Phonological awareness and reading in boys with fragile X syndrome.

BACKGROUND: Reading delays are well documented in children with fragile X syndrome (FXS), but few studies have examined linguistic precursors of reading in this population. This study examined the longitudinal development of phonological awareness and its relationship with basic reading in boys with FXS. Individual differences in genetic, social-behavioral and environmental factors were also investigated as predictors of phonological awareness. METHODS: Participants included 54 boys with FXS and 53 typically developing (TD) mental age-matched peers who completed assessments of phonological awareness, nonverbal intelligence, and reading annually for up to 4 years. FMRP level and autism symptomatology were also measured within the FXS group. Hierarchical linear modeling was used to examine change in phonological awareness over time and its predictors. Linear regression was used to examine phonological awareness as a predictor of word reading. RESULTS: Boys with FXS exhibited slower growth than TD peers in phonological awareness only when nonverbal cognitive abilities were not controlled. The rate of change in phonological awareness decreased significantly after age 10 in boys with FXS. Phonological awareness accounted for 18% unique variance in basic reading ability after controlling for nonverbal cognition, with similar relationships across groups. CONCLUSION: Phonological awareness skills in the boys with FXS were commensurate with their nonverbal cognitive abilities, with similar relationships between phonological awareness and reading as observed in the TD mental age-matched peers. More research is needed to examine potential causal relationships between phonological awareness, other language skills, and reading abilities in individuals with FXS and other neurodevelopmental disorders.

Reading and Math Achievement in Children With Dyslexia, Developmental Language Disorder, or Typical Development: Achievement Gaps Persist From Second Through Fourth Grades.

We examined how children (N = 448) with separate or co-occurring developmental language disorder (DLD) and dyslexia performed on school-based measures of academic functioning between second and fourth grades. Children were recruited from 1 school district in the U.S. state of South Carolina via classroom screenings and met common research criteria for DLD and dyslexia. Growth curve models were used to examine the overall form of growth and differences between groups. Children with DLD and/or dyslexia in second grade showed early and persistent deficits on school-administered measures of reading and math. In second grade, children with typical development (TD) scored significantly higher than children with dyslexia-only and DLD-only, who did not differ from each other. Children with DLD+dyslexia scored significantly lower than all other groups. Only small differences in growth rates were observed, and gaps in second grade did not close. Despite lower academic performance, few children (20%-27%) with dyslexia and/or DLD had received specialized support services. Children with DLD-only received services at less than half the rate of dyslexia-only or DLD+dyslexia despite similar impacts on academic performance. Evidence of significant and persistent functional impacts in the context of low rates of support services in these children-especially those with DLD-only-highlights the need to raise awareness of these disorders.

Examining the Associations Between Parent Concerns and School-Age Children's Language and Reading Abilities: A Comparison of Samples Recruited for In-School Versus Online Participation.

PURPOSE: The purpose of this study was to examine the relationship between parent concerns about children's oral language, reading, and related skills and their children's performance on standardized assessments of language and reading, with a particular focus on whether those relationships differed between children recruited for in-school versus online participation. METHOD: This study used data from a larger, longitudinal project focused on children with and without developmental language disorder (DLD) and/or dyslexia. The "in-school" sample (n = 133) completed assessments in-person before school closures, and the "online" sample (n = 84) recruited via advertisements completed assessments online. Parents completed a checklist of concerns. All children completed norm-referenced assessments of language and reading. RESULTS: The two recruitment strategies yielded samples that differed in racial diversity (higher in the in-school sample), caregiver education levels (higher in the online sample), and word reading test scores (higher in the online sample). Parents in both samples reported higher levels of concerns about literacy skills than oral language skills, and the correlation between parent concerns about literacy and children's word reading test scores was stronger than the correlation between parent concerns about oral language and children's language test scores. CONCLUSIONS: Researchers and clinicians should be aware of how recruitment strategies and assessment modalities (e.g., in-person vs. tele-assessment) may impact participation in studies and clinical service. A reliance on parent concerns about oral language to prompt a language evaluation may contribute to low rates of identification of children who meet criteria for DLD. Future research can consider parent concerns about literacy, attention, and executive functions as indicators of a need for language evaluation, especially considering the high comorbidity between language and other developmental disorders.

