Language in autism: domains, profiles and co-occurring conditions.

This article reviews the current knowledge state on pragmatic and structural language abilities in autism and their potential relation to extralinguistic abilities and autistic traits. The focus is on questions regarding autism language profiles with varying degrees of (selective) impairment and with respect to potential comorbidity of autism and language impairment: Is language impairment in autism the co-occurrence of two distinct conditions (comorbidity), a consequence of autism itself (no comorbidity), or one possible combination from a series of neurodevelopmental properties (dimensional approach)? As for language profiles in autism, three main groups are identified, namely, (i) verbal autistic individuals without structural language impairment, (ii) verbal autistic individuals with structural language impairment, and (iii) minimally verbal autistic individuals. However, this tripartite distinction hides enormous linguistic heterogeneity. Regarding the nature of language impairment in autism, there is currently no model of how language difficulties may interact with autism characteristics and with various extralinguistic cognitive abilities. Building such a model requires carefully designed explorations that address specific aspects of language and extralinguistic cognition. This should lead to a fundamental increase in our understanding of language impairment in autism, thereby paving the way for a substantial contribution to the question of how to best characterize neurodevelopmental disorders.

The emergence of subjects in Lebanese two-year-olds.

In Lebanese Arabic, lexical subjects may occur before or after verbs, but only before non-verbal predicates. Analysis of spontaneous language samples from 19 two-year-old children shows that postverbal (VS) and preverbal (SV) subjects emerge simultaneously. The youngest children displayed no VS-SV difference in frequency. A slight preference for SV is observed in older children. No preference for SV subjects was found in the speech of the mothers of the younger or older children. Lexical subjects systematically appeared before non-verbal predicates. We interpret these results as evidence for early knowledge of syntactic movement, consistent with Wexler's (1998) Very Early Parameter Setting.

Does Phonological Complexity Provide a Good Index of Language Disorder in Children With Cochlear Implants?

Purpose Phonological complexity is known to be a good index of developmental language disorder (DLD) in normal-hearing children, who have major difficulties on some complex structures. Some deaf children with cochlear implants (CIs) present a profile that evokes DLD, with persistent linguistic difficulties despite good audiological and environmental conditions. However, teasing apart what is related to auditory deficit or to language disorder remains complex. Method We compared the performance of three groups of school-age children, 33 children with CI, 22 with DLD, and 24 with typical development, on a nonword repetition (NWR) task based on phonological complexity. Children with CI were studied regarding their linguistic profile, categorized in four subgroups ranging from excellent to very poor performance. Influence of syllable length and phonological structures on the results of all the children were explored. Results The NWR task correctly distinguished children with DLD from typically developing children, and also children with CI with the poorest linguistic performance from other children with CI. However, most complex phonological structures did not reliably identify children with CI displaying a profile similar to that of children with DLD because these structures were difficult for all of the children with CI. The simplest phonological structures were better at detecting persistent language difficulties in children with CI, as they were challenging only for the children with the poorest language outcomes. Conclusions The most complex phonological structures are not good indices of language disorder in children with CI. Phonological complexity represents a gradient of difficulty that affects normal-hearing and deaf children differently.

Coconuts and curtain cakes: The production of wh-questions in ASD.

Background and aims: Children with autism spectrum disorders (ASD) have been found to exhibit difficulties in wh-question production. It is unclear whether these difficulties are pragmatic or syntactic in nature. The current study used a question elicitation task to assess the production of subject and object wh-questions of children with ASD in two different languages (Hebrew and French) wherein the syntactic structure of wh-questions is different, a fact that may contribute to better understanding of the underlying deficits affecting wh-question production. Crucially, beyond the general correct/error rate we also performed an in-depth analysis of error types, comparing syntactic to pragmatic errors and comparing the distribution of errors in the ASD group to that of children with typical development (TD) and children with Developmental Language Disorder (DLD). Results: Correct production rates were found to be similar for the ASD and DLD groups, but error analysis revealed important differences between the ASD groups in the two languages and the DLD group. The Hebrew- and French ASD groups were found to produce pragmatic errors, which were not found in children with DLD. The pragmatic errors were similar in the two ASD groups. Syntactic errors were affected by the structure of each language. Conclusions: Our results have shown that although the two ASD groups come from different countries and speak different languages, the correct production rates and more importantly, the error types were very similar in the two ASD groups, and very different compared to TD children and children with DLD.Implications: Our results highlight the importance of creating research tasks that test different linguistic functions independently and strengthen the need for conducting fine-grained error analysis to differentiate between groups and gain insights into the deficits underlying each of them.

Identifying Language and Cognitive Profiles in Children With ASD via a Cluster Analysis Exploration: Implications for the New ICD-11.

