Growth of Complex Syntax: Coordinate and Subordinate Clause Use in Elementary School-Aged Children.

PURPOSE: Production of complex syntax is a hallmark of later language development; however, most of the research examining age-related changes has focused on adolescents or analyzed narrative language samples. Research documenting age-related changes in the production of complex syntax in elementary school-aged children in conversational language samples is limited. Therefore, the purpose of this article is to examine age-related changes in the production of coordinate and subordinate clauses in children between 5 and 10 years of age obtained from 50-utterance conversational language samples. METHOD: The analytic sample included 196 children with typical language development, who ranged in age from 5;0 to 10;11 (years;months; girls = 103; boys = 96; three cases were excluded). Fifty-utterance conversational language samples were examined for use of coordinate and subordinate clauses. RESULTS: Results of regression analyses indicated that the production of coordinate and subordinate clauses could be predicted from age. The proportion of utterances that included subordinate clauses increased 0.20% for every month increase in age (p < .001). Coordinate clauses also continued to grow, although at a slower rate (0.10% increase for every month increase in age, p < .001). Finally, the proportion of simple utterances (i.e., utterances without coordinate or subordinate clauses) decreased with age (0.40% decrease for every month increase in age, p < .001). CONCLUSIONS: This study indicated that as children's age increased, they used fewer, simple, one-clause sentences and more utterances that included subordinate clauses, with or without coordinate clauses. These results were obtained from 50-utterance language samples, further supporting use of language sampling to develop intervention goals and monitor progress in therapy. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25262725.

Syntactic Complexity Across Language Sampling Contexts in School-Age Children, Ages 8-11 Years.

PURPOSE: Syntax has been called the structural foundation of language, as its development allows for more efficient and effective communication. Complex syntax production is known to lag in children and adolescents with language impairment. Conversation, narrative, and expository language sampling contexts are recommended tools for the comprehensive assessment of school-age children, including syntactic abilities. Despite these recommendations, few studies have examined syntactic differences obtained from these three sampling contexts in a within group sample of school-age children, (i.e., ages 8-11 years). Information about similarities and differences in syntactic measures obtained from these three sampling contexts is needed to identify the optimal sampling context(s) for eliciting complex syntax. METHOD: Conversational, narrative, and expository language samples were elicited from 85 children with typically developing language ages 8;0-11;11 (years;months). Samples were transcribed and analyzed for the mean length of utterance in words and clausal density, or the number of clauses per communication unit as measured by the subordination index. RESULTS: Syntactic measures differed significantly across the three sampling contexts. Namely, narrative and expository language samples elicited longer utterances and more syntactically complex language than conversation samples. Age-related differences in the syntactic measures were not detected. CONCLUSIONS: Differences in syntactic measures between conversation and narrative samples and conversation and expository samples within children ages 8-11 years support use of narrative and expository contexts as the most appropriate language sampling contexts for elicitation of complex syntax in school-age children ages 8-11 years. Conversation sampling is unlikely to elicit children's capacities for complex sentence production.

Revisiting Reliability: Using Sampling Utterances and Grammatical Analysis Revised (SUGAR) to Compare 25- and 50-Utterance Language Samples.

Purpose The goal of this study was to determine whether the results obtained from a 25-utterance conversational language sample were as reliable as those obtained from a 50-utterance sample. Method Robust conversational language samples from 220 children with typically developing language (106 boys, 114 girls) ranging in age from 3;2 to 7;10 (years;months) were collected. The language samples were randomly assigned to one of two conditions: a 25-utterance condition and a 50-utterance condition. Transcripts were examined for three metrics, including mean length of utteranceSUGAR, words per sentence, and clauses per sentence. Results Data were analyzed using two methods. A linear mixed-model analysis was used to assess absolute and relative reliability, and the Bland-Altman procedure was used to assess absolute reliability and clinical acceptability. Results of the mixed-model analysis indicated that mean length of utteranceSUGAR and words per sentence demonstrated relative reliability; however, none of the metrics demonstrated absolute reliability. In contrast, results of the Bland-Altman scatter plots indicated that all three metrics demonstrated absolute reliability because 94%-96% of participants' scores fell within the limits of agreement. Taken together, the results suggested that the statistically significant differences indicated by the mixed-model analysis were not clinically significant. Conclusion These results highlighted the importance of using different methods of analysis in studies of reliability. The findings indicated that reliable language sample results can be obtained from 25-utterance samples. Furthermore, by including practices already in use (e.g., collecting samples ≤ 50 utterances) and including only minimal changes to current practices, the methods used in this study are feasible for school-based clinicians, could be easily integrated into clinical practice, and could increase the use of evidence-based assessment practices in schools.

Sampling Utterances and Grammatical Analysis Revised (SUGAR): Quantitative Values for Language Sample Analysis Measures in 7- to 11-Year-Old Children.