Spoken Word Learning in Children With Developmental Language Disorder or Dyslexia.

Purpose Word learning difficulties have been documented in multiple studies involving children with dyslexia and developmental language disorder (DLD; see also specific language impairment). However, no previous studies have directly contrasted word learning in these two frequently co-occurring disorders. We examined word learning in second-grade students with DLD-only and dyslexia-only as compared to each other, peers with both disorders (DLD + dyslexia), and peers with typical development. We hypothesized that children with dyslexia-only and DLD-only would show differences in word learning due to differences in their core language strengths and weaknesses. Method Children (N = 244) were taught eight novel pseudowords paired with unfamiliar objects. The teaching script included multiple exposures to the phonological form, the pictured object, a verbal semantic description of the object, and spaced retrieval practice opportunities. Word learning was assessed immediately after instruction with tasks requiring recall or recognition of the phonological and semantic information. Results Children with dyslexia-only performed significantly better on existing vocabulary measures than their peers with DLD-only. On experimental word learning measures, children in the dyslexia-only and DLD + dyslexia groups showed significantly poorer performance than typically developing children on all word learning tasks. Children with DLD-only differed significantly from the TD group on a single word learning task assessing verbal semantic recall. Conclusions Overall, results indicated that children with dyslexia display broad word learning difficulties extending beyond the phonological domain; however, this contrasted with their relatively strong performance on measures of existing vocabulary knowledge. More research is needed to understand relations between word learning abilities and overall vocabulary knowledge and how to close vocabulary gaps for children with both disorders. Supplemental Material https://doi.org/10.23641/asha.14832717.

Promoting Reading Achievement in Children With Developmental Language Disorders: What Can We Learn From Research on Specific Language Impairment and Dyslexia?

Purpose Specific language impairment (SLI; see also developmental language disorder) and dyslexia are separate, yet frequently co-occurring disorders that confer risks to reading comprehension and academic achievement. Until recently, most studies of one disorder had little consideration of the other, and each disorder was addressed by different practitioners. However, understanding how the two disorders relate to each other is important for advancing theories about each disorder and improving reading comprehension and academic achievement. The purpose of this clinical focus article is to integrate research on SLI and dyslexia as well as advocate for the consideration of comorbidities in future research and clinical practice. Method The first section reviews definitions as well as inclusionary and exclusionary criteria for SLI and dyslexia. The second section reviews research demonstrating that SLI and dyslexia are different disorders that often co-occur. Studies examining language, working memory, and academic achievement in children with separate versus co-occurring SLI and dyslexia are reviewed. The final section compares and contrasts school identification frameworks for children with SLI and dyslexia and considers the potential benefits of incorporating broad language skills into response to intervention (RTI) assessment frameworks. Conclusions Children with weak language skills are at a high risk of experiencing reading problems, but language difficulties are often hidden from view. Directly addressing language skills within school RTI frameworks can help improve the identification and treatment of children with SLI and dyslexia as well as support improved reading comprehension and academic achievement for all students. Presentation Video https://doi.org/10.23641/asha.13063793.

Production of Morphosyntax Within and Across Different Dialects of American English.

Purpose This study examined the production of morphosyntactic markers by school-age children with and without developmental language disorder. Comparisons were made between students who speak mainstream American English (MAE) dialects and nonmainstream American English (NMAE) dialects. Method First- and second-grade students (N = 82) completed assessments of dialect use and language ability, which are designed for students who speak NMAE dialects. Students also completed an experimental production task targeting three morphosyntactic features: past tense -ed marking, third-person singular -s marking, and plural -s marking. Past tense marking and third-person singular are produced differently across MAE and NMAE dialects, whereas plural marking is produced more similarly across dialects. Results When comparing across dialects, children with typical language skills who spoke NMAE dialects overtly marked past tense and third-person singular less often compared to MAE peers. However, when comparing to same-dialect peers with language disorders, children with typical language skills who spoke NMAE dialects overtly marked these morphosyntactic markers more often than peers with developmental language disorder. Conclusion The results underscore the importance of considering a child's dialect use when assessing language ability, in particular with measures that include features that are variable in NMAE dialects. At the same time, within-dialect comparisons suggest that a broader set of morphosyntactic features may provide useful information for evaluations of language ability. Future research should investigate the source of these differences, including the extent to which students with language disorders have acquired the social and linguistic factors that condition the use of variable features.

