Developmental Language Disorder and the Assessment of Spoken Language

Best Practice ◽

Language Disorder ◽

Language Skills ◽

Language Abilities ◽

Language Sample Analysis ◽

Language Sample

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.

Considering the Language Disorder Label Debate From a School Speech-Language Pathology Lens

10.1044/2019_persp-19-00077 ◽

2020 ◽

Vol 5 (1) ◽

pp. 47-54

Author(s):

Kimberly A. Murza ◽

Barbara J. Ehren

Keyword(s):

Language Impairment ◽

Language Disorder ◽

Public Awareness ◽

Speech Language Pathology ◽

Speech Language Pathologist ◽

School Based ◽

Language Pathology ◽

Education Act

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.

A 200-Year History of the Study of Childhood Language Disorders of Unknown Origin: Changes in Terminology

10.1044/2019_pers-sig1-2019-0007 ◽

2020 ◽

Vol 5 (1) ◽

pp. 6-11 ◽

Cited By ~ 2

Author(s):

Laurence B. Leonard

Keyword(s):

Language Impairment ◽

Scientific Literature ◽

Language Disorder ◽

Language Disorders ◽

Unknown Origin ◽

The Past ◽

History Of ◽

The Many

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.

Developmental Language Disorder: Applications for Advocacy, Research, and Clinical Service

10.1044/2019_persp-19-00083 ◽

2020 ◽

Vol 5 (1) ◽

pp. 38-46 ◽

Cited By ~ 3

Author(s):

Karla K. McGregor ◽

Lisa Goffman ◽

Amanda Owen Van Horne ◽

Tiffany P. Hogan ◽

Lizbeth H. Finestack

Keyword(s):

Public Schools ◽

Language Impairment ◽

Language Disorder ◽

Scientific Progress ◽

The United States ◽

Specific Language ◽

Language Deficit ◽

English Speaking

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.

Measure What You Treat: Using Language Sample Analysis for Grammatical Outcome Measures in Children With Developmental Language Disorder

10.1044/2019_persp-19-00100 ◽

2020 ◽

Vol 5 (2) ◽

pp. 350-363

Author(s):

John F. Gallagher ◽

Jill R. Hoover

Keyword(s):

Outcome Measures ◽

Progress Monitoring ◽

Language Disorder ◽

Language Disorders ◽

Sample Analysis ◽

Treatment Target ◽

Language Sample Analysis ◽

Percent Accuracy ◽

Language Sample

Purpose Language sample analysis (LSA) is commonly used to monitor progress for children with language disorders (Pavelko et al., 2016). For children with grammar goals, pediatric speech-language pathologists report mean length of utterance (MLU) and type–token ratio (TTR) as the two LSA measures most commonly used (Finestack & Satterlund, 2018). For focused grammatical intervention, these measures may be ineffective in capturing treatment growth. In this clinical focus article, we provide a preliminary comparison of four measures that could be considered as progress monitoring tools following intervention for one finiteness marker. Method Pre- and posttreatment spontaneous language samples from six children with developmental language disorder who underwent treatment for the third-person singular –s ( –3s ) morpheme were analyzed qualitatively. Four measures are reported: MLU, TTR, percent accuracy of –3s , and Tense and Agreement Productivity score of –3s (cf. Hadley & Short, 2005). Results Increases were most common across participants in measures that examined use of the treatment target (i.e., percent accuracy and Tense and Agreement Productivity score of –3s ). Changes in MLU were not always congruent with measures of the treatment target. Change was mostly not appreciable for TTR. Conclusions For preschool-aged children with developmental language disorder, MLU and TTR may not be effective as the sole outcome measures following treatment of –3s. Our six case studies highlight the benefit of measuring the treated skill as discretely as possible and with multiple measures. More research is needed into the use of LSA for outcome measures in children with language disorders.

The Specific Language Impairment/Developmental Language Disorders Forum: Fostering a Discussion of Terminology

10.1044/2019_persp-19-00184 ◽

2020 ◽

Vol 5 (1) ◽

pp. 3-5 ◽

Cited By ~ 4

Author(s):

Laura Green

Keyword(s):

Clinical Practice ◽

Public School ◽

Language Impairment ◽

Language Disorder ◽

Language Disorders ◽

Language Deficits ◽

Developmental Language Disorders ◽

Specific Language

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.

