Phonological working memory and central executive function differ in children with typical development and dyslexia.

The primary purpose of this study was to compare the working memory performance of monolingual English-speaking second- grade children with dyslexia (N = 82) to second-grade children with typical development (N = 167). Prior to making group comparisons, it is important to demonstrate invariance between working memory models in both groups or between-group comparisons would not be valid. Thus, we completed invariance testing using a model of working memory that had been validated for children with typical development (Gray et al., 2017) to see if it was valid for children with dyslexia. We tested three types of invariance: configural (does the model test the same constructs?), metric (are the factor loadings equivalent?), and scalar (are the item intercepts the same?). Group comparisons favoured the children with typical development across all three working memory factors. However, differences in the Focus-of-Attention/Visuospatial factor could be explained by group differences in non-verbal intelligence and language skills. In contrast, differences in the Phonological and Central Executive working memory factors remained, even after accounting for non-verbal intelligence and language. Results highlight the need for researchers and educators to attend not only to the phonological aspects of working memory in children with dyslexia, but also to central executive function.

Phonological Working Memory and Sentence Production in School-Age Children with Typical Language, Dyslexia, and Comorbid Dyslexia and Developmental Language Disorder.

PURPOSE: Little is known about the relationship between sentence production and phonological working memory in school-age children. To fill this gap, we examined how strongly these constructs correlate. We also compared diagnostic groups' working memory abilities to see if differences co-occurred with qualitative differences in their sentences. METHOD: We conducted Bayesian analyses on data from seven- to nine-year-old children (n = 165 typical language, n = 81 dyslexia-only, n = 43 comorbid dyslexia and developmental language disorder). We correlated sentence production and working memory scores and conducted t tests between groups' working memory scores and sentence length, lexical diversity, and complexity. RESULTS: Correlations were positive but weak. The dyslexic and typical groups had dissimilar working memory and comparable sentence quality. The dyslexic and comorbid groups had comparable working memory but dissimilar sentence quality. CONCLUSION: Contrary to literature-based predictions, phonological working memory and sentence production are weakly related in school-age children.

Multifactorial pathways facilitate resilience among kindergarteners at risk for dyslexia: A longitudinal behavioral and neuroimaging study.

Recent efforts have focused on screening methods to identify children at risk for dyslexia as early as preschool/kindergarten. Unfortunately, while low sensitivity leads to under-identification of at-risk children, low specificity can lead to over-identification, resulting in inaccurate allocation of limited educational resources. The present study focused on children identified as at-risk in kindergarten who do not subsequently develop poor reading skills to specify factors associated with better reading outcomes among at-risk children. Early screening was conducted in kindergarten and a subset of children was tracked longitudinally until second grade. Potential protective factors were evaluated at cognitive-linguistic, environmental, and neural levels. Relative to at-risk kindergarteners with subsequent poor reading, those with typical reading outcomes were characterized by significantly higher socioeconomic status (SES), speech production accuracy, and structural organization of the posterior right-hemispheric superior longitudinal fasciculus (SLF). A positive association between structural organization of the right SLF and subsequent decoding skills was found to be specific to at-risk children and not observed among typical controls. Among at-risk children, several kindergarten-age factors were found to significantly contribute to the prediction of subsequent decoding skills: white matter organization in the posterior right SLF, age, gender, SES, and phonological awareness. These findings suggest that putative compensatory mechanisms are already present by the start of kindergarten. The right SLF, in conjunction with the cognitive-linguistic and socioeconomic factors identified, may play an important role in facilitating reading development among at-risk children. This study has important implications for approaches to early screening, and assessment strategies for at-risk children.

Factors that influence non-word repetition performance in children with and without persistent speech sound disorders.

