Grammar intervention using graduated input type variation (GITV) for pre-primary children: A single-case experimental design study.

PURPOSE: This study examined the early efficacy of a new theory-driven principle of grammar intervention, graduated input type variation (GITV). METHOD: Three Cantonese-speaking children, aged between 4;01 and 5;10, with oral language difficulties participated in this single baseline within-participant single case experimental study. The children received a total of 300 teaching episodes of the target serial verb construction via focused stimulation and recast over 10 30- to 45-minute sessions. The 30 exemplars of the target included low type variation of the verbs in each of the first five sessions, followed by high type variation in the remaining sessions. RESULT: Visual analysis revealed that all children improved their performance in the target construction but not the control vocabulary in the probes, suggesting a treatment effect. Maintenance of treatment effects was also observed in all children. Positive results in across-behaviour generalisation to the untrained construction were observed in all children. Generalisation to other less structured linguistic contexts and to the narrative retell discourse context was minimal and observed in one child only. CONCLUSION: Preliminary evidence suggested early efficacy of GITV as a principle for grammar intervention. Modifications in the research methodology are recommended for future studies involving children with developmental language disorder.

A comparison of learning and retention of a syntactic construction between Cantonese-speaking children with and without DLD in a priming task.

Procedural circuit Deficit Hypothesis (PDH) of Developmental Language Disorder (DLD) predicts problems with learning and retention of grammar. Twenty 7- to 9-year-old Cantonese-speaking children with DLD and their typically developing (TD) age peers participated in a syntactic priming task that was given in two sessions one week apart. Production of Indirect Object Relative Clause (IORC) was tested using a probe test before and after the priming task, and one week later. The study involved two cycles of learning and retention, and two levels of prior knowledge. Bayesian linear mixed effects modelling was used for data analysis. Children with DLD learned, and possibly retained, IORC less well than TD children after age, working memory and general grammatical knowledge were controlled for. No interaction effects were significant, meaning that cycle and prior knowledge affected both groups similarly in learning and retention. Results were discussed in relation to PDH and the Complementary Learning Systems Theory.

Students' interaction anxiety and social phobia in interprofessional education in Hong Kong: mapping a new research direction.

BACKGROUND: Interprofessional education (IPE) has been promoted as a breakthrough in healthcare because of the impact when professionals work as a team. However, despite its inception dating back to the 1960s, its science has taken a long time to advance. There is a need to theorize IPE to cultivate creative insights for a nuanced understanding of IPE. This study aims to propose a research agenda on social interaction by understanding the measurement scales used and guiding researchers to contribute to the discussion of social processes in IPE. METHOD: This quantitative research was undertaken in a cross-institutional IPE involving 925 healthcare students (Medicine, Nursing, Social Work, Chinese Medicine, Pharmacy, Speech Language Pathology, Clinical Psychology, Food and Nutritional Science and Physiotherapy) from two institutions in Hong Kong. Participants completed the Social Interaction Anxiety Scale (SIAS-6) and Social Phobia Scale (SPS-6). We applied a construct validation approach: within-network and between-network validation. We performed confirmatory factors analysis, t-test, analysis of variance and regression analysis. RESULTS: CFA results indicated that current data fit the a priori model providing support to within-network validity [RMSEA=.08, NFI=.959, CFI=.965, IFI=.965, TLI=.955]. The criteria for acceptable fit were met. The scales were invariant between genders, across year levels and disciplines. Results indicated that social interaction anxiety and social phobia negatively predicted behavioural engagement (F = 25.093, p<.001, R2=.065) and positively predicted behavioural disaffection (F = 22.169, p<.001, R2=.057) to IPE, suggesting between-network validity. CONCLUSIONS: Our data provided support for the validity of the scales when used among healthcare students in Hong Kong. SIAS-6 and SPS-6 have sound psychometric properties based on students' data in Hong Kong. We identified quantitative, qualitative and mixed methods research designs to guide researchers in getting involved in the discussion of students' social interactions in IPE.Key MessagesThe Social Anxiety Scale (SIAS-6) and Social Phobia Scale (SPS-6) scales have sound psychometric properties based on the large-scale healthcare students' data in IPE in Hong Kong.Social interaction anxiety and social phobia negatively predicted students' behavioural engagement with IPE and positively predicted behavioural disaffection. The scales are invariant in terms of gender, year level and discipline.Quantitative, qualitative and mixed methods studies are proposed to aid researchers to contribute in healthcare education literature using the SIAS-6 and SPS-6.

Vocabulary Acquisition and Usage for Late Talkers Treatment: Effect on Expressive Vocabulary and Phonology.

