Mobile device screen time is associated with poorer language development among toddlers: results from a large-scale survey.

BACKGROUND: Despite young children's widespread use of mobile devices, little research exists on this use and its association with children's language development. The aim of this study was to examine the associations between mobile device screen time and language comprehension and expressive language skills. An additional aim was to examine whether three factors related to the domestic learning environment modify the associations. METHODS: The study uses data from the Danish large-scale survey TRACES among two- and three-year-old children (n = 31,125). Mobile device screen time was measured as time spent on mobile devices on a normal day. Measurement of language comprehension and expressive language skills was based on subscales from the Five to Fifteen Toddlers questionnaire. Multivariable linear regression was used to examine the association between child mobile device screen time and language development and logistic regression to examine the risk of experiencing significant language difficulties. Joint exposure analyses were used to examine the association between child mobile device screen time and language development difficulties in combination with three other factors related to the domestic learning environment: parental education, reading to the child and child TV/PC screen time. RESULTS: High mobile device screen time of one hour or more per day was significantly associated with poorer language development scores and higher odds for both language comprehension difficulties (1-2 h: AOR = 1.30; ≥ 2 h: AOR = 1.42) and expressive language skills difficulties (1-2 h: AOR = 1.19; ≥ 2 h: AOR = 1.46). The results suggest that reading frequently to the child partly buffers the negative effect of high mobile device screen time on language comprehension difficulties but not on expressive language skills difficulties. No modifying effect of parental education and time spent by the child on TV/PC was found. CONCLUSIONS: Mobile device screen time of one hour or more per day is associated with poorer language development among toddlers. Reading frequently to the child may have a buffering effect on language comprehension difficulties but not on expressive language skills difficulties.

Velopharyngeal insufficiency, speech, and language impairment in craniofacial microsomia: a scoping review.

This review provides a comprehensive overview of the literature on velopharyngeal insufficiency, associated anomalies, and speech/language impairment in patients with craniofacial microsomia (CFM). A systematic search of the literature was conducted to identify records on VPI and speech impairment in CFM from their inception until September 2022 within the databases Embase, PubMed, MEDLINE, Ovid, CINAHL EBSCO, Web of Science, Cochrane, and Google Scholar. Seventeen articles were included, analysing 1,253 patients. Velopharyngeal insufficiency results in hypernasality can lead to speech impairment. The reported prevalence of both velopharyngeal insufficiency and hypernasality ranged between 12.5% and 55%, while the reported prevalence of speech impairment in patients with CFM varied between 35.4% and 74%. Language problems were reported in 37% to 50% of patients. Speech therapy was documented in 45.5% to 59.6% of patients, while surgical treatment for velopharyngeal insufficiency consisted of pharyngeal flap surgery or pharyngoplasty and was reported in 31.6% to 100%. Cleft lip and/or palate was reported in 10% to 100% of patients with CFM; these patients were found to have worse speech results than those without cleft lip and/or palate. No consensus was found on patient characteristics associated with an increased risk of velopharyngeal insufficiency and speech/language impairment. Although velopharyngeal insufficiency is a less commonly reported characteristic of CFM than other malformations, it can cause speech impairment, which may contribute to delayed language development in patients with CFM. Therefore, timely recognition and treatment of speech impairment is essential.

Developmental trajectories of speech and language in neglected children aged 3 to 5 years: Results of the ELLAN study.

BACKGROUND: Neglected children are at high risk for significant difficulties in speech and language development. Because no longitudinal study has been conducted to date, the dynamic description of development during the preschool period is unknown. OBJECTIVES: Establish the developmental trajectories of speech sounds, receptive and expressive vocabulary, and morphosyntax among neglected children during the preschool years and compare them with those of non-neglected children. PARTICIPANTS AND SETTING: Participants are 69 neglected children and 99 same age non-neglected peers (37 and 46 males respectively) recruited at 36 months of age. Data were collected at home. METHODS: Data were collected at six-month intervals between the ages of 3 and 5.5 years using psychometrically robust tools. Neglected and control groups were compared according to age using repeated measures ANOVAs on all variables. A discrete mixture model for clustering longitudinal data was used for testing the heterogeneity of the language trajectories among neglected children. RESULTS: The language development of the neglected children as a whole group is lower than that of the control group for all variables. Two subgroups are identified within the neglected group: one with a developmental trajectory similar to that of the non-neglected children, and another whose trajectory is far below that of the control group. The effect sizes of these differences vary between 1.4 and 3 standard deviations under the mean. CONCLUSIONS: A large proportion of neglected children present significant speech and language difficulties from the age of 3, but some of them catch up and develop similarly to non-neglected children.

