Grammatical correction and morphological productivity tasks as potential identifiers of developmental language disorder in Spanish-Catalan bilingual children: a pilot study.

A critical problem for Catalan-Spanish bilinguals is the lack of assessment tools to conduct valid and accurate oral language evaluations. The purpose of this preliminary study was to provide pilot data for a new potential assessment tool in Catalan. We examined the possibility that two novel tasks, a grammatical correction (GramCorr) and morphological productivity (MP; nonword and word subtasks), could differentiate between Catalan-speaking children with and without developmental language disorder (DLD) with good diagnostic accuracy. Twenty-seven school-aged children with DLD (Mage = 9;1 years) and twenty-seven age/sex-matched typically developing (TD) children (Mage = 9;0 years) participated in the study. Group differences and diagnostic accuracy analyses (sensitivity and specificity and likelihood ratios) were conducted. Results showed that the overall accuracy of children with DLD was significantly poorer than that of the TD controls in the two tasks. The preliminary diagnostic accuracy results suggested that the overall test (GramCorr+MP) could be useful in identifying children with DLD (cut-off point 62.1%; sensitivity (.929)/specificity (.893); +LH (8.67)/-LH (0.80). Moreover, the overall MP task (nonword + word subtasks; cut-off point 60%; sensitivity (.897)/specificity (.931), +LH (13.00)/-LH (0.111)) appears to provide adequate information to help in detecting DLD. The nature of both tasks, their usefulness for practitioners and future steps in the design of valid tools for the identification of Catalan speaking children with DLD are discussed.

Diagnostic Accuracy of Grammaticality and Utterance Length in Bilingual Children.

PURPOSE: The purpose of this study was to investigate the diagnostic accuracy of two measures derived from spontaneous language samples, mean length of utterance in words (MLUw) and percentage of grammatical utterances (PGU), in identifying developmental language disorder (DLD) in Spanish-English bilingual children. We examined two approaches: best language and total language. METHOD: The participants in this study included 74 Spanish-English bilingual children with (n = 36) and without (n = 38) DLD. Language samples were elicited through a story retell and story generation task using Frog wordless picture books in English and Spanish. Stories were transcribed and coded using the Systematic Analysis of Language Samples (Miller & Iglesias, 2020) to extract MLUw and PGU in both languages. RESULTS: Logistic regression analyses suggested that a model that included PGU, MLUw, and age achieved the best diagnostic accuracy in predicting group membership. Both approaches, best language and total language, had fair diagnostic accuracy. CONCLUSIONS: In combination, PGU and MLUw seem to be useful diagnostic tools to differentiate bilingual children with and without DLD. Clinical implications and usability are discussed.

Differences in Child Language Assessment Practices Between School-Based and Non-School-Based Speech-Language Pathologists: Results From a Nationwide Survey.

PURPOSE: The purpose of this study was to compare child language assessment practices of speech-language pathologists (SLPs) working in school and nonschool settings to determine if their place of employment impacts the diagnostic decision-making process. METHOD: School-based SLPs (e.g., direct service providers employed in preschool and/or K-12 schools; n = 382) and non-school-based SLPs (e.g., direct service providers employed in private practices, university clinics, and/or medical settings; n = 147) completed a web-based questionnaire. The questionnaire examined the types, frequency, and perceived importance of specific assessment tools and potential workplace factors that may impact their diagnostic decision-making process. RESULTS: Both school-based and non-school-based SLPs reported using a combination of assessment tools when evaluating children with potential language disorders. School-based SLPs tended to rank the frequency of use and importance of most assessment tools similarly, while non-school-based SLPs ranked interviews as the most frequently used and most important assessment tool. Statistically significant group differences indicated that school-based SLPs ranked the frequency of use and importance of standardized testing higher compared to their non-school-based counterparts. Also, school-based SLPs rated employment-based factors impacting diagnostic decision making higher compared to non-school-based SLPs. CONCLUSIONS: SLPs practicing in school-based settings seem to handle more employment-based factors that impact independent diagnostic decision making than SLPs working in different employment settings when assessing children for potential language disorders. Clinical recommendations are provided, and implications for implementation-based assessment research in child language are discussed.

Spanish Bilingual Morphosyntactic Development in Bilingual Children With and Without Developmental Language Disorder: Articles, Clitics, Verbs, and the Subjunctive Mood.