Spoken Word Learning in Children with Developmental Language Disorder or Dyslexia

10.31219/osf.io/h2xdj ◽

2021 ◽

Author(s):

Suzanne Adlof ◽

Lauren Baron ◽

Bethany A Bell ◽

Joanna Scoggins

Keyword(s):

Word Learning ◽

Language Impairment ◽

Retrieval Practice ◽

Language Disorder ◽

Learning Difficulties ◽

Learning Task ◽

Vocabulary Knowledge ◽

Learning Abilities

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.

Clinical Intersections Among Idiopathic Language Disorder, Social (Pragmatic) Communication Disorder, and Attention-Deficit/Hyperactivity Disorder

10.1044/2020_jslhr-20-00050 ◽

2020 ◽

Vol 63 (10) ◽

pp. 3263-3276

Author(s):

Sean M. Redmond

Keyword(s):

Language Impairment ◽

Language Disorder ◽

Occurrence Rate ◽

Communication Disorder ◽

Statistical Manual ◽

Hyperactivity Disorder ◽

Diagnostic And Statistical Manual ◽

Pragmatic Communication

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

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

10.1044/2020_jslhr-20-00118 ◽

2020 ◽

Vol 63 (10) ◽

pp. 3277-3292

Author(s):

Suzanne M. Adlof

Keyword(s):

Academic Achievement ◽

Reading Comprehension ◽

Language Impairment ◽

Language Disorder ◽

Language Skills ◽

Future Research ◽

Specific Language ◽

School Identification ◽

Potential Benefits

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

Diagnosis of Developmental Language Disorder in Research Studies

10.1044/2020_jslhr-20-00091 ◽

2020 ◽

Vol 63 (8) ◽

pp. 2777-2788

Author(s):

Hallie Nitido ◽

Elena Plante

Keyword(s):

Language Impairment ◽

Language Disorder ◽

The United States ◽

Diagnostic Methods ◽

Identification Accuracy ◽

Cut Score ◽

English Speaking ◽

High Level

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.

A Family Aggregation Study

10.1044/1092-4388(2003/021) ◽

2003 ◽

Vol 46 (2) ◽

pp. 261-272 ◽

Cited By ~ 80

Author(s):

Naseem Choudhury ◽

April Ann Benasich

Keyword(s):

Language Impairment ◽

Language Disorder ◽

Sociodemographic Factors ◽

Similar Data ◽

Language Abilities ◽

Standardized Measures ◽

History Of ◽

Family Aggregation ◽

And Control

Substantial evidence continues to accrue for familial transmission of specific language impairment (SLI). The incidence in families with a history of SLI is estimated at approximately 20%–40%, whereas in the general population the estimated incidence is about 4%. Typical aggregation studies compare data on the speech and language status of parents and siblings of individuals with SLI (the probands) to similar data from family members of control individuals with no speech or language disorder history. In the present study, family aggregation of SLI was examined for a unique sample of children who were ascertained before 6 months of age and thus did not have SLI, but were born into a family with a positive history of SLI (FH + ). No study to date has examined the pattern of affectance in families of children ascertained at such a young age. In addition, the ratio of boys to girls born into such families was investigated, as previous studies have suggested alterations in the expected gender ratios. Consistent with prior research, SLI was found to aggregate in families; the average affectance rate in FH + families was 32%, with significantly more boys (41%) reported as having SLI than girls (16%). A comparison of FH + and control families (FH–) on sociodemographic factors and medical history revealed differences in the overall rate of autoimmune diseases; FH + families reported a significantly higher incidence (35%) compared to FH– families (9%). Finally, the 3- year language abilities of a subset of 32 children from FH + families were compared with those of 60 children from FH– families. Children from FH + families scored significantly lower on standardized measures of language and were more likely to fall below the 16th percentile (28%) than children from FH– families (7%). These results provide converging evidence that children from FH + families are indeed at greater risk of developing language delay compared to children from control families.