Search

Objectives: The primary objective of this article was to describe recruitment, data collection, and methods for a longitudinal, multicenter study involving children with bilateral mild to severe hearing loss. The goals of this research program were to characterize the developmental outcomes of children with mild to severe bilateral hearing loss during infancy and the preschool years. Furthermore, the researchers examined how these outcomes were associated with the child's hearing loss and how home background and clinical interventions mediated and moderated these outcomes., Design: The participants in this study were children who are hard of hearing (CHH) and children with normal hearing (CNH) who provided comparison data. CHH were eligible for participation if (1) their chronological age was between 6 months and 7 years of age at the time of recruitment, (2) they had a better-ear pure-tone average of 25 to 75 dB HL, (3) they had not received a cochlear implant, (4) they were from homes where English was the primary language, and (5) they did not demonstrate significant cognitive or motor delays. Across the time span of recruitment, 430 parents of potential children with hearing loss made contact with the research group. This resulted in 317 CHH who qualified for enrollment. In addition, 117 CNH qualified for enrollment. An accelerated longitudinal design was used, in which multiple age cohorts were followed long enough to provide overlap. Specifically, children were recruited and enrolled continuously across an age span of 6.5 years and were followed for at least 3 years. This design allowed for tests of time (period) versus cohort age effects that could arise by changes in services and technology over time, yet still allowed for examination of important developmental relationships., Results: The distribution of degree of hearing loss for the CHH showed that the majority of CHH had moderate or moderate-to-severe hearing losses, indicating that the sample undersampled children with mild HL. For mothers of both CHH and CNH, the distribution of maternal education level showed that few mothers lacked at least a high school education and a slight majority had completed a bachelor's degree, suggesting that this sample of research volunteers was more advantaged than the United States population. The test battery consisted of a variety of measures concerning participants' hearing and behavioral development. These data were gathered in sessions during which the child was examined by an audiologist and a speech-language examiner. In addition, questionnaires concerning the child's behavior and development were completed by the parents., Conclusion: The Outcomes of Children with Hearing Loss study was intended to examine the relationship between variation in hearing ability across children with normal and mild to severe hearing loss and variation in their outcomes across several domains of development. In addition, the research team sought to document important mediators and moderators that act between the hearing loss and the outcomes. Because the study design provided for the examination of outcomes throughout infancy and early childhood, it was necessary to employ a number of different measures of the same construct to accommodate changes in developmental performance across age. This resulted in a large matrix of measures across variable types and developmental levels, as described in this manuscript.

The aim of the current study was to examine different aspects of procedural memory in young adults who varied with regard to their language abilities. We selected a sample of procedural memory tasks, each of which represented a unique type of procedural learning, and has been linked, at least partially, to the functionality of the corticostriatal system. The findings showed that variance in language abilities is associated with performance on different domains of procedural memory, including the motor domain (as shown in the pursuit rotor task), the cognitive domain (as shown in the weather prediction task), and the linguistic domain (as shown in the nonword repetition priming task). These results implicate the corticostriatal system in individual differences in language.

Purpose: Individual differences in vocabulary development may affect academic or social opportunities. It has been proposed that individual differences in word reading could affect the rate of vocabulary growth, mediated by the amount of reading experience, a process referred to as a Matthew effect (Stanovich, 1986)., Method: In the current study, assessments of written word-reading skills in the 4th grade and oral vocabulary knowledge collected in kindergarten and in the 4th, 8th, and 10th grades from a large epidemiologically based sample (n = 485) allowed a test of the relationship of early word-reading skills and the subsequent rate of vocabulary growth., Results: Consistent with the hypothesis, multilevel modeling revealed the rate of vocabulary growth after the 4th grade to be significantly related to 4th-grade word reading after controlling for kindergarten vocabulary level, that is, above average readers experienced a higher rate of vocabulary growth than did average readers., Conclusions: Vocabulary growth rate differences accumulated over time such that the effect on vocabulary size was large.