Speech and Language Delay in Children.

Childhood speech and language concerns are commonly encountered in the primary care setting. Family physicians are integral in the identification and initial evaluation of children with speech and language delays. Parental concerns and observations and milestone assessment aid in the identification of speech and language abnormalities. Concerning presentations at 24 months or older include speaking fewer than 50 words, incomprehensible speech, and notable speech and language deficits on age-specific testing. Validated screening tools that rely on parental reporting can serve as practical adjuncts during clinic evaluation. Early referral for additional evaluation can mitigate the development of long-term communication disorders and adverse effects on social and academic development. All children who have concerns for speech and language delays should be referred to speech language pathology and audiology for diagnostic and management purposes. Parents and caretakers may also self-refer to early intervention programs for evaluation and management of speech and language concerns in children younger than three years.

Language outcomes at 4 years of linguistically diverse children born very preterm: an Australian retrospective single-centre study.

BACKGROUND: Very preterm children are at increased risk of language delays. Concerns have been raised about the utility of standardised English language tools to diagnose language delay in linguistically diverse children. Our study investigated the incidence of language delay at 4 years in linguistically diverse very preterm children. METHODS: Very preterm children born in South Western Sydney, Australia, between 2012 and 2016, were assessed with the Clinical Evaluation of Language Fundamentals Preschool-2 (CELF-P2) tool at 4 years of age. We sought to determine the incidence of language delay in this cohort using language scores from the CELF-P2 assessment tool, and explore potential predictors associated with language delay. RESULTS: One hundred and sixty very preterm children attended the 4-year assessment out of the included 270 long-term survivors. At 4 years, 76 (52%) very preterm children had language delay diagnosed using the CELF-P2 assessment tool. Children who preferred a language other than English had lower average core language scores on the CELF-P2 assessment tool (75.1±14.4) compared with children that preferred English (86.5±17.9); p=0.002. Very preterm children growing up in households that preferenced a language other than English and those who were born from multiple births had higher odds of language delay at 4 years (AOR 10.30 (95% CI 2.82 to 38.28); p<0.001 and AOR 2.93 (95% CI 1.20 to 7.14); p=0.018, respectively). Assessing these children using an English language tool may have affected language scores at 4 years. CONCLUSIONS: In this metropolitan setting, very preterm children from linguistically diverse backgrounds were found to be vulnerable to language delays at 4 years. Further large-scale studies evaluating the language outcomes of linguistically diverse preterm children with more culturally appropriate tools are warranted. We question the utility of standardised English language tools to assess language outcomes of linguistically diverse populations.

Factors Impacting Implementation of Universal Screening of Developmental Language Disorder in Public Schools.

PURPOSE: Developmental language disorder (DLD) is an underidentified neurodevelopmental disorder that affects, on average, one out of 11 kindergarten-age children (ages 4-6 years). Children with DLD can face academic, behavioral, psychiatric, emotional, and social challenges. Universal screening is seen as an effective way for public school districts to increase DLD identification rates. However, little is known about factors impacting implementation of school-based universal screenings for DLD. We partnered with a large suburban school district in the Intermountain West region of the United States to gather detailed perspectives from school personnel regarding the barriers and facilitators to the implementation of universal screening in their district. METHOD: Using a two-phase mixed-methods design, we first conducted focus groups to identify potential barriers and facilitators to universal screening. We then used the qualitative data from the first phase to develop a 20-item survey to assess agreement with the focus group results among a wider group of district speech-language pathologists and kindergarten teachers from the school district. RESULTS: Our survey showed moderate levels of agreement with our focus group results. In particular, school personnel showed high levels of support for universal screening for DLD, with interesting interplay across various factors: (a) the negative impact of unmanageable workload on personnel under both referral- and universal-based identification formats, (b) the preference for paraprofessionals to administer screenings, (c) the role that Response to Intervention programs may play in offsetting workloads associated with universal screenings, and (d) the need for increased awareness and education about child language development and impairment among general education teachers and the public. CONCLUSION: Recommendations for incorporating these factors into more useful and applicable collaborative research-based efforts are presented. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23661876.

