Evidence to support test interpretation: Evaluating the content validity of a new item set for the Transition Pragmatics Interview.

PURPOSE: There is little consensus on evidence-based practice guidelines for the selection of criterion-referenced assessments. Having confidence in scores from criterion-referenced assessments requires evidence that items align with their intended constructs. The purposes of these studies were to demonstrate evidence of content validity for the revised item set of a developing social communication assessment and to provide clinicians with a model of content validity evaluations that can be generalised to the review of other assessments. METHOD: In Study 1, 10 experts rated 25 newly-developed items for how well they represented the intended construct. In Study 2, seven participants ages 14-20 were administered the Three Step Test Interview to assess their cognitive processes for responding to new items. Examinee responses were coded for construct-relevant and construct-irrelevant factors. RESULT: Twenty-three of the 25 newly-developed items were deemed representative of the intended construct by experts and elicited construct-relevant response processes from examinees. CONCLUSION: The integration of expert review and examinee cognitive interviewing provides a more complete evaluation of the alignment of the items to their intended construct. Transparent reports of the methods and findings of content validity studies strengthen the ability of clinicians to select criterion-referenced assessments that support valid decisions.

Comprehensive Assessments of Theory of Mind Abilities for School-Age Children: A Systematic Review.

PURPOSE: Theory of mind involves perceiving both the thoughts and emotions of others. Theory of mind skills continue to develop in school-age individuals. For children at risk for social communication difficulties, evaluating theory of mind is warranted to determine whether theory of mind should be a target of intervention. There are hundreds of tasks designed to evaluate theory of mind, but many evaluate a single facet of the construct and have uneven psychometric properties. Comprehensive assessments evaluate both cognitive and affective aspects of theory of mind. The purpose of this systematic review was to identify comprehensive theory of mind assessments for school-age individuals and to critically appraise their measurement properties. METHOD: Four databases were searched to identify 27 included records describing the measurement properties of comprehensive theory of mind assessments for 5- to 21-year-olds. Assessments appearing in at least three records were included. The methodological quality of the studies and the sufficiency of assessments' measurement properties were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). RESULTS: Nine assessments were evaluated, and four met COSMIN standards for sufficient content validity and internal consistency to be recommended for clinical use. CONCLUSIONS: Comprehensive assessments enable examiners to develop a profile of children's theory of mind strengths and needs. Strengths of the identified assessments include sufficient convergent validity and internal consistency. Further research is required to develop higher quality evidence for the content validity, structural validity, and reliability of the included assessments. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23817495.

Exploring the contributions of expert review and cognitive interviewing to evaluating the content validity of items for a new measure of adolescent social communication, the Transition Pragmatics Interview.

Interventions to facilitate improvement in adolescent social communication are more effective when they are tailored to adolescents' individual profiles of ability. Current social communication assessments for adolescents are not designed to identify their profiles of ability for settings beyond compulsory education. To address this gap, we developed the Transition Pragmatics Interview (TPI). The purpose of these studies was to evaluate the content validity of items developed for the TPI using expert review and cognitive interviewing. Cognitive interviewing is recommended in health-related measurement standards but is not widely reported for assessments of developmental language disorders. Six speech-language pathologists participated in the expert review, rating how well TPI items represented facets of social communication ability. All questions were rated as representative of their intended construct. Eight adolescents (age 14-21) of varied social communication abilities participated in the cognitive interview study to explore whether items were understood as intended by the developers. Participants responded to each item while a researcher observed their response process and asked questions to identify the respondents' thinking about the items. Transcribed responses were classified based on whether they indicated a construct-irrelevant difficulty with the item. Nine of 52 items were identified with recall difficulties, ambiguous wording or potential sources of bias. Cognitive interviewing complemented expert review by identifying issues with content validity not identified by expert review. Items with construct-irrelevant barriers to response will be modified and re-evaluated prior to field testing.

Challenges Faced by Childcare Directors During COVID-19: Leading During A Global Pandemic.

