Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review.

BACKGROUND: Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children. METHODS: We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies. RESULTS: Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy. CONCLUSIONS: Monitoring risk situations and employing caregivers' reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.

Morphosyntactic weaknesses in Developmental Language Disorder: the role of structure and agreement configurations.

Agreement is a morphosyntactic dependency which is sensitive to the hierarchical structure of the clause and is constrained by the structural distance that separates the elements involved in this relation. In this paper we present two experiments, providing new evidence that Italian-speaking children with Developmental Language Disorder (DLD), as well as Typically Developing (TD) children, are sensitive to the same hierarchical and locality factors that characterise agreement in adult grammars. This sensitivity holds even though DLD children show accrued difficulties in more complex agreement configurations. In the first experiment, a forced-choice task was used to establish whether children are more affected in the computation of S-V agreement when an element intervenes hierarchically or linearly in the agreement relation: DLD children are more subject to attraction errors when the attractor intervenes hierarchically, indicating that DLD children discriminate between hierarchical and linear configurations. The second experiment, also conducted through a forced-choice task, shows that the computation of agreement in DLD children is more 'fragile' than in TD children (and also in children with a primary impairment in the phonological domain), in that it is more sensitive to the factors of complexity identified in Moscati and Rizzi's (2014) typology of agreement configurations. To capture the agreement pattern found in DLD children, we put forth a novel hypothesis: the Fragile Computation of Agreement Hypothesis. Its main tenet is that DLD children make use of the same grammatical operations employed by their peers, as demonstrated in Experiment 1, but difficulties increase as a function of the complexity of the agreement configuration.

Training RAN or reading? A telerehabilitation study on developmental dyslexia.

Rehabilitation procedures recommended for developmental dyslexia (DD) are still not fully defined, and only few studies directly compare different types of training. This study compared a training (Reading Trainer) working on the reading impairment with one (Run the RAN) working on the rapid automatized naming (RAN) impairment, one of the main cognitive deficits associated with DD. Two groups of DD children (N = 45) equivalent for age, sex, full IQ, and reading speed were trained either by Reading Trainer (n = 21) or by Run the RAN (n = 24); both trainings required an intensive home exercise, lasting 3 months. Both trainings showed significant improvements in reading speed and accuracy of passages and words. Bypassing the use of alphanumeric stimuli, but empowering the cognitive processes underlying reading, training RAN may be a valid tool in children with reading difficulties opening new perspectives for children with severe impairments or, even, at risk of reading difficulties.

Telerehabilitation in developmental dyslexia: methods of implementation and expected results.

BACKGROUND: Developmental Dyslexia is a disorder, highly frequent in the school population, for which the recommended rehabilitation procedures are not well defined. This study aimed to automatize reading decoding skills by using an innovative system for rehabilitation, based on a telerehabilitation method. It requires an intensive home-exercise with the supervision, by web, of the clinician. The study had three main aims: to diffuse knowledge on new methods for rehabilitation of reading difficulties; to verify whether an intensive and simplified exercise, targeted to the automation of reading, is suitable for different subgroups of dyslexic children; to define the treatment effects on basic cognitive functions underlying reading. METHODS: Twenty-five children, grouped according to the neuropsychological and anamnestic profiles, took part to the treatment by the software Reading Trainer®. RESULTS: Both speed and accuracy of reading decoding increased significantly after treatment, independently from the functional neuropsychological profile or the history of oral language delay. These changes were specific to decoding and not associated with improvements in reading comprehension or spelling skills. However, there was a "cascade effect" of the treatment efficacy on those basic cognitive functions considered precursors of the ability to read, with significant improvements in rapid lexical access, phonological processing and visual attention. CONCLUSIONS: This study provides information on the efficacy of new tools for telerehabilitation of specific reading disorders.

The Relationship between Socioeconomic Status and Narrative Abilities in a Group of Italian Normally Developing Children.

OBJECTIVE: Only limited and conflicting information is available regarding the relationship between socioeconomic status (SES) and narrative abilities. Besides, the role fathers' SES plays in the development of their children's narrative abilities has never been investigated. The aim of this study was to analyze the relationship between fathers' and mothers' SES and narrative abilities of their children assessed with the Italian version of the Bus Story Test (I-BST). SUBJECTS AND METHODS: A total of 505 normally developing Italian children were enrolled in the study. Information regarding parents' educational level and employment was collected for each child. Narrative abilities were evaluated using the I-BST. The relationships between parents' employment, educational level, and I-BST scores were analyzed by univariate and multivariate regression analysis. RESULTS: In univariate analysis, both fathers' and mothers' education and employment were associated with most I-BST subscale scores, especially when higher educational and employment levels were contrasted with the lowest educational and employment levels. In multiple regression analysis, significant associations were found only between the fathers' working status and educational level and I-BST subscale scores. CONCLUSIONS: Parental education and employment might impact narrative abilities of children. When both fathers' and mothers' SES variables are considered together, only fathers' education and working status seemed to be associated with I-BST scores.