Validation of PleaseApp: a digital tool for the assessment of receptive pragmatic abilities in children with neurodevelopmental disorders.

Background: Pragmatic skills allow children to use language for social purposes, that is, to communicate and interact with people. Most children with neurodevelopmental disorders (NDDs) face pragmatic difficulties during development. Nevertheless, pragmatic skills are often only partially assessed because the existing instruments usually focus on specific aspects of pragmatics and are not always adapted to children with communication difficulties. In this sense, digital tools (e.g., apps) are an optimal method to compensate for some difficulties. Moreover, there is a lack of pragmatic tools measuring the receptive domain. Therefore, the present study aims to validate PleaseApp as a digital instrument that measures eight pragmatic skills by presenting the design of the assessment tool and its psychometric properties. Methods: PleaseApp was designed based on previous empirical studies of developmental pragmatics in children with and without NDD. PleaseApp assesses eight receptive pragmatic skills: figurative language, narrative, reference, indirect speech acts, visual and verbal humor, gesture-speech integration, politeness, and complex intentionality. The study involved 150 typically developing children between 5 and 12 years of age. Results: A confirmatory factor analysis proposes an eight-factor model with no underlying factor structure. The eight tests that compose PleaseApp have obtained a model with a good fit and with adequate reliability and validity indices. Discussion: PleaseApp is an objective, valid, and reliable tool for assessing pragmatic skills in children with NDD. In this sense, it helps to assess whether a child has acquired pragmatic skills correctly according to his/her age and clarify the specific problems a child has in eight different components to plan personal and personalized interventions.

Coping with the Stress through Individual and Contextual Resilient Factors in Primary School Settings.

Children face school stress as students through all educational stages. A negative association between resilience and stress has been demonstrated by many authors, but most of these studies have been carried out in higher educational stages. So, the aim of the present study is, on the one hand, to find out the level of stress of primary school children and also the types of stressful situations in school settings, and on the other hand, to analyze the effect of individual and contextually resilient factors on their level of school stress. The study involved 427 children between 6 and 12 years of age, who were administered the IECI school stress scale and the RES-PRIM Resilience questionnaire for children. Descriptive analyses, correlations, and regression analyses were performed on the data. Results showed an average level of school stress, with the most stressful situations being: participating in too many activities, concentration problems, and nervousness when being asked by the teacher in class. Predictive analysis showed that part of the school stress could be explained by both individual factors (self-esteem, introspection, future purpose, and social skills) and resilient contextual factors (teacher support, parental support, and peer support). It is concluded that it is necessary to pay more attention to the transitions between different educational stages with programs that reinforce academic information and encourage the development of individual resilient skills, stressing the importance of the role of teachers, peers, and parents as support groups.

Factors influencing resilience of parents with children with neurodevelopmental disorders: The role of structural language, social cognition, and social support.

Background: Resilience allows a more positive coping and improves parents' wellbeing when they face a difficult situation like having a child with a neurodevelopmental disorder (NDD). We aim to analyze the development of resilience in parents of children with different NDD (ASD, DLD and ADHD) with different levels of structural language and social cognition, as well as the social support available for their families, and compare it to children with typical development (TD). Method: We analyzed the level of resilience of 156 parents, 73 with children with TD and 73 with three different NDD, taking into account variables such as age, structural language (receptive grammar) and social cognition (emotional understanding) of the children, and also the type of social support available to them. Results: Children with DLD and ASD showed lower receptive grammar and emotional comprehension skills, although only parents of children with ASD obtained better resilience scores. Moreover, age of children and formal support variables predicted the resilience of the parents according to the type of NDD. Discussion: The severity of social cognition and structural language difficulties of children with NDD and the fact of having support from professionals and family associations have a significant influence on the development of parental resilience.

Exploring different aspects of emotion understanding in adults with Down Syndrome.