PURPOSE: The purpose of this study was to examine the growth of previously established clinical markers of developmental language disorder (DLD) in Spanish-speaking bilingual children with and without DLD. METHOD: Forty-three bilingual children with DLD and 57 typically developing children were tested 3 times over a 2-year period. Their average age at Time 1 was 5;10 (years;months). All children completed an elicitation task examining the production of articles, clitics, verbs, and the subjunctive mood in Spanish at each time point, in addition to other behavioral testing in Spanish and English. We used growth curve analysis to examine change patterns of the morphosyntactic structures over time. RESULTS: At the onset of the study, children without DLD produced higher accuracy rates than children with DLD across all morphosyntactic structures. In addition, there was a positive effect of time on all structures. Furthermore, the interaction between time and DLD was statistically significant for clitic pronouns. CONCLUSION: In agreement with previous literature on language growth in monolingual children with DLD, bilingual children with DLD showed language growth that was parallel to that of bilingual children without DLD but with significantly lower levels of attainment. SUPPLEMENTAL MATERIAL AND PRESENTATION VIDEO: https://doi.org/10.23641/asha.23810820.

Longitudinal Examination of Morphosyntactic Skills in Bilingual Children: Spanish and English Standardized Scores.

PURPOSE: This study aimed to examine changes in English and Spanish morphosyntactic standardized scores over time in bilingual children. METHOD: One hundred bilingual children participated in this longitudinal study. The average age of the children at the beginning of the study was 5;11 (years;months). A subset of the participants was identified as children with developmental language disorder (DLD, n = 43). Children completed behavioral testing in Spanish and English at three time points over a period of 2 years. Growth curve modeling was employed to analyze longitudinal data. RESULTS: Distinct patterns of Spanish and English language growth were observed. While the average standard score in English increased, the average score in Spanish decreased over time for both groups. Children with DLD showed persistent language difficulties in both Spanish and English over time in comparison to their peers. CONCLUSIONS: The results of this study provide evidence of a shift in language proficiency from Spanish to English for bilingual children with and without language disorders. This study also shows that bilingual children with DLD show a protracted but parallel growth in morphosyntactic skills in comparison to children without DLD. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23671464.

Recast Therapy for Treating Syntax in Bilingual Children With Developmental Language Disorder: A Feasibility and Early Efficacy Study Examining the Role of Language of Intervention on Outcomes.

PURPOSE: The purpose of this study is to examine the feasibility of the delivery of complex syntax recast therapy via telepractice to Spanish-English bilingual children and provide preliminary evidence of the efficacy of this approach. METHOD: Fifteen bilingual children with developmental language disorders were stratified based on language proficiency and randomized to one of three treatment conditions: Spanish only (n = 5), English only (n = 6), or Spanish + English (n = 4). Using a within-subject design, we hypothesized that we could document treatment efficacy based on change in the treated structure in the absence of change in an untreated comparison structure. All 15 children completed ~16 hr of treatment via telepractice and participated in pre- and posttesting of their production of conditional adverbs (treated structure) and subject relative clauses (untreated structure) carried out by a masked assessor. RESULTS: Analyses included all participants. Treatment fidelity was high, and participant attendance was remarkable, indicating feasibility. Regarding efficacy, recast therapy led to group-level gains on treated syntactic structures that exceeded those observed for the untreated comparison structure. For the 11 children who received therapy in only one language, approximately equal gains were observed in both the treated and untreated languages for conditional adverbials. CONCLUSIONS: Preliminary evidence suggests that for highly overlapping structures like conditional adverbials, recast therapy is effective and leads to change in both of the child's languages. Larger studies are required to understand how language of administration and proficiency may affect outcomes. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23739996.

Code-Switching During Narratives by Bilingual Children With and Without Developmental Language Disorder.

