Is frontal EEG gamma power a neural correlate of language in toddlerhood? An examination of late talking and expressive language ability.

Few studies have examined neural correlates of late talking in toddlers, which could aid in understanding etiology and improving diagnosis of developmental language disorder (DLD). Greater frontal gamma activity has been linked to better language skills, but findings vary by risk for developmental disorders, and this has not been investigated in late talkers. This study examined whether frontal gamma power (30-50 Hz), from baseline-state electroencephalography (EEG), was related to DLD risk (categorical late talking status) and a continuous measure of expressive language in n = 124 toddlers. Frontal gamma power was significantly associated with late talker status when controlling for demographic factors and concurrent receptive language (ß = 1.96, McFadden's Pseudo R2 = 0.21). Demographic factors and receptive language did not significantly moderate the association between frontal gamma power and late talker status. A continuous measure of expressive language ability was not significantly associated with gamma (r = -0.07). Findings suggest that frontal gamma power may be useful in discriminating between groups of children that differ in DLD risk, but not for expressive language along a continuous spectrum of ability.

Exploring vowel errors produced in nonword repetition in children with speech and language disorders.

BACKGROUND: Accurate nonword repetition (NWR) is contingent on many underlying skills, including encoding, memory and motor planning and programming. Though vowel errors are frequently associated with childhood apraxia of speech (CAS), several recent studies have found that children with developmental language disorder (DLD) produce high rates of vowel errors in NWR tasks. AIMS: This retrospective analysis explored whether the overall frequency and types of vowel errors produced in NWR distinguish children with DLD, children with CAS, children with speech sound disorder (SSD) and children with typical development (TD). METHODS AND PROCEDURE: We present data for 24 children (six per DLD, CAS, SSD and TD groups), ranging in age from 50-92 months. Children with DLD, CAS and SSD showed similar articulation scores and children with DLD and children with CAS showed similar expressive language scores. Total vowel errors, total monophthong errors, monophthong substitutions, diphthongization errors, total diphthong errors, diphthong substitutions and diphthong reduction errors were calculated by syllable length and group. Repeated measures analyses of variance were used to examine group differences. OUTCOMES AND RESULTS: Children with DLD and children with CAS produced a higher frequency of total vowel errors compared to children with TD. Children with DLD produced more total monophthong errors than children with TD. Children with DLD and children with CAS produced more total diphthong errors than children with TD. For children with DLD, these were characterised by diphthong substitutions. For children with CAS, these were characterised by diphthong substitutions and diphthong reduction errors. For all measures, error rates in children with SSD did not significantly differ from any of the other three groups. CONCLUSION: Preliminary evidence indicates that children with DLD and children with CAS both show high rates of vowel errors in NWR tasks and weaknesses in encoding and memory. For children with CAS, additional motor planning difficulties are associated with an increased likelihood to reduce diphthongs. Children with SSD show more mild processing difficulties than children with DLD and children with CAS, though they do not perform as well as TD peers. Future work should replicate and further specify the processing weaknesses that affect vowel accuracy in NWR tasks in a larger sample. WHAT THIS PAPER ADDS: What is already known on the subject Nonword repetition (NWR) tasks are often included in diagnostic batteries to identify children with developmental language disorder (DLD). Poor performance on these tasks have historically been attributed to phonological working memory deficits in children with DLD. However, repeating nonwords relies on a number of underlying processing skills and many of these skills are affected to varying degrees in children with speech and language disorders. An in-depth analysis of vowel errors has the potential to reveal the shared as well as specific underlying processing weaknesses in children with DLD, children with childhood apraxia of speech (CAS) and children with speech sound disorder (SSD). What this paper adds to existing knowledge We found that children with DLD and children with CAS show low vowel competence compared to children with typical development. A nuanced examination of vowel error types further revealed that children with DLD and children with CAS show weaknesses in encoding and memory. Motor planning and programming weaknesses were unique to CAS. Children with SSD show more mild processing deficits and their performance did not significantly differ from any of the other three groups. What are the clinical implications of this work? Examining the types of vowel errors produced by children with DLD, children with CAS and children with SSD in NWR allows us to further specify the underlying processing weaknesses that differentiate these three groups. This research informs theoretical accounts of language processing in children with different types of speech and language disorders and has the potential to improve the diagnostic utility of NWR tasks.