BACKGROUND: Adults with Down Syndrome (DS) present difficulties in emotion understanding, although research has mainly focused on emotion recognition (external aspects), and little is known about their performance in other complex components (mental and reflective aspects). AIMS: This study aims to examine different aspects of emotion understanding in adults with DS, including a codification of their error pattern, and also to determine the association with other variables that are commonly impaired in adults with DS. METHODS AND PROCEDURES: Twenty-two adults with DS and twenty-two children with typical development (TD) matched for vocabulary level were assessed with the Test of Emotion Comprehension (TEC), along with other non-verbal reasoning (NVR), structural language and working memory (WM) tasks. OUTCOMES AND RESULTS: Adults with DS showed lower emotion competence than children with TD in different components of the TEC, and also a different pattern of errors was observed. Structural language, NVR and WM predicted distinct emotion understanding skills in different ways. CONCLUSIONS AND IMPLICATIONS: It is important to plan interventions aimed at improving particular aspects of emotion understanding skills for adults with DS, taking into account the different components, the type of error and the different cognitive and linguistic skills involved in each emotion understanding skill.

Association between CCC-2 and Structural Language, Pragmatics, Social Cognition, and Executive Functions in Children with Developmental Language Disorder.

(1) Background: Developmental Language Disorder (DLD) is diagnosed when the child experiences problems in language with no known underlying biomedical condition and the information required for its correct evaluation must be obtained from different contexts. The Children's Communication Checklist (CCC-2) covers aspects of a child's communication related to structural language and pragmatic skills, which are linked to social cognition or executive functions. The aim of this article is to examine parents' reports using the Spanish version of the CCC-2 questionnaire and its association with different formal assessments related to communication. (2) Methods: 30 children with DLD (3; 10-9 years old) and 39 age-matched (AM) children with typical development were assessed using formal measures of structural language, pragmatics, social cognition, and executive functions. Parents of children with DLD answered the Spanish version of the CCC-2. (3) Results: The performance of children with DLD was lower in all the formal assessments in comparison to AM children. The CCC-2 was significantly correlated with all the direct child assessments, although only formal measures of structural language predicted both the structural language and pragmatics scales of the CCC-2. (4) Conclusions: The CCC-2 answered by parents was consistent with formal assessments in children with DLD, and structural language seemed to be the best predictor of all the subscales.

A Distinction Between Linguistic and Social Pragmatics Helps the Precise Characterization of Pragmatic Challenges in Children With Autism Spectrum Disorders and Developmental Language Disorder.

Purpose Children with autism spectrum disorders (ASDs) and children with developmental language disorder (DLD) face challenges with pragmatics, but the nature and sources of these difficulties are not fully understood yet. The purpose of this study was to compare the competence of children with ASD and children with DLD in two pragmatics tasks that place different demands on theory of mind (ToM) and structural language. Method Twenty Spanish-speaking children with ASD, 20 with DLD, and 40 age- and language-matched children with neurotypical development were assessed using two pragmatics tasks: a linguistic pragmatics task, which requires competence with structural language, and a social pragmatics task, which requires competence with ToM as well. Results For linguistic pragmatics, the ASD group performed similarly to the DLD and language-matched groups, and performance was predicted by structural language. For social pragmatics, the ASD group performed lower than the DLD and language-matched groups, and performance was predicted both by structural language and ToM. Conclusions Children with ASD and children with DLD face difficulties in linguistic pragmatics tasks, in keeping with their structural language. Children with ASD face exceptional difficulties with social pragmatics tasks, due to their difficulties with ToM. The distinction between linguistic and social pragmatic competences can inform assessment and intervention for pragmatic difficulties in different populations.

Social cognition makes an independent contribution to peer relations in children with Specific Language Impairment.

BACKGROUND: Language is important for developing and maintaining social relationships, and also for understanding others minds. Separate studies have shown that children with Specific Language Impairment (SLI) present difficulties in both abilities, although the role of social cognition (SC) on peers' perception remains unexplored. AIMS: The present study aims to assess specific sociometric features of children with SLI through peer nominations of liking and disliking, and also to explore their relationship to the children's SC. METHODS AND PROCEDURES: Thirty-five children with SLI attending ordinary schools (3;10 to 8;00 years old) and thirty-five age-matched children (AM) were assessed with language, SC and sociometric measures. RESULTS: SLI group received more disliked nominations and had lower scores on SC tasks compared to the AM group. After controlling for age and language, SC made an independent contribution to disliked nominations within the SLI group. CONCLUSIONS: Difficulties with peers of children with SLI are related to their language level but also with their SC abilities. Consequently, only resolving language impairments will not necessarily improve early peer acceptance in children with SLI. IMPLICATION: This finding stresses the importance of early intervention programmes aimed at reducing deleterious effects in later development and socialization with peers.