Adult and child semantic neighbors of the Kroll and Potter (1984) nonobjects.

PURPOSE: The purpose was to determine the number of semantic neighbors, namely, semantic set size, for 88 nonobjects (J. F. Kroll & M. C. Potter, 1984) and determine how semantic set size related to other measures and age. METHOD: Data were collected from 82 adults and 92 preschool children in a discrete association task. The nonobjects were presented via computer, and participants reported the first word that came to mind that was meaningfully related to the nonobject. Words reported by 2 or more participants were considered semantic neighbors. The strength of each neighbor was computed as the proportion of participants who reported the neighbor. All data are provided online in a Microsoft Excel file accompanying this article (the data file can be found accompanying this article online at http://jslhr.asha.org). RESULTS: Results showed that semantic set size was not significantly correlated with objectlikeness ratings or object decision reaction times from J. F. Kroll and M. C. Potter (1984). However, semantic set size was significantly negatively correlated with the strength of the strongest neighbor(s). In terms of age effects, adult and child semantic set sizes were significantly positively correlated and the majority of numeric differences were on the order of 0-3 neighbors. Comparison of actual neighbors showed greater discrepancies; however, this varied by neighbor strength. CONCLUSIONS: Semantic set size can be determined for nonobjects. Specific guidelines are suggested for using these nonobjects in future research.

The effect of semantic set size on word learning by preschool children.

PURPOSE: The purpose was to determine whether semantic set size, a measure of the number of semantic neighbors, influenced word learning, and whether the influence of semantic set size was broad, showing effects on multiple measures both during and after learning. METHOD: Thirty-six preschool children were exposed to 10 nonobjects, varying in semantic set size, paired with 10 nonwords, controlling phonotactic probability and neighborhood density. Nonobject-nonword pairs were presented in a game format. Learning was measured in naming and referent identification tasks administered before, during, and 1 week after training. RESULTS: Results showed no differences in naming or identifying the referents of the nonobject-nonword pairs with small versus large semantic set sizes before and during training. However, 1 week after training, children named and identified the referents of nonobject-nonword pairs with small set sizes more accurately than those with large set sizes. CONCLUSIONS: Similarity to known representations appears to influence word learning, regardless of whether the similarity involves lexical or semantic representations. However, the direction of the effect of similarity to known representations on word learning varies depending on the specific type of representation involved. Specifically, lexical similarity speeds learning, whereas semantic similarity slows learning.

Prologue to the Forum: Vocabulary Across the School Grades.

Purpose This prologue introduces the LSHSS Forum: Vocabulary Across the School Grades. The goals of the forum are to provide an overview of the importance of vocabulary to literacy and academic achievement, to review evidence regarding best practices for vocabulary instruction, and to highlight recent research related to word learning with students across different grade levels. Method The prologue provides a foundational overview of vocabulary's role in literacy and introduces the topics of the other ten articles in the forum. These include clinical focus articles, research reviews, and word-learning and vocabulary intervention studies involving students in elementary grades through college. Conclusion Children with language and reading disorders experience specific challenges learning new words, but all students can benefit from high-quality vocabulary instruction. The articles in this issue highlight the characteristics of evidence-based vocabulary interventions for children of different ages, ability levels, and language backgrounds and provide numerous examples of intervention activities that can be modified for use in individual, small-group, or large-group instructional settings.

If we don't look, we won't see: Measuring language development to inform literacy instruction.