Rate of speech affects the comprehension of pronouns in children with developmental language disorder.

This study examined whether children with Developmental Language Disorder (DLD) have knowledge of binding principles (i.e., linking pronouns to their structurally licensed antecedent) during real-time sentence processing (cross-modal priming, real-time) and overt comprehension (sentence-picture matching, interpretative) and whether rate of speech impacted access to that knowledge. Fourteen children with DLD participated in two experiments, with sentences presented auditorily at either a regular or slow speech rate. Sentences were matched except to contain a pronoun, reflexive, or noun phrase (control) in the same syntactic position. Experiment (1) used a cross-modal picture priming paradigm to test real-time pronoun-antecedent linking abilities at both rates of speech. Children were instructed to make a binary decision during the uninterrupted auditory presentation of a sentence to a visually presented image (of the antecedent) at the offset of a pronoun, a reflexive, or a control noun. Response times between conditions (e.g., pronoun vs. control noun) were compared to determine whether participants showed evidence of facilitative priming (faster response times in the pronoun than control noun condition) at either speech rate. Experiment (2) used an auditory sentence-picture-matching task to test final comprehension of similar sentences containing a pronoun or reflexive. Accuracy was compared across both speech rates. For Experiment (1), children with DLD did not show evidence of real-time pronoun-antecedent priming at the regular speech rate. However, when sentences were slowed, they showed facilitative priming for the pronoun condition. For experiment (2), children with DLD performed at-chance when interpreting sentences with pronouns regardless of speech rate. While children with DLD have been shown to have difficulty processing sentences containing anaphors (such as pronouns), results suggest that this is not due to loss of intrinsic knowledge of binding principles. By slowing the rate of speech input, we showed that children with DLD do have access to that knowledge and can make the correct link during real-time processing between a pronoun and its structurally licensed antecedent (Experiment 1) but need more time to do so. However, the effect of slowed speech input does not extend to final comprehension (Experiment 2).

LITMUS Turkish sentence repetition test: The best items, effect of scoring and diagnostic accuracy.

PURPOSE: This study aimed to examine LITMUS Turkish Sentence Repetition Test's (LITMUS-TR) diagnostic accuracy, as well as the best scoring method and most distinguishing test items. We also sought to ascertain whether age has an impact on the sensitivity and specificity. METHOD: Two hundred and fifty children with typical language development (TD) between the ages of 4 and 7, as well as 44 children with developmental language disorder (DLD), took part in the study. Data was collected using TODIL, LITMUS-TR, and the pediatric family interview form. LITMUS-TR was graded using four different methods. RESULTS: The performance of children with DLD in each score type was lower and the number of errors higher than those with TD. All items have excellent or acceptable item difficulty and discrimination values for binary scoring and total number of errors. LITMUS-TR's most distinctive items were complex structures with dependencies, such as syntactic movement and embedding. LITMUS-TR had high diagnostic accuracy for the whole test (0.887) and each scoring method. A separate analysis of each age group showed sensitivity and specificity above 0.80. CONCLUSIONS: When employed as a supportive objective measure, LITMUS-TR was proven to be an effective diagnostic tool for DLD, with age influencing the diagnostic accuracy outcomes.

Word learning by children with developmental language disorder: Identifying gaps in our understanding of spaced retrieval effects.

Background and aims: Current evidence shows that children with developmental language disorder (DLD) benefit from spaced retrieval during word learning activities. Word recall is quite good relative to recall with alternative word learning procedures. However, recall on an absolute basis can be improved further; many studies report that fewer than two-thirds of the words are learned, even with the assistance of spaced retrieval during the learning activities. In this article we identify details of spaced retrieval that are less well understood in an effort to promote more effective learning through retrieval practice. Main contribution: We discuss the importance of factors such as: (a) integrating immediate retrieval with spaced retrieval trials; (b) determining whether gradual increases in spacing have more than short-term benefits relative to equal spacing; (c) discovering the number of successful retrievals sufficient to ensure later recall; (d) using spaced retrieval to avoid erosion of phonetic details on later recall tests; and (e) whether the well-documented difficulties with learning word forms might be tied to a particular subgroup of children with DLD. We also speculate on some of the possible reasons why spaced retrieval is beneficial in the first place. Conclusions: Although many children with DLD make gains in word learning through procedures that incorporate spaced retrieval, there are numerous details involved in the process that can alter its success. Until we have a better understanding of the boundaries of spaced retrieval's effectiveness, we will not be taking full advantage of this promising addition to word learning procedures. Implications: Spaced retrieval activities can be an important addition to the resources that clinicians and educators have available to assist children in their word learning. With a deeper understanding of the issues discussed here, we should be able to put spaced retrieval to even greater use.