Understanding the prevalence and manifestation of anxiety and other socio-emotional and behavioural difficulties in children with Developmental Language Disorder.

BACKGROUND: It is well-documented that children with Developmental Language Disorder (DLD) have a higher likelihood of experiencing anxiety, as well as other socio-emotional and behavioural (SEB) difficulties. Despite this, there is little consensus as to how these difficulties manifest. This study aims to understand the prevalence of broader SEB difficulties and anxiety, informing intervention development by understanding the relationships between them. METHODS: A mixed-methods, case-control study was conducted. First, an online survey was completed by 107 parents of either children with DLD ("DLD sample"; n = 57) or typically developing children ("typical sample"; n = 50), aged 6-12 years old. Binary SEB statements informed by previous qualitative work (e.g. "my child requires routine/sameness"; "my child has frequent tantrums") provided an insight into the prevalence of SEB difficulties in both DLD and typical samples. Validated measures of anxiety, emotion regulation, intolerance of uncertainty, insistence on sameness, family stress and coping mechanisms were also collected. Correlation and mediation analyses were run using these validated measures to understand the manifestation of anxiety in children with DLD in more detail. Qualitative interviews were then carried out with a select panel of survey respondents (n = 4). RESULTS: The DLD sample scored significantly higher on all binary SEB statements than the typical sample: experiencing anxiety (80.7%, p < .05), requiring routine and sameness (75.4%, p < .001) and emotional dysregulation (75.4%; p < .001) were the most common difficulties reported for children with DLD. Using the validated scales, family stress and coping mechanisms were found to only correlate with the manifestation of anxiety in the typical group, not the DLD group. "Intolerance of uncertainty" and "insistence on sameness" were found to fully mediate the relationship between DLD diagnosis and symptoms of anxiety. Parent's interviews provided contextual support for the analysis, as well as highlighting sensory sensitivities as a focus for future research. CONCLUSIONS: Parents of children with DLD appear to cope well with their children's complex SEB needs. Intervention focussing on intolerance of uncertainty may help the management of difficulties with anxiety. Behaviours such as insistence on sameness should be investigated further, as potential indicators for anxiety amongst children with DLD.

Risk factors for early language delay in children within a minority ethnic, bilingual, deprived environment (Born in Bradford's Better Start): a UK community birth cohort study.

BACKGROUND: Preschool language skills and language delay predict academic and socioemotional outcomes. Children from deprived environments are at a higher risk of language delay, and both minority ethnic and bilingual children can experience a gap in language skills at school entry. However, research that examines late talking (preschool language delay) in an ethnically diverse, bilingual, deprived environment at age 2 is scarce. METHODS: Data from Born in Bradford's Better Start birth cohort were used to identify rates of late talking (≤10th percentile on the Oxford-Communicative Development Inventory: Short) in 2-year-old children within an ethnically diverse, predominantly bilingual, deprived UK region (N=712). The relations between known demographic, maternal, distal and proximal child risk factors, and language skills and language delay were tested using hierarchical linear and logistic regression. RESULTS: A total of 24.86% of children were classified as late talkers. Maternal demographic factors (ethnicity, born in UK, education, financial security, employment, household size, age) predicted 3.12% of the variance in children's expressive vocabulary. Adding maternal language factors (maternal native language, home languages) and perinatal factors (birth weight, gestation) to the model predicted 3.76% of the variance. Adding distal child factors (child sex, child age) predicted 11.06%, and adding proximal child factors (receptive vocabulary, hearing concerns) predicted 49.51%. Significant risk factors for late talking were male sex (OR 2.07, 95% CI 1.38 to 3.09), receptive vocabulary delay (OR 8.40, 95% CI 4.99 to 14.11) and parent-reported hearing concerns (OR 7.85, 95% CI 1.90 to 32.47). Protective factors were increased household size (OR 0.85, 95% CI 0.77 to 0.95) and age (OR 0.82, 95% CI 0.70 to 0.96). CONCLUSIONS: Almost one in four children living in an ethnically diverse and deprived UK area have early language delay. Demographic factors explained little variance in early vocabulary, whereas proximal child factors held more predictive value. The results indicate further research on early language delay is warranted for vulnerable groups.

