Search

Williams syndrome (WS) is a rare genetic syndrome. As with all rare syndromes, obtaining adequately powered sample sizes is a challenge. Here we present legacy data from seven UK labs, enabling the characterisation of cross-sectional and longitudinal developmental trajectories of verbal and non-verbal development in the largest sample of individuals with WS to-date. In Study 1, we report cross-sectional data from between N=102 and N=209 children and adults with WS on measures of verbal and non-verbal ability. In Study 2, we report longitudinal data from N=17 to N=54 children and adults with WS who had been tested on at least three timepoints on these measures. Data support the WS characteristic cognitive profile of stronger verbal than non-verbal ability, and shallow developmental progression for both domains. Both cross-sectional and longitudinal data demonstrate steeper rates of development in the child participants than the adolescent and adults in our sample. Cross-sectional data indicate steeper development in verbal than non-verbal ability, and that individual differences in the discrepancy between verbal and non-verbal ability are largely accounted for by level of intellectual functioning. A diverging developmental discrepancy between verbal and non-verbal ability, whilst marginal, is not mirrored statistically in the longitudinal data. Cross-sectional and longitudinal data are discussed with reference to validating cross-sectional developmental patterns using longitudinal data and the importance of individual differences in understanding developmental progression.

Research with English-speaking populations has shown that there is a relationship between developmental language disorder (DLD) and emergent literacy skills in children. A small number of Arabic studies have indirectly investigated this relationship in typically developing (TD) children, and children with reading difficulties, and demonstrated the important role of morphosyntactic skills in Arabic reading acquisition. However, none of the previous work has examined the relationship between oral language and emergent literacy skills in children with and without DLD. The aims of this study are twofold: to investigate the language and emergent literacy skills of Saudi Arabic children with DLD aged between 4;0- 6;11 years of age; to compare their performance to age and socioeconomic status matched TD children, and to investigate the relationship between language and emergent literacy skills in both groups. A comprehensive Arabic language and emergent literacy battery was administered. Findings demonstrated that the TD group significantly outperformed the DLD group on most emergent literacy tasks. The DLD group was significantly less accurate than the TD group on syllable segmentation, and phoneme awareness skills. There were significant associations between oral language skills and emergent literacy skills in the DLD group. In the TD group, vocabulary knowledge and syntactic skills were associated with some emergent literacy skills. Syntactic skills were found to have moderately significant relationship with all emergent literacy skills in both groups. This might suggest the important role of morphosyntactic skills to literacy development in Arabic. Overall, findings were consistent with existing literature, and demonstrated strong relationships between oral language and emergent literacy skills in the Arabic language.

Purpose This study evaluates the effectiveness of a nonword repetition (NWR) task in discriminating between Palestinian Arabic–speaking children with developmental language disorder (DLD) and age-matched typically developing (TD) children. Method Participants were 30 children with DLD aged between 4;0 and 6;10 (years;months) and 60 TD children aged between 4;0 and 6;8 matched on chronological age. The Arabic version of a Quasi-Universal NWR task was administered. The task comprises 30 nonwords that vary in length, presence of consonant clusters (CCs) and wordlikeness ratings. Responses were scored using an item-level scoring method to assess the diagnostic accuracy of the task. Receiver operating characteristic curve analysis was conducted to determine the best cutoff point with the highest sensitivity and specificity values, and likelihood ratios were calculated. Results Children with DLD scored significantly lower on the NWR task than their age-matched TD peers. Only the DLD group was influenced by the phonological complexity of the nonwords, with nonwords with two CC being more difficult than nonwords with no or only one CC. For both groups, three-syllable nonwords were repeated less accurately than two- and one-syllable nonwords. Also, high word-like nonwords were repeated more accurately than nonwords with low wordlikeness ratings. The best cutoff score had sensitivity and specificity of 93% and highly informative likelihood ratios. Conclusions NWR was an area of difficulty for Palestinian Arabic–speaking children with DLD. NWR showed excellent discriminatory power in differentiating Arabic-speaking children diagnosed with DLD from their age-matched TD peers. NWR appears to hold promise for clinical use as it is a useful indicator of DLD in Arabic. These results need to be further validated using population-based studies. Supplemental Material https://doi.org/10.23641/asha.14880360