Although there is considerable evidence that individual differences in language development are highly heritable, there have been few genome-wide scans to locate genes associated with the trait. Previous analyses of language impairment have yielded replicable evidence for linkage to regions on chromosomes 16q, 19q, 13q (within lab) and at 13q (between labs). Here we report the first linkage study to screen the continuum of language ability, from normal to disordered, as found in the general population. 383 children from 147 sib-ships (214 sib-pairs) were genotyped on the Illumina(®) Linkage IVb Marker Panel using three composite language-related phenotypes and a measure of phonological memory (PM). Two regions (10q23.33; 13q33.3) yielded genome-wide significant peaks for linkage with PM. A peak suggestive of linkage was also found at 17q12 for the overall language composite. This study presents two novel genetic loci for the study of language development and disorders, but fails to replicate findings by previous groups. Possible reasons for this are discussed., (© 2015 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.)

Purpose: The authors examined speech perception deficits associated with individual differences in language ability, contrasting auditory, phonological, or lexical accounts by asking whether lexical competition is differentially sensitive to fine-grained acoustic variation., Method: Adolescents with a range of language abilities (N = 74, including 35 impaired) participated in an experiment based on McMurray, Tanenhaus, and Aslin (2002). Participants heard tokens from six 9-step voice onset time (VOT) continua spanning 2 words (beach/peach, beak/peak, etc.) while viewing a screen containing pictures of those words and 2 unrelated objects. Participants selected the referent while eye movements to each picture were monitored as a measure of lexical activation. Fixations were examined as a function of both VOT and language ability., Results: Eye movements were sensitive to within-category VOT differences: As VOT approached the boundary, listeners made more fixations to the competing word. This did not interact with language ability, suggesting that language impairment is not associated with differential auditory sensitivity or phonetic categorization. Listeners with poorer language skills showed heightened competitors fixations overall, suggesting a deficit in lexical processes., Conclusion: Language impairment may be better characterized by a deficit in lexical competition (inability to suppress competing words), rather than differences in phonological categorization or auditory abilities.

Reading disability (RD) and language impairment (LI) are common neurodevelopmental disorders with moderately strong genetic components and lifelong implications. RD and LI are marked by unexpected difficulty acquiring and processing written and verbal language, respectively, despite adequate opportunity and instruction. RD and LI-and their associated deficits-are complex, multifactorial, and often comorbid. Genetic studies have repeatedly implicated the DYX2 locus, specifically the genes DCDC2 and KIAA0319, in RD, with recent studies suggesting they also influence LI, verbal language, and cognition. Here, we characterize the relationship of the DYX2 locus with RD, LI, and IQ. To accomplish this, we developed a marker panel densely covering the 1.4 Mb DYX2 locus and assessed association with reading, language, and IQ measures in subjects from the Avon Longitudinal Study of Parents and Children. We then replicated associations in three independent, disorder-selected cohorts. As expected, there were associations with known RD risk genes KIAA0319 and DCDC2. In addition, we implicated markers in or near other DYX2 genes, including TDP2, ACOT13, C6orf62, FAM65B, and CMAHP. However, the LD structure of the locus suggests that associations within TDP2, ACOT13, and C6orf62 are capturing a previously reported risk variant in KIAA0319. Our results further substantiate the candidacy of KIAA0319 and DCDC2 as major effector genes in DYX2, while proposing FAM65B and CMAHP as new DYX2 candidate genes. Association of DYX2 with multiple neurobehavioral traits suggests risk variants have functional consequences affecting multiple neurological processes. Future studies should dissect these functional, possibly interactive relationships of DYX2 candidate genes.