Language in autism: domains, profiles and co-occurring conditions.

This article reviews the current knowledge state on pragmatic and structural language abilities in autism and their potential relation to extralinguistic abilities and autistic traits. The focus is on questions regarding autism language profiles with varying degrees of (selective) impairment and with respect to potential comorbidity of autism and language impairment: Is language impairment in autism the co-occurrence of two distinct conditions (comorbidity), a consequence of autism itself (no comorbidity), or one possible combination from a series of neurodevelopmental properties (dimensional approach)? As for language profiles in autism, three main groups are identified, namely, (i) verbal autistic individuals without structural language impairment, (ii) verbal autistic individuals with structural language impairment, and (iii) minimally verbal autistic individuals. However, this tripartite distinction hides enormous linguistic heterogeneity. Regarding the nature of language impairment in autism, there is currently no model of how language difficulties may interact with autism characteristics and with various extralinguistic cognitive abilities. Building such a model requires carefully designed explorations that address specific aspects of language and extralinguistic cognition. This should lead to a fundamental increase in our understanding of language impairment in autism, thereby paving the way for a substantial contribution to the question of how to best characterize neurodevelopmental disorders.

Developmental language disorder - a comprehensive study of more than 46,000 individuals.

Developmental language disorder (DLD) is characterized by enduring low language abilities with a significant functional impact, in the absence of biomedical conditions in which language impairment is part of a complex of impairments. There is a lack of awareness of DLD even among healthcare professionals. Here we estimated the prevalence of DLD and its links to reading and learning difficulties and physical and mental health in the Danish Blood Donor Study (N = 46,547), where DLD-related information is based on questionnaires (self-report). We compared the questionnaire-derived DLD status with the relevant language-related diagnoses from hospital registers. We also investigated the genetic architecture of DLD in a subset of the cohort (N = 18,380). DLD was significantly associated with reading and learning difficulties and poorer mental and physical health. DLD prevalence was 3.36%-3.70% based on questionnaires, compared with 0.04% in hospital registers. Our genetic analyses identified one genome-wide significant locus, but not a significant heritability estimate. Our study shows that DLD has health-related implications that may last into adulthood, and that DLD may be undiagnosed in general healthcare. Furthermore, DLD is likely more genetically heterogeneous than narrower developmental language phenotypes. Our results emphasize the need to raise awareness of DLD and consider criteria for molecular studies of DLD to reduce case heterogeneity.

Positive Predictive Values Associated With Adapting the Redmond Sentence Recall Measure Into a Kindergarten Screener for Developmental Language Disorder.

PURPOSE: Researchers estimate the prevalence of developmental language disorder (DLD) in 5-year-olds to be between 7% and 12%. Current identification systems in public schools typically favor referral identification formats over targeted or universal screenings. Public schools face unique challenges when assessing the value of screening measures for DLD that include real-world considerations such as administration, time, and resource constraints. This study used the positive predictive value (PPV) of the Redmond Sentence Recall (RSR) to assess its fidelity when administered by special education paraprofessionals. Our obtained PPV was compared across three areas: (a) previous studies that have utilized the RSR, (b) rates extrapolated from the participating school district's preexisting referral system from a previous study, and (c) expectations based on DLD prevalence. METHOD: Language screenings were conducted in two elementary schools using the RSR administered by school-based paraprofessionals trained on the screener protocol. One hundred sixty-four kindergarten students (age range: 5-6 years) were screened. Confirmatory testing was completed on all students who failed the screener. RESULTS: Of the 164 students screened, 19 failed the RSR (11.5%), and 14 met criteria (8.5%) for DLD (PPV = .74). Our PPV was similar to previously published studies that utilized the RSR using research assistants and was higher than the PPV associated with teacher-based referrals from the participating school district. CONCLUSION: The RSR represents a potentially useful screener for identifying children at risk for previously unidentified language disorders in public schools. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22044479.

Structural brain abnormalities and their association with language impairment in school-aged children with Autism Spectrum Disorder.