BACKGROUND: Nonword repetition (NWR) is a common phonological processing task that is reported to tap into many cognitive, perceptual, and motor processes. For this reason, NWR is often used in assessment batteries to aid in verifying the presence of a reading or language disorder. AIMS: To examine the extent to which child- and item-level factors predict the probability of a correct response on a non-word repetition (NWR) task in a sample of children with persistent speech sound disorders (P-SSDs) compared with their typically developing peers. METHODS & PROCEDURES: A total of 40 American-English-speaking children were tested on an NWR task for which the stimuli were manipulated for phonological neighbourhood density and list length. Additional measures of vocabulary and word reading were also administered. OUTCOMES & RESULTS: Children who were typically developing were 1.82 times more likely than children with P-SSD to respond correctly. The item-level factor of phonological neighbourhood density influenced performance, but only for the P-SSD group, and only at certain list lengths. Vocabulary and word-reading ability also influenced NWR task performance. CONCLUSIONS & IMPLICATIONS: Children with P-SSD present as a complex and heterogeneous group. Multiple factors contribute to their ability to perform phonological tasks such as NWR. As such, attention to the item-level factors in screenings and assessments is necessary to ensure that appropriate decisions are made regarding diagnosis and subsequent treatment. WHAT THIS PAPER ADDS: What is already known on the subject? Good expressive vocabulary is important for children with speech sound disorders; it can aid in their performance on phonological processing tasks like NWR. Nonword repetition may be a helpful test/ subtest to add to assessment batteries when evaluating children with speech sound disorders. What this paper adds to existing knowledge? Vocabulary and word reading abilities must also be measured for children with SSDs, to observe the bigger picture of their linguistic abilities. What are the potential or actual clinical implications of this work? The relation between word reading and speech sound production influences performance on phonological processing tasks.

Phonological Vulnerability for School-Aged Spanish-English-Speaking Bilingual Children.

This study examined accuracy on syllable-final (coda) consonants in newly-learned English-like nonwords to determine whether school-aged bilingual children may be more vulnerable to making errors on English-only codas than their monolingual, English-speaking peers, even at a stage in development when phonological accuracy in productions of familiar words is high. Bilingual Spanish-English-speaking second- graders (age 7-9) with typical development (n=40) were matched individually with monolingual peers on age, sex, and speech skills. Participants learned to name sea monsters as part of five computerized word learning tasks. Dependent t-tests revealed bilingual children were less accurate than monolingual children in producing codas unique to English; however, the groups demonstrated equivalent levels of accuracy on codas that occur in both Spanish and English. Results suggest that, even at high levels of English proficiency, bilingual Spanish-English-speaking children may demonstrate lower accuracy than their monolingual English-speaking peers on targets that pattern differently in their two languages. Differences between a bilingual's two languages can be used to reveal targets that may be more vulnerable to error, which could be a result of cross-linguistic effects or more limited practice with English phonology.

Short-term Memory in Childhood Dyslexia: Deficient Serial Order in Multiple Modalities.

In children with dyslexia, deficits in working memory have not been well-specified. We assessed second-grade children with dyslexia, with and without concomitant specific language impairment, and children with typical development. Immediate serial recall of lists of phonological (non-word), lexical (digit), spatial (location) and visual (shape) items were included. For the latter three modalities, we used not only standard span but also running span tasks, in which the list length was unpredictable to limit mnemonic strategies. Non-word repetition tests indicated a phonological memory deficit in children with dyslexia alone compared with those with typical development, but this difference vanished when these groups were matched for non-verbal intelligence and language. Theoretically important deficits in serial order memory in dyslexic children, however, persisted relative to matched typically developing children. The deficits were in recall of (1) spoken digits in both standard and running span tasks and (2) spatial locations, in running span only. Children with dyslexia with versus without language impairment, when matched on non-verbal intelligence, had comparable serial order memory, but differed in phonology. Because serial orderings of verbal and spatial elements occur in reading, the careful examination of order memory may allow a deeper understanding of dyslexia and its relation to language impairment. Copyright © 2017 John Wiley & Sons, Ltd.

Speech Perception and Working Memory in Children with Residual Speech Errors: A Case Study Analysis.