Developmental language disorder - heritability and genetic correlations with other disorders affecting language.

Developmental language disorder (DLD) is a neurodevelopmental disorder primarily affecting language in the absence of a known biomedical condition, which may have a large impact on a person's life and mental health. Family-based studies indicate a strong genetic component in DLD, but genetic studies of DLD are scarce. In this study we estimated the heritability of DLD and its genetic correlations with related disorders and traits in sample of >25,000 individuals from the Danish Blood Donor Study for whom we had both genotype data and questionnaire data on language disorder and language support. We estimated SNP-based heritabilities for DLD and genetic correlations with disorders which may involve spoken language deficits and traits related to spoken language. We found significant heritability estimates for DLD ranging from ∼27 % to ∼52 %, depending on the method used. We found no significant evidence for genetic correlation with the investigated disorders or traits, although the strongest effect was observed for a negative genetic correlation between DLD and nonword repetition ability. To our knowledge, this study reports the first significant heritability estimate for DLD from molecular genetic data.

Variability of theory of mind versus pragmatic ability in typical and atypical development.

INTRODUCTION: Numerous studies have linked deficits in Theory of Mind (ToM) with language problems. We aimed to explore the similarities and differences between children's patterns of performance on a ToM task that requires minimal linguistic skill and a pragmatic inference task that relies on both ToM and language. We assessed variability in pragmatic inference skills and ToM across populations of children (8-14 years) displaying varying cognitive profiles. We further compared the sensitivity of ToM versus pragmatic ability to core language skills, memory and executive functioning (EF). METHOD: ToM was tested using the Social Attribution Task (SAT-MC-II). Pragmatic ability was assessed in an implicature comprehension task. Receptive vocabulary, grammar comprehension, short-term and working memory (STM and WM) capacity and EF were measured using Hungarian adaptations of standard tasks and tests developed by the authors' lab. In addition to typically developing (TD) children (n = 33), we included children with neurodevelopmental disorders where ToM and/or language abilities are vulnerable: autism spectrum disorder (ASD, n = 26), attention deficit hyperactivity disorder (ADHD, n = 25) and developmental language disorder (DLD, n = 18). RESULTS: Results revealed a significant but only moderate positive correlation between pragmatic inference and ToM indicating that the two abilities are related but distinct. The ASD group showed impairments in both ToM and pragmatic inference ability but no significant deficit was observed in ADHD or DLD relative to TD children in either skill. However, while SAT-MC-II results were only affected by verbal WM and vocabulary measures, pragmatic performance was associated with STM, verbal WM, EF, grammatical skills and vocabulary. CONCLUSION: Our findings indicate that disentangling the contributions of different cognitive skills to ToM tasks may help clarify the role of ToM in language skills and identify distinct patterns of ToM and pragmatic skills in developmental disorders.

Caregivers' reports of the home literacy environments of children with developmental language disorder and typically developing peers during the COVID-19 pandemic.

PURPOSE: Children with developmental language disorder (DLD) are at heightened risk for reading difficulty. We investigated the home literacy environments of kindergarten children with DLD and typically developing (TD) peers during the COVID-19 pandemic. METHOD: We analysed scores from standardised assessments of oral language, nonverbal intelligence, and word reading in conjunction with home literacy questionnaire data at three time points. RESULT: Frequency of engagement in home literacy activities did not differ by group during school closures or when schools reopened. Caregivers from both groups reported increased home literacy engagement during closures. Engagement returned to pre-pandemic levels when schools reopened. For the DLD group, the child's word reading ability and interest in literacy were positively associated with the home literacy environment. Family history of language and/or literacy difficulty was negatively associated with the home literacy environment. For the TD group, only the child's interest in literacy was positively associated with the home literacy environment. CONCLUSION: These findings elucidate the need for further research related to home literacy and families of children with DLD, with a focus on identifying potential strengths and vulnerabilities related to child and caregiver factors.