Referring expressions and structural language abilities in children with specific language impairment: A pragmatic tolerance account.

Specific language impairment (SLI) has traditionally been characterized as a deficit of structural language (specifically grammar), with relative strengths in pragmatics. In this study, comprehensive assessment of production, comprehension, and metalinguistic judgment of referring expressions revealed that children with SLI have weaknesses in both structural and pragmatic language skills relative to age-matched peers. Correlational analyses highlight a relationship between their performance on the experimental tasks and their structural language ability. Despite their poor performance on the production and comprehension tasks, children with SLI were able to recognize pragmatically under-informative reference relative to other types of utterance, although they imposed a less severe penalty on such expressions than typically developing peers, a pattern that supports the pragmatic tolerance account. Our novel methodology (which probed structural abilities from both the speaker's and hearer's perspectives as well as metalinguistic and pragmatic skills in the same sample) challenges the assumption that pragmatic errors stem from deficits in social cognition and instead supports recent findings suggesting that when the impact of structural language is isolated, pragmatic deficits may be resolved.

Which are the best predictors of theory of mind delay in children with specific language impairment?

BACKGROUND: The relationship between language and theory of mind (ToM) development in participants with specific language impairment (SLI) it is far from clear due to there were differences in study design and methodologies of previous studies. AIMS: This research consisted of an in-depth investigation of ToM delay in children with SLI during the typical period of acquisition, and it studied whether linguistic or information-processing variables were the best predictors of this process. It also took into account whether there were differences in ToM competence due to the degree of pragmatic impairment within the SLI group. METHODS & PROCEDURES: Thirty-one children with SLI (3;5-7;5 years old) and two control groups (age matched and language matched) were assessed with False Belief (FB) tasks, a wide battery of language measures and additional information-processing measures. OUTCOMES & RESULTS: The members of the SLI group were less competent than their age-matched peers at solving FB tasks, but they performed similarly to the language-matched group. Regression analysis showed that overall linguistic skills of children with SLI were the best predictor of ToM performance, and especially grammar abilities. No differences between SLI subgroups were found according to their pragmatic level. CONCLUSIONS & IMPLICATIONS: A delay in ToM development in children with SLI around the critical period of acquisition is confirmed more comprehensively, and it is shown to be more strongly related to their general linguistic level than to their age and other information-processing faculties. This finding stresses the importance of early educational and clinical programmes aimed at reducing deleterious effects in later development.

Entrenar la comprensión de la falsa creencia en niños con alteraciones del lenguaje / Training in false-belief understanding in children with language difficulties

La capacidad de atribuir estados mentales a uno mismo y a los demás, es decir, la teoría de la mente, ha sido intensamente estudiada en los últimos años. La mayoría de trabajos se han centrado en el estudio de la comprensión de la falsa creencia, uno de los hitos más importantes en el desarrollo de la teoría de la mente que se adquiere alrededor de los 4-5 años. Sin embargo, diversos autores han señalado que los niños con dificultades en el lenguaje comprenden la falsa creencia a edades más avanzadas. Por otra parte, la adquisición de la comprensión de la falsa creencia se ha relacionado con las habilidades lingüísticas. En concreto, algunos estudios de entrenamiento subrayan que la denominación de objetos con doble perspectiva facilita el desarrollo de esta capacidad. En esta línea, el objetivo del presente estudio es aplicar este tipo de entrenamiento a sujetos con dificultades en el desarrollo del lenguaje. La muestra estaba formada por 14 niños con alteraciones en el desarrollo del lenguaje, de edades comprendidas entre los 58 y los 107 meses. Se administraron un pretest y un postest para evaluar el efecto del entrenamiento en la comprensión de la falsa creencia. En la línea de los estudios previos, los resultados subrayan un retraso en la adquisición de la comprensión de la falsa creencia y apuntan que la denominación de objetos con doble perspectiva facilita la mejora de esta (AU)