Childcare centers have faced many stressors both during and prior to the COVID-19 pandemic. Building on stress and coping theories, this study explores how the pandemic affected childcare center practices and how center directors responded. Childcare directors were surveyed to explore their perspectives about the pandemic's effects on teachers and staff, children and families, and the daily routines at their centers. The ramifications of masking, quarantines, and social distancing were also discussed. In addition, directors were asked how they envisioned the future for their centers, and their plans to move forward after the pandemic. Twenty-seven responses were analyzed using a content analysis approach, and the results indicated that staffing issues, increased stress levels, reduced parent involvement, and low enrollment were all prevalent themes. Some directors felt optimistic about the future, while others doubted their ability to keep their doors open to families. Many of the childcare centers felt they simply couldn't compete with retail and restaurant businesses to increase pay and retain teachers. More optimistic directors focused on identifying resources to aid their centers to cope with the adversities experienced during the COVID-19 pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s10643-022-01398-z.

Moment-to-Moment Processing of Complex Sentences by Adults with and without Developmental Language Disorder.

INTRODUCTION: . Limited evidence suggests that adults with developmental language disorder (DLD) take different information into account as they process sentences as compared to peers with typical language. The purpose of this study was to evaluate how two factors affect sentence processing in adults with DLD: online storage costs and lexical expectations created by nouns. METHODS: . Forty-three adults, 21 with DLD, listened to complex sentences presented word-by-word, and their listening times were recorded. The sentences included either object relative clauses or sentential complements which differed in online storage demands. The main clause subject nouns differed in co-occurrence frequency with "that" in sentences produced by typical adults. Participants completed a running span task to assess verbal working memory capacity. RESULTS: . Mixed effects models found differences by sentence region. Participants with DLD processed embedded clause verbs faster than participants with typical language, and poorer language ability was associated with faster processing of conjunctions "that" and "which." Participants with greater verbal working memory capacity or typical language were affected by noun co-occurrence frequencies but those with lower working memory or DLD were not. CONCLUSIONS: . The results align with prior findings that verbal working memory capacity influences what information affects moment-to-moment sentence processing. Those with greater capacity appeared to be more affected by temporary ambiguity. As compared to adults with typical language, processing times of adults with DLD were less sensitive to information on words that frequently co-occur with nouns. This aligns with prior findings suggesting that adults with DLD are less sensitive to the frequency of the structures and arguments that co-occur with verbs.

Speech production factors and verbal working memory in children and adults with developmental language disorder.

Verbal working memory (VWM) deficits are common in individuals with developmental language disorder (DLD) but are not well understood. This study evaluated how both memory and language production factors influence VWM performance in children and adults with DLD, focusing on the influence of serial position, phonological activation (PA), and lexical frequency. Participants were 30 children with DLD and 26 with typical language (TL), and 21 adults with DLD and 23 with TL. The participants completed a listening span task in which they were asked to recall the final words of sentences in sets of increasing size. Responses (dependent variable) were coded as correct, incorrect, or no response. Final words were coded for frequency, serial position within the set, and PA (number of occurrences of the initial phoneme, vowel, and whole word in the task). These variables, along with age and language status, were entered as predictors in mixed-effects multinomial regression models. Extreme serial position, greater PA, and higher frequency reduced incorrect and no responses. These effects were attenuated for the DLD group, and the effect of greater PA varied with set size. The findings suggest that for individuals with DLD, VWM performance is affected by more limited effective language experience and by the dynamic task demands.

Measurement Properties of Social Communication Assessments for Transition-Age Adolescents: A Systematic Review.

Purpose An important role of social communication assessment is to support intervention planning as adolescents with disabilities transition to workplaces and other adult settings. Adoption of evidence-based assessment practices would align professionals with legal and ethical mandates for schools and other settings. There is, however, limited adoption of evidence-based assessment selection. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) provide a structured approach to identifying assessments with sufficient validity and reliability backed by strong evidence. The purpose of this review was to identify directly administered social communication assessments for adolescents and to apply the COSMIN framework to evaluate their measurement properties. Method A systematic search identified 13 assessments designed for 14- to 21-year-olds with developmental disabilities putting them at risk for social communication deficits. Measurement properties were extracted from included studies and rated for sufficiency. The quality of evidence supporting the findings was graded using COSMIN guidelines. Results Five social communication assessments were recommended as having sufficient evidence of content validity and internal consistency. Remaining assessments could be recommended as gaps in the evidence for their measurement properties are filled. Conclusions The application of the COSMIN standards has the potential to advance evidence-based assessment for social communication. There were important gaps in the independent replication of measurement properties and methodological shortcomings in the evaluation of reliability, measurement error, and structural validity.