Some children with residual deficits in speech production also display characteristics of dyslexia; however, the causes of these disorders--in isolation or comorbidly--remain unknown. Presently, the role of phonological representations is an important construct for considering how the underlying system of phonology functions. In particular, two related skills--speech perception and phonological working memory--may provide insight into the nature of phonological representations. This study provides an exploratory investigation into the profiles of three 9-year-old children: one with residual speech errors, one with residual speech errors and dyslexia, and one who demonstrated typical, age-appropriate speech sound production and reading skills. We provide an in-depth examination of their relative abilities in the areas of speech perception, phonological working memory, vocabulary, and word reading. Based on these preliminary explorations, we suggest implications for the assessment and treatment of children with residual speech errors and/or dyslexia.

A Review of Screeners to Identify Risk of Developmental Language Disorder.

PURPOSE: This review aims to comprehensively summarize, compare, and evaluate screeners used to identify risk for developmental language disorder (DLD), a common learning disability that is underidentified. Screening for DLD is a cost-effective way to identify children in need of further assessment and, in turn, provides much needed supports. METHOD: We identified 15 commercially available English language DLD screeners in North America. We then characterized each screener on 27 aspects in three domains, including (a) accessibility information (acronym, subtest, website, cost, materials included, publish year, examiner qualification, age range, administration time, and administration format), (b) usability features (dialect compatibility, progress monitoring function, actionable follow-up instruction, group assessment capability, and online administration availability), and (c) technical standards (the availability of a technical manual, conceptual definition, the sample size used in classification accuracy calculation, sample distribution, year of sample collection, outcome measure, sample base rate, cutoff score, sensitivity, specificity, positive predictive value, and negative predictive value). RESULTS: We obtained sufficient accessibility information from 14 out of 15 (93%) screeners. In contrast, none of the screeners (0%) included comprehensive usability features. Ten screeners (67%) included a range of classification accuracy (70%-100% sensitivity and 68%-90% specificity). We provided areas of strength and weakness for each screener as a quick reference for users and generated screener recommendations for five practical scenarios. CONCLUSIONS: Our findings presented some DLD screeners that meet most standards and highlight numerous areas for improvement, including improving classification accuracy and clarifying follow-up instructions for children who are identified with DLD risk. Screening for DLD is critical to provide timely early identification, intervention, and classroom support, which in turn facilitates student outcomes.

Caregivers' Perceptions of COVID-19 Educational Disruptions on Children With Developmental Language Disorder and Typically Developing Peers.

PURPOSE: Understanding the experiences of families of children with developmental language disorder (DLD) during COVID-19 educational disruptions is essential for designing responsive supports during pandemic recovery efforts and beyond. This qualitative study describes the experiences of families of first- and second-grade children with DLD during the pandemic as compared to the experiences of families of typically developing (TD) peers. METHOD: A conventional content analysis approach was used to analyze caregivers' written responses to open-ended questions regarding their perceptions of COVID-19 educational disruptions. Responses were analyzed separately by group: caregivers of children with DLD (n = 23) and caregivers of TD children (n = 22). RESULTS: Four categories of caregiver responses were generated for each group: impacts on children, remote learning challenges, impacts on caregivers, and protective factors. For both groups, concerns about the child's well-being and literacy learning were most prevalent and prevailed over concerns about oral language. Most caregivers in each group described negative impacts of educational disruptions on their cdhildren. As compared to caregivers of TD children, caregivers of children with DLD reported higher rates of remote learning challenges and more negative impacts on literacy learning, speech and/or language, and education in general. DLD caregivers also shared fewer positive comments and remarks related to protective factors. CONCLUSIONS: Results indicate that families of children with DLD may have experienced more challenges during COVID-19 educational disruptions as compared to families of TD peers. Thus, responsive research and supports for these families is essential.

Minding the Gap: Using Implementation Science to Improve Clinical Practice in Schools.

PURPOSE: This purpose of this prologue is to introduce readers to the Language, Speech, and Hearing Services in Schools Forum: Minding the Gap: Using Implementation Science to Improve Clinical Practice in Schools. Ten articles comprise this forum presenting a variety of topics, such as the use of implementation science frameworks and methods, program adaptation, de-implementation, and interprofessional collaboration. CONCLUSION: As showcased in this forum, implementation science offers many ways to bridge the gap between research and practice and improve school-based services for children with communication disorders.

A Generic Implementation Framework for School-Based Research and Practice.