PurposeThis study investigated the production of tense and subject–verb agreement in Palestinian Arabic–speaking children with developmental language disorder (DLD) in comparison to their typically developing (TD) peers in terms of (a) performance accuracy and (b) error patterns.MethodParticipants were 14 children with DLD aged 4;0–7;10 and 32 TD children aged 3;0–8;0 matched on nonverbal abilities. Children were asked to complete a picture-based verb elicitation task. The task was designed to measure the production accuracy of tense and subject–verb agreement inflections in Arabic.ResultsThe DLD group scored significantly lower than the TD group on the verb elicitation task. The DLD group was significantly less accurate than the TD group in marking tense, specifically present tense. They were also less accurate in marking agreement in general, with specific difficulty in using feminine verb forms. The DLD and TD groups differed in their tense error patterns, but not in agreement error patterns.ConclusionsThe acquisition of verb morphology in Palestinian Arabic–speaking children with DLD appears to be delayed and possibly different from their TD peers. The DLD group found the production of marked verb forms more challenging than less marked ones. These results are discussed in light of the structural characteristics of Arabic. Future studies would need to include larger sample sizes; investigate other aspects of verb morphology, including both production and comprehension; include other language domains; and consider longitudinal designs to provide more in-depth knowledge of Arabic language acquisition.

13% of deaf children in the UK use more than one spoken language. Parents of deaf children from bilingual backgrounds must decide whether to communicate with their child using more than one spoken language, with or without a signed language(s) as well. As most deaf children are born to hearing parents with little or no knowledge of deafness, professional guidance received during this decision-making process is critical. This study examined the beliefs of professionals on the ability of a deaf child to acquire two spoken languages and the advice professionals give to parents considering spoken language bilingualism for their deaf child. 108 professionals who work with deaf children in the UK (50 Teachers of the Deaf [ToDs], 47 speech and language therapists [SLTs] and 11 audiologists) completed an online questionnaire between the 24th May 2019 and the 1st July 2019. Most participants believed deaf children can achieve spoken language bilingualism and would advise parents to speak in their home language, regardless of the parents’ English proficiency. However, audiologists were 11 times more likely than SLTs to report linguistic confusion, and ToDs at least 11 times more likely than SLTs to report reduced proficiency in English and the home language because of bilingualism. ToDs and SLTs were found to play a key role in bilingual parents’ decision-making process. Consequently, there is a need for specific training and interprofessional learning to ensure parents receive consistent evidence-based advice.