IMPORTANCE Hearing loss (HL) in children can be deleterious to their speech and language development. The standard of practice has been early provision of hearing aids (HAs) to moderate these effects; however, there have been few empirical studies evaluating the effectiveness of this practice on speech and language development among children with mild-to-severe HL. OBJECTIVE To investigate the contributions of aided hearing and duration of HA use to speech and language outcomes in children with mild-to-severe HL. DESIGN, SETTING, AND PARTICIPANTS An observational cross-sectional design was used to examine the association of aided hearing levels and length of HA use with levels of speech and language outcomes. One hundred eighty 3- and 5-year-old children with HL were recruited through records of Universal Newborn Hearing Screening and referrals from clinical service providers in the general community in 6 US states. INTERVENTIONS All but 4 children had been fitted with HAs, and measures of aided hearing and the duration of HA use were obtained. MAIN OUTCOMES AND MEASURES Standardized measures of speech and language ability were obtained. RESULTS Measures of the gain in hearing ability for speech provided by the HA were significantly correlated with levels of speech (ρ179 = 0.20; P = .008) and language: ρ155 = 0.21; P = .01) ability. These correlations were indicative of modest levels of association between aided hearing and speech and language outcomes. These benefits were found for children with mild and moderate-to-severe HL. In addition, the amount of benefit from aided hearing interacted with the duration of HA experience (Speech: F4,161 = 4.98; P < .001; Language: F4,138 = 2.91; P < .02). Longer duration of HA experience was most beneficial for children who had the best aided hearing. CONCLUSIONS AND RELEVANCE The degree of improved hearing provided by HAs was associated with better speech and language development in children. In addition, the duration of HA experience interacted with the aided hearing to influence outcomes. These results provide support for the provision of well-fitted HAs to children with HL. In particular, the findings support early HA fitting and HA provision to children with mild HL.

Being able to track dependencies between syntactic elements separated by other constituents is crucial for language acquisition and processing (e.g., in subject-noun/verb agreement). Although long assumed to require language-specific machinery, research on statistical learning has suggested that domain-general mechanisms may support the acquisition of non-adjacent dependencies. In this study, we investigated whether individuals with specific language impairment (SLI)-who have problems with long-distance dependencies in language-also have problems with statistical learning of non-adjacent relations. The results confirmed this hypothesis, indicating that statistical learning may subserve the acquisition and processing of long-distance dependencies in natural language.

Objectives: Few studies have examined the long-term effect of age at implantation on outcomes using multiple data points in children with cochlear implants. The goal of this study was to determine whether age at implantation has a significant, lasting impact on speech perception, language, and reading performance for children with prelingual hearing loss., Design: A linear mixed-model framework was used to determine the effect of age at implantation on speech perception, language, and reading abilities in 83 children with prelingual hearing loss who received cochlear implants by the age of 4 years. The children were divided into two groups based on their age at implantation: (1) under 2 years of age and (2) between 2 and 3.9 years of age. Differences in model-specified mean scores between groups were compared at annual intervals from 5 to 13 years of age for speech perception, and 7 to 11 years of age for language and reading., Results: After controlling for communication mode, device configuration, and preoperative pure-tone average, there was no significant effect of age at implantation for receptive language by 8 years of age, expressive language by 10 years of age, reading by 7 years of age. In terms of speech-perception outcomes, significance varied between 7 and 13 years of age, with no significant difference in speech-perception scores between groups at ages 7, 11, and 13 years. Children who used oral communication (OC) demonstrated significantly higher speech-perception scores than children who used total communication (TC). OC users tended to have higher expressive language scores than TC users, although this did not reach significance. There was no significant difference between OC and TC users for receptive language or reading scores., Conclusions: Speech perception, language, and reading performance continue to improve over time for children implanted before 4 years of age. The present results indicate that the effect of age at implantation diminishes with time, particularly for higher-order skills such as language and reading. Some children who receive cochlear implants after the age of 2 years have the capacity to approximate the language and reading skills of their earlier-implanted peers, suggesting that additional factors may moderate the influence of age at implantation on outcomes over time.