Sentence Repetition Accuracy in Adults With Developmental Language Impairment: Interactions of Participant Capacities and Sentence Structures.

PURPOSE: We asked whether sentence repetition accuracy could be explained by interactions of participant processing limitations with the structures of the sentences. We also tested a prediction of the procedural deficit hypothesis (Ullman & Pierpont, 2005) that adjuncts are more difficult than arguments for individuals with developmental language impairment (DLI). METHOD: Forty-four young adults participated, 21 with DLI. The sentence repetition task varied sentence length and the use of arguments and adjuncts. We also administered measures of working memory and processing speed. Our regression models focused on these interactions: group and argument status; processing speed, length, and argument status; and working memory capacity, length, and argument status. RESULTS: Language ability group was a significant predictor of sentence repetition accuracy but did not interact with argument status. Processing speed interacted with sentence length and argument status. Working memory capacity and its separate interactions with argument status and sentence length predicted sentence repetition accuracy. CONCLUSIONS: Many adults with DLI may have difficulty with adjuncts as a result of their working memory limitations rather than their language ability. Cognitive limitations common to individuals with DLI are revealed more by particular sentence structures, suggesting ways to construct more diagnostically accurate sentence repetition tasks.

Evidence of compensatory processing in adults with developmental language impairment: testing the predictions of the procedural deficit hypothesis.

BACKGROUND: The Procedural Deficit Hypothesis (PDH) proposes that individuals with primary developmental language impairment (DLI) have a deficient procedural memory, compromising their syntactic abilities. Individuals with DLI may compensate for procedural memory deficits by engaging declarative memory for syntactic tasks. Arguments are part of the lexicon whereas adjuncts rely on syntactic processing. As a result, individuals with DLI may have unusual difficulty processing adjuncts. Alternatively, processing for adjuncts may be typical for individuals with DLI but show frequency effects, indicating compensatory use of declarative memory. AIMS: Our goal was to test the predictions of the PDH by comparing argument and adjunct processing times for adults with and without DLI, and to seek evidence of compensatory use of declarative memory for adjunct processing. We further evaluated group performance on measures of visual procedural and declarative memory. METHODS AND PROCEDURES: Forty-four adults, 21 with DLI, completed a self-paced listening task, a procedural memory task, and a declarative memory task. The self-paced listening task tracked the word-by-word processing time for sentences that included prepositional phrases acting as arguments or adjuncts. We used regression analysis to determine effects of group membership and argument or adjunct status on processing times. Correlation analyses evaluated relationships between argument and adjunct frequency on processing times by group. RESULTS AND OUTCOMES: We found no effect of group membership on the processing time for arguments and adjuncts in the self-paced listening task. Argument phrases were processed more easily by both groups. There were frequency effects for adjunct processing for the group with DLI, but not the group with typical language. We did not find the expected frequency effects for argument processing. The group with DLI also performed more poorly in both the procedural and declarative memory tasks. Secondary analyses found that non-verbal intelligence was related to outcomes on the declarative memory but not the procedural memory task. CONCLUSIONS AND IMPLICATIONS: We found mixed evidence on the predictions of the PDH. Adults with DLI may compensate for procedural memory deficits but it is unclear whether this depends on declarative memory or language processing experience. Compensatory processing is an important element of the language profile for adults with DLI. LEARNING OUTCOMES: The readers will be able to describe how processing arguments and adjuncts in sentences may depend on different memory systems, and how adults with developmental language impairment may compensate for syntactic processing deficits.

Lexical decay during online sentence processing in adults with specific language impairment.