Language impairment is comorbid in most children with Autism Spectrum Disorder (ASD) but its neural basis is poorly understood. Using structural magnetic resonance imaging (MRI), the present study provides the whole-brain comparison of both volume- and surface-based characteristics between groups of children with and without ASD and investigates the relationships between these characteristics in language-related areas and the language abilities of children with ASD measured with standardized tools. A total of 36 school-aged children participated in the study: 18 children with ASD and 18 age- and sex-matched typically developing controls. The results revealed that multiple regions differed between groups of children in gray matter volume, gray matter thickness, gyrification, and cortical complexity (fractal dimension). White matter volume and sulcus depth did not differ between groups of children in any region. Importantly, gray matter thickness and gyrification of language-related areas were related to language functioning in children with ASD. Thus, the results of the present study shed some light on the structural brain abnormalities associated with language impairment in ASD.

Prevalence and functional impact of social (pragmatic) communication disorders.

BACKGROUND: The aim of this study was to evaluate the Children's Communication Checklist-2 (CCC-2) for measuring social-pragmatic communication deficits and to ascertain their prevalence and functional impact in a community sample. METHODS: We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for social (pragmatic) communication disorder (SPCD). We tested the prevalence of social-pragmatic deficits in a population-based sample of children (n = 386) aged 5-6 years old using CCC-2 algorithms. We also investigated the academic and behavioural profiles of children with broadly defined limitations in social-pragmatic competence on the CCC-2. RESULTS: Regardless of the diagnostic algorithm used, the resulting prevalence rates for social-pragmatic deficits indicated that very few children had isolated social-communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this profile was associated with a range of adverse academic and behavioural outcomes. CONCLUSIONS: A considerable proportion of children in the early years of primary school has social-pragmatic deficits that interfere with behaviour and scholastic activity; however, these rarely occur in isolation. Exclusionary criteria that include structural language may lead to underidentification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.

Sex differences in early language delay and in developmental language disorder.

Developmental language disorder (DLD) is a neurodevelopmental condition, occurring in about 3% to 7% of preschoolers, that can impair communication and negatively impact educational and social attainments, in spite of adequate neurological, cognitive, emotional, social development, and educational opportunities for language learning. Significant risk factors for DLD are male sex, familial history of early language delay, low parental education, and various perinatal factors. A strong sex effect with a higher prevalence of language delay and DLD in males than in females has been consistently reported. Neurobiological and environmental risk factors, interacting with each other, are probably responsible for the phenotypic expression of DLD. The aim of this brief review is to further the knowledge of the role of sex in early language delay and DLD by analyzing the evidence from four significant sources: epidemiological studies, studies on twins, family aggregation studies, and studies on sex chromosome trisomies. Data pertaining only to sex differences (biological and physiological characteristics of females and males) will be analyzed. Studies on family aggregations and twins confirm the role of genetic factors and of sex in determining language abilities and disabilities, but genes alone do not determine outcomes. Sex chromosome trisomies represent a unique example of the relationship between a genetic alteration and a language disorder. Clarification of how sex acts in determining DLD could provide new information on early risk factors and, thus, contribute to improve diagnosis and clinical management.

The Engage with Developmental Language Disorder (E-DLD) project: Cohort profile.