Though much is known about how words are recognized, little research has focused on how a degraded signal affects the fine-grained temporal aspects of real-time word recognition. The perception of degraded speech was examined in two populations with the goal of describing the time course of word recognition and lexical competition. Thirty-three postlingually deafened cochlear implant (CI) users and 57 normal hearing (NH) adults (16 in a CI-simulation condition) participated in a visual world paradigm eye-tracking task in which their fixations to a set of phonologically related items were monitored as they heard one item being named. Each degraded-speech group was compared with a set of age-matched NH participants listening to unfiltered speech. CI users and the simulation group showed a delay in activation relative to the NH listeners, and there is weak evidence that the CI users showed differences in the degree of peak and late competitor activation. In general, though, the degraded-speech groups behaved statistically similarly with respect to activation levels., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Language impairment (LI) and reading disability (RD) are common pediatric neurobehavioral disorders that frequently co-occur, suggesting they share etiological determinants. Recently, our group identified prenatal nicotine exposure as a factor for RD and poor reading performance. Using smoking questionnaire and language data from the Avon Longitudinal Study of Parents and Children, we first determined if this risk could be expanded to other communication disorders by evaluating whether prenatal nicotine exposure increases risk for LI and poor performance on language tasks. Prenatal nicotine exposure increased LI risk (OR = 1.60; p = 0.0305) in a dose-response fashion with low (OR = 1.25; p = 0.1202) and high (OR = 3.84; p = 0.0002) exposures. Next, hypothesizing that the effects of prenatal nicotine may also implicate genes that function in nicotine related pathways, we determined whether known nicotine dependence (ND) genes associate with performance on language tasks. We assessed the association of 33 variants previously implicated in ND with LI and language abilities, finding association between ANKK1/DRD2 and performance on language tasks (p≤0.0003). The associations of markers within ANKK1 were replicated in a separate LI case-control cohort (p<0.05). Our results show that smoking during pregnancy increases the risk for LI and poor performance on language tasks and that ANKK1/DRD2 contributes to language performance. More precisely, these findings suggest that prenatal environmental factors influence in utero development of neural circuits vital to language. Our association of ANKK1/DRD2 further implicates the role of nicotine-related pathways and dopamine signaling in language processing, particularly in comprehension and phonological memory.

This study investigated the development of tense markers (e.g., past tense -ed) in children with cochlear implants (CIs) over a 3-year span. Nine children who received CIs before 30 months of age participated in this study at three, four, and five years postimplantation. Nine typical 3-, 4-, and 5-year- olds served as control groups. All children participated in a story-retell task. Percent correct of tense marking in the task was computed. Within the groups, percent correct of tense marking changed significantly in children with CIs and in typical children who had more hearing experience. Across the groups, children with CIs were significantly less accurate in tense marking than typical children at four and five years postimplantation. In addition, the performance of tense marking in children with CIs was correlated with their speech perception skills at earlier time points. Errors of tense marking tended to be omission rather than commission errors in typical children as well as in children with CIs. The findings suggested that despite the perceptual and processing constraints, children who received CIs may learn tense marking albeit with a delayed pattern.

The aim of the study was to examine reinforcement learning (RL) in young adults with developmental language impairment (DLI) within the context of a neurocomputational model of the basal ganglia-dopamine system (Frank, Seeberger, & O'Reilly, 2004). Two groups of young adults, one with DLI and the other without, were recruited. A probabilistic selection task was used to assess how participants implicitly extracted reinforcement history from the environment based on probabilistic positive/negative feedback. The findings showed impaired RL in individuals with DLI, indicating an altered gating function of the striatum in testing. However, they exploited similar learning strategies as comparison participants at the beginning of training, reflecting relatively intact functions of the prefrontal cortex to rapidly update reinforcement information. Within the context of Frank's model, these results can be interpreted as evidence for alterations in the basal ganglia of individuals with DLI., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: To document the epidemiological characteristics of a group of children who are hard of hearing, identify individual predictor variables for timely follow-up after a failed newborn hearing screening, and identify barriers to follow-up encountered by families., Method: The authors used an accelerated longitudinal design to investigate outcomes for children who are hard of hearing in a large, multicenter study. The present study involved a subgroup of 193 children with hearing loss who did not pass the newborn hearing screening. The authors used available records to capture ages of confirmation of hearing loss, hearing aid fitting, and entry into early intervention. Linear regression models were used to investigate relationships among individual predictor variables and age at each follow-up benchmark., Results: Of several predictor variables, only higher levels of maternal education were significantly associated with earlier confirmation of hearing loss and fitting of hearing aids; severity of hearing loss was not. No variables were significantly associated with age of entry into early intervention. Each recommended benchmark was met by a majority of children, but only one third met all of the benchmarks within the recommended time frame., Conclusion: Results suggest that underserved communities need extra support in navigating steps that follow failed newborn hearing screening.