PURPOSE: Decay of memory traces is an important component of many theories of working memory, but there is conflicting evidence on whether the rate of decay differs for individuals with specific language impairment (SLI) as compared to peers with typical language. The authors tested the hypothesis that adults with SLI have a slower decay rate. METHOD: Twenty adults with SLI, ages 18-27 years, and 23 age-matched peers identified target words in sentences. Sentences were presented at normal and slow rates. Participants separately judged whether a picture and sentence matched in meaning as a measure of sentence processing efficiency. RESULTS: After controlling for sentence processing efficiency, the group with SLI was slower to detect words in sentences. Response times for the group with SLI increased less in the slow condition as compared to the group with typical language, resulting in a Group × Presentation Rate interaction. CONCLUSIONS: The Group × Presentation Rate interaction is consistent with a slower lexical decay rate for adults with SLI, but differences in the ability to manage interference could not be ruled out. The findings suggest that decay rate differences may play a role in the working memory limitations found in individuals with SLI.

Late talking, typical talking, and weak language skills at middle childhood.

To better understand early predictors of weak language and academic abilities, we identified children with and without weak abilities at age 8. We then looked back at age 2 vocabulary and word combining, and evaluated these measures as predictors of age 8 outcomes. More than 60% of children with weak oral language abilities at 8 were not late talkers at 2. However, no word combining at 2 was a significant risk factor for poor oral language, reading comprehension, and math outcomes at 8. The association of no word combining with age 8 reading comprehension and math ability was mediated by age 8 oral language ability. The findings indicate that children take different developmental pathways to weak language abilities in middle childhood. One begins with a delayed onset of language. A second begins with language measures in the typical range, but ends with language ability falling well below typical peers.

Effects of children's working memory capacity and processing speed on their sentence imitation performance.

BACKGROUND: More limited working memory capacity and slower processing for language and cognitive tasks are characteristics of many children with language difficulties. Individual differences in processing speed have not consistently been found to predict language ability or severity of language impairment. There are conflicting views on whether working memory and processing speed are integrated or separable abilities. AIMS: To evaluate four models for the relations of individual differences in children's processing speed and working memory capacity in sentence imitation. The models considered whether working memory and processing speed are integrated or separable, as well as the effect of the number of operations required per sentence. The role of working memory as a mediator of the effect of processing speed on sentence imitation was also evaluated. METHODS & PROCEDURES: Forty-six children with varied language and reading abilities imitated sentences. Working memory was measured with the Competing Language Processing Task (CLPT), and processing speed was measured with a composite of truth-value judgment and rapid automatized naming tasks. Mixed-effects ordinal regression models evaluated the CLPT and processing speed as predictors of sentence imitation item scores. A single mediator model evaluated working memory as a mediator of the effect of processing speed on sentence imitation total scores. OUTCOMES & RESULTS: Working memory was a reliable predictor of sentence imitation accuracy, but processing speed predicted sentence imitation only as a component of a processing speed by number of operations interaction. Processing speed predicted working memory capacity, and there was evidence that working memory acted as a mediator of the effect of processing speed on sentence imitation accuracy. CONCLUSIONS & IMPLICATIONS: The findings support a refined view of working memory and processing speed as separable factors in children's sentence imitation performance. Processing speed does not independently explain sentence imitation accuracy for all sentence types, but contributes when the task requires more mental operations. Processing speed also has an indirect effect on sentence imitation by contributing to working memory capacity.

Investigating sentence processing and language segmentation in explaining children's performance on a sentence-span task.