PURPOSE: One of our biggest challenges is integrating evidence-based research into practice to serve students with communication disorders. To encourage the systematic application of research findings into practice, implementation science offers frameworks and tools, many of which have a narrow scope. It is important to have comprehensive frameworks that encompass all essential implementation concepts to support implementation in schools. METHOD: Guided by the generic implementation framework (GIF; Moullin et al., 2015), we reviewed implementation science literature to identify and tailor frameworks and tools covering all core concepts of implementation: (a) the process of implementation, (b) the domains and determinants of practice, (c) implementation strategies, and (d) evaluations. RESULTS: We created a version of the GIF for school settings, called the GIF-School, to bring together frameworks and tools that sufficiently cover core concepts of implementation. The GIF-School is accompanied by an open access toolkit, which lists selected frameworks, tools, and useful resources. CONCLUSION: Researchers and practitioners, in speech-language pathology and education more broadly, who seek to apply implementation science frameworks and tools to improve school services for students with communication disorders may turn to the GIF-School as a resource. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23605269.

Speech/Language Impairment or Specific Learning Disability? Examining the Usage of Educational Categories.

PURPOSE: Developmental language disorder (DLD) is a lifelong condition that when impacting educational performance is identified and serviced through U.S. schools as outlined in the Individuals with Disabilities Education Act. A few examples of educational categories that refer to DLD are (a) speech or language impairment (S/LI) and (b) specific learning disability (SLD). In this research note, we aim to examine trends in how these categories are assigned. METHOD: We analyzed publicly available data released by the U.S. Department of Education from six school years between 2010 and 2020. We examined the use of S/LI and SLD categories across students of different ages at the U.S. national and state levels. RESULTS: We present a trend in which younger students tend to be identified with the S/LI category, whereas older students tend to be identified with the SLD category. This trend is evident in all 6 years of data analyzed at the national level, and in 49 of 50 states. CONCLUSIONS: We discuss these findings in the context of research on language disorders to explain this trend. We highlight the potential damaging effects of using inconsistent terminology, including affecting the services for which students with DLD qualify and causing confusion for their parents and educators.

Preliteracy Skills Mediate the Relation Between Early Speech Sound Production and Subsequent Reading Outcomes.

PURPOSE: Learning to read is a complex, multifaceted process that relies on several speech and language-related subskills. Individual differences in word reading outcomes are indicated among children with inaccurate speech sound productions, with some of these children developing later reading difficulties. There are inconsistent reports as to whether phonological deficits and/or weaknesses in oral language explain these subsequent reading difficulties. Thus, it remains unclear how variability in speech production accuracy in early childhood may impact reading development. Therefore, the present longitudinal study seeks to clarify the relation between speech sound production accuracy in kindergarten and subsequent reading outcomes with a focus on additional potential mediating factors. METHOD: Speech accuracy, core preliteracy skills (phonological awareness, rapid naming, and letter-name knowledge), and additional potential mediators (phonological memory and oral language abilities) were characterized at the start of formal reading instruction. Word reading, decoding, reading fluency, and comprehension were assessed at the end of second grade. Mediation analyses were conducted to examine factors that mediate the relation between speech accuracy in kindergarten and subsequent reading outcomes. RESULTS: Initial associations between early speech sound production accuracy and subsequent reading outcomes were indicated; however, mediation effects of preliteracy skills (phonological awareness and letter-name knowledge) were identified for word reading, decoding, and reading fluency outcomes. For reading comprehension, mediation effects of preliteracy and vocabulary skills were observed. CONCLUSIONS: The relation between speech sound production accuracy and subsequent word reading, decoding, reading fluency, and comprehension was observed to be mediated by preliteracy skills, specifically phonological awareness and letter-name knowledge. For reading comprehension only, vocabulary knowledge were of additional importance. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23671491.

Is weak oral language associated with poor spelling in school-age children with specific language impairment, dyslexia or both?