Background\ud Speech and language acquisition can be a challenge for young children with Down syndrome (DS), and while early intervention is important, we do not know what early interventions exist and how effective they may be.\ud \ud Aims\ud To systematically review existing early speech, language and communication interventions for young children with DS from birth up to 6 years, and to investigate their effectiveness in improving speech, language and communication outcomes in children with DS. Other outcomes are changes in parental behaviour and their responsiveness\ud \ud Methods & Procedures\ud We conducted a systematic search of relevant electronic databases to identify early intervention studies targeting speech, language and communication outcomes in children with DS published up to May 2020. A total of 11 studies that met the inclusion criteria were synthesized and appraised for quality using the PEDro-P scale. There were a total of 242 children. We identified three types of intervention: communication training and responsive teaching, early stimulation programme, and dialectic–didactic approach.\ud \ud Main contribution\ud The findings from nine out of the 11 studies reported positive outcomes for children's language and communication up to 18 months following the intervention. All nine studies reported interventions that were co-delivered by parents and clinicians. However, there was also a de-accelerated growth in requesting behaviours in the intervention group reported by one study as well as a case of no improvement for the intervention group. Three studies provided some evidence of improvements to parent outcomes, such as increased parental language input and increased responsiveness. However, there was a moderate to high risk of bias for all studies included.\ud \ud Conclusions\ud The findings from this review suggest that interventions that have high dosage, focus on language and communication training within a naturalistic setting, and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with DS between 0 and 6 years of age. Due to the limited number of studies, limited heterogeneous data and the moderate to high risk of bias across studies, there is an urgent need for higher quality intervention studies in the field to build the evidence base.\ud \ud WHAT THIS PAPER ADDS\ud What is already known on the subject\ud Speech and language acquisition is usually delayed in children with DS, yet there are currently no standard interventions for children under 6. A number of research-based interventions exist in the literature, yet it is unknown how effective these are.\ud \ud What this study adds to existing knowledge\ud This is the first systematic review that specifically and exclusively focuses on parent- and non-parent-mediated speech, language and communication interventions for children with DS between 0 and 6 years of age. It complements three existing recent reviews, each of which has a slightly different focus. The previously published reviews have covered only parent-mediated interventions, excluding interventions not mediated by parents, have reviewed interventions including children and adults, without any mention of what early interventions may be like or how effective these may be for young children with DS, have not always assessed risk of bias or have focused specifically on language interventions excluding those focusing on speech articulation or pre-linguistic skills. The findings from the current review suggest that interventions that have high dosage focus on language and communication training within a naturalistic setting and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with Diwn syndrome from 0 to 6. We acknowledge that the current evidence base comes from studies with moderate to high risk of bias, hence our conclusions are not definitive.\ud \ud What are the potential or actual clinical implications of this work?\ud Speech and language therapists will have synthesized information and a quick reference point on what type of interventions exist for children with DS under the age of 6, and evidence of which intervention approaches may be promising in terms of providing positive outcomes. However, it is acknowledged that, due to the limited number of studies and the moderate to high risk of bias inherent in the evidence, there is an urgent need for higher quality intervention studies in the field to build the evidence base.

BackgroundDown syndrome is the most common cause of learning disability, affecting approximately 1 in every 700 babies. Children with Down syndrome have particular difficulties with speech and language. This makes it challenging for them to participate fully in life, access healthcare services and educational opportunities. Improving the language skills of young children with Down syndrome is vital for their future social and emotional well-being and behaviour, and consequently contribution to society. As Down syndrome is detected before or at birth, we can provide support from early on. There are currently no standard interventions for improving the language skills of children with Down syndrome under the age of 36 months. Evidence suggests that early parent-based interventions may be effective in improving language outcomes. In partnership with parents and speech and language therapists, we have co-developed an intervention focusing on early social communication skills and our preliminary work shows that it can lead to better language in children with Down syndrome. Our aim is to carry out a feasibility study which will inform a future pilot/full trial to test whether the intervention is effective in improving language skills before children with Down syndrome start school.MethodsThis is a two-arm feasibility randomised controlled trial (RCT), with 1:1 randomisation stratified by trial site comparing the intervention (plus standard NHS speech and language therapy) with no intervention (standard NHS speech and language therapy only). We aim to recruit between 25 and 30 children with Down syndrome aged between 11 and 36 months. Sites are defined by the geographical boundaries of three National Health Service (NHS) Trusts. Recruitment is from NHS Speech and Language Therapist caseloads within the 3 Trusts, and self-referral. In the intervention arm, parents/guardians will receive brief training on the parent-based intervention and a manual to follow with their child for 10 weeks. The children’s language and early communication skills and family health outcomes will be assessed by a blinded assessor at baseline, post-intervention and 6 month follow-up. Questionnaire and semi-structured interviews will explore the acceptability of the intervention to parents and SLTs.DiscussionThe feasibility study’s outcomes will determine whether it would be viable to progress to a full-trial and whether adjustments need to made to the procedures, data collection methods, intervention delivery and the intensity of support needed. We want to assess whether our early intervention can be delivered and rolled out through NHS Speech and Language Therapy (SLT) Services. We anticipate that NHS SLT Services will need to make ongoing changes due to the COVID-19 pandemic, so it is likely that we will need to make adjustments for the definitive trial. We will also calculate descriptive statistics of the language outcome measure which we will use for any future sample size calculation.Trial registrationISRCTN13902755. Registered on 25 August 2020.http://www.isrctn.com/ISRCTN13902755