BACKGROUND: Children with poor language abilities tend to perform poorly on verbal working memory tasks. This result has been interpreted as evidence that limitations in working memory capacity may interfere with the development of a mature linguistic system. However, it is possible that language abilities, such as the efficiency of sentence processing and the ability to segment language, directly influence performance on common working memory tasks. AIMS: This study investigated the possible roles of sentence-processing efficiency and the ability to segment language in children's performance on a verbal working memory task. METHODS & PROCEDURES: Participants were 37 children (aged 6;2-13;7) with varying oral language and reading abilities. Children completed a sentence-span task to assess working memory: the Competing Language Processing Task (CLPT). In the CLPT, children determine the truth value of sentences while maintaining sentence final words in memory. Sentence-processing efficiency was evaluated by measuring response latencies to CLPT sentence veracity judgments outside the context of the CLPT. The Elision and Blending Words subtests of the Comprehensive Test of Phonological Processing were used to measure the ability to segment and combine units of language. OUTCOMES & RESULTS: Children's ability to segment words into smaller units (Elision) was a significant predictor of word recall on the CLPT, which is commonly assumed to reflect working memory capacity. Sentence processing latency did not reach significance as a unique predictor. CONCLUSIONS & IMPLICATIONS: Individual differences on the sentence-span task are partly explained by the ability to segment language into smaller units. Future studies should further consider the metalinguistic and metacognitive demands of tasks used to measure working memory. If metalinguistic abilities directly impact performance on working memory tasks, the utility of working memory theories in explaining individual differences in language abilities is reduced. Inferences that link 'working memory capacity' to language ability become circular. One clinical implication of such a result would be that appropriate intervention strategies may not involve focusing on working memory capacity, but rather on building language skills, including metalinguistic knowledge, which in turn should directly improve children's processing capacities.

Increasing the odds: applying emergentist theory in language intervention.

PURPOSE: This review introduces emergentism, which is a leading theory of language development that states that language ability is the product of interactions between the child's language environment and his or her learning capabilities. The review suggests ways in which emergentism provides a theoretical rationale for interventions that are designed to address developmental language delays in young children. METHOD: A review of selected literature on emergentist theory and research is presented, with a focus on the acquisition of early morphology and syntax. A significant method for developing and testing emergentist theory, connectionist modeling, is described. Key themes from both connectionist and behavioral studies are summarized and applied with specific examples to language intervention techniques. A case study is presented to integrate elements of emergentism with language intervention. CONCLUSIONS: Evaluating the theoretical foundation for language interventions is an important step in evidence-based practice. This article introduces three themes in the emergentist literature that have implications for language intervention: (a) sufficiency of language input, (b) active engagement of the child with the input, and (c) factors that increase the odds for correctly mapping language form to meaning. Evidence supporting the importance of these factors in effective language intervention is presented, along with limitations in that evidence.

Identification of clinical markers of specific language impairment in adults.

PURPOSE: To investigate the usefulness of 3 tasks known to be effective diagnostic clinical markers of specific language impairment (SLI) in children: (a) nonword repetition, (b) sentence repetition, and (c) grammaticality judgments of finiteness marking. METHOD: Two groups of young adults, 13 with SLI and 18 with typical language, completed 3 experimental tasks: (a) nonword repetition, (b) sentence repetition, and (c) grammaticality judgments of sentences that were either correct or contained an omitted finiteness marker, an overt agreement error, or an omitted progressive -ing. Analyses included receiver operating characteristic curve analyses and computation of likelihood ratios associated with the use of each task as a clinical marker for SLI, as well as development of a logistic regression model that used multiple tasks as predictors. RESULTS: Each marker task significantly contributed to classification of adults as affected or unaffected by SLI, with moderate positive and negative likelihood ratios. A combination of the 3 marker tasks was the best predictor of affectedness status with moderate to large likelihood ratios. CONCLUSIONS: The results suggest that SLI persists into adulthood and that effective clinical markers of this disorder are similar to those used to identify SLI in children. Refinement of these tasks to increase their likelihood ratios will improve their usefulness in diagnosing SLI in adults.

Response time in adults with a history of language difficulties.

UNLABELLED: The purpose of the study was to investigate speed of processing in college students with a history of problems with language. Affected individuals (n=16) were identified through a self-reported history of language and/or reading difficulties, and compared to a group of 16 unaffected individuals. Measures of language ability and a battery of response time tasks were administered. Results showed that the affected group had lower language performance and slower response time than the unaffected group. Better language performance was associated with faster response time, and this relationship was stronger in the affected group. These findings are consistent with the literature showing that language impairment often persists into adulthood. Further investigation of the relation between processing speed and language ability may help describe vulnerabilities for adults with language problems, as well as ways to promote compensation for those vulnerabilities. LEARNING OUTCOMES: Readers will (1) increase understanding of associations between processing speed and language in children and adults; (2) become familiar with a method for assessing processing speed; and (3) increase understanding of possible vulnerabilities in adults with a history of language and/or reading problems.