Oral language abilities enable children to learn to read, and they predict future academic achievement and life outcomes. However, children with language impairment frequently go unidentified because schools do not systematically measure oral language development. Given that identification paves the way for treatment, schools should increase attention to oral language development, particularly within response to intervention (RTI) frameworks, which aim to prevent learning disabilities by identifying and intervening at early stages. Formal schooling should address language comprehension (in addition to word reading) to ensure an adequate foundation for future reading comprehension. In support, we overview the developmental relations between oral language abilities and reading skills, review current school-based assessment frameworks, and discuss how these frameworks can include language assessments. Measuring language skills early and often benefits not only those who have language impairment but also all children, as it documents language variability to inform differentiated instruction.

Identifying Children at Risk for Developmental Language Disorder Using a Brief, Whole-Classroom Screen.

Purpose The aim of this study was to determine whether parents of children with developmental language disorder (DLD) were aware of their children's language difficulties and whether a brief, classroom-based language screen can reliably identify children at risk for DLD, including those with both good and poor word reading skills. Method First- and second-grade students ( N = 97) completed a language screen and assessments of nonverbal intelligence, word reading, and language designed for linguistically diverse students. Their parents completed a questionnaire. Results Few parents of children with DLD reported that their child had ever received speech, language, reading, or other educational services. Parents of children with DLD with average word reading skills reported receiving services approximately half as often as children with DLD with poor word reading. Parents of children with DLD also reported few concerns about their children's speech, language, and academic development. The brief whole-classroom screen showed acceptable classification accuracy for identifying children with DLD overall, although sensitivity was lower for children with DLD with average word reading skills. Conclusion Based on reports of prior services and concerns, many parents of children with DLD appear to be unaware of their children's difficulty with oral language. Whole-classroom screens for language show potential for efficient identification of children who may benefit from comprehensive assessments for DLD without relying on their parents or teachers to raise concerns.

Accelerating Adolescent Vocabulary Growth: Development of an Individualized, Web-Based, Vocabulary Instruction Program.

Purpose Improving vocabulary knowledge is important for many adolescents, but there are few evidence-based vocabulary instruction programs available for high school students. The purpose of this article is to describe the iterative development of the DictionarySquared research platform, a web-based vocabulary program that provides individualized vocabulary instruction, and to report the results of 2 pilot studies examining the feasibility of implementation and potential effectiveness with high school students. Method We describe our theory of change and 5 phases of iterative development. In Phases 1 and 2, we evaluated the initial implementation of DictionarySquared and revised the instructional materials. In Phase 3, we conducted a feasibility study involving 169 high school students who used the program for 4 weeks. Student usage data and feedback from teachers were used to guide program revisions in Phase 4. In Phase 5, we examined potential effectiveness for 264 high school students who were assigned to use the program for 1 semester. Results Results of the Phase 3 study indicated that implementation of the program was feasible, although usage was below assigned levels. Results of the Phase 5 study indicated that the duration of active program usage significantly predicted posttest vocabulary scores on the proximal assessment after controlling for pretest standardized vocabulary scores. Analyses using propensity score matching revealed positive, but nonsignificant, gains on standardized assessments between pre- and posttests. Conclusion Together, the results of early-stage pilot studies are promising and suggest that a more rigorous test of efficacy is warranted. Successful implementation of the DictionarySquared research program, as well as lessons learned from the program development process, will expand the range of evidence-based treatment options that clinicians and educators can use to improve adolescent vocabulary and reading comprehension skills. Supplemental Material https://doi.org/10.23641/asha.9765161.

Understanding Dyslexia in the Context of Developmental Language Disorders.