Purpose This study examined the effect of Vocabulary Acquisition and Usage for Late Talkers (VAULT) treatment on toddlers' expressive vocabulary and phonology. Parent acceptability of VAULT treatment was also considered. Method We used a nonconcurrent multiple baseline single case experimental design with three late talking toddlers aged 21-25 months. The treatment was delivered twice weekly in 30-min sessions for 8 weeks by a rotating team of four speech-language pathologists. Toddlers heard three of their 10 strategically selected target words a minimum of 64 times in play activities each session. Expressive vocabulary and phonology was assessed pre-post, with parent interviews conducted posttreatment. Results All toddlers increased production of target words and expressive vocabulary. Ambient expressive vocabulary size increased by an average of 16 words per week (range of 73-169 words learned over the treatment period). On a 20-item, single-word speech assessment, the toddlers' phonetic inventories increased on average from three to seven consonants, and five to eight vowels. Two toddlers used protowords pretreatment, which were replaced by recognizable attempts at words posttreatment. Parents reported the treatment was acceptable for the child and their family with future consideration of parent-based delivery of the treatment in the home. Conclusions The results of this treatment provide further evidence of a model of intervention informed by the principles of implicit learning, and the interconnectedness of phonological and lexical learning. Investigation is required to establish the efficacy and feasibility of VAULT in clinical contexts. Supplemental Material https://doi.org/10.23641/asha.14714733.

The Influence of Presentation Format of Story on Narrative Production in Chinese Children Learning English-as-a-Second-Language: A Comparison Between Graphic Novel, Illustration Book and Text.

Past studies have shown that multimodal presentation of story can improve story-retelling performance in the first language. The purpose of the present study was to investigate whether similar multimedia effects can be observed in second language learning and graphic novel reading. A total of 51 Chinese elementary school children, aged 7-8, who were learning English as a second language were recruited. They were randomly assigned to one of the three experimental conditions that differed in the format of story presentation: English text, English text with pictorial illustrations or graphic novel. After reading the same story, the children retold the story in English. The narratives produced were then rated by two independent raters. The results of group comparison showed that children from the three experimental groups had similar performance, indicating that multimedia presentation may not always facilitate narrative production in English as a second language. Within-subject comparison further showed that the children were relatively strong in language skills and capturing the main ideas of the story, while showing weakness in story structure awareness, elaboration, as well as local and global cohesion. Suggestions for the application of multimodal presentation of narrative texts are discussed.

Auditory perception and word recognition in Cantonese-Chinese speaking children with and without Specific Language Impairment.

Auditory processing and spoken word recognition difficulties have been observed in Specific Language Impairment (SLI), raising the possibility that auditory perceptual deficits disrupt word recognition and, in turn, phonological processing and oral language. In this study, fifty-seven kindergarten children with SLI and fifty-three language-typical age-matched controls were assessed with a speech-gating task to measure spoken word recognition, psychophysical tasks to measure auditory Frequency Modulation (FM) detection and Frequency Discrimination (FD), and standardized psychometric tests of phonological processing and oral language. As a group, children with SLI took significantly longer than language-typical controls to recognize words with high neighborhood density, perhaps reflecting subpar phonological representations. FM, but not FD, was significantly worse in SLI. However, while both poorer speech-gating performance and poorer auditory thresholds (FM) were evident in SLI, spoken word recognition did not mediate any relation between auditory perception and either phonological processing or oral language.

Development of reading-related skills in Chinese and English among Hong Kong Chinese children with and without dyslexia.

This 2-year longitudinal study sought to identify a developmental pattern of Chinese and English reading skills in children with and without dyslexia from 6 to 8years of age. Three groups of 15 children each-those with dyslexia, age-matched (AM) controls, and reading-matched (RM) controls-participated. Dyslexia was diagnosed at 8years of age. All children were tested on phonological awareness, rapid automatized naming (RAN), morphological awareness, word reading, and vocabulary knowledge in both Chinese and English and also speed of processing skill. AM controls outperformed the group with dyslexia on all measures except for phonological awareness, English word reading, and vocabulary. However, those with dyslexia and AM controls developed at a similar rate across all reading-related skills from 6 to 8years of age. Compared with the RM controls, the group with dyslexia scored higher in phonological awareness, morphological awareness, and vocabulary knowledge in both Chinese and English and also in English word reading but scored similarly in RAN. Children with dyslexia, thus, manifested clear difficulties in Chinese vocabulary knowledge, morphological awareness, and RAN as well as general speed of processing, representing a developmental lag in cognitive skills. Among these, RAN deficits are likely to be the most severe deficits in Chinese children with dyslexia.

