Clinical Practice Guideline: Interventions for Developmental Language Delay and Disorders.

BACKGROUND: It is estimated that 9.9% of children have developmental language disorders (DLD), 7.6% in the form of circumscribed DLD without any serious accompanying impairment and 2.3% with comorbidities that have a bearing on language, such as hearing disorders. Developmental language disorders are among the more commonly treated childhood disorders; if they persist, they often adversely affect educational attainment and social standing later in life. Developmental language delay during the third year of life is an important risk factor for developmental language disorders. METHODS: This interdisciplinary clinical practice guideline reflects current knowledge on evidence-based interventions for developmental language delay and disorders. A systematic literature review was conducted on the efficacy of various interventions against developmental language disorders. RESULTS: The recommendations in this guideline include: for expressive developmental language delay, structured parental training (Hedges' g = 0.38-0.82); in case of a receptive component or other risk factors, language therapy (Cohen's d = -0.20-0.90); for phonological pronunciation disturbances, phonological or integrated treatment methods (Cohen's d = 0.89-1.04); for phonetic disturbances (in the absence of a developmental language disorder), a traditional motor approach; for lexical-semantic and morphologic-syntactical disturbances, combinations of implicit and explicit methods (input enrichment, modeling techniques, elicitation methods, creation of production opportunities, metalanguage, visualizations; Cohen's d = 0.89-1.04). Further recommendations include interventions for pragmatic-communicative developmental language disorders, as well as for developmental language disorders in bi-/multilingual children and in children with impaired hearing, intellectual disability, autism-spectrum disorders, selective mutism, and syndromes and multiple disabilities that have a bearing on language. Inpatient language rehabilitation is also recommended in certain situations. CONCLUSION: Early parent- and child-centered interventions combined with pedagogical language promotion, and the use of evidence-based treatment components, dose frequencies and forms, and settings, can help improve the efficacy of interventions for developmental language delay and disorders.

Are Temporal and Tonal Musical Skills Related to Phonological Awareness and Literacy Skills? - Evidence From Two Cross-Sectional Studies With Children From Different Age Groups.

Temporal and spectral auditory processing abilities are required for efficient and unimpaired processing of speech and might thus be associated with the development of phonological and literacy skills in children. Indeed, studies with unselected children have found links between these basic auditory processing abilities and the development of phonological awareness, reading, and spelling. Additionally, associations between the processing of temporal or spectral/tonal information in music and phonological awareness/literacy have been reported, but findings concerning relations between music processing and spelling are rather sparse. To gain more insights into the specific, potentially age-dependent relevance of various temporal (e.g., rhythm, tempo) and tonal (e.g., pitch, melody) musical subdomains for phonological awareness and literacy, we adapted five music-processing tasks (three temporal, two tonal) for use with tablet computers and used them in two cross-sectional studies with German children from two age groups: Study 1 was conducted with preschool children (about 5 years of age; without formal reading and spelling instruction) and focused on associations between music processing and phonological awareness. In Study 2, third-graders (about 8 years of age) were investigated concerning relations between music processing, phonological awareness, reading comprehension, and spelling. In both studies, rhythm reproduction and pitch perception turned out to be significant predictors of phonological awareness in stepwise regression analyses. Although various associations between music processing and literacy were found for third-graders in Study 2, after phonological awareness was accounted for, only rhythm reproduction made a unique contribution to literacy skills, namely, to alphabetic spelling skills. Hence, both studies indicate that temporal (i.e., rhythm reproduction) and spectral/tonal (i.e., pitch perception) musical skills are distinctly and uniquely related to phonological awareness in children from different age groups (preschool vs. Grade 3). The finding that rhythm reproduction, an auditory temporal processing skill integrating perceptual and motor aspects of rhythm processing, was especially tightly linked to phonological awareness and literacy corroborates other findings on associations between rhythm processing and literacy development and is of interest from the viewpoint of current theories of developmental dyslexia. The potential relevance of our results for applied research concerning early diagnosis and training of literacy-related skills is discussed.

Music Perception Influences Language Acquisition: Melodic and Rhythmic-Melodic Perception in Children with Specific Language Impairment.

Language and music share many properties, with a particularly strong overlap for prosody. Prosodic cues are generally regarded as crucial for language acquisition. Previous research has indicated that children with SLI fail to make use of these cues. As processing of prosodic information involves similar skills to those required in music perception, we compared music perception skills (melodic and rhythmic-melodic perception and melody recognition) in a group of children with SLI (N = 29, five-year-olds) to two groups of controls, either of comparable age (N = 39, five-year-olds) or of age closer to the children with SLI in their language skills and about one year younger (N = 13, four-year-olds). Children with SLI performed in most tasks below their age level, closer matching the performance level of younger controls with similar language skills. These data strengthen the view of a strong relation between language acquisition and music processing. This might open a perspective for the possible use of musical material in early diagnosis of SLI and of music in SLI therapy.

Children with specific language impairment also show impairment of music-syntactic processing.

Both language and music consist of sequences that are structured according to syntactic regularities. We used two specific event-related brain potential (ERP) components to investigate music-syntactic processing in children: the ERAN (early right anterior negativity) and the N5. The neural resources underlying these processes have been posited to overlap with those involved in the processing of linguistic syntax. Thus, we expected children with specific language impairment (SLI, which is characterized by deficient processing of linguistic syntax) to demonstrate difficulties with music-syntactic processing. Such difficulties were indeed observed in the neural correlates of music-syntactic processing: neither an ERAN nor an N5 was elicited in children with SLI, whereas both components were evoked in age-matched control children with typical language development. Moreover, the amplitudes of ERAN and N5 were correlated with subtests of a language development test. These data provide evidence for a strong interrelation between the language and the music processing system, thereby setting the ground for possible effects of musical training in SLI therapy.