Comprehension of verb morphology in Arabic-speaking children with and without developmental language disorder.

Children with developmental language disorder (DLD) experience difficulties with a range of morphosyntactic skills, particularly with tense and subject - verb agreement. Many studies have examined verb-morphology production in children with DLD. We extend this line of research by profiling verb-morphology comprehension in 67 monolingual Saudi Arabic-speaking children, comprising 33 with DLD (M = 61 months, SD = 10.70), and 34 age-matched typically developing (TD) children (M = 63 months, SD = 8.94). Children completed a novel picture selection task developed to assess their comprehension of verb tense, gender agreement, and number agreement. Children with DLD scored significantly lower than TD children on the verb morphology comprehension task. They showed greater difficulty identifying verb tense forms, particularly future tense. They also demonstrated lower accuracy in identifying subject-verb agreement in general, with specific difficulty in comprehending masculine verbs, and singular verbs. These findings were compared with production verb-morphology data from previous Arabic studies. Overall, this study highlights the challenges experienced by Arabic-speaking children with DLD in comprehending verb morphology, particularly tense and subject-verb agreement inflections. These findings can be used to tailor appropriate assessment designs and interventions for an Arabic-speaking DLD population.

Revisiting nonword repetition as a clinical marker of developmental language disorder: Evidence from monolingual and bilingual L2 Cantonese.

Cross-linguistically, nonword repetition (NWR) tasks have been found to differentiate between typically developing (TD) children and those with Developmental Language Disorder (DLD), even when second-language TD (L2-TD) children are considered. This study examined such group differences in Cantonese. Fifty-seven age-matched children (19 monolingual DLD (MonDLD); 19 monolingual TD (MonTD); and 19 L2-TD) repeated language-specific nonwords with varying lexicality levels and Cantonese-adapted quasi-universal nonwords. At whole-nonword level scoring, on the language-specific, High-Lexicality nonwords, MonDLD scored significantly below MonTD and L2-TD groups which did not differ significantly from each other. At syllable-level scoring, the same pattern of group differentiation was found on quasi-universal nonwords. These findings provide evidence from a typologically distinct and understudied language that NWR tasks can capture significant TD/DLD group differences, even for L2-Cantonese TD children with reduced language experience. Future studies should compare the performance of an L2-DLD group and evaluate the sensitivity and specificity of Cantonese NWR.

Speech sound development of young Dutch children with a developmental language disorder: A complex matter.

BACKGROUND: Approximately 50% of all young children with a developmental language disorder (DLD) also have problems with speech production. Research on speech sound development and clinical diagnostics of speech production difficulties focuses mostly on accuracy; it relates children's phonological realizations to adult models. Contrarily to these relational analyses, independent analyses indicate the sounds and structures children produce irrespective of accuracy. Such analyses are likely to provide more insight into a child's phonological strengths and limitations, and may thus provide better leads for treatment. AIMS: Ram (1) To contribute to a more comprehensive overview of the speech sound development of young Dutch children with DLD by including independent and relational analyses, (2) to develop an independent measure to assess these children's speech production capacities; and (3) to examine the relation between independent and relational speech production measures for children with DLD. METHODS & PROCEDURES: We describe the syllable structures and sounds of words elicited in two picture-naming tasks of 82 children with DLD and speech production difficulties between ages 2;7 and 6;8. The children were divided into four age groups to examine developmental patterns in a cross-sectional manner. Overviews of the children's productions on both independent and relational measures are provided. We conducted a Spearman correlation analysis to examine the relation between accuracy and independent measures. OUTCOMES & RESULTS: The overviews show these children are able to produce a greater variety of syllable structures and consonants irrespective of target positions than they can produce correctly in targets. This is especially true for children below the age of 4;5. The data indicate that children with DLD have difficulty with the production of clusters, fricatives, liquids and the velar nasal (/ŋ/). Based on existing literature and our results, we designed a Dutch version of an independent measure of word complexity, originally designed for English (word complexity measure-WCM) in which word productions receive points for specific word, syllable and sound characteristics, irrespective of accuracy. We found a strong positive correlation between accuracy scores and scores on this independent measure. CONCLUSIONS & IMPLICATIONS: The results indicate that the use of independent measures, including the proposed WCM, complement traditional relational measures by indicating which sounds and syllable structures a child can produce (irrespective of correctness). Therefore, the proposed measure can be used to monitor the speech sound development of children with DLD and to better identify treatment goals, in combination with existing relational measures. WHAT THIS PAPER ADDS: What is already known on the subject Speech production skills can be assessed in different ways: (1) using analyses indicating the structures and sounds a child produces irrespective of accuracy, that is, performance analyses; and (2) using analyses indicating how the productions of a child relate to the adult targets, that is, accuracy analyses. In scientific research as well as in clinical practice the focus is most often on accuracy analyses. As a consequence, we do not know if children who do not improve in accuracy scores, improve in other phonological aspects that are not captured in these analyses, but can be captured by performance analyses. What this study adds to the existing knowledge The overviews show these children are able to produce a greater variety of syllable structures and consonants irrespective of target positions than they can produce correctly in targets. Consequently, adding performance analyses to existing accuracy analyses provides a more complete picture of a child's speech sound development. What are the potential or actual clinical implications of this work? We propose a Dutch version of a WCM, originally designed for English, in which word productions receive points for word structures, syllable structures and sounds, irrespective of accuracy. This measure may be used by Dutch clinicians to monitor the speech sound development of children with DLD and to formulate better treatment goals, in addition to accuracy measures that are already used.

