A preliminary epidemiologic study of social (pragmatic) communication disorder in the context of developmental language disorder

Author(s):  
Susan Ellis Weismer ◽  
J. Bruce Tomblin ◽  
Maureen S. Durkin ◽  
Daniel Bolt ◽  
Mari Palta
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 (6) ◽  
pp. 1916-1932 ◽  
Author(s):  
Haiying Yuan ◽  
Christine Dollaghan

Purpose No diagnostic tools exist for identifying social (pragmatic) communication disorder (SPCD), a new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition category for individuals with social communication deficits but not the repetitive, restricted behaviors and interests (RRBIs) that would qualify them for a diagnosis of autism spectrum disorder (ASD). We explored the value of items from a widely used screening measure of ASD for distinguishing SPCD from typical controls (TC; Aim 1) and from ASD (Aim 2). Method We applied item response theory (IRT) modeling to Social Communication Questionnaire–Lifetime ( Rutter, Bailey, & Lord, 2003 ) records available in the National Database for Autism Research. We defined records from putative SPCD ( n = 54), ASD ( n = 278), and TC ( n = 274) groups retrospectively, based on National Database for Autism Research classifications and Autism Diagnostic Interview–Revised responses. After assessing model assumptions, estimating model parameters, and measuring model fit, we identified items in the social communication and RRBI domains that were maximally informative in differentiating the groups. Results IRT modeling identified a set of seven social communication items that distinguished SPCD from TC with sensitivity and specificity > 80%. A set of five RRBI items was less successful in distinguishing SPCD from ASD (sensitivity and specificity < 70%). Conclusion The IRT modeling approach and the Social Communication Questionnaire–Lifetime item sets it identified may be useful in efforts to construct screening and diagnostic measures for SPCD.


2020 ◽  
Vol 63 (11) ◽  
pp. 3700-3713
Author(s):  
Saleh Shaalan

Purpose This study examined the performance of Gulf Arabic–speaking children with developmental language disorder (DLD) on a Gulf Arabic nonword repetition (GA-NWR) test and compared it to their age- and language-matched groups. We also investigated the role of syllable length, wordlikeness, and phonological complexity in light of NWR theories. Method A new GA-NWR test was conducted with three groups of Gulf Arabic–speaking children: school-age children with DLD, language-matched controls (LCs), and age-matched controls (ACs). The test consisted of two- and three-syllable words that either had no clusters, medial clusters, final clusters, or medial + final clusters. Results The GA-NWR distinguished between the performance of children with DLD and the LC and AC groups. Results showed significant syllable length, wordlikeness, and phonological complexity effects. Differences between the DLD and typically developing groups were seen in two- and three-syllable nonwords; however, when compared on nonwords with no clusters, children with DLD were not significantly different from the LC group. Conclusions The GA-NWR test differentiated between children with DLD and their ACs and LCs. Findings, therefore, support its clinical utility in this variety of Arabic. Results showed that phonological processing factors, such as phonological complexity, may have stronger effects when compared to syllable length effects. Supplemental Material https://doi.org/10.23641/asha.12996812


2020 ◽  
Vol 63 (9) ◽  
pp. 3036-3050
Author(s):  
Elma Blom ◽  
Tessel Boerma

Purpose Many children with developmental language disorder (DLD) have weaknesses in executive functioning (EF), specifically in tasks testing interference control and working memory. It is unknown how EF develops in children with DLD, if EF abilities are related to DLD severity and persistence, and if EF weaknesses expand to selective attention. This study aimed to address these gaps. Method Data from 78 children with DLD and 39 typically developing (TD) children were collected at three times with 1-year intervals. At Time 1, the children were 5 or 6 years old. Flanker, Dot Matrix, and Sky Search tasks tested interference control, visuospatial working memory, and selective attention, respectively. DLD severity was based on children's language ability. DLD persistence was based on stability of the DLD diagnosis. Results Performance on all tasks improved in both groups. TD children outperformed children with DLD on interference control. No differences were found for visuospatial working memory and selective attention. An interference control gap between the DLD and TD groups emerged between Time 1 and Time 2. Severity and persistence of DLD were related to interference control and working memory; the impact on working memory was stronger. Selective attention was unrelated to DLD severity and persistence. Conclusions Age and DLD severity and persistence determine whether or not children with DLD show EF weaknesses. Interference control is most clearly impaired in children with DLD who are 6 years and older. Visuospatial working memory is impaired in children with severe and persistent DLD. Selective attention is spared.


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.


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