Diagnosis of Developmental Language Disorder in Research Studies

2020 ◽  
Vol 63 (8) ◽  
pp. 2777-2788
Author(s):  
Hallie Nitido ◽  
Elena Plante

Purpose The aim of this study was to investigate the extent to which researchers in the field of developmental language disorder are utilizing validated methods to diagnose their research participants. Method We examined 90 research articles published from 2015 to 2019 that included English-speaking participants from the United States who were identified as having a developmental language disorder or specific language impairment. From these articles, we identified the tests and measures used to identify participants and classify them as healthy or impaired. We then consulted the test manuals and the literature to find information on sensitivity and specificity of the test and the evidence-based cut score that maximized identification accuracy. Results Of the 90 articles examined, 38 (42%) were found to reflect validated diagnostic methods, and 51 (58%) did not. Conclusion Our results illustrate that validated methods are used less than half of the time even by those who should have a high level of expertise and despite calls for increasing scientific rigor in research practices.

2020 ◽  
Vol 5 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Karla K. McGregor ◽  
Lisa Goffman ◽  
Amanda Owen Van Horne ◽  
Tiffany P. Hogan ◽  
Lizbeth H. Finestack

Purpose The CATALISE group (Bishop, Snowling, Thompson, Greenhalgh, & CATALISE Consortium, 2016; Bishop, Snowling, Thompson, Greenhalgh, & CATALISE-2 Consortium, 2017) recommended that the term developmental language disorder (DLD) be used to refer to neurodevelopmental language deficit. In this tutorial, we explain the appropriate application of the term and present advantages in adhering to the CATALISE recommendations. Conclusion Both specific language impairment and DLD refer to a neurodevelopmental condition that impairs spoken language, is long-standing and, is not associated with any known causal condition. The applications of the terms specific language impairment and DLD differ in breadth and the extent to which identification depends upon functional impact. Use of the term DLD would link advocacy efforts in the United States to those in other English-speaking countries. The criteria for identifying DLD presented in the CATALISE consensus offer opportunities for scientific progress while aligning well with practice in U.S. public schools.


2020 ◽  
Vol 5 (1) ◽  
pp. 47-54
Author(s):  
Kimberly A. Murza ◽  
Barbara J. Ehren

Purpose The purpose of this article is to situate the recent language disorder label debate within a school's perspective. As described in two recent The ASHA Leader articles, there is international momentum to change specific language impairment to developmental language disorder . Proponents of this change cite increased public awareness and research funding as part of the rationale. However, it is unclear whether this label debate is worthwhile or even practical for the school-based speech-language pathologist (SLP). A discussion of the benefits and challenges to a shift in language disorder labels is provided. Conclusions Although there are important arguments for consistency in labeling childhood language disorder, the reality of a label change in U.S. schools is hard to imagine. School-based services are driven by eligibility through the Individuals with Disabilities Education Act, which has its own set of labels. There are myriad reasons why advocating for the developmental language disorder label may not be the best use of SLPs' time, perhaps the most important of which is that school SLPs have other urgent priorities.


2020 ◽  
Vol 5 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Laurence B. Leonard

Purpose The current “specific language impairment” and “developmental language disorder” discussion might lead to important changes in how we refer to children with language disorders of unknown origin. The field has seen other changes in terminology. This article reviews many of these changes. Method A literature review of previous clinical labels was conducted, and possible reasons for the changes in labels were identified. Results References to children with significant yet unexplained deficits in language ability have been part of the scientific literature since, at least, the early 1800s. Terms have changed from those with a neurological emphasis to those that do not imply a cause for the language disorder. Diagnostic criteria have become more explicit but have become, at certain points, too narrow to represent the wider range of children with language disorders of unknown origin. Conclusions The field was not well served by the many changes in terminology that have transpired in the past. A new label at this point must be accompanied by strong efforts to recruit its adoption by clinical speech-language pathologists and the general public.


2013 ◽  
Vol 14 (4) ◽  
pp. 95-101 ◽  
Author(s):  
Robert Kraemer ◽  
Allison Coltisor ◽  
Meesha Kalra ◽  
Megan Martinez ◽  
Bailey Savage ◽  
...  

English language learning (ELL) children suspected of having specific-language impairment (SLI) should be assessed using the same methods as monolingual English-speaking children born and raised in the United States. In an effort to reduce over- and under-identification of ELL children as SLI, speech-language pathologists (SLP) must employ nonbiased assessment practices. This article presents several evidence-based, nonstandarized assessment practices SLPs can implement in place of standardized tools. As the number of ELL children SLPs come in contact with increases, the need for well-trained and knowledgeable SLPs grows. The goal of the authors is to present several well-establish, evidence-based assessment methods for assessing ELL children suspected of SLI.