The purpose of this study was to test the hypothesis that word reading accuracy, not oral language, is associated with spelling performance in school-age children. We compared fourth grade spelling accuracy in children with specific language impairment (SLI), dyslexia or both (SLI/dyslexia) to their typically developing grade-matched peers. Results of the study revealed that children with SLI performed similarly to their typically developing peers on a single-word spelling task. Alternatively, those with dyslexia and SLI/dyslexia evidenced poor spelling accuracy. Errors made by both those with dyslexia and SLI/dyslexia were characterized by numerous phonologic, orthographic and semantic errors. Cumulative results support the hypothesis that word reading accuracy, not oral language, is associated with spelling performance in typically developing school-age children and their peers with SLI and dyslexia. Findings are provided as further support for the notion that SLI and dyslexia are distinct, yet co-morbid, developmental disorders.

Less Is More: Implementing the Minimal Intervention Needed for Change Approach to Increase Contextual Fit of Speech-Language Interventions.

PURPOSE: Speech-language pathologists (SLPs) and researchers face difficulties in moving evidence-based practices from clinical research into widespread practice, in part due to a mismatch between the design of typical intervention research studies and the realities of clinical settings. SLPs must adapt interventions from the literature or established programs to fit the needs of specific clients and settings. Researchers must design studies that better reflect clinical practice. METHOD: Here, we provide an overview of the Minimal Intervention Needed for Change (MINC) approach, a systematic approach to developing and adapting interventions that focuses on achieving meaningful outcomes within specific contexts. We outline the principles of MINC and illustrate this process through the use of a case study. RESULTS: MINC can support systematic development and adaptation of interventions in clinical and research settings, particularly settings with resource limitations. CONCLUSIONS: Researchers should work to align research intervention work with typical clinical settings. This involves both targeting outcomes that are functional and clinically significant and acknowledging resource limitations. SLPs should adapt evidence-based interventions systematically and carefully to meet the needs of clients and settings while retaining the core components of intervention that result in meaningful change for clients.

Working Memory Predicts New Word Learning Over and Above Existing Vocabulary and Nonverbal IQ.

PURPOSE: The purpose of this study was to use an established model of working memory in children to predict an established model of word learning to determine whether working memory explained word learning variance over and above the contributions of expressive vocabulary and nonverbal IQ. METHOD: One hundred sixty-seven English-speaking second graders (7- to 8-year-olds) with typical development from two states participated. They completed a comprehensive battery of working memory assessments and six word learning tasks that assessed the creation, storage, retrieval, and production of phonological and semantic representations of novel nouns and verbs and the ability to link those representations. RESULTS: A structural equation model with expressive vocabulary, nonverbal IQ, and three working memory factors predicting two word learning factors fit the data well. When working memory factors were entered as predictors after expressive vocabulary and nonverbal IQ, they explained 45% of the variance in the phonological word learning factor and 17% of the variance in the semantic word learning factor. Thus, working memory explained a significant amount of word learning variance over and above expressive vocabulary and nonverbal IQ. CONCLUSION: Results show that working memory is a significant predictor of dynamic word learning over and above the contributions of expressive vocabulary and nonverbal IQ, suggesting that a comprehensive working memory assessment has the potential to identify sources of word learning difficulties and to tailor word learning interventions to a child's working memory strengths and weaknesses. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19125911.

Building Sustainable Models of Research-Practice Partnerships Within Educational Systems.

PURPOSE: To describe the 9-year journey of a group of language and literacy researchers in establishing and cultivating Research-Practice Partnerships (RPPs). Those interested in incorporating implementation science frameworks in their research may benefit from reading our exploration into this type of work and our lessons learned. METHOD: We showcase how a group of researchers, who are committed to collaboration with school practitioners, navigated building and scaling RPPs within educational systems necessary for our long-term implementation work. We provide details and illustrative examples for three, distinct, mutually beneficial, and sustainable partnerships. RESULTS: Three different practice organizations are represented: (1) a single metropolitan school, (2) a small metropolitan school district, and (3) a large metropolitan school district, highlighting specific priorities and needs depending on the type of practice organization. Each partnership has distinct research and practice goals related to improving language and literacy outcomes in children. We describe how the researchers assisted with meeting the partner practice organizations' goals and engaged in capacity building while producing rigorous scientific knowledge to inform clinical and educational practice. Additionally, we discuss how research priorities and strategies were pivoted in the past year due to the COVID-19 pandemic, illustrating our commitment to the partnerships and how to respond to challenges to guarantee long-term sustainability. CONCLUSION: By discussing three distinctive partnerships, we demonstrate the various ways researchers can approach RPPs and grow them into mutually beneficial collaborations and support implementation goals.