Development of a Mandarin Expressive and Receptive Vocabulary Test for children using cochlear implants.

Cochlear implants (CIs) provide children with profound hearing loss access to sounds and speech. Research on the effects of CI on speech and language development in mainland China is scarce due to the lack of standardized tests. This study aims at developing a vocabulary measure, the Mandarin Expressive and Receptive Vocabulary Test (MERVT), for pre-school children with CIs. Using responses from 102 normal-hearing preschool children, the initial vocabulary set was subjected to analyses to identify items with appropriate levels of difficulty and discrimination. Norms on 245 normal-hearing children aged 1;6 to 3;11 were later collected based on the final set of the items. Evaluation of the test's psychometric properties revealed good internal consistency. Significant correlations between the total MERVT scores and the Gesell Developmental Scale scores, between the MERVT expressive and receptive subtest scores and the total scores, and the gradual increase in MERVT scores with age, provided evidence of construct validity. Results from 29 children with CIs were also examined for evidence of the MERVT's construct validity. There was a significant correlation between these children's MERVT scores and their scores from an intelligence test. The MERVT scores increased with an increase in the duration of CI use and in chronological age. With good reliability and strong validity, the test is recommended for use in the monitoring of language development in children with CI.

Assessing bilingual Chinese-English young children in Malaysia using language sample measures.

One reason why specific language impairment (SLI) is grossly under-identified in Malaysia is the absence of locally- developed norm-referenced language assessment tools for its multilingual and multicultural population. Spontaneous language samples provide quantitative information for language assessment, and useful descriptive information on child language development in complex language and cultural environments. This research consisted of two studies and investigated the use of measures obtained from English conversational samples among bilingual Chinese-English Malaysian preschoolers. The research found that the language sample measures were sensitive to developmental changes in this population and could identify SLI. The first study examined the relationship between age and mean length of utterance (MLU(w)), lexical diversity (D), and the index of productive syntax (IPSyn) among 52 typically-developing (TD) children aged between 3;4-6;9. Analyses showed a significant linear relationship between age and D (r = .450), the IPsyn (r = .441), and MLU(w) (r = .318). The second study compared the same measures obtained from 10 children with SLI, aged between 3;8-5;11, and their age-matched controls. The children with SLI had significantly shorter MLU(w) and lower IPSyn scores than the TD children. These findings suggest that utterance length and syntax production can be potential clinical markers of SLI in Chinese-English Malaysian children.

Validating the language domain subtest in a developmental assessment scale for preschool children.

This study reports on the validation of the language domain subtest of a developmental assessment scale for Cantonese Chinese preschool children. Three hundred and seventy eight multi-stage randomly selected children between 3;4 and 6;3 years of age were tested on the 104-item subtest. Fifty-four of these children, spreading across three age groups, demonstrated developmental problems. Results from the Rasch analyses suggested that the original and the shortened 66-item version demonstrated adequate measurement properties, including targeting and uni-dimensionality. Statistical analyses of the shortened version suggested that the subtest demonstrated strong test-retest reliability, and adequate convergent and criterion validity. This study contributes to good practice in the development of standardized normative tests, particularly those for investigations of language problems in Chinese children given that reports on existing tests' psychometric properties were often incomplete.

Writing Quality in Chinese Children: Speed and Fluency Matter.

There were two goals of the present study. The first was to create a scoring scheme by which 9-year-old Chinese children's writing compositions could be rated to form a total score for writing quality. The second was to examine cognitive correlates of writing quality at age 9 from measures administered at ages 6-9. Age 9 writing compositions were scored using a 7-element rubric; following confirmatory factor analyses, 5 of these elements were retained to represent overall writing quality for subsequent analyses. Measures of vocabulary knowledge, Chinese word dictation, phonological awareness, speed of processing, speeded naming, and handwriting fluency at ages 6-9 were all significantly associated with the obtained overall writing quality measure even when the statistical effect of age was removed. With vocabulary knowledge, dictation skill, age, gender, and phonological awareness included in a regression equation, 35% of the variance in age 9 writing quality was explained. With the variables of speed of processing, speeded naming, and handwriting fluency additionally included as a block, 12% additional variance in the equation was explained. In addition to gender, overall unique correlates of writing quality were dictation, speed of processing, and handwriting fluency, underscoring the importance of both general automaticity and specific writing fluency for writing quality development in children.

Development of the language subtest in a developmental assessment scale to identify Chinese preschool children with special needs.