Purpose: Research on the typical and impaired grammatical acquisition of Arabic is limited. This study systematically examined the morphosyntactic abilities of Arabic-speaking children with and without developmental language disorder (DLD) using a novel sentence repetition task. The usefulness of the task as an indicator of DLD in Arabic was determined. Method: A LITMUS (Language Impairment Testing in Multilingual Settings) sentence repetition task was developed in Palestinian Arabic (LITMUS-SR-PA-72) and administered to 30 children with DLD ( M = 61.50 months, SD = 11.27) and 60 age-matched typically developing (TD) children ( M = 63.85 months, SD = 10.16). The task targeted grammatical structures known to be problematic for Arabic-speaking children with DLD (language specific) and children with DLD across languages (language independent). Responses were scored using binary, error, and structural scoring methods. Results: Children with DLD scored below TD children on the LITMUS-SR-PA-72, in general, and in the repetition of language-specific and language-independent structures. The frequency of morphosyntactic errors was higher in the DLD group relative to the TD group. Despite the large similarity of the type of morphosyntactic errors between the two groups, some atypical errors were exclusively produced by the DLD group. The three scoring methods showed good diagnostic power in the discrimination between children with DLD and children without DLD. Conclusions: Sentence repetition was an area of difficulty for Palestinian Arabic–speaking children with DLD. The DLD group demonstrated difficulties with language-specific and language-independent structures, particularly complex sentences with noncanonical word order. Most grammatical errors made by the DLD group resembled those of the TD group and were mostly omissions or substitutions of grammatical affixes or omissions of function words. SR appears to hold promise as a good indicator for the presence or absence of DLD in Arabic. Further validation of these findings using population-based studies is warranted. Supplemental Material https://doi.org/10.23641/asha.16968043

Purpose The study explored longitudinally the course of vocabulary and general language development in a group of infants with Down syndrome (DS) compared to a group of typically developing (TD) infants matched on nonverbal mental ability (NVMA). Method We compared the vocabulary and general language trajectories of the two groups in two ways: (a) at three time points during a 12-month period and (b) at two time points when the groups had made equal progress in NVMA (a period of 6 months for the TD infants vs. 12 months for the infants with DS). Results The TD group had overtaken the DS group on all general language and vocabulary measures by the end of the 12-month period. However, expressive communication and expressive vocabulary were developing at the same rate and level in the two groups when examined over a period in which the two groups were matched in gains in NVMA. Furthermore, the infants with DS showed a receptive language advantage over the TD group; this group's auditory comprehension and receptive vocabulary scores were superior to those of the TD group at both time points when NVMA was accounted for. Conclusion The results shed light on the widely reported discrepancy between expressive and receptive language in individuals with DS. Although infants with DS appear to be developing language skills more slowly than chronological age TD peers, when NVMA is taken into account, infants with DS do not have expressive language delays, and they seem to show a receptive language advantage.

There is a robust amount of evidence (mostly from English) suggesting that, while listening to speech, the initial part of words is scrutinised with more attention. Similarly, data suggests that stressed syllables are processed with more precision than unstressed syllables. How do these two kinds of saliencies interact? In this experimental study, the issue was investigated in a group of Italian speakers. Participants were presented with minimal pairs of nonwords differing in one individual phoneme (and specifically one trait, voicing). Nonwords were created as to contain phonological clusters in either an initial or medial position, and, similarly, stress was placed in either initial or medial position. Results show that when the clusters were in word medial position, there was a large effect of stress, with stressed syllables being recognised with greater accuracy. When the clusters were in initial position, instead, accuracy was at an intermediate level and we did not observe any effect of stress. The result is discussed in relation to previous literature addressing these phenomena in English.

