking controls aged 30 to 79 years was orthographically transcribed. Scoring was based on the completeness of the main concepts produced in the preamble and subsequent elaborations, defined as Opening (O) and New Information (NI). Measures examining the validity and reliability were conducted. RESULTS: An age effect was found in neurologically healthy controls, and therefore z scores were used for subsequent comparisons between neurologically healthy controls and PWA. The test showed strong evidence for known-group validity in both O [χ2 (2) = 95.2, p < .001] and NI [χ2 (2) = 100.4, p < .001]. A moderate to strong correlation was found between CANELT and standardized aphasia assessment tools, suggesting satisfactory concurrent validity. Reliability measures were excellent in terms of internal consistency (Cronbach's α of .95 for both 'O' and 'NI'), test-retest reliability (ICC = .96; p < .001), intra-rater reliability (ICC = 1.00; p < .001), and inter-rater reliability for O (ICC = .99; p < .001) and NI (ICC = .99; p < .001). Sensitivity and specificity for O are 97% and 76.8%, respectively, while for NI, a sensitivity of 95% and specificity of 91.1% were obtained. CONCLUSIONS: Measures on validity and reliability yielded promising results, suggesting CANELT as a useful and reliable functional communication assessment for PWA. Its application in managing PWA and potential areas for development are discussed.

Impact of Hearing Aids on Language Outcomes in Preschool Children With Mild Bilateral Hearing Loss.

This study aimed to investigate the role of hearing aid (HA) usage in language outcomes among preschool children aged 3-5 years with mild bilateral hearing loss (MBHL). The data were retrieved from a total of 52 children with MBHL and 30 children with normal hearing (NH). The association between demographical, audiological factors and language outcomes was examined. Analyses of variance were conducted to compare the language abilities of HA users, non-HA users, and their NH peers. Furthermore, regression analyses were performed to identify significant predictors of language outcomes. Aided better ear pure-tone average (BEPTA) was significantly correlated with language comprehension scores. Among children with MBHL, those who used HA outperformed the ones who did not use HA across all linguistic domains. The language skills of children with MBHL were comparable to those of their peers with NH. The degree of improvement in audibility in terms of aided BEPTA was a significant predictor of language comprehension. It is noteworthy that 50% of the parents expressed reluctance regarding HA use for their children with MBHL. The findings highlight the positive impact of HA usage on language development in this population. Professionals may therefore consider HAs as a viable treatment option for children with MBHL, especially when there is a potential risk of language delay due to hearing loss. It was observed that 25% of the children with MBHL had late-onset hearing loss. Consequently, the implementation of preschool screening or a listening performance checklist is recommended to facilitate early detection.

Language impairment in sporadic and familial (type 8) amyotrophic lateral sclerosis: A comparative study.

INTRODUCTION/AIMS: Language is frequently affected in patients with sporadic amyotrophic lateral sclerosis (sALS), with reduced performance in naming, syntactic comprehension, grammatical expression, and orthographic processing. However, the language profile of patients with familial type 8 ALS (ALS8), linked to p.P56S VAPB mutation, remains unclear. We investigated language in patients with ALS8 by examining their auditory comprehension and verbal production. METHODS: We included three groups of participants: (1) patients with sALS (n = 20), (2) patients with familial ALS8 (n = 22), and (3) healthy controls (n = 21). The groups were matched for age, sex, and education level. All participants underwent a comprehensive language battery, including the Boston Diagnostic Aphasia Examination, the reduced Token test, letter fluency, categorical fluency (animals), word definition from the Cambridge Semantic Memory Research Battery, and a narrative discourse analysis. Participants also were evaluated using Addenbrooke's Cognitive Exam-Revised Version, the Hospital Anxiety and Depression Scale, and the ALS Functional Rating Scale-Revised. RESULTS: Compared to controls, sALS and ALS8 patients had impaired performance on oral (syntactic and phonological processing) comprehension and inappropriate discourse cohesion. sALS and ALS8 did not differ in any language measure. There was no correlation between language scores and functional and psychiatric scales. DISCUSSION: ALS8 patients exhibit language deficits that are independent of motor features. These findings are consistent with the current evidence suggesting that ALS8 has prominent non-motor features.

Lexical development in Kuwaiti Arabic in typically developing children and late talkers.

INTRODUCTION: This study explored vocabulary development and lexical composition in young typically developing (TD) Kuwaiti children and late talkers (LT) using the Kuwaiti Arabic Communicative Development Inventory-Words and Sentences (KACDI-WS) Abdalla et al., 2016). The sample included 161 children aged 20 to 37 months: 127 TD and 34 children who were late talkers (LT group). The late talkers were first identified based on a background questionnaire answered by the parents. All the caregivers completed a 698-item web-based KACDI expressive vocabulary inventory by selecting non-imitative words that their children produced. RESULTS: Lexical size and composition (nouns, predicates, and closed-class words) were analyzed. Across the TD age groups (20-26, 27-31, 32-37 months), a significant age effect for vocabulary size and composition was found in favor of the older groups. Nouns were more prevalent than predicates or closed-class words in within-group comparisons. The vocabulary size of the TD (M= 263.8) was significantly larger than that of the LT group (M= 69.2). The development of their lexical composition followed a similar pattern. CONCLUSIONS: The results suggested that the KACDI parent report instrument has the potential for measuring vocabulary development in TD children and could serve as an initial screening tool to identify late talkers.