This study reports on the development of the language subtest in the Preschool Developmental Assessment Scale (PDAS) for Cantonese-Chinese speaking children. A pilot pool of 158 items covering the two language modalities and the three language domains was developed. This initial item set was subsequently revised based on Rasch analyses of data from 324 multi-stage randomly selected children between 3 and 6 years of age. The revised 106-item set demonstrated adequate measurement properties, including targeting and uni-dimensionality. The revised 106-item set successfully discriminated preschool children in the three age groups, and between preschool children and their age peers with special education needs (SEN). Results from this study support the collection of normative data from a larger population sample of children to examine its accuracy in identifying language impairment in children with SEN. Test development procedures reported in this study provide insight for the development of language subtests in multi-domain developmental assessment tools for children speaking other varieties of Chinese.

Differentiating Cantonese-speaking preschool children with and without SLI using MLU and lexical diversity (D).

PURPOSE: In this study, the authors examined the diagnostic accuracy of a composite clinical assessment measure based on mean length of utterance (MLU), lexical diversity (D), and age (Klee, Stokes, Wong, Fletcher, & Gavin, 2004) in a second, independent sample of 4-year-old Cantonese-speaking children with and without specific language impairment (SLI). METHOD: The composite measure was calculated from play-based, conversational language samples of 15 children with SLI and 14 children without SLI. Scores were dichotomized and compared to diagnostic outcomes using a reference standard based on clinical judgment supported by test scores. RESULTS: Eleven of 15 children with SLI and 8 of 14 children with typical language skills were correctly classified by the dichotomized composite measure. The measure's sensitivity in this second sample was 73.3% (95% confidence interval [CI] 48%-89%); specificity was 57.1% (95% CI 33%-79%); positive likelihood ratio was 1.71 (95% CI 0.87-3.37); and negative likelihood ratio was 0.47 (95% CI 0.18-1.21). CONCLUSIONS: The diagnostic accuracy of the composite measure was substantially lower than in the original study, suggesting that it is unlikely to be informative for clinical use in its present form. The value of replication studies is discussed.

Early oral language markers of poor reading performance in Hong Kong Chinese children.

This study investigated the extent to which language skills at ages 2 to 4 years could discriminate Hong Kong Chinese poor from adequate readers at age 7. Selected were 41 poor readers (age M = 87.6 months) and 41 adequate readers (age M = 88.3 months). The two groups were matched on age, parents' education levels, and nonverbal intelligence. The following language tasks were tested at different ages: vocabulary checklist and Cantonese articulation test at age 2; nonword repetition, Cantonese articulation, and receptive grammar at age 3; and nonword repetition, receptive grammar, sentence imitation, and story comprehension at age 4. Significant differences between the poor and adequate readers were found in the age 2 vocabulary knowledge, age 3 Cantonese articulation, and age 4 receptive grammar skill, sentence imitation, and story comprehension. Among these measures, sentence imitation showed the greatest power in discriminating poor and adequate readers.

Optional elements and variant structures in the productions of bei2 'to give' dative constructions in Cantonese-speaking adults and three-year-old children.

To express object transfer, Cantonese-speakers use a 'ditransitive' ([V-R-T] or [V-T-R] where V=Verb, T=Theme, R=Recipient), or a more complex prepositional/serial-verb (P/SV) construction. Clausal elements in Cantonese datives can be optional (resulting in 'full' versus 'non-full' forms) or appear in variant orders (full non-canonical and full canonical). We report on usage of dative constructions with the word bei2 'to give' in 86 parents and 53 three-year-old children during conversations. The parents used more P/SV than ditransitive bei2-datives, and vice versa for the children. Both groups showed a similar usage pattern of optional elements and variant structures in their ditransitive and P/SV bei2-datives. The roles of multiple construction types, optional elements and variant structures in children's learning of bei2-dative constructions are described.

The perception of lexical tone contrasts in Cantonese children with and without specific language impairment (SLI).

PURPOSE: This study examined the perception of fundamental frequency (f0) patterns by Cantonese children with and without specific language impairment (SLI). METHOD: Participants were 14 five-year-old children with SLI, and 14 age-matched (AM) and 13 four-year-old vocabulary-matched (VM) controls. The children identified a word from familiar word pairs that illustrated the 8 minimally contrastive pairs of the 6 lexical tones. They discriminated the f0 patterns within contrastive tonal pairs in speech and nonspeech stimuli. RESULTS: In tone identification, the SLI group performed worse than the AM group but not the VM group. In tone discrimination, the SLI group did worse than the AM group on 2 contrasts and showed a nonsignificant trend of poorer performance on all contrasts combined. The VM group generally did worse than the AM group. There were no group differences in discrimination performance between speech and nonspeech stimuli. No correlation was found between identification and discrimination performance. Only the normal controls showed a moderate correlation between vocabulary scores and performance in the 2 perception tasks. CONCLUSION: The SLI group's poor tone identification cannot be accounted for by vocabulary knowledge alone. The group's tone discrimination performance suggests that some children with SLI have a deficit in f0 processing.