PURPOSE: This study examined the frequency, direction, and structural characteristics of code-switching (CS) during narratives by Spanish-English bilingual children with and without developmental language disorder (DLD) to determine whether children with DLD exhibit unique features in their CS that may inform clinical decision-making. METHOD: Spanish-English bilingual children, aged 4;0-6;11 (years;months), with DLD (n = 33) and with typical language development (TLD; n = 33) participated in narrative retell and story generation tasks in Spanish and English. Instances of CS were classified as between utterance or within utterance; within-utterance CS was coded for type of grammatical structure. Children completed the morphosyntax subtests of the Bilingual English-Spanish Assessment to assist in identifying DLD and to index Spanish and English morphosyntactic proficiency. RESULTS: In analyses examining the contributions of both DLD status and Spanish and English proficiency, the only significant effect of DLD was on the tendency to engage in between-utterance CS; children with DLD were more likely than TLD peers to produce whole utterances in English during the Spanish narrative task. Within-utterance CS was related to lower morphosyntax scores in the target language, but there was no effect of DLD. Both groups exhibited noun insertions as the most frequent type of within-utterance CS. However, children with DLD tended to exhibit more determiner and verb insertions than TLD peers and increased use of "congruent lexicalization," that is, CS utterances that integrate content and function words from both languages. CONCLUSIONS: These findings reinforce that use of CS, particularly within-utterance CS, is a typical bilingual behavior even during narrative samples collected in a single-language context. However, language difficulties associated with DLD may emerge in how children code-switch, including use of between-utterance CS and unique patterns during within-utterance CS. Therefore, analyzing CS patterns may contribute to a more complete profile of children's dual-language skills during assessment. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23479574.

Parental Beliefs, Language Practices and Language Outcomes in Spanish-English Bilingual Children.

As the U.S. population who speaks a language other than English at home continues to grow, few studies have focused on the effect of parental beliefs on the importance of bilingualism have on language outcomes of their children. In this study, we surveyed families raising Spanish-English bilingual children on their beliefs concerning both languages, language practices they implement at home, at school, and in the community, and language outcomes of their children. Using a single mediator model, this study aimed to understand the impact of parental beliefs on language outcomes in Spanish and English and the mediating effects of language practices. We then examined the individual mediating effects of language practices at home, school, and community on the relationship between parental beliefs and language outcomes for each language using a multiple mediator model. Our results suggest that parental beliefs in Spanish predict Spanish language outcomes and parental beliefs in English predict English outcomes and that practices in each language mediated this effect. In particular, we found that Spanish practices at home mediated the effect of language outcomes in Spanish and that English practices at home and in the community mediated English language outcomes.

Can Bilingual Children Self-Report Their Bilingual Experience and Proficiency? The Houston Questionnaire.

PURPOSE: The aim of this study was to develop a child self-report questionnaire measuring bilingual experience and self-perceptions of Spanish and English proficiency and establish preliminary evidence of validity and reliability for the questionnaire. METHOD: Participants included 113 Spanish-English bilingual children with and without developmental language disorders ranging in age from 4 to 8 years. All children completed the questionnaire in Spanish and participated in behavioral assessment of their language skills in both Spanish and English. RESULTS: Using confirmatory factor analysis, a model with three correlated factors (self-perception of proficiency in Spanish, self-perception of proficiency in English, and bilingual experience) emerged with the best global fit, reasonableness, consistency with theory, and model parsimony, suggesting that the questionnaire has good internal reliability. The scaled results of the questionnaires significantly correlated with behavioral measures of both Spanish and English, supporting the convergent validity of the measure. CONCLUSIONS: The Houston Questionnaire is an assessment tool for the assessment of bilingual experience and self-perception of proficiency in Spanish and English bilingual children between the ages of 4 and 8 years. The results provide foundational evidence supporting the reliability and convergent validity of this tool. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21158887.

Is Bilingual Receptive Vocabulary Assessment via Telepractice Comparable to Face-to-Face?

PURPOSE: This study investigated the effect of delivery method (face-to-face or telepractice), time, home language, and language ability on bilingual children's receptive vocabulary scores in Spanish and English. METHOD: Participants included bilingual children with (n = 32) and without (n = 57) developmental language disorders (DLD) that were assessed at 2 time points about 1 year apart. All children participated in face-to-face assessment at Time 1. At Time 2, 41 children were assessed face-to-face and 48 children were assessed using telepractice. RESULTS: Delivery method was not a significant predictor of receptive scores in either Spanish or English. Spanish and English receptive vocabulary increased over time in both children with and without DLD. Children with DLD had lower receptive vocabulary raw scores than children with typical development. Children who spoke English-only at home had significantly higher English receptive scores than children who spoke Spanish-only or both Spanish and English at home. CONCLUSIONS: Face-to-face and telepractice assessments seem to be comparable methods for the assessments of Spanish and English receptive skills. Spanish and English receptive skills increased over time in children with and without DLD. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.17912297.