A number of studies in different languages have shown that speakers may be sensitive to the presence of inflectional morphology in the absence of verb meaning (Caramazza et al. in Cognition 28(3):297–332, 1988; Clahsen in Behav Brain Sci 22(06):991–1013, 1999; Post et al. in Cognition 109(1):1–17, 2008). In this study, sensitivity to inflectional morphemes was tested in a purposely developed task with English-like nonwords. Native speakers of English were presented with pairs of nonwords and were asked to judge whether the two nonwords in each pair were the same or different. Each pair was composed either of the same nonword repeated twice, or of two slightly different nonwords. The nonwords were created taking advantage of a specific morphophonological property of English, which is that regular inflectional morphemes agree in voicing with the ending of the stem. Using stems ending in /l/, thus, we created: (1) nonwords ending in potential inflectional morphemes, vɔld, (2) nonwords without inflectional morphemes, vɔlt, and (3) a phonological control condition, vɔlb. Our new task endorses some strengths presented in previous work. As in Post et al. (2008) the task accounts for the importance of phonological cues to morphological processing. In addition, as in Caramazza et al. (1988) and contrary to Post et al. (2008), the task never presents bare-stems, making it unlikely that the participants would be aware of the manipulation performed. Our results are in line with Caramazza et al. (1988), Clahsen (1999) and Post et al. (2008), and offer further evidence that morphologically inflected nonwords take longer to be discriminated compared to uninflected nonwords.

Down syndrome (DS) is more detrimental to language acquisition compared to other forms of learning disability. It has been shown that early social communication skills are important for language acquisition in the typical population; however few studies have examined the relationship between early social communication and language in DS. The aim of the current study is to compare the relationship between joint attention and concurrent language skills, and maternal interactive style and concurrent language skills in infants with DS and in typically developing (TD) infants matched for mental age. We also investigated if these relationships differ between children with DS and TD children. Twenty-five infants with DS (17–23 months) and 30 TD infants (9–11 months) were assessed on measures of joint attention, maternal interactive style and language. The results indicated a significant positive relationship between responding to joint attention (RJA) and concurrent language for the DS group, and a significant positive relationship between maternal positive expressed emotion (PEEM) and concurrent language for the TD group. We hypothesise that different social-communication factors are associated with language skills in DS, at least between 17 and 23 months of age compared to TD infants of similar non-verbal and general language abilities.

The aim of the present study is to investigate the developmental profile of three aspects of prosody function, i.e. affect, focus and turn-endings in children with Williams and in those with Down’s syndrome compared to typically developing English speaking children. The tasks used were part of the computer-based battery, Profiling Elements of Prosody for Speech Communication (Peppe, McCann & Gibon, 2003). Cross-sectional developmental trajectories linking chronological and non-verbal mental age and affects and turn-ending functions of prosody were constructed. The results showed an atypical profile in both clinical populations. More interestingly, the profiles were atypical for different reasons, suggesting multiple and possibly different developmental pathways to the acquisition of prosody in these two populations., L’objectif de cette recherche est d’étudier le profil développemental de trois aspects de la fonction de prosodie : émotion, focalisation et fin de phrase chez des enfants porteurs 1˚ du syndrome de Williams et 2˚ du syndrome de Down en les comparant à des enfants de langue anglaise ayant un développement normal. Les tâches utilisées sont une partie de la batterie informatisée, Profiling Elements of Prosody for Speech Communication. Des trajectoires développementales mettant en lien l’âge chronologique, l’âge mental non verbal et les fonctions de la prosodie (émotion, focalisation et fin de phrase) ont été construites. Les résultats montrent des profils atypiques dans les deux populations cliniques. Cependant, les profils sont atypiques pour des raisons différentes, suggérant des trajectoires développementales différentes pour acquérir la prosodie dans ces deux populations.