Dynamic assessment of phonological awareness in monolingual and bilingual French-speaking children.

Dynamic assessment (DA) is a tool used to assess children's learning potential. Research on English-speaking children indicates that DA effectively diagnoses language disorders in monolingual and bilingual children. However, few DAs have been developed for French-speaking children. This study aimed to examine the validity of a dynamic phonological awareness task for differentiating French-speaking monolingual and bilingual children with and without developmental language disorder (DLD). Thirty-eight monolingual and bilingual children, aged 4-8 years, 23 with typical development (TD) and 15 with DLD, participated in the study. They performed a dynamic phoneme segmentation task, in which graduated cues were provided. Children were also administered a nonword repetition (NWR) task, and a modifiability scale, in which the examiner rated the child's responsivity during the task. Statistical analyses examined what factors influenced dynamic task performance, and calculated the sensitivity and specificity of the tests. Results indicated that four factors emerged as significant in a mixed-effects logistic regression model: age, diagnostic group (TD vs. DLD), modifiability, and the number of phonemes in the target word. Older children who had TD and higher modifiability scores had better segmentation skills than other children. Words with fewer phonemes were also easier to segment than words with greater numbers of phonemes. The dynamic task had good sensitivity in the identification of DLD but less good specificity. Our findings indicate that a dynamic task of phonological awareness has the potential to be used as a diagnostic tool to differentiate TD and DLD.

Developmental changes in the word co-occurrences of Spanish-English bilingual children with and without developmental language disorder.

PURPOSE: The study aimed to understand how bilingual children with typical language development (TLD) and those with developmental language disorder (DLD) use frequent word co-occurrences in their narratives. METHOD: We studied the change over time in the word co-occurrences used by 30 Spanish-English bilingual children with and without DLD (experimental group). An additional normative group consisted of 98 TLD Spanish-English bilingual first graders. Children narrated two Spanish and two English stories in kindergarten and first grade. Employing a Python program on the transcribed narratives, we extracted all adjacent two-word and three-word co-occurrences. From the normative group, the 90 most frequently occurring two-word and 90 most frequently occurring three-word co-occurrences were extracted. The type and tokens of word co-occurrences each child in the experimental group produced out of the 180 identified word co-occurrences were analysed. RESULT: Overall, children at first grade produced more word co-occurrences types than in kindergarten. Children with DLD used fewer types of word co-occurrences but produced them as often as than their TLD peers. Children with DLD increased their word co-occurrences from kindergarten to first grade at the same rate although at a lower frequency. Children in both groups produced similar types and tokens of word co-occurrences in both Spanish and English, except tokens of two word co-occurrences. Children produced two word co-occurrences more often in English than in their Spanish narratives. CONCLUSION: The results shed light on children with DLD's deficits in production of word co-occurrences, indirectly reflecting possible deficits in statistical pattern detection.

How word meaning structure relates to executive functioning and theory of mind in children with developmental language disorder: A multiple case study.