Educators' Perceptions of Barriers and Facilitators to the Implementation of Screeners for Developmental Language Disorder and Dyslexia.

Developmental language disorder (DLD) and dyslexia are common but under-identified conditions that affect children's ability to read and comprehend text. Universal screening is a promising solution for improving under-identification of DLD and dyslexia, however, we lack evidence for how to effectively implement and sustain screening procedures in schools. In the current study, we solicited input from educators in the U.S. around perceived barriers and facilitators to the implementation of researcher-developed screeners for DLD and dyslexia. Using thematic analysis, we identified barriers and facilitators within five domains: (1) features of the screeners, (2) preparation for screening procedures, (3) administration of the screeners, (4) demands on users, and (5) screening results. We discuss these findings and ways we can continue improving our efforts to maximize the contextual fit and utility of screening practices in schools.

Australian Meningococcal Surveillance Programme annual report, 2018.

Invasive meningococcal disease (IMD) is a notifiable disease in Australia, and both probable and laboratory-confirmed cases of IMD are reported to the National Notifiable Diseases Surveillance System (NNDSS). In 2018, there were 281 IMD cases notified to the NNDSS. Of these, 278 were laboratory-confirmed cases analysed by the reference laboratories of the Australian National Neisseria Network (NNN). On investigation, the serogroup was able to be determined for 98.6% (274/278) of laboratory-confirmed cases. Serogroup B infections accounted for 44.2% of cases (123 cases); serogroup W for 36.3% of cases (101 cases); serogroup Y infections for 15.8% (44 cases) and serogroup C 1.4% (4 cases); and there were two unrelated cases (0.7%) of IMD attributable to serogroup E. Using molecular methods, 181/278 IMD cases were able to be typed. Of note was that 89% of typed serogroup W IMD cases (66/74) were porA antigen type P1.5,2; of this number, 44% (29/66) were sequence type 11, the hypervirulent strain reported in recent outbreaks in Australia and overseas. The primary age peak of IMD in Australia in 2018 was again observed in adults aged 45 years or more; a secondary disease peak was observed in children and infants aged less than 5 years. Serogroup B infections predominated in those aged less than 5 years, whereas serogroup W and serogroup Y infections predominated in those aged 45 years or more. Of the IMD isolates tested for antimicrobial susceptibility, 1.4% (3/210) were resistant to penicillin with an MIC ≥ 1 mg/L, and decreased susceptibility to penicillin was observed in a further 93.8% (197/210) of isolates. All isolates were susceptible to ceftriaxone and rifampicin; there was one isolate less susceptible to ciprofloxacin.

Modeling Reading Ability Gain in Kindergarten Children during COVID-19 School Closures.

By 15 April 2020, more than 1.5 billion students worldwide experienced school closures in an effort to slow the spread of a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during the worldwide coronavirus disease 2019 (COVID-19) pandemic. These interruptions in formal in-person educational experiences caused adverse consequences on school-age children's academic outcomes. Using a pre-existing database, we calculated changes in children's reading ability without formal education (i.e., the summer months). The resultant models predicted that the rate of reading ability gain in kindergarten children during COVID-19 school closures without formal in-person education will decrease 66% (2.46 vs. 7.17 points/100 days), compared to the business-as-usual scenario, resulting in a 31% less reading ability gain from 1 January 2020 to 1 September 2020. Additionally, the model predicted that kindergarten children who have books read to them daily would have 2.3 points less loss (42%) compared to those who do not, who are predicted to have a 5.6-point loss during the same time period. Even though reading books to children will not substitute the critical role of formal education in teaching children how to read, families, educators, and policy makers can promote this simple strategy to facilitate and maintain reading ability gain during school closures, which may be a common occurrence as nations see the public health benefits of physical distancing for the current and future pandemic outbreaks.