The long-term educational/vocational, affiliation, and quality-of-life outcomes of the first and second cohorts of children with bilateral, profound hearing loss who received cochlear implants under a large National Institutes of Health-funded study was investigated in 41 of 61 eligible participants. Educational and vocational outcomes were collected from user survey data. Affiliation and quality-of-life data were collected from the Satisfaction-with-Life scale and the Deaf Identity Scale. Qualitative results indicated that compared with their hearing, adult-age peers, this group obtained high educational achievement, and they reported a very high satisfaction of life. With respect to forming an identity in these first 2 cohorts of cochlear implant users, we found that most of the individuals endorsed a dual identity, which indicates they feel just as comfortable with Deaf individuals as they do with hearing individuals. Quantitative results revealed a significant relationship between ability to hear and ability to speak, in addition to consistency of device use. Additional relationships were found between mother's and the individual's educational statuses, hearing scores, and communication system used. Younger individuals scored higher on satisfaction-with-life measures, and they also tended to endorse a dual identity more often. Taken together, these findings diminish concerns that profoundly deaf individuals growing up with cochlear implants will become culturally bereft and unable to function in the hearing world.

In the companion papers this issue we presented the value of research on comorbidity, particularly in complex developmental disorders where the identification of etiology is challenging. As we will document below, Language Impairment (SLI) and Attention Deficit Hyperactivity Disorder (ADHD) have been shown to co-occur in a number of studies, and this phenomenon is commonplace in the experience of many clinicians. Given this, we must ask whether the overlap between SLI and ADHD can aid our understanding of these disorders, particularly with regard to the basis for comorbidity. As we review the literature, we will consider the models of comorbidity that were outlined in the Introduction to this issue. Finally, we present original data on SLI and ADHD from a population-based sample of children that have studied over the last two decades in the State of Iowa.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common developmental disorder often associated with other developmental disorders including speech, language, and reading disorders. Here we review the principal features of ADHD and current diagnostic standards for the disorder. We outline the ADHD subtypes, which are based upon the dimensions of inattention and hyperactivity. These serve as the phenotype for ADHD. Current nomenclature implies a deficit in the cognitive construct of attention, and this has taken researchers on an extended inquiry into several potential endophenotypes underlying ADHD, in particular executive function and its subcomponents. We review this literature and then delve into the neurobiology of ADHD. This research has suggested to us that the corticostriatal system is a strong candidate system in the etiology of ADHD, in part because of the dopaminergic system, which is known to play a role in the disorder. We present this system as an important contributor to the comorbidty of ADHD with other developmental disorders, especially language disorder.

Inspired by the localization, on 15q21.2 of the CYP19A1 gene in the linkage region of speech and language disorders, and a rare translocation in a dyslexic individual that was brought to our attention, we conducted a series of studies on the properties of CYP19A1 as a candidate gene for dyslexia and related conditions. The aromatase enzyme is a member of the cytochrome P450 super family, and it serves several key functions: it catalyzes the conversion of androgens into estrogens; during early mammalian development it controls the differentiation of specific brain areas (e.g. local estrogen synthesis in the hippocampus regulates synaptic plasticity and axonal growth); it is involved in sexual differentiation of the brain; and in songbirds and teleost fishes, it regulates vocalization. Our results suggest that variations in CYP19A1 are associated with dyslexia as a categorical trait and with quantitative measures of language and speech, such as reading, vocabulary, phonological processing and oral motor skills. Variations near the vicinity of its brain promoter region altered transcription factor binding, suggesting a regulatory role in CYP19A1 expression. CYP19A1 expression in human brain correlated with the expression of dyslexia susceptibility genes such as DYX1C1 and ROBO1. Aromatase-deficient mice displayed increased cortical neuronal density and occasional cortical heterotopias, also observed in Robo1-/- mice and human dyslexic brains, respectively. An aromatase inhibitor reduced dendritic growth in cultured rat neurons. From this broad set of evidence, we propose CYP19A1 as a candidate gene for human cognitive functions implicated in reading, speech and language.

This paper serves to provide a background for the topic of comorbidity than extends through this issue. Comorbidity is common within developmental disorders. It is shown that there are many possible reasons for comorbidity. Some of these can be viewed as artifacts as simple as chance occurrence or because of the way that the research participants were sampled. If these artifacts are eliminated, then comorbidity can be informative with respect to possible causes of the disorders that are comorbid. Several possible etiologic models are presented along with a general framework for considering levels of causality in developmental disorders.