Sentence Repetition as a Diagnostic Tool for Developmental Language Disorder: A Systematic Review and Meta-Analysis.

PURPOSE: This systematic review and multilevel meta-analysis examines the accuracy of sentence repetition (SR) tasks in distinguishing between typically developing (TD) children and children with developmental language disorder (DLD). It explores variation in the way that SR tasks are administered and/or evaluated and examines whether variability in the reported ability of SR to detect DLD is related to these differences. METHOD: Four databases were searched to identify studies that had used an SR task on groups of monolingual children with DLD and TD children. Searches produced 3,459 articles, of which, after screening, 66 were included in the systematic review. A multilevel meta-analysis was then conducted using 46 of these studies. Multiple preregistered subgroup analyses were conducted in order to explore the sources of heterogeneity. RESULTS: The systematic review found a great deal of methodological variation, with studies spanning 19 languages, 39 SR tasks, and four main methods of production scoring. There was also variation in study design, with different sampling (clinical and population sampling) and matching (age and language matching) methods. The overall meta-analysis found that, on average, TD children outperformed children with DLD on the SR tasks by 2.08 SDs. Subgroup analyses found that effect size only varied as a function of the matching method and language of the task. CONCLUSIONS: Our results indicate that SR tasks can distinguish children with DLD from both age- and language-matched samples of TD children. The usefulness of SR appears robust to most kinds of task and study variation. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25864405.

Transcription Decisions of Conjoined Independent Clauses Are Equitable Across Dialects but Impact Measurement Outcomes.

PURPOSE: Transcription of conjoined independent clauses within language samples varies across professionals. Some transcribe these clauses as two separate utterances, whereas others conjoin them within a single utterance. As an inquiry into equitable practice, we examined rates of conjoined independent clauses produced by children and the impact of separating these clauses within utterances on measures of mean length of utterance (MLU) by a child's English dialect, clinical status, and age. METHOD: The data were archival and included 246 language samples from children classified by their dialect (African American English or Southern White English) and clinical status (developmental language disorder [DLD] or typically developing [TD]), with those in the TD group further classified by their age (4 years [TD4] or 6 years [TD6]). RESULTS: Rates of conjoined independent clauses and the impact of these clauses on MLU varied by clinical status (DLD < TD) and age (TD4 < TD6), but not by dialect. Correlations between the rate of conjoined clauses, MLU, and language test scores were also similar across the two dialects. CONCLUSIONS: Transcription decisions regarding conjoined independent clauses within language samples lead to equitable measurement outcomes across dialects of English. Nevertheless, transcribing conjoined independent clauses as two separate utterances reduces one's ability to detect syntactic differences between children with and without DLD and document syntactic growth as children age. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25822675.

Validation of the Mediated Learning Observation Instrument Among Children With and Without Developmental Language Disorder in Dynamic Assessment.

PURPOSE: In this validation study, we examined the factor structure of the mediated learning observation (MLO) used during the teaching phase of dynamic assessment. As an indicator of validity, we evaluated whether the MLO factor structure was consistent across children with and without developmental language disorder (DLD). METHOD: Two hundred twenty-four children (188 typically developing and 36 DLD) from kindergarten to second grade completed a 30-min individual mediated learning session on narrative production. Performance during the session was rated using the 12-item MLO by clinicians on affect, behavior, arousal, and elaboration. Exploratory and confirmatory factor analyses were conducted to establish the factor structure and reliability of the MLO. RESULTS: Factor analysis of the MLO suggested a stable three-factor model with adequate fit indices across kindergarten and school-age samples, across both typically developing and DLD subgroups with good to excellent reliability. The final 11-item MLO (one item was removed due to low factor loading) comprises three subscales including (a) cognitive factor, (b) learning anticipation, and (c) learning engagement. CONCLUSIONS: The MLO is a valid and reliable instrument for assessing language learning skills in children with and without DLD during dynamic assessment. Practical implications and suggestions for future research addressing the utilization of MLO in dynamic assessment are provided.

Sentence Production and Sentence Repetition in Autistic Adolescents and Young Adults: Linguistic Sensitivity to Finiteness Marking.

PURPOSE: Despite the clinical utility of sentence production and sentence repetition to identify language impairment in autism, little is known about the extent to which these tasks are sensitive to potential language variation. One promising method is strategic scoring, which has good clinical utility for identifying language impairment in nonautistic school-age children across variants of English. This report applies strategic scoring to analyze sentence repetition and sentence production in autistic adolescents and adults. METHOD: Thirty-one diverse autistic adolescents and adults with language impairment (ALI; n = 15) and without language impairment (ASD; n = 16) completed the Formulated Sentences and Recalling Sentences subtests of the Clinical Evaluation of Language Fundamentals-Fifth Edition. Descriptive analyses and regression evaluated effects of scoring condition, group, and scoring condition by group on outcomes, as well as group differences in finiteness marking across utterances and morphosyntactic structures. RESULTS: Strategic and unmodified item-level scores were essentially constant on both subtests and significantly lower in the ALI than the ASD group. Only group predicted item-level scores. Group differences were limited to: percent grammatical utterances on Formulated Sentences and percent production of overt structures combined on Sentence Repetition (ALI < ASD). DISCUSSION: Findings support the feasibility of strategic scoring for sentence production and sentence repetition to identify language impairment and indicate that potential language variation in finiteness marking did not confound outcomes in this sample. To better understand the clinical utility of strategic scoring, replication with a larger sample varying in age and comparisons with dialect-sensitive measures are needed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25822336.