Purpose The purpose of this study was to document whether mean length of utteranceSUGAR (MLUS), total number of words (TNW), clauses per sentence (CPS), and/or words per sentence (WPS) demonstrated age-related changes in children with typically developing language, aged 7;0-10;11 (years;months). Method Participants were 132 typically developing children (aged 7;0-10;11), with a final sample size of 112 participants (57 boys and 55 girls). Fifty utterance conversational language samples were collected using a language sampling protocol. Four language sample analysis metrics (i.e., MLUS, TNW, CPS, and WPS) were calculated from the samples. Results Results indicated statistically significant age-related increases in three (MLUS, TNW, and WPS) of the four metrics. Conclusions MLUS, TNW, CPS, and WPS may be used with other assessment data to document age-related language changes in children aged 7;0-10;11. When combined with previous data from younger (aged 3;0-7;11) children (Pavelko & Owens, 2017), the data suggest that these metrics offer a set of measures that can be used to assess children's conversational language skills from preschool through late elementary school.

A National Survey of Speech-Language Pathologists' Engagement in Interprofessional Collaborative Practice in Schools: Identifying Predictive Factors and Barriers to Implementation.

Purpose This study examined the models of collaboration used by school-based speech-language pathologists (SLPs) during the provision of special education services including factors predicting use of the interprofessional collaborative practice (IPP) model and barriers to collaboration. Method School-based SLPs responded to a survey on models of collaboration within their work setting. Anchored vignettes were created to determine their engagement in 3 different models (i.e., multidisciplinary, interdisciplinary, and interprofessional) used in the provision of special education services during evaluation and intervention. Predictive factors supporting and/or hindering the use of IPP were identified. Results Results demonstrated low percentages of school-based SLPs engaging in IPP during initial evaluations (8%), eligibility meetings (43%), and intervention sessions (14%). Three factors predicted use of IPP in schools: prior training in collaboration, years of experience, and educational setting. The most frequently cited barriers to SLPs' engagement in collaboration included time constraints/scheduling (48%), resistance from other professionals (23%), and lack of support from employers/administration (11%). Conclusions The results of the current study indicated that systemic change is needed at both the university and public school levels. At the university level, preprofessional students need collaborative learning opportunities that are integrated across programs and colleges. School-based SLPs and other education professionals could benefit from job-embedded learning focused on IPP to increase their knowledge and engagement in IPP and improve student outcomes. Supplemental Material https://doi.org/10.23641/asha.9340760.

SUGAR (Sampling Utterances and Grammatical Analysis Revised): Breaking Tradition.

Purpose In this letter, the authors respond to Guo, Eisenberg, Ratner, and MacWhinney's (2018) letter to the editor, which expressed concerns regarding the clinical applicability of the Sampling Utterances and Grammatical Analysis Revised (SUGAR; Pavelko & Owens, 2017 ) language sample analysis (LSA) method. Method The authors respond to concerns regarding transcription and morpheme segmentation and language sample elicitation contexts. The results of two published research studies are described, which detail the impact of this new LSA method. Results Published research studies have documented that the SUGAR method of LSA can accurately distinguish between children developing language typically and children with language impairment and can also aid clinicians in developing intervention goals. Conclusion SUGAR is a clinically applicable method of LSA that clinicians can use as one part of a comprehensive evaluation to efficiently and accurately identify children with language impairment. Further, clinicians can complete subanalysis of a language sample to identify appropriate therapy targets.

Diagnostic Accuracy of the Sampling Utterances and Grammatical Analysis Revised (SUGAR) Measures for Identifying Children With Language Impairment.

Purpose The purpose of this study was twofold: (a) to determine the diagnostic accuracy of the four Sampling Utterances and Grammatical Analysis Revised (SUGAR) metrics, including total number of words, mean length of utteranceSUGAR, words per sentence, and clauses per sentence in differentiating children with language impairment (LI) from those with typical language development, and (b) to compare the average time to collect, transcribe, and analyze 50-utterance language samples for children with LI to those with typical language development. Method Participants were 306 children (LI, 36; typical language development, 270) who ranged in age from 3;0 (years;months) to 7;11. Fifty-utterance conversational language samples were obtained using a conversational protocol. The four SUGAR metrics were calculated from the samples. Results Cut scores of -1 SD for mean length of utteranceSUGAR and -1.25 cut score for clauses per sentence resulted in sensitivity of 97.22%, specificity of 82.96%, a positive likelihood ratio of 5.71, and a negative likelihood ratio of 0.03. On average, it took a total time of 20:20 min ( SD = 4:37, range: 13:11-30:25) to collect, transcribe, and analyze language samples for children with LI. Children with LI took significantly less time to produce 50 utterances, when compared to their typically developing peers. There were no significant differences in the time to transcribe and analyze language samples of children with LI compared to their typically developing peers. Conclusions The SUGAR metrics, in combination with other data sources (e.g., standardized testing, dynamic assessment, observation), can be used to identify preschool- and early elementary-aged children with LI. Furthermore, for children with LI, language sampling and analysis using the SUGAR method can be completed in approximately 20 min. The results of this study indicated the SUGAR measures can effectively and efficiently help in identifying LI. Supplemental Material https://doi.org/10.23641/asha.7728638.