Background and aims: Many children with developmental language disorder (DLD) have difficulties in executive functioning (EF) and theory of mind (ToM). These difficulties might be explained by the theory that children's conceptual understanding changes over five stages of word meaning structure, from concrete and context-dependent to abstract and precise. We present a multiple case study examining how word meaning structure relates to EF and ToM in children with DLD. Methods: Participants were five children with DLD aged 9-12 and five typically developing children matched for age, gender, and nonverbal intelligence. Word meaning structure was assessed using new dynamic test. EF was assessed using the Zoo Map Task and Behavioral Rating Inventory for EF. ToM was assessed using the ToM test, Frith-Happé Animations, and Bermond-Vorst Alexithymia Questionnaire. Behavioral problems were measured using the Child Behavior Checklist. Anamnestic interviews with the parents were conducted to describe the case histories. Results: For the children with DLD, lower scores in the word meaning structure task were observed compared to those observed for their matched peers, with no statistical test applied. Word meaning structure related positively to EF and ToM, but not to behavioral problems. Instances in which word meaning structure dissociates from EF and ToM are discussed in individual case descriptions. Conclusions: By linking language to conceptual development, variations in word meaning structure may explain some EF and ToM difficulties in children with DLD. Implications: The present study offers a basis for future research on the relationships among word meaning structure, EF, and ToM.

Data visualization and decision making in adults with acquired and developmental language disabilities: A scoping review.

BACKGROUND: Accessibility of data visualization has been explored for users with visual disabilities but the needs of users with language disabilities have seldom been considered. AIM: This scoping review synthesised what is known about data visualization for adults with language disabilities, specifically the acquired language disability, aphasia and Developmental Language Disorder. It sought to extract key findings and identify what practices support effective visualization for decision making for people with language disabilities. METHOD: Papers were included if they investigated visualization of data, and the consumers of the data visualization were people with aphasia or developmental language disability. Seven databases were searched: CINAHL, Academic Search, Medline, PsychINFO, Ovid, ACM Digital Library and IEEE Xplore. Included studies were charted to extract title, author(s), year, country, paper type, scientific field, participant number(s), participant group(s), main topic, subtopic, method, task description, task category, data visualization, summary, key findings relevant to the review question, and guidelines or recommendations. Narrative synthesis was used to describe how people with language disability have interacted with data visualization from a range of literature. MAIN CONTRIBUTION: Six studies (seven publications) were included in the review. One study came from the field of health, one from a disability rights collaboration and four studies from computer science. No studies satisfying the review criteria explored data visualization for Developmental Language Disorder; however, five studies explored participants with cognitive disabilities that included impairments of language, so these were included. A range of visualization designs were found. Studies predominantly explored understanding of visualization (4/6). One study explored how to express data visually, and one explored the use of the visualization that is, for an action, choice, or decision. Cognitively accessible data visualization practices were described in four papers and synthesized. Supportive practices reported were reducing the cognitive load associated with processing a visualization and increasing personal relevance of data visualization. CONCLUSION: Accessible data visualization for adults with aphasia and Developmental Language Disorder has only minimally been explored. Practices to specifically support users with language disability are not yet apparent. As data use in making everyday decisions is widespread, future research should explore how people with language disabilities make use of data visualization. WHAT THIS PAPER ADDS: What is already known on this subject Visual resources are used widely to support people with language disabilities in understanding of language. That is, icons, maps timelines and so forth, are used to support auditory processing. However, data visualization is used routinely by people without a language disability to support everyday decisions for example, visualization of live traffic data is used to provide users with the best route to their destination. It is unclear whether any work has explored data visualization for people with language disabilities.  What this paper adds to existing knowledge This paper brings together research on the use of data visualization by adults with either Developmental Language Disorder or aphasia, collectively people with language disabilities. It highlights a gap in the design of inclusive data visualization for language disabilities and the minimal research exploring the use of data visualization for decision making in these populations. What are the clinical implications of this work? Access to data can be empowering. It has potential to enable agency in decisions and increase social participation. The existing gap in knowledge about how to design inclusive data visualization for people with language disabilities thus poses a risk of exclusion and threats to informed decision making. Highlighting the current field of literature may drive research and clinical activity.

Executive functions in children with developmental language disorder: a systematic review and meta-analysis.