The capacity to attribute mental states to oneself and others, that is, theory of mind, has been intensely studied in the last few years. Most of the investigations in this field have focused on the study of false beliefs, a developmental milestone that normally developing children acquire around the age of 4 to 5 years. However, several authors have pointed out that children with language difficulties may show a delay in the acquisition of false belief understanding. On the other hand, this attainment has been related to linguistic abilities. Concretely, some training studies suggest that labeling objects with a double perspective fosters false-belief understanding. The aim of the present study was to apply this kind of training to children with language development difficulties. We studied 14 children with language difficulties aged between 58 and 107 months. The participants were administered a pretest and a posttest to evaluate the effects of the training. Consistently with the results of prior studies, our results showed a delay in children's false-belief understanding, suggesting, however, that training based on labeling objects with a double perspective facilitated their acquisition of this ability (AU)

[Pragmatic difficulties in children with specific language impairment. The role of mentalistic tasks]. / Dificultades pragmáticas en el trastorno especifico del lenguaje. El papel de las tareas mentalistas.

Several subjects with Specific Language Impairment (SLI) show communicative and pragmatic problems. In this study, we suggested that mentalistic comprehension tasks would help us to find a deteriorated pragmatic profile among the population with SLI. To achieve this goal, a group of participants with conventional SLI (n=11) was compared to a group of SLI with more pragmatic problems (n=9) and their respective control group with typically developed language (n=13), of ages between 4 and 7 years. Results revealed that all the groups were able to attribute mental states in tasks where the context was structured. However, the subjects with predominant pragmatic SLI showed poorer performance than those with conventional SLI when tasks were communicative-oriented and they needed to process non-explicit information from the context. These findings suggest that it is possible to isolate a SLI subtype with more pragmatic problems and also that we can use mentalistic tasks to assess these difficulties more accurately.

Dificultades pragmáticas en el trastorno específico del lenguaje. El papel de las tareas mentalistas / Pragmatic difficulties in children with specific language impairment. The role of mentalistic tasks

Gran número de sujetos con Trastorno Específico del Lenguaje (TEL) manifiestan problemas comunicativos y de tipo pragmático. Este estudio se planteó analizar el papel de las tareas de comprensión mentalista en la distinción de un perfil TEL con problemas predominantemente pragmáticos. Para ello se comparó la ejecución en tareas mentalistas de un grupo de participantes con TEL convencional (n= 11), un grupo con TEL con mayor afectación pragmática (n= 9) y un grupo con desarrollo típico del lenguaje (n= 13) de edades comprendidas entre 4 y 7 años. Los resultados revelaron que todos los grupos fueron igualmente capaces de atribuir estados mentales cuando el contexto está estructurado. Sin embargo, los sujetos con TEL pragmático tuvieron menos éxito que el grupo TEL convencional cuando las tareas estaban orientadas de manera comunicativa y necesitaban procesar información no explícita del contexto. Nuestros datos apoyan la posibilidad de aislar un subtipo de TEL con especiales problemas pragmáticos, así como el uso de tareas mentalistas para evaluar de forma más precisa estas dificultades (AU)

Several subjects with Specific Language Impairment (SLI) show communicative and pragmatic problems. In this study, we suggested that mentalistic comprehension tasks would help us to find a deteriorated pragmatic profile among the population with SLI. To achieve this goal, a group of participants with conventional SLI (n= 11) was compared to a group of SLI with more pragmatic problems (n= 9) and their respective control group with typically developed language (n= 13), of ages between 4 and 7 years. Results revealed that all the groups were able to attribute mental states in tasks where the context was structured. However, the subjects with predominant pragmatic SLI showed poorer performance than those with conventional SLI when tasks were communicative-oriented and they needed to process non-explicit information from the context. These findings suggest that it is possible to isolate a SLI subtype with more pragmatic problems and also that we can use mentalistic tasks to assess these difficulties more accurately (AU)