The Contributions of Phonological Awareness, Alphabet Knowledge, and Letter Writing to Name Writing in Children With Specific Language Impairment and Typically Developing Children.

Purpose: Name writing is one aspect of emergent writing that has been used to understand emergent literacy development. Name-writing skills and the relationship of name writing to other emergent literacy skills have not been studied extensively in children with specific language impairment (SLI). Children with SLI consistently demonstrate delays in phonological awareness (PA), alphabet knowledge (AK), print awareness, and emergent writing. The purpose of this study was to examine the contributions of PA, AK, and letter writing to name writing in children with SLI and typically developing (TD) children. Method: Participants were 65 children (22 SLI, 43 TD) with an average age of 53 months. Participants completed the Assessment of Literacy and Language (Lombardino, Lieberman, & Brown, 2005), a letter-writing task, and a name-writing task. Results: Data were analyzed using correlation and mediation modeling. Mediation modeling, a more sophisticated analysis, revealed that PA, AK, and letter writing, in serial, were mediating variables for language status on name writing. Conclusion: Phonemic awareness, AK, and letter writing help to explain the relationship between language status and name writing. These skills should be integrated during treatment, using a horizontal approach with developmentally appropriate activities, particularly for children with SLI.

Sampling Utterances and Grammatical Analysis Revised (SUGAR): New Normative Values for Language Sample Analysis Measures.

Purpose: The purpose of this study was to document whether mean length of utterance (MLUS), total number of words (TNW), clauses per sentence (CPS), and/or words per sentence (WPS) demonstrated age-related changes in children with typical language and to document the average time to collect, transcribe, and analyze conversational language samples. Method: Participants were 385 typically developing children (ages 3;0-7;11 [years;months]), with a final sample size of 270 participants (133 males and 137 females). Fifty-utterance conversational language samples were collected using a language sampling protocol. Four language sample analysis (LSA) metrics (i.e., MLUS, TNW, CPS, WPS) were calculated from the samples. Results: Results indicated statistically significant age-related increases in the four metrics. The average time to collect, transcribe, and analyze each sample was 20.91 min (SD = 3.97; range = 10.55-33.37). Conclusion: MLUS, TNW, CPS, and WPS may be used with other assessment data to document age-related changes in children's language. When used as part of an assessment, the results from all of the metrics should be considered. Considering results from only 1 individual metric is not encouraged. These results suggest LSA may be completed in approximately 20 min, which is less than the average time to administer a standardized, norm-referenced language assessment.

The development of writing skills in 4-year-old children with and without specific language impairment.

Research shows that many preschool children with specific language impairment (SLI) have difficulty acquiring literacy skills including phonological awareness, print concepts, and alphabet knowledge. Limited research suggests that preschool children with SLI also have difficulty with emergent writing tasks such as name writing and word writing. In typically developing children, research indicates that emergent writing skills are acquired in a developmental sequence: (1) linearity, (2) segmentation, (3) simple characters, (4) left-right orientation, (5) complex characters, (6) random letters, and (7) invented spelling. This study compared the emergent writing skills of 4-year-old children with SLI (n = 22) to their age- and gender-matched peers (n = 22). Results indicated that children with SLI demonstrate difficulty with a variety of writing tasks, including letter writing, name writing, word writing, and sentence writing when compared to their typically-developing peers. Children with SLI followed the same developmental sequence in acquiring writing skills as their typically-developing peers.

Use of Language Sample Analysis by School-Based SLPs: Results of a Nationwide Survey.

PURPOSE: This article examines use of language sample analysis (LSA) by school-based speech-language pathologists (SLPs), including characteristics of language samples, methods of transcription and analysis, barriers to LSA use, and factors affecting LSA use, such as American Speech-Language-Hearing Association certification, number of years' experience, and caseload characteristics. METHOD: School-based SLPs responded to an invitation to complete an electronic survey related to LSA. RESULTS: One third of respondents indicated they did not use LSA during the 2012-2013 school year. SLPs who served middle and high school students were less likely to use LSA. Most respondents reported using conversation to analyze fewer than 10 samples and transcribing in real time. Additional analyses revealed that SLPs who had 3 or fewer years of experience and who analyzed fewer than 20 language samples per year were statistically less likely to report using real-time transcription. The most frequently cited barrier to using LSA was "LSA is too time-consuming." CONCLUSION: Many school-based SLPs do not routinely use LSA. Further, many did not report engaging in evidence-based practices, such as recording samples, using established protocols, or using tasks designed to elicit complex syntax. These results indicate a continued need for professional development regarding evidenced-based practices relative to LSA use.