Early Identification of Children at Risk of Communication Disorders: Introducing a Novel Battery of Dynamic Assessments for Infants.

PURPOSE: Many children with communication disorders (CDs) experience lengthy gaps between parental reporting of concerns and formal identification by professionals. This means that children with CDs are denied access to early interventions that may help support the development of communication skills and prevent possible negative sequelae associated with long-term outcomes. This may be due, in part, to the lack of assessment instruments available for children younger than 3 years of age. This study therefore reports on promising preliminary data from a novel set of valid dynamic assessment (DA) measures designed for infants. METHOD: We recruited 53 low-risk children and two groups of children considered to be at high risk for CDs (n = 17, social high risk, and n = 22, language high risk) due to family members with language and social communication difficulties. The children were between 1 and 2 years of age and were assessed using a battery of five DA tasks related to receptive vocabulary, motor imitation, response to joint attention, turn taking, and social requesting. A set of standardized measures were also used. RESULTS: The DA tasks showed high levels of interrater reliability and relationships with age across a cross-sectional sample of children from the low-risk group. Three tasks showed moderate to strong correlations with standardized measures taken at the same age, with particularly strong correlations between the DA of receptive vocabulary and other receptive language measures. The DA of receptive vocabulary was also the only task to discriminate between the three risk groups, with the social high risk group scoring lower. CONCLUSIONS: These results provide preliminary information about early DA tasks, forming the basis for further research into their utility. DA tasks might eventually facilitate the development of new methods for detecting CDs in very young children, allowing earlier intervention and support.

Two clinical markers for DLD in monolingual Italian speakers: what can they tell us about second language learners with DLD?

A large number of children worldwide are only exposed to their L2 around 3 years of age and can exhibit linguistic behaviours that resemble those of a child with Developmental Language Disorder (DLD). This can lead to under- or over-identification of DLD in this population. This study endeavors to contribute to overcoming this problem, by determining whether two specific clinical markers used with the Italian monolingual population can also be used with early L2 acquiring children, namely clitic production and non-word repetition. Our study involved two groups of 5-year-old L2 learners of Italian from various language backgrounds; 18 children had been referred to Speech and Language Therapy (SLT) services (EL2_DLD), and 30 children were typically developing (EL2_TD). The participants completed an Italian clitic production task and a non-word repetition task based on Italian phonotactics. Data was also collected from the participants' caregivers with the ALDeQ Parental Questionnaire to obtain information about the children's L1. Our results suggest that non-word repetition and clitic production in Italian are potentially useful for identifying L2 learners of Italian with DLD, at the age of 5 years. The repetition of non-words is highly accurate in identifying children with DLD among the participants, while clitic production is somewhat less discriminative in this sample. This study is a first step towards uncovering clinical markers that could be used to determine the presence of DLD in children acquiring their L2.

Dynamic Assessment of Sentence Structure (DASS): design and evaluation of a novel procedure for the assessment of syntax in children with language impairments.

BACKGROUND: Sentence construction and syntactic organization are known to be poor in children with specific language impairments (SLI), but little is known about the way in which children with SLI approach language tasks, and static standardized tests contribute little to the differentiation of skills within the population of children with language impairments (LI). Information about the nature and intensity of prompts that facilitate sentence construction for a particular child may be useful in planning effective intervention. AIMS: This paper describes the development of a dynamic assessment (DA) task which requires implicit knowledge of syntactic structure. The aim was to formulate a valid and reliable procedure for the DA of sentence formulation that could yield useful information for planning intervention for children with LI. METHODS & PROCEDURES: The Dynamic Assessment of Sentence Structure (DASS) was employed on 24 children aged 8-10 years, with identified language impairments, who were tested four times, at 4 monthly intervals. OUTCOMES & RESULTS: A range of scores was elicited with no limiting ceiling or floor effects, and the test showed high internal reliability of α= 0.833. Inter-rater reliability was high. Concurrent validity was demonstrated by significant correlation with scores obtained on the CELF-3(UK) and predictive validity of the measure was also found to exceed that of the standardized test measure. Information about the ability of the children to use strategies and less directive prompts, and to transfer learning between items was elicited, and the information was thought to be useful by speech and language therapists involved in their management. CONCLUSIONS & IMPLICATIONS: The application of DA principles to the assessment of children previously diagnosed with LI, for the purposes of finding out more information about their potential to benefit from language intervention, was found to be effective. The tool developed was shown to be valid and reliable, and it has potentially important applications for the planning of individual intervention programmes and service delivery.