Some children demonstrate adequate or better reading achievement in early school grades, but fall significantly behind their peers in later grades. These children are often referred to as late-emerging poor readers. In this study, we investigated the prevalence and heterogeneity of these poor readers. We also examined the early language and nonverbal cognitive abilities of late-emerging poor readers. Participants were 493 children who were a subsample from an epidemiological study of language impairments in school-age children. In kindergarten, children were administered a battery of language, early literacy, and nonverbal cognitive measures. Word reading and reading comprehension achievement was assessed in second, fourth, eighth, and tenth grades. Latent transition analysis was used to model changes in reading classification (good vs. poor reader) across grades. Population estimates revealed that 13.4% percent of children could be classified as late-emerging poor readers. These children could be divided into those with problems in comprehension alone (52%), word reading alone (36%), or both (12%). Further results indicated that late-emerging poor readers often had a history of language and/or nonverbal cognitive impairments in kindergarten. Subtypes of poor readers also differed significantly in their profiles of language, early literacy, and nonverbal cognitive abilities in kindergarten. Results are discussed in terms of causal factors and implications for early identification.

Purpose: Prior work (Guo, Owen, & Tomblin, 2010) has shown that at the group level, auxiliary is production by young English-speaking children was symmetrical across lexical noun and pronominal subjects. Individual data did not uniformly reflect these patterns. On the basis of the framework of the gradual morphosyntactic learning (GML) hypothesis, the authors tested whether the addition of a theoretically motivated developmental measure, tense productivity (TP), could assist in explaining these individual differences., Method: Using archival data from 20 children between age 2;8 and 3;4 (years;months), the authors tested the ability of 3 developmental measures (TP; finite verb morphology composite, FVMC; mean length of utterance, MLU) to predict use of auxiliary is with different subject types., Results: TP, but not MLU or FVMC, significantly improved model fit. Children with low TP scores produced auxiliary is more accurately with pronominal subjects than with lexical subjects. The facilitative effect of pronominal subjects on the production of auxiliary is, however, was not found in children with high TP scores., Conclusion: The finding that the effect of subject types on the production accuracy of auxiliary is changed with children's TP is consistent with the GML hypothesis.

Brief tonal stimuli and spoken sentences were utilized to examine whether adolescents (aged 14;3-18;1) with specific language impairments (SLI) exhibit atypical neural activity for rapid auditory processing of non-linguistic stimuli and linguistic processing of verb-agreement and semantic constraints. Further, we examined whether the behavioral and electrophysiological indices for rapid auditory processing were correlated with those for linguistic processing. Fifteen adolescents with SLI and 15 adolescents with normal language met strict criteria for displaying consistent diagnoses from kindergarten through the eighth grade. The findings provide evidence that auditory processing for non-linguistic stimuli is atypical in a significant number of adolescents with SLI compared to peers with normal language and indicate that reduced efficiency in auditory processing in SLI is more vulnerable to rapid rates (200ms ISI) of stimuli presentation (indexed by reduced accuracy, a tendency for longer RTs, reduced N100 over right anterior sites, and reduced amplitude P300). Many adolescents with SLI displayed reduced behavioral accuracy for detecting verb-agreement violations and semantic anomalies, along with less robust P600s elicited by verb-agreement violations. The results indicate that ERPs elicited by morphosyntactic aspects of language processing are atypical in many adolescents with SLI. Additionally, correlational analyses between behavioral and electrophysiological indices of processing non-linguistic stimuli and verb-agreement violations suggest that the integrity of neural functions for auditory processing may only account for a small proportion of the variance in morphosyntactic processing in some adolescents., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Purpose: In this study, the authors tested the unique checking constraint (UCC) hypothesis and the usage-based approach concerning why young children variably use tense and agreement morphemes in obligatory contexts by examining the effect of subject types on the production of auxiliary is., Method: Twenty typically developing 3-year-olds were included in this study. The children's production of auxiliary is was elicited in sentences with pronominal subjects, high-frequency lexical noun phrase (NP) subjects (e.g., the dog), and low-frequency lexical NP subjects (e.g., the deer)., Results: As a group, children did not use auxiliary is more accurately with pronominal subjects than with lexical NP subjects. Furthermore, individual data revealed that although some children used auxiliary is more accurately with pronominal subjects than with lexical NP subjects, the majority of children did not show this trend., Conclusion: The symmetry observed between lexical and pronominal subjects supports the predictions of the UCC hypothesis, although additional mechanisms may be needed to account for the asymmetry between subject types in some individual children. Discrepant results between the present study and previous studies were attributed to differences in task formats and children's developmental levels.