The new version of the International Classification of Diseases (ICD-11) mentions the existence of four different profiles in the verbal part of the Autism Spectrum Disorder (ASD), describing them as combinations of either spared or impaired functional language and intellectual abilities. The aim of the present study was to put ASD heterogeneity to the forefront by exploring whether clear profiles related to language and intellectual abilities emerge when investigation is extended to the entire spectrum, focusing on verbal children. Our study proposed a systematic investigation of both language (specifically, structural language abilities) and intellectual abilities (specifically, nonverbal cognitive abilities) in 51 6- to 12-year-old verbal children with ASD based on explicitly motivated measures. For structural language abilities, sentence repetition and nonword repetition tasks were selected; for nonverbal cognitive abilities, we chose Raven's Progressive Matrices, as well as Matrix Reasoning and Block Design from the Wechsler Scales. An integrative approach based on cluster analyses revealed five distinct profiles. Among these five profiles, all four logically possible combinations of structural language and nonverbal abilities mentioned in the ICD-11 were detected. Three profiles emerged among children with normal language abilities and two emerged among language-impaired children. Crucially, the existence of discrepant profiles of abilities suggests that children with ASD can display impaired language in presence of spared nonverbal intelligence or spared language in the presence of impaired nonverbal intelligence, reinforcing the hypothesis of the existence of a separate language module in the brain. Autism Res 2020, 13: 1155-1167. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The present work put Autism Spectrum Disorder heterogeneity to the forefront by exploring whether clear profiles related to language and cognitive abilities emerge when investigation is extended to the entire spectrum (focusing on verbal children). The use of explicitly motivated measures of both language and cognitive abilities and of an unsupervised machine learning approach, the cluster analysis, (a) confirmed the existence of all four logically possible profiles evoked in the new ICD-11, (b) evoked the existence of (at least) a fifth profile of language/cognitive abilities, and (c) reinforced the hypothesis of a language module in the brain.

Age of acquisition of 299 words in seven languages: American English, Czech, Gaelic, Lebanese Arabic, Malay, Persian and Western Armenian.

We present a new set of subjective Age of Acquisition (AoA) ratings for 299 words (158 nouns, 141 verbs) in seven languages from various language families and cultural settings: American English, Czech, Scottish Gaelic, Lebanese Arabic, Malaysian Malay, Persian, and Western Armenian. The ratings were collected from a total of 173 participants and were highly reliable in each language. We applied the same method of data collection as used in a previous study on 25 languages which allowed us to create a database of fully comparable AoA ratings of 299 words in 32 languages. We found that in the seven languages not included in the previous study, the words are estimated to be acquired at roughly the same age as in the previously reported languages, i.e. mostly between the ages of 1 and 7 years. We also found that the order of word acquisition is moderately to highly correlated across all 32 languages, which extends our previous conclusion that early words are acquired in similar order across a wide range of languages and cultures.

Identifying language impairment in bilingual children in France and in Germany.

BACKGROUND: The detection of specific language impairment (SLI) in children growing up bilingually presents particular challenges for clinicians. Non-word repetition (NWR) and sentence repetition (SR) tasks have proven to be the most accurate diagnostic tools for monolingual populations, raising the question of the extent of their usefulness in different bilingual populations. AIMS: To determine the diagnostic accuracy of NWR and SR tasks that incorporate phonological/syntactic complexity as discussed in recent linguistic theory. The tasks were developed as part of the Language Impairment Testing in Multilingual Settings (LITMUS) toolkit, in two different national settings, France and Germany, and investigated children with three different home languages: Arabic, Portuguese and Turkish. METHODS & PROCEDURES: NWR and SR tasks developed in parallel were administered to 151 bilingual children, aged 5;6-8;11, in France and in Germany, to 64 children in speech-language therapy (SLT) and to 87 children not in SLT, whose first language (L1) was Arabic, Portuguese or Turkish. Children were also administered standardized language tests in each of their languages to determine likely clinical status (typical development (TD) or SLI), and parents responded to a questionnaire including questions about early and current language use (bilingualism factors) and early language development (risk factors for SLI). Monolingual controls included 47 TD children and 29 children with SLI. Results were subjected to inter-group comparisons, to diagnostic accuracy calculation, and to correlation and multiple regression analyses. OUTCOMES & RESULTS: In accordance with previous studies, NWR and SR identified SLI in the monolingual children, yielding good to excellent diagnostic accuracy. Diagnostic accuracy in bilingual children was fair to good, generally distinguishing children likely to have SLI from children likely to have TD. Accuracy was necessarily linked to the determination of clinical status, which was based on standardized assessment in each of the child's languages. Positive early development, a composite risk factor for SLI, and not variables related to language exposure and use, generally emerged as the strongest predictor of performance on the two tasks, constituting additional, independent support for the efficacy of NWR and SR in identifying impairment in bilingual children. CONCLUSIONS & IMPLICATIONS: NWR and SR tasks informed by linguistic theory are appropriate for use as part of the diagnostic process for identifying language impairment in bilingual children for whom the language of assessment is different from the home language, in diverse sociolinguistic contexts.