Purpose: The purpose of this tutorial is to discuss the language basis of dyslexia in the context of developmental language disorders (DLDs). Whereas most studies have focused on the phonological skills of children with dyslexia, we bring attention to broader language skills. Method: We conducted a focused literature review on the language basis of dyslexia from historical and theoretical perspectives with a special emphasis on the relation between dyslexia and DLD and on the development of broader language skills (e.g., vocabulary, syntax, and discourse) before and after the identification of dyslexia. Results: We present clinically relevant information on the history of dyslexia as a language-based disorder, the operational definitions used to diagnose dyslexia in research and practice, the relation between dyslexia and DLD, and the language abilities of children with dyslexia. Conclusions: We discuss 3 clinical implications for working with children with dyslexia in school settings: (a) Children with dyslexia-with and without comorbid DLDs-often have language deficits outside the phonological domain; (b) intervention should target a child's strengths and weaknesses relative to reading outcomes, regardless of diagnostic labels; and (c) those who have dyslexia, regardless of language abilities at the time of diagnosis, may be at risk for slower language acquisition across their lifetime. Longitudinal studies are needed to assess multiple language skills early, at the time of the diagnosis of dyslexia, and years later to better understand the complex development of language and reading in children with dyslexia.

Reading in Children With Fragile X Syndrome: Phonological Awareness and Feasibility of Intervention.

Individuals with fragile X syndrome (FXS) present with significant deficits in reading skills, but scant research exists to understand the characteristics of the reading delays or best practices for reading instruction with this population. Study 1 examined the relationship between phonological awareness and reading skills in individuals with FXS. Study 2 evaluated the feasibility of a web-based reading intervention, which incorporated phonological awareness and phonics instruction but was originally developed for mainstream students, for children with FXS. Results suggest that phonological awareness and reading skills are correlated in this population, and that instruction targeting phonological awareness and phonics should not be ruled out for individuals with FXS. Further studies are needed to examine their potential effects.

Understanding Word Reading Difficulties in Children With SLI.

Children with specific language impairment (SLI) often show considerable reading difficulties. Research has revealed two primary reading profiles among children with SLI: (a) one of poor word reading and decoding skills and associated reading comprehension difficulties, and (b) one involving relatively strong word reading skills but poor comprehension. This article reviews studies characterizing these two subtypes of SLI, discusses their current clinical implications, and suggests important directions for future study.

Language Assessment With Children Who Speak Nonmainstream Dialects: Examining the Effects of Scoring Modifications in Norm-Referenced Assessment.

Purpose: We compared outcomes from 2 measures of language ability in children who displayed a range of dialect variation: 1 using features that do not contrast between mainstream American English (MAE) and nonmainstream dialects (NMAE), and 1 using contrastive features. We investigated how modified scoring procedures affected the diagnostic accuracy of the measure with contrastive features. Method: Second-grade students (N = 299; 167 White, 106 African American, 26 other) completed measures of language variation and ability (the Diagnostic Evaluation of Language Variation-Screening Test and the Clinical Evaluation of Language Fundamentals-Fourth Edition [CELF-4]). The CELF-4 was scored with and without the recommended scoring modifications for children who spoke African American English. Results: Partial correlations controlling for socioeconomic status revealed small to moderate correlations between measures of language ability and the use of NMAE features. Modified scoring yielded higher scores for children who spoke African American English and a reduced association between the use of NMAE features and CELF-4 scores. Modified scoring also affected the diagnostic accuracy of the CELF-4, resulting in a lower positive likelihood ratio and a higher negative likelihood ratio. Conclusions: The decision to apply scoring modifications affects both the false positive and false negative rates. Implications for language assessment for children who speak NMAE dialects are discussed, including the need for further investigation.

Nonword Repetition and Vocabulary Knowledge as Predictors of Children's Phonological and Semantic Word Learning.

Purpose: This study examined the unique and shared variance that nonword repetition and vocabulary knowledge contribute to children's ability to learn new words. Multiple measures of word learning were used to assess recall and recognition of phonological and semantic information. Method: Fifty children, with a mean age of 8 years (range 5-12 years), completed experimental assessments of word learning and norm-referenced assessments of receptive and expressive vocabulary knowledge and nonword repetition skills. Hierarchical multiple regression analyses examined the variance in word learning that was explained by vocabulary knowledge and nonword repetition after controlling for chronological age. Results: Together with chronological age, nonword repetition and vocabulary knowledge explained up to 44% of the variance in children's word learning. Nonword repetition was the stronger predictor of phonological recall, phonological recognition, and semantic recognition, whereas vocabulary knowledge was the stronger predictor of verbal semantic recall. Conclusions: These findings extend the results of past studies indicating that both nonword repetition skill and existing vocabulary knowledge are important for new word learning, but the relative influence of each predictor depends on the way word learning is measured. Suggestions for further research involving typically developing children and children with language or reading impairments are discussed.