Background: The purpose of the current study was to assess the differences between children with developmental language disorder (DLD) and typically developing (TD) children in their performance of executive functions from working memory, inhibitory control, and cognitive flexibility. Methods: We performed a systematical search of PubMed, Embase, Cochrane, and Web of Science for case control studies (published in English between January 1, 1950, and October 11, 2023) comparing the differences in the performance of executive functions between DLD and TD children. Results: Forty eligible studies were included in the present study (N = 3,168 participants). In comparison with TD children, DLD children exhibited significantly poorer performances in all six verbal working memory tasks (backward digit recall task, SMD -1.4321, 95% CI -2.2692 to -0.5950; listening recall task, SMD -1.4469, 95% CI -1.7737 to -1.1202; counting recall task, SMD -0.9192, 95% CI -1.4089 to -0.4295; digit recall task, SMD -1.2321, 95% CI -1.4397 to -1.0244; word list recall task, SMD -1.1375, 95% CI -1.5579 to -0.7171; non-word recall task, SMD -1.5355, 95% CI -1.8122 to -1.2589). However, regarding inhibitory control and cognitive flexibility, the differences between DLD and TD children depended on specific circumstances. In subgroup analyses of all verbal working memory tasks, DLD children presented notably lower performance than TD children in both the monolingual English and monolingual non-English groups, and in both the preschooler and school-aged groups. Conclusion: This study proves that verbal working memory deficits can be seen as a marker for children with DLD and are not affected by age or language type. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=391070, CRD42023391070.

Training morphosyntactic skills in Dutch preschoolers with (presumed) Developmental Language Disorder: A novel group-based intervention.

BACKGROUND: Morphosyntactic problems are a core symptom of Developmental Language Disorder (DLD). In the Netherlands, children with (presumed) DLD can receive special care in language-focused treatment groups. The focus of these groups mainly lies in improving communicative intentions, vocabulary and phonology. Morphosyntactic skills receive less attention. AIMS: The authors developed a scripted group-based intervention targeting morphosyntactic skills in young children with DLD. In this study, the effect of the intervention on the morphosyntactic skills of preschoolers with (presumed) DLD was tested and the usability for pedagogical practitioners (PPs) was evaluated. METHODS & PROCEDURES: Twenty-seven preschoolers with DLD (aged 2;10-3;10 [years;months]) participated in an A-B group study in which the development of grammatical structures was monitored with a morphosyntactic task and language sample analyses (LSA). Progression during 8 weeks usual care (UC) and 8 weeks morphosyntactic intervention was examined using Bayesian mixed effects models. In LSA, structures that were targeted were compared to control structures. The intervention consisted of a weekly script-based group session in which morphosyntactic structures were targeted, and daily activities in which these target structures were repeated. The intervention was provided by trained PPs, who were coached by a speech-language therapist. An early indication of usability and feasibility was evaluated using an online questionnaire. OUTCOMES & RESULTS: The analyses show that morphosyntactic skills improved during the intervention period, with strong evidence for growth in the production of target structures on the morphosyntactic task and target and control structures in LSA, while barely any evidence was found for growth in the use of these structures in UC. However, target structures and control structures seem to develop at the same rate. General measures of morphosyntactic ability showed improvement both during UC and the intervention phase. Evaluation among practitioners suggested that the intervention is regarded as usable and feasible. CONCLUSIONS & IMPLICATIONS: Growth in morphosyntactic skills of children in the intervention period was demonstrated, but this could not be proven to be related to the intervention because both target and control structures improved during the intervention. This growth might be due to maturation instead of the intervention. Nevertheless, our study demonstrates that the morphosyntactic skills of preschoolers with DLD can show considerable improvement over a period of 8 weeks. Furthermore, our study underlines the importance of using LSA measures when monitoring the morphosyntactic development of children, as they might be more sensitive to change than standardised tests. WHAT THIS PAPER ADDS: What is already known on the subject Most children with Developmental Language Disorder (DLD) experience difficulties in their morphosyntactic development. In the Netherlands, preschoolers with DLD can receive special care in language-focused treatment groups. These groups mainly focus on stimulating communicative intentions, vocabulary and phonology, but less so on stimulating morphosyntactic skills. What this study adds We designed a new group-based intervention targeting the expressive morphosyntactic skills of children with DLD, examined the effect and investigated the usability and feasibility. Although there is strong evidence for growth in morphological skills, intervention effects could not be demonstrated. Evaluations among practitioners suggested that the intervention is regarded as usable and feasible. Furthermore, this study shows that children's morphosyntactic skills can improve over relatively short periods of time and language sample analyses seem to be sensitive to detect these changes. What are the clinical implications of this work? Currently, very few group-based morphosyntactic interventions exist (in the Netherlands). Since practitioners were generally positive about the intervention and its usability and feasibility, the proposed intervention might benefit the treatment of morphosyntactic problems in children with DLD.