A strategic plan to identify key neurophysiological mechanisms and brain circuits in autism.

Autism and Autism Spectrum Disorder (ASD) cover a large variety of clinical profiles which share two main dimensions: social and communication impairment and repetitive behaviors or restricted interests, which are present during childhood. There is now no doubt that genetic factors are a major component in the etiology of autism but precise physiopathological pathways are still being investigated. Furthermore, developmental trajectories combined with compensatory mechanisms will lead to various clinical and neurophysiological profiles which together constitute this Autism Spectrum Disorder. To better understand the pathophysiology of autism, comprehension of key neurophysiological mechanisms and brain circuits underlying the different bioclinical profiles is thus crucial. To achieve this goal we propose a strategy which investigates different levels of information processing from sensory perception to complex cognitive processing, taking into account the complexity of the stimulus and whether it is social or non-social in nature. In order to identify different developmental trajectories and to take into account compensatory mechanisms, we further propose that such protocols should be carried out in individuals from childhood to adulthood representing a wide variety of clinical forms.

Assessing successive bilinguals in two languages: A longitudinal look at English-speaking children in France.

This study examines longitudinal standardized test scores in both languages of a group of successive bilinguals with L1 English acquiring L2 French. Participants included 22 native English-speaking children living in France. French was evaluated using a standardized receptive vocabulary test, as well as tests of phonology and morphosyntax. English was evaluated using the Core Language Score subtests from the CELF-4-UK. The children varied in age (6;9-12;7) and length of exposure (0;11-3;9) to French and were tested twice at 12-month intervals. At T1, 7 children scored below norms in both languages, while only 3 did so at T2. Two out of these 3 were arguably not typically developing children. Length of exposure to French emerged as an important factor only at T1, when a number of children were in early stages of acquisition (≤18months of exposure). English scores varied by age and weekly use of English. In successive bilingual children, language performance on L2 standardized tests can be expected to be (well) below norms during the first 18 months of exposure. English scores revealed that weak L1 performance is part of typical development in this bilingual context, but that L1 retention is also a possibility. LEARNING OUTCOMES: The reader will be able to: (1) describe challenges associated with language assessment of successive bilingual children, (2) describe the impact that age and length of exposure can have on language performance in bilinguals, and (3) understand how assessing successive bilinguals using monolingual norms can lead to underestimation of language abilities.

Language development and mild-to-moderate hearing loss: does language normalize with age?

PURPOSE: The authors' purpose was to explore the nature of the link between hearing loss (HL) and language impairment in adolescents with mild-to-moderate hearing loss (MMHL). Does language performance (generally or in certain areas) normalize at adolescence? METHOD: The language skills of 19 French-speaking adolescents (ages 11-15) with moderate or mild sensorineural HL were evaluated via a series of tests assessing oral and written language, including an experimental probe, and compared with typically developing adolescents and adolescents with specific language impairment (SLI). RESULTS: Language disorders were found, notably in the areas of phonology and grammar, in more than half the adolescents with MMHL; affected domains and error patterns were identical to those found in adolescents with SLI. Language scores of the adolescents with MMHL were significantly linked with degree of HL, a correlation not generally found in studies of children with MMHL. CONCLUSION: Normalization of language performance does not generalize at adolescence in the context of MMHL. The fact that an effect of the severity of HL was found only after childhood might be because linguistic development is basically complete at adolescence. Prior to this time, this effect could be obscured by developmental rhythms that vary from child to child.

Language in benign childhood epilepsy with centro-temporal spikes abbreviated form: rolandic epilepsy and language.

Although Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS) has a good prognosis, a few studies have suggested the existence of language disorders relating to the interictal dysfunction of perisylvian language areas. In this study, we focused on language assessment in 16 children aged 6-15 currently affected by BECTS or in remission. An important proportion of children showed moderate or more severe language impairment. The most affected domains were expressive grammar and literacy skills. We found linguistic deficits during the course of epilepsy but also persistent deficits in children in remission, suggesting possible long-term effects. Our results support the hypothesis that BECTS may be associated with impairment to language and suggest the possibility of a direct link between epileptic activity and language development, and the existence of long-term consequences.