2020 ◽  
Vol 29 (2) ◽  
pp. 776-788
Author(s):  
Javier Jasso ◽  
Stephanie McMillen ◽  
Jissel B. Anaya ◽  
Lisa M. Bedore ◽  
Elizabeth D. Peña

Purpose We examined the English semantic performance of three hundred twenty-seven 7- to 10-year-old Spanish–English bilinguals with ( n = 66) and without ( n = 261) developmental language disorder (DLD) with varying levels of English experience to classify groups. Method English semantic performance on the Bilingual English–Spanish Assessment—Middle Extension Experimental Test Version (Peña et al., 2008) was evaluated by language experience, language ability, and task type. Items that best identified DLD for children with balanced and high English experience were selected. Separately, items that best identified children with high Spanish experience were selected. Results Typically developing bilingual children performed significantly higher than their peers with DLD across semantic tasks, with differences associated with task type. Classification accuracy was fair when item selection corresponded to balanced or high level of experience in English, but poor for children with high Spanish experience. Selecting items specifically for children with high Spanish experience improved classification accuracy. Conclusions Tailoring semantic items based on children's experience is a promising direction toward organizing items on a continuum of exposure. Here, classification effectively ruled in impairment. Future work to refine semantic items that more accurately represent the continuum of exposure may help rule out language impairment.


2020 ◽  
Vol 5 (1) ◽  
pp. 3-5 ◽  
Author(s):  
Laura Green

Purpose This prologue provides an introduction to the SIG 1 Perspectives forum addressing use of a more recently applied term, developmental language disorder (DLD), as well as a term that has been used in research for several decades, specific language impairment (SLI), to describe children who exhibit language deficits. Included are brief summaries of the 5 articles that comprise the forum. Conclusion The articles in this SLI/DLD forum offer perspectives on the use of both terms. Implications include their application in clinical practice, advocacy, research, treatment, funding, and public school speech/language services.


2021 ◽  
pp. 155-170
Author(s):  
Carol-Anne Murphy ◽  
Pauline Frizelle ◽  
Cristina McKean

Developmental language disorder (DLD), previously known as specific language impairment (SLI), is a long-term developmental disorder affecting approximately 7.5% of children. Language abilities in children with DLD are variable and can be challenging to ascertain with confidence. This chapter aims to discuss some of the challenges associated with assessing the language skills of children with DLD through an overview of different forms of language assessment including standardized language testing, language sample analysis, and observations. Uses and limitations of the different forms of assessment are considered, bearing in mind the different functions of assessment and the need to gain a full understanding of children’s profiles of strength and weakness and communicative functioning in context. The authors conclude with requirements for best practice in assessment and promising avenues of development in this area.


2021 ◽  
Author(s):  
Suzanne Adlof ◽  
Lauren Baron ◽  
Bethany A Bell ◽  
Joanna Scoggins

Purpose: Word learning difficulties have been documented in multiple studies involving children with dyslexia and developmental language disorder (DLD; see also specific language impairment (SLI)). 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 (TD). We hypothesized that children with dyslexia-only and DLD-only would show differences in word learning due to differences in phonological and semantic skills. 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 TD 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.


2020 ◽  
Vol 63 (10) ◽  
pp. 3263-3276
Author(s):  
Sean M. Redmond

Purpose Estimates of the expected co-occurrence rates of idiopathic language disorder and attention-deficit/hyperactivity disorder (ADHD) provide a confusing and inconsistent picture. Potential sources for discrepancies considered so far include measurement and ascertainment biases ( Redmond, 2016a , 2016b ). In this research symposium forum article, the potential impact of applying different criteria to the observed co-occurrence rate is examined through an appraisal of the literature and an empirical demonstration. Method Eighty-five cases were selected from the Redmond, Ash, et al. (2019) study sample. Standard scores from clinical measures collected on K–3rd grade students were used to assign language impairment status, nonverbal impairment status, social (pragmatic) communication disorder status, and ADHD status. Criteria extrapolated from the specific language impairment ( Stark & Tallal, 1981 ), developmental language disorder ( Bishop et al., 2017 ), and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder ( American Psychiatric Association, 2013 ) designations were applied. Results The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder designation and its separation of language disorder from the social (pragmatic) communication disorder designation provided the clearest segregation of idiopathic language deficits from elevated ADHD symptoms, showing only a 2% co-occurrence rate. In contrast, applying the broader developmental language disorder designation raised the observed co-occurrence rate to 22.3%. The specific language impairment designation yielded an intermediate value of 16.9%. Conclusions Co-occurrence rates varied as a function of designation adopted. The presence of pragmatic symptoms exerted a stronger influence on observed co-occurrence rates than low nonverbal abilities. Impacts on clinical management and research priorities are discussed. Presentation Video https://doi.org/10.23641/asha.13063751


2020 ◽  
Vol 63 (12) ◽  
pp. 4109-4126
Author(s):  
Sara Benham ◽  
Lisa Goffman

Purpose When learning novel word forms, preschoolers with developmental language disorder (DLD; also known as specific language impairment ) produce speech targets inaccurately and with a high degree of intraword variability. The aim of the current study is to specify whether and how layering lexical–semantic information onto novel phonological strings would induce increased organization of sound production patterns. Method Twenty-one preschoolers with DLD and 21 peers with typical language (ranging in age from 4;1 to 5;11 [years;months]) imitated multiple renditions of novel words, half with (i.e., words) and half without (i.e., nonwords) a linked visual referent. Methods from network science were used to assess the stability and patterning of syllable sequences. Sound accuracy was also measured. Results Children with DLD were less accurate and more variable than their typical peers. However, once word forms were associated with a visual referent, network stability, but not accuracy, improved for children with DLD. Conclusions Children with DLD showed significant word form deficits as they acquired novel words and nonwords. The inclusion of a meaningful referent resulted in increased sound sequence stability, suggesting that lexical–semantic information provides a bootstrap for phonological organization in children with DLD.


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