Purpose: Children with Down syndrome (DS) typically have marked delays in language development relative to their general cognitive development, with particular difficulties in expressive compared to receptive language. Although early social communication skills, including gestures and joint attention, have been shown to be related to later language outcomes in DS, knowledge is limited as to whether these factors exclusively predict outcomes, or whether other factors (e.g. perceptual and non-verbal skills) are involved. This study addressed this question.Method: Longitudinal data for a group of infants with DS (n = 14) and a group of typically-developing (TD) infants (n = 35) were collected on measures that have been shown to predict language in TD infants and/or those with developmental delays. These included: non-verbal mental ability, speech segmentation skills, and early social communication skills (initiating and responding to joint attention, initiating behavioural requests).Results: Linear regression analyses showed that speech segmentation and initiating joint attention were the strongest predictors of later language in the TD group, whereas non-verbal mental ability and responding to joint attention were the strongest predictors of later language for infants with DS.Conclusions: Speech segmentation ability may not determine language outcomes in DS, and language acquisition may be more constrained by social communication and general cognitive skills.

Artificial grammar learning is an empirical paradigm that investigates basic pattern and structural processing in different populations. It can inform how higher cognitive functions, such as language use, take place. Our study used artificial grammar learning to assess how children with Williams syndrome (WS; n = 16) extract patterns in structured sequences of synthetic speech, how they compare to typically developing (TD) children (n = 60), and how prosodic cues affect learning. The TD group was divided into a group whose nonverbal abilities were within the range of the WS group, and a group whose chronological age was within the range of the WS group. TD children relied mainly on rule-based generalization when making judgments about sequence acceptability, whereas children with WS relied on familiarity with specific stimulus combinations. The TD participants whose nonverbal abilities were similar to the WS group showed less evidence of relying on grammaticality than TD participants whose chronological age was similar to the WS group. In absence of prosodic cues, the children with WS did not demonstrate evidence of learning. Results suggest that, in WS children, the transition to rule-based processing in language does not keep pace with TD children and may be an indication of differences in neurocognitive mechanisms.

The aim of the present study was to investigate whether the saliency effect for word beginnings reported in children with dyslexia (Marshall & Van der Lely, 2009) can be found also in typically developing children. Thirty-four typically developing Italian children aged 8–10 years completed two specifically designed tasks: a production task and a perception task. Both tasks used nonwords containing clusters consisting of plosive plus liquid (e.g. pl). Clusters could be either in a stressed or in an unstressed syllable and could be either in initial position (first syllable) or in medial position (second syllable). In the production task, children were asked to repeat the nonwords. In the perception task, the children were asked to discriminate between two nonwords differing in one phoneme belonging to a cluster by reporting whether two repetitions were the same or different. Results from the production task showed that children are more accurate in repeating stressed than unstressed syllables, but there was no difference with respect to position of the cluster. Results from the perception task showed that children performed more accurately when discriminating word initial contrasts than when discriminating word medial contrasts, especially if the cluster was unstressed. Implications of this finding for clinical assessments are discussed. Copyright © 2015 John Wiley & Sons, Ltd.

The Children's Test of Nonword Repetition (CNRep) is one of the most popular tests of nonword repetition. The test is composed of nonwords of different length, and normative data suggest that children experience more difficulties in repeating long nonwords. An analysis of the distribution of phonological clusters in the test shows that noninitial clusters are unequally distributed in the test: They only appear in long nonwords (four and five syllables). For this reason, we hypothesized that the difficulties children encounter with long nonwords may be influenced by the phonological complexity of the clusters and not just by the challenge for working memory associated with length. To test the hypothesis, we compared repetition performance in long nonwords with and without a noninitial cluster in 18 children with language impairment and 18 typically developing children. The analysis shows that long nonwords with noninitial clusters are repeated less accurately by both groups. In addition, there was an interaction between cluster and age: The effect of cluster is absent in younger children and gradually increases with age. These findings suggest that phonological complexity may be having an impact on the length effect normally observed in the CNRep, and this impact may be particularly evident in older children.