Home language maintenance in bilingual children with normal hearing and with hearing loss who use cochlear implants.

We investigated home language (Spanish) maintenance in Spanish- and English-speaking bilingual children with normal hearing (NH) and their peers with hearing loss (HL) who used cochlear implants (CIs) at two time points about 7 months apart. Twenty-two bilingual children (11 with NH and 11 with CIs) between the ages of 4;6 and 7;11 participated in the study, who were matched as closely as possible on chronological age, time elapsed between the first and the second sample, gender, and age of exposure to their languages across groups. We compared group performance on the Preschool Language Scales - 5th edition (PLS-5) and the Word Intelligibility Picture Identification at each time point as well as home language maintenance calculated based on item responses on the PLS-5. Our results indicated differences on all measures at both time points between the performance of children with NH and their peers with HL who used CIs in that the former group outperformed the latter. We also found that bilingual children with NH maintained their home language at a higher level than their peers with HL who used CIs. Further, the data also showed that despite the group differences, both groups displayed maintenance of their home language and that individual variability was more prevalent in the CI group. We conclude that home language maintenance is not only possible, but it should be encouraged for both bilingual children with NH and their peers with HL who used CIs.

The Complex Role of Utterance Length on Grammaticality: Multivariate Multilevel Analysis of English and Spanish Utterances of First-Grade English Learners.

PURPOSE: This study examined the relationship between utterance length, syntactic complexity, and the probability of making an error at the utterance level. METHOD: The participants in this study included 830 Spanish-speaking first graders who were learning English at school. Story retells in both Spanish and English were collected from all children. Generalized mixed linear models were used to examine within-child and between-children effects of utterance length and subordination on the probability of making an error at the utterance level. RESULTS: The relationship between utterance length and grammaticality was found to differ by error type (omission vs. commission), language (Spanish vs. English), and level of analysis (within-child vs. between-children). For errors of commission, the probability of making an error increased as a child produced utterances that were longer relative to their average utterance length (within-child effect). Contrastively, for errors of omission, the probability of making an error decreased when a child produced utterances that were longer relative to their average utterance length (within-child effect). In English, a child who produced utterances that were, on average, longer than the average utterance length for all children produced more errors of commission and fewer errors of omission (between-children effect). This between-children effect was similar in Spanish for errors of commission but nonsignificant for errors of omission. For both error types, the within-child effects of utterance length were moderated by the use of subordination. CONCLUSION: The relationship between utterance length and grammaticality is complex and varies by error type, language, and whether the frame of reference is the child's own language (within-child effect) or the language of other children (between-children effect). SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.17035916.

Characterization of English and Spanish language proficiency among middle school English learners with reading difficulties.

Among bilinguals, language-related variables such as first and second language proficiency and balance may be related to important cognitive and academic outcomes, but approaches to characterizing these variables are inconsistent, particularly among at-risk samples of children. The current study employed comprehensive language assessment of English and Spanish language skills and contrasted various approaches to the characterization of language among at-risk ELs in middle school (N = 161). Specifically, we contrasted variable-centered and person-centered approaches, and convergence between objective and self-report measures. Findings support a two-factor structure of English and Spanish language skills in this population, three profiles of students (balanced, moderately unbalanced-higher Spanish, and very unbalanced-higher English), convergence between variable-centered and person-centered approaches, and mixed support for subjective indices of usage. Results provide a foundation from which to examine the roles of L1 and L2 proficiency as well as balance in important cognitive and academic outcomes in this at-risk and understudied population.