BACKGROUND: Public awareness of Developmental Language Disorder (DLD) is lower than other neurodevelopmental disorders, despite its high prevalence of 7.6%. This lower awareness means recruitment for DLD research studies is difficult. DLD is both underfunded and under-researched, resulting in relatively limited research investigating individuals with DLD. Engage with Developmental Language Disorder (E-DLD) is a response to these considerations. E-DLD is the first international participant database of those affected by DLD. Parents of children with DLD under 16 and young people and adults over 16 from anywhere in the world can sign up to be a part of the E-DLD. AIMS: This paper aims to describe the families of children with DLD and adults with DLD in the database thus far. METHODS & PROCEDURES: E-DLD members sign up via our website, reporting demographic characteristics as part of this procedure. We request all E-DLD members subsequently fill in a yearly survey. The content of the yearly survey changes dependent on the age of the child, while the yearly survey for adults remains consistent. We measure a wide range of domains, such as speech and language therapy (SLT) support, school support, socialisation skills, and early developmental milestones for our youngest members, and health care support and mental well-being measurements for our adults. We also collect parent and self-reported reflections on strengths and challenges for the person with DLD using open-ended questions and the Strengths and Difficulties Questionnaire. OUTCOMES & RESULTS: The database currently consists of 196 parents of children with DLD and 20 individuals over the age of 16 with DLD or suspected DLD across a range of socioeconomic status (SES) backgrounds. Our initial results confirm that E-DLD members meet the linguistic profile of DLD in relation to self- or parent-rated language difficulties. Both children and adults show increased rates of psychosocial difficulties compared to established norms, consistent with past research on clinical samples of people with DLD. CONCLUSIONS & IMPLICATIONS: The findings indicate that a participant database for DLD research is feasible and useful. The rates of emotional, behavioural and sleep difficulties among the child probands are higher than reported rates amongst typically developing children. Initial data indicate that adults with DLD have poorer well-being than their peers. The E-DLD is a useful collection of data on those affected by DLD and is a promising method for connecting people with DLD with academic researchers. WHAT THIS PAPER ADDS: What is already known on this subject Developmental Language Disorder (DLD) is characterised by expressive and/or receptive language difficulties in the absence of another biomedical condition that could explain these difficulties. It is critically under-researched and underfunded. As such, there is a lack of public awareness and difficulty recruiting sufficient sample sizes for DLD research studies. What this paper adds to existing knowledge Engage with Developmental Language Disorder (E-DLD) is the first international participant database of individuals with DLD. This paper provides a preliminary report on the profile of linguistic and psychosocial skills among the individuals on the database, adding to current understanding of DLD across age groups. What are the potential or actual clinical implications of this work? Our aim is that the E-DLD will provide much-needed facilitation of research into DLD. E-DLD will enable those with DLD and their families more readily to shape research agendas and to participate in studies that interest them. Families may be recruited into research that could directly translate to better clinical treatment of DLD. We also believe that the E-DLD yearly survey holds potential to provide key information on the development and longitudinal experience of children and adults with DLD.

The prevalence of and potential risk factors for Developmental Language Disorder at 10 years in the Raine Study.

AIM: This study sought to determine the prevalence of Developmental Language Disorder (DLD) in Australian school-aged children and associated potential risk factors for DLD at 10 years. METHODS: This study used a cross-sectional design to estimate the prevalence of DLD in Generation 2 of the prospective Raine Study. Participants included 1626 children aged 10 years with available language data. Primary outcomes included variables matching diagnostic criteria for DLD. Associations of other potential prenatal and environmental variables were analysed as secondary outcomes. RESULTS: The prevalence of DLD in this sample was 6.4% (n = 104) at 10 years. This sub-cohort comprised 33.7% (n = 35) with expressive language deficits, 20.2% (n = 21) with receptive language deficits, and 46.2% (n = 48) with receptive-expressive deficits. No significant difference in sex distribution was observed (52.9% male, p = 0.799). Children who were exposed to smoke in utero at 18 weeks gestation were at increased risk of DLD at 10 years (OR = 2.56, CI = 1.23-5.35, p = 0.012). CONCLUSIONS: DLD is a relatively prevalent condition in Australian children, even when assessed in middle childhood years. These findings can inform future research priorities, and public health and educational policy which account for the associations with potential risk factors.

[Early detection of primary developmental language disorders-increasing relevance due to changes in diagnostic criteria?] / Früherkennung primärer Sprachentwicklungsstörungen ­ zunehmende Relevanz durch Änderung der Diagnosekriterien?

Language development disorders (in German: Sprachentwicklungsstörungen, SES) are the most common developmental disorders in childhood. In contrast to "secondary SES," "primary SES" (prevalence about 7%) are not (co-)caused by other developmental disorders or diseases. In the German modification of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-GM-22), primary SES are referred to as "circumscribed developmental disorders of speech and language" (in German: USES; international previously known as Specific Language Impairment SLI), with an intelligence quotient (IQ) < 85 as an exclusion criterion, among other criteria. In ICD-11, primary SES are listed as "developmental language disorders" (DLD).German-speaking speech and language therapists would now like to replace the term "USES" with "DLD" using the diagnostic criteria proposed by the international CATALISE consortium (Criteria and Terminology Applied to Language Impairments Synthesizing the Evidence), in an effort to redefine the disorder. However, according to this conceptualization, only children with an intellectual disability (IQ < 70) would be excluded from the diagnosis. This change in the diagnostic criteria would most likely result in an increase in prevalence of DLDs. This makes the issue of early detection more important than ever. This discussion paper explains that the public health relevance of primary SES is growing and that systematic early detection examinations will play an even more important role. With early diagnosis and treatment, risks in the areas of mental health, behaviour and skill development can be mitigated.Currently, diagnosis (and therapy) are usually carried out relatively late. The way out could lie in the application of neurobiological parameters. However, this requires further studies that examine child cohorts for early indicators in a prospective longitudinal design. The formation of an early detection index from several indicators should also be considered.