Modal verbs with and without tense: a study of English- and Cantonese-speaking children with specific language impairment.

BACKGROUND: Surprisingly little is known about the use of modal auxiliaries by children with specific language impairment (SLI). These forms fall within the category of grammatical morphology, an area of morphosyntax that is purportedly very weak in children with SLI. AIMS: Three studies were conducted to examine the use of modal auxiliaries by preschool-aged children with SLI. METHODS & PROCEDURES: In each study, probe tasks were designed to create contexts that encouraged the use of modals to express the modality functions of ability and permission. In Studies 1 and 3, English-speaking children participated. In Study 2, the participants were Cantonese-speaking children. In each study, three groups of children participated: A group exhibiting SLI, a group of younger typically developing children (YTD), and a group of (older) typically developing children (OTD) matched with the SLI group according to age. OUTCOME & RESULTS: In Study 1, English-speaking children with SLI were as proficient as YTD children, though less proficient than OTD children in the use of the modal can to express the modality functions of ability and permission. In Study 2, the same modality functions were studied in the speech of SLI, YTD and OTD groups who were speakers of Cantonese. In this language, tense is not employed, and therefore the modality function could be examined independent of formal tense. Results similar to those of Study 1 were obtained. Study 3 again studied SLI, YTD and OTD groups in English to determine whether the children's expression of ability differed across past (could) and non-past (can) contexts. The results for can replicated the findings from Study 1. However, the children with SLI were significantly more limited than both the YTD and OTD groups in their use of could. CONCLUSIONS: The results suggest that most children with SLI have access to modality functions such as ability and permission. However, the findings of Study 3 suggest that they may have a reduced inventory of modal forms or difficulty expressing the same function in both past and non-past contexts. These potential areas of difficulty suggest possible directions for intervention.

Nonword repetition and sentence repetition as clinical markers of specific language impairment: the case of Cantonese.

PURPOSE: Recent research suggests that nonword repetition (NWR) and sentence repetition (SR) tasks can be used to discriminate between children with SLI and their typically developing age-matched (TDAM) and younger (TDY) peers. METHOD: Fourteen Cantonese-speaking children with SLI and 30 of their TDAM and TDY peers were compared on NWR and SR tasks. NWR of IN nonwords (CV combinations attested in the language) and OUT nonwords (CV combinations unattested in the language) were compared. SR performance was compared using 4 different scoring methods. RESULTS: The SLI group did not score significantly lower than the TDAM group on the test of NWR (overall results were TDAM = SLI > TDY). There were nonsignificant group differences on IN syllables but not on OUT syllables. The results do not suggest a limitation in phonological working memory in Cantonese-speaking children with SLI. The SR task discriminated between children and their TDAM peers but not between children with SLI and their TDY peers matched for mean length of utterance. CONCLUSIONS: SR but not NWR discriminates between children with SLI and their TDAM peers. Poorer NWR for English-speaking children with SLI might be attributable to weaker use of the redintegration strategy in word repetition. Further cross-linguistic investigations of processing strategies are required.

The Production of Passives by Children with Specific Language Impairment Acquiring English or Cantonese.

The production of passive sentences by children with specific language impairment (SLI) was studied in two languages, English and Cantonese. In both languages, the word order required for passive sentences differs from the word order used for active sentences. However, English and Cantonese passive sentences are quite different in other respects. We found that English-speaking children with SLI were less proficient than both same-age and younger typically developing peers in the use of passives, though difficulty could not be attributed to word order or a reliance on active sentences. Cantonese-speaking children with SLI proved less capable than same-age peers but at least as proficient as younger peers in their use of passive sentences. The implications of these cross-linguistic differences are discussed.

The expression of aspect in Cantonese-speaking children with specific language impairment.

Previous studies of verb morphology in children with specific language impairment (SLI) have been limited in the main to tense and agreement morphemes. Cantonese, which, like other Chinese languages, has no grammatical tense, presents an opportunity to investigate potential difficulties for children with SLI in other areas of verb morphology, via scrutiny of elements of its aspectual system. The performance of 3 groups of children (n = 15 in each group)--preschoolers with SLI, typically developing same-age peers, and younger, typically developing peers--was compared in procedures designed to elicit aspect forms. The children with SLI were less likely to produce both perfective and imperfective aspect markers. It is suggested that reasons for these findings are to be found in the sparse morphology of Cantonese and in the nonobligatory nature of these forms.