Identifying Children at Risk for Language Impairment or Dyslexia With Group-Administered Measures.

Purpose: The study aims to determine whether brief, group-administered screening measures can reliably identify second-grade children at risk for language impairment (LI) or dyslexia and to examine the degree to which parents of affected children were aware of their children's difficulties. Method: Participants (N = 381) completed screening tasks and assessments of word reading, oral language, and nonverbal intelligence. Their parents completed questionnaires that inquired about reading and language development. Results: Despite considerable overlap in the children meeting criteria for LI and dyslexia, many children exhibited problems in only one domain. The combined screening tasks reliably identified children at risk for either LI or dyslexia (area under the curve = 0.842), but they were more accurate at identifying risk for dyslexia than LI. Parents of children with LI and/or dyslexia were frequently unaware of their children's difficulties. Parents of children with LI but good word reading skills were the least likely of all impairment groups to report concerns or prior receipt of speech, language, or reading services. Conclusions: Group-administered screens can identify children at risk of LI and/or dyslexia with good classification accuracy and in less time than individually administered measures. More research is needed to improve the identification of children with LI who display good word reading skills.

Language deficits in poor comprehenders: a case for the simple view of reading.

PURPOSE: To examine concurrently and retrospectively the language abilities of children with specific reading comprehension deficits ("poor comprehenders") and compare them to typical readers and children with specific decoding deficits ("poor decoders"). METHOD: In Study 1, the authors identified 57 poor comprehenders, 27 poor decoders, and 98 typical readers on the basis of 8th-grade reading achievement. These subgroups' performances on 8th-grade measures of language comprehension and phonological processing were investigated. In Study 2, the authors examined retrospectively subgroups' performances on measures of language comprehension and phonological processing in kindergarten, 2nd, and 4th grades. Word recognition and reading comprehension in 2nd and 4th grades were also considered. RESULTS: Study 1 showed that poor comprehenders had concurrent deficits in language comprehension but normal abilities in phonological processing. Poor decoders were characterized by the opposite pattern of language abilities. Study 2 results showed that subgroups had language (and word recognition) profiles in the earlier grades that were consistent with those observed in 8th grade. Subgroup differences in reading comprehension were inconsistent across grades but reflective of the changes in the components of reading comprehension over time. CONCLUSIONS: The results support the simple view of reading and the phonological deficit hypothesis. Furthermore, the findings indicate that a classification system that is based on the simple view has advantages over standard systems that focus only on word recognition and/or reading comprehension.

Are specific language impairment and dyslexia distinct disorders?

PURPOSE: The purpose of this study was to determine whether specific language impairment (SLI) and dyslexia are distinct developmental disorders. METHOD: Study 1 investigated the overlap between SLI identified in kindergarten and dyslexia identified in 2nd, 4th, or 8th grades in a representative sample of 527 children. Study 2 examined phonological processing in a subsample of participants, including 21 children with dyslexia only, 43 children with SLI only, 18 children with SLI and dyslexia, and 165 children with typical language/reading development. Measures of phonological awareness and nonword repetition were considered. RESULTS: Study 1 showed limited but statistically significant overlap between SLI and dyslexia. Study 2 found that children with dyslexia or a combination of dyslexia and SLI performed significantly less well on measures of phonological processing than did children with SLI only and those with typical development. Children with SLI only showed only mild deficits in phonological processing compared with typical children. CONCLUSIONS: These results support the view that SLI and dyslexia are distinct but potentially comorbid developmental language disorders. A deficit in phonological processing is closely associated with dyslexia but not with SLI when it occurs in the absence of dyslexia.