The co-occurrence of motor and language impairments in children evaluated for autism spectrum disorder. An explorative study from Norway.

BACKGROUND: Current research suggest that motor and language impairments are common and closely related in infants with autism spectrum disorder (ASD). In older children, less is known about how these impairments are related to each other. AIMS: The current study explored the co-occurrence and potential impact of motor and language impairments in a sample of school-aged children evaluated for ASD by Norwegian specialist health services. METHODS: Besides clinical evaluation for ASD, all participants (N = 20, mean age 10.7 (SD = 3.4) years) underwent a standardized test of motor performance (MABC-2), parent report measures of current motor (DCDQ'07), language (CCC-2), and social (SRS) skills, and a caregiver interview on everyday functioning, providing an overall impairment score (DD-CGAS). RESULTS: The majority (85%) had motor and/or structural language deficits in addition to their social impairment. All children identified with motor impairment on both measures (39%) also had structural language deficits. Better motor performance was strongly correlated with better structural language skills (r = .618, p = .006). CONCLUSIONS: Our findings suggest that co-occurring motor and structural language deficits should be anticipated and assessed when evaluating children for ASD. These deficits may need specific interventions that complement those targeting social skills deficits and other ASD core symptoms.

Screen time of children with speech delay: a cross-sectional study in a tertiary center in Kuantan, Malaysia.

BACKGROUND: Studies suggest excessive screen time (use of smartphones, televisions, computers and/or video games) is linked to speech and language delay. This study explored the sociodemographic characteristics of children with speech delay in Kuantan, Malaysia, and the association of screen time with speech and other developmental delays. METHODS: This cross-sectional study was conducted between July and November 2019 at the child psychiatry and speech therapy clinics, at Kuantan Hospital, Pahang, Malaysia. Parents of children with speech delay aged <72 months provided information on their children's and their own screen times. Speech and other developmental skills were assessed using the Schedule of Growing Skills II with scores reported as developmental quotient (DQ) level. RESULTS: The study included 91 children (67 boys, 24 girls) of whom 54.9% had primary speech delay and 45.1% had neurodevelopmental disorders; their mean age was 39.9 ± 11.52 months. The children's mean screen time was 2.26 ± 1.98 h daily, with 36.3% exceeding 2 h. Higher children's screen time was moderately correlated with higher parental screen time (rs = 0.479, P < 0.01). Household income was positively correlated with screen times of the children and the parents (rs = 0.243, P = 0.02 and rs = 0.390, p < 0.01, respectively). Parents who intended to reduce their children's screen time reported higher screen time in their children (t(89) = 2.322, P = 0.023). Children's age was positively correlated with the number of types of screen media (rs = 0.225, P = 0.032). The mean speech DQ was 54.76 ± 24.06%. Lower speech DQ was associated with lower DQs in other skills (P < 0.01). No significant correlation was shown between children's and parents' screen time with DQs of speech and other skills (P > 0.05). CONCLUSION: The correlation between parent and child screen time provides an opportunity for possible intervention, where necessary. Larger studies are required to examine this correlation further.

Editorial Perspective: Speaking up for developmental language disorder - the top 10 priorities for research.

Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions, yet is chronically underserved, with far fewer children receiving clinical services than expected from prevalence estimates, and very little research attention relative to other neurodevelopmental conditions of similar prevalence and severity. This editorial describes a research priority-setting exercise undertaken by the Royal College of Speech and Language Therapists, which aims to redress this imbalance. From consultations with researchers, practitioners and individuals with lived experience, 10 research priorities emerge. Our goal is to share these priorities with the wider research community, to raise awareness and encourage research collaboration to improve outcomes for young people with DLD.