Microstructural Properties of the Cerebellar Peduncles in Children With Developmental Language Disorder.

Children with developmental language disorder (DLD) struggle to learn their native language for no apparent reason. While research on the neurobiological underpinnings of the disorder has focused on the role of corticostriatal systems, little is known about the role of the cerebellum in DLD. Corticocerebellar circuits might be involved in the disorder as they contribute to complex sensorimotor skill learning, including the acquisition of spoken language. Here, we used diffusion-weighted imaging data from 77 typically developing and 54 children with DLD and performed probabilistic tractography to identify the cerebellum's white matter tracts: the inferior, middle, and superior cerebellar peduncles. Children with DLD showed lower fractional anisotropy (FA) in the inferior cerebellar peduncles (ICP), fiber tracts that carry motor and sensory input via the inferior olive to the cerebellum. Lower FA in DLD was driven by lower axial diffusivity. Probing this further with more sophisticated modeling of diffusion data, we found higher orientation dispersion but no difference in neurite density in the ICP of children with DLD. Reduced FA is therefore unlikely to be reflecting microstructural differences in myelination, rather the organization of axons in these pathways is disrupted. ICP microstructure was not associated with language or motor coordination performance in our sample. We also found no differences in the middle and superior peduncles, the main pathways connecting the cerebellum with the cortex. To conclude, it is not corticocerebellar but atypical olivocerebellar white matter connections that characterize DLD and suggest the involvement of the olivocerebellar system in speech and language acquisition and development.

Enhancing Parental Understanding of Emotions in Children with Developmental Language Disorder: An Online Parent-Led Intervention Program.

Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents' perspectives regarding children with DLD emotional understanding through a parent-led online emotion recognition (ER) intervention. Ten parents of children with DLD aged 6-11 participated in the study. A nonconcurrent multiple baseline design was employed, allowing for a rigorous analysis of changes in parental beliefs over time. Weekly data were collected through the Parents' Beliefs About Children's Emotions Questionnaire. Interviews were also conducted to gain deeper insights into parents' perceptions regarding the ER skills of their children. Results indicated that parents' beliefs about the need for guiding and supporting their child's ER skills increased over the intervention. Interviews also supported this, and three main themes were generated. The intervention program increased parents' awareness of (a) the importance of ER for children with DLD, (b) emotion-focused communication and engagement with their child, and (c) the integration of emotions into daily life. This study is the first known study that explores parents' beliefs about children with DLD ER skills, highlighting the importance of supporting parents through accessible interventions.

Neural Correlates of Telicity in Spanish-Speaking Children with and without Developmental Language Disorder.

BACKGROUND: It is broadly acknowledged that children with Developmental Language Disorder (DLD) show verb-related limitations. While most previous studies have focused on tense, the mastery of lexical aspect-particularly telicity-has not been the primary focus of much research. Lexical aspect refers to whether an action has a defined endpoint (telic verbs) or not (atelic verbs). OBJECTIVE: This study investigates the effect of telicity on verb recognition in Chilean children with DLD compared to their typically developing (TD) peers using the Event-Related Potential (ERP) technique. METHOD: The research design is a mixed factorial design with between-group factors of 2 (DLD/TD) and within-group factors of 2 (telic/atelic verbs) and 2 (coherent/incoherent sentences). The participants were 36 school-aged children (18 DLD, 18 TD) aged 7 to 7 years and 11 months. The task required subjects to listen to sentences that either matched or did not match an action in a video, with sentences including telic or atelic verbs. RESULTS: The study found notable differences between groups in how they processed verbs (N400 and post-N400 components) and direct objects (N400 and P600 components). CONCLUSIONS: Children with DLD struggled to differentiate telic and atelic verbs, potentially because they employed overgeneralization strategies consistent with the Event Structural Bootstrapping model.