Considerable individual differences in language ability exist among normally developing children and adults. Whereas past research have attributed such differences to variations in verbal working memory or experience with language, we test the hypothesis that individual differences in statistical learning may be associated with differential language performance. We employ a novel paradigm for studying statistical learning on-line, combining a serial-reaction time task with artificial grammar learning. This task offers insights into both the timecourse of and individual differences in statistical learning. Experiment 1 charts the micro-level trajectory for statistical learning of nonadjacent dependencies and provides an on-line index of individual differences therein. In Experiment 2, these differences are then shown to predict variations in participants' on-line processing of long-distance dependencies involving center-embedded relative clauses. The findings suggest that individual differences in the ability to learn from experience through statistical learning may contribute to variations in linguistic performance.

Thirty years of research has uncovered the broad principles that characterize spoken word processing across listeners. However, there have been few systematic investigations of individual differences. Such an investigation could help refine models of word recognition by indicating which processing parameters are likely to vary, and could also have important implications for work on language impairment. The present study begins to fill this gap by relating individual differences in overall language ability to variation in online word recognition processes. Using the visual world paradigm, we evaluated online spoken word recognition in adolescents who varied in both basic language abilities and non-verbal cognitive abilities. Eye movements to target, cohort and rhyme objects were monitored during spoken word recognition, as an index of lexical activation. Adolescents with poor language skills showed fewer looks to the target and more fixations to the cohort and rhyme competitors. These results were compared to a number of variants of the TRACE model (McClelland & Elman, 1986) that were constructed to test a range of theoretical approaches to language impairment: impairments at sensory and phonological levels; vocabulary size, and generalized slowing. None of the existing approaches were strongly supported, and variation in lexical decay offered the best fit. Thus, basic word recognition processes like lexical decay may offer a new way to characterize processing differences in language impairment.

Purpose: This article describes a database that was created in the process of conducting a large-scale epidemiologic study of specific language impairment (SLI). As such, this database will be referred to as the EpiSLI database. Children with SLI have unexpected and unexplained difficulties learning and using spoken language. Although there is no uniform standard for the diagnosis of SLI, the construct encompasses a language deficit occurring in the presence of grossly normal sensory and nonverbal cognitive abilities (H. Tager-Flusberg & J. Cooper, 1999). Although these language difficulties are most apparent during the preschool and early school years, evidence now exists that these problems are usually present well into adulthood and are probably present throughout a person's life (see, for instance, C. J. Johnson et al., 1999; S. E. Stothard, M. J. Snowling, D. V. M. Bishop, B. B. Chipchase, & C. A. Kaplan, 1998; J. B. Tomblin, 2008)., Discussion: Much of what we know of these children has come from research on children who have been clinically identified and served. Certainly, by studying those who are being served, our research base is most likely to be relevant to clinical services. However, there is a danger in this research strategy. It is quite possible that not all children with SLI are clinically identified and served within our service delivery systems. In such circumstances, there is the potential for systematic factors to influence which children do or do not find their way to clinical service., Clinical Implications: If our research questions are concerned with the characteristics of the actual population of children with SLI that exists in our communities and not just those who are being served, then we need to turn to methods of epidemiology to aid our research.

This study investigated the phonological processing skills of 29 children with prelingual, profound hearing loss with 4 years of cochlear implant experience. Results were group matched with regard to word-reading ability and mother's educational level with the performance of 29 hearing children. Results revealed that it is possible to obtain a valid measure of phonological processing (PP) skills in children using CIs