Elicited vs. spontaneous language as methods for the assessment of grammatical development: The DEME assessment tool / Lenguaje elicitatdo vs. lenguaje espontáneo como métodos de evaluación del desarollo gramatical: la prueba de evaluación DEME

Introduction and objectives: This study compares data collection approaches in the assessment of grammatical development in Spanish-speaking children. Specifically, we compared error rates produced in data collected using samples from spontaneous language versus elicited production, using both broad (overall) and narrow measures (errors with noun phrases). Methods and participants: Monolingual-Spanish-speaking five-year-olds (n=55) were divided into typical language development (TL) and at-risk (Risk) according to a preexisting test, Tamiz de Problemas del Lenguaje. All children completed an elicited production and a narrative task. Results: Children in the TL group outperform children in the Risk group in all measures used in this study. Statistically significant differences were found between children at Risk and TL children in both spontaneous and elicited language measures, although the effect size of the elicited language measures was considerably higher. Elicited and spontaneous tasks are more likely to produce results that are in accord than in disaccord. However, when results are in disaccord, the results almost always show low performance in elicited language but high performance in spontaneous language. Elicitation methods do not seem to have an impact on the type of error produced for neither narrow nor broad measures.(AU)

Introducción y objetivos: Este estudio compara los enfoques de recolección de datos para la evaluación del desarrollo gramatical en niños que hablan español. Específicamente, comparamos las tasas de error producidas usando muestras de lenguaje espontáneo versus la producción elicitada, usando medidas generales (todos los errores) y específicas (errores con frases nominales). Métodos y participantes: Los niños monolingües de cinco años de habla hispana (n=55) se dividieron en dos grupos: desarrollo del lenguaje típico o a riesgo de desórdenes del lenguaje, para lo cual se usó el Tamiz de Problemas del Lenguaje. Todos los niños completaron una producción del lenguaje elicitada y una tarea narrativa. Resultados: Los niños del grupo típico superan a los niños del grupo a riesgo en todas las medidas utilizadas en este estudio. Se encontraron diferencias estadísticamente significativas entre los niños a riesgo y los niños típicos en las medidas de lenguaje espontáneo y elicitado, aunque el tamaño del efecto de las medidas de lenguaje elicitado fue considerablemente mayor. El lenguaje elicitado y espontáneo producen mas resultados que están de acuerdo que en desacuerdo; sin embargo, cuando los resultados están en desacuerdo, casi siempre muestran un bajo rendimiento en el lenguaje elicitado pero un alto rendimiento en el lenguaje espontáneo. Los métodos de obtención no parecen tener un impacto en el tipo de error producido ni para medidas específicas ni amplias.(AU)

Predictors of Item Accuracy on the Test de Vocabulario en Imagenes Peabody for Spanish-English Speaking Children in the United States.

This study examines the response patterns of 288 Spanish-English dual language learners on a standardized test of receptive Spanish vocabulary. Investigators analyzed responses to 54 items on the Test de Vocabulario en Imagenes (TVIP) (Dunn & Dunn, 2007) focusing on differential accuracy on items influenced by a) cross-linguistic overlap, b) context (home/school), and c) word frequency in Spanish. The response patterns showed cross-linguistic overlap in phonology was a significant predictor of accuracy at the item level. After accounting for item number (expected difficulty level), context of exposure was a significant predictor of the likelihood of obtaining a correct response. Spanish word frequency was not a significant predictor of accuracy. The current findings substantiate the influence of cross-linguistic overlap in phonology and context on Spanish vocabulary recognition by Spanish-English speaking children. Children were more likely to obtain correct responses on lexical items that were associated with the home context. Researchers and practitioners should consider phonological cross-linguistic overlap in addition to context of word exposure and word frequency when designing and utilizing vocabulary assessments for children from linguistic minority backgrounds.

Morphological Errors in Spanish-Speaking Bilingual Children With and Without Developmental Language Disorders.

Purpose The purpose of this study was to find morphological markers with good diagnostic accuracy to identify developmental language disorders (DLD) in Spanish-English bilingual children. Method The participants in this study included 66 Spanish-English bilingual children between the ages of 4;0 and 6;11 (years;months) with (n = 33) and without DLD (n = 33). We employed a comprehensive production task in Spanish to elicit morphological structures that have been previously found to be problematic for Spanish-speaking children with DLD. These structures included elements of nominal morphology (articles, direct object pronouns, adjectives, and plurals) and verbal morphology (verbs and the subjunctive mood). Logistic regression was used in this study to find a set of grammatical structures that most accurately predicted group membership. Results Spanish-English bilingual children with and without DLD significantly differed from each other in their accurate production of articles, clitics, adjectives, verbs, and the subjunctive mood. Clitics, verbs, and the subjunctive mood in isolation had adequate diagnostic accuracy. A combination of verb and subjective mood accuracy best predicted group membership in this study (sensitivity of 85% and specificity of 91%). Conclusion In addition to clitics, verbs, and the subjunctive mood, both elements of verbal morphology should be considered grammatical markers of DLD in Spanish-English bilingual children. Supplemental Material https://doi.org/10.23641/asha.13641320.

Elicited vs. Spontaneous Language as Methods for the Assessment of Grammatical Development: The DEME Assessment Tool.

Introduction and Objectives: This study compares data collection approaches in the assessment of grammatical development in Spanish-speaking children. Specifically, we compared error rates produced in data collected using samples from spontaneous language versus elicited production, using both broad (overall) and narrow measures (errors with noun phrases). Methods and Participants: Monolingual-Spanish-speaking five-year-olds (n=55) were divided into typical language development (TL) and at-risk (Risk) according to a preexisting test, Tamiz de Problemas del Lenguaje. All children completed an elicited production and a narrative task. Results: Children in the TL group outperform children in the Risk group in all measures used in this study. Statistically significant differences were found between children at Risk and TL children in both spontaneous and elicited language measures, although the effect size of the elicited language measures was considerably higher. Elicited and spontaneous tasks are more likely to produce results that are in accord than in disaccord. However, when results are in disaccord, the results almost always show low performance in elicited language but high performance in spontaneous language. Elicitation methods do not seem to have an impact on the type of error produced for neither narrow nor broad measures.

Vulnerability of Clitics and Articles to Bilingual Effects in Typically Developing Spanish-English Bilingual Children.

This study examines bilingual effects in Spanish-English bilingual children with good maintenance of the minority language. The present study compares the performance of a group of Spanish-monolingual children (MON; n=30) with two groups of Spanish-speaking bilingual children (Low English proficiency group: LEP; n=36; High English proficiency group, HEP; n=36) on the elicited productions of Spanish articles and object clitics. Our results suggest that children with LEP performed significantly lower than MON children of the same age on both articles and clitics in Spanish. However, children with HEP, who were a year older on average, performed similarly to the MON group. Both groups of bilingual children produced errors of clitic omission and substitution, but these errors were minimal in the MON group. The results suggest that Spanish clitics and articles are vulnerable to bilingual effects for English/Spanish speaking children with good Spanish maintenance.

Beyond Scores: Using Converging Evidence to Determine Speech and Language Services Eligibility for Dual Language Learners.

Purpose Speech-language pathologists have both a professional and ethical responsibility to provide culturally competent services to dual language learners (DLLs). In this tutorial, we recommend that clinicians use a comprehensive assessment of converging evidence to make diagnostic decisions in DLLs in accordance with the American Speech-Language-Hearing Association's Code of Ethics. The content of this tutorial is most appropriate for Spanish-English DLLs between the ages of 4 and 8 years. Method We propose a converging evidence approach, in which one single method is not the deciding factor in making diagnostic decisions regarding the dual language and speech production skills of DLLs. Converging evidence refers to the idea that multiple pieces of assessment data must come together and trend in the same direction to make a diagnostic decision. We recommend gathering assessment data using a combination of language experience questionnaires, bilingual language sample analysis using large-scale reference databases, evaluation of learning potential, and standardized testing. These four assessment methods allow clinicians to examine the child in different contexts to determine their strengths and weakness in communication abilities. Conclusion We illustrate the converging evidence framework using two case studies to guide the clinician through the diagnostic decision-making process.

Morphological Errors in Monolingual Spanish-Speaking Children With and Without Developmental Language Disorders.

Purpose The purpose of this study was to identify which morphological markers have the best diagnostic accuracy to identify developmental language disorders (DLD) in monolingual Spanish-speaking children. Method The participants in this study included 50 Spanish-speaking monolingual children with (n = 25) and without (n = 25) DLD. Data collection took place in Mexico. Children were administered a comprehensive elicitation task that set up felicitous contexts to produce morphological structures previously identified as problematic for Spanish-speaking children with DLD: articles, direct object pronouns, adjectives, plurals, verb conjugations, and the subjunctive in Spanish. Results Statistically significant group differences between children with and without DLD were found for all morphological structures examined but plurals. Logistic regression analyses suggested that a model that included clitic and verbs was the best model to uniquely predict group membership. This model showed sensitivity of 96% and specificity of 80%. Conclusion Clitics and verbs should be considered morphological markers of DLD in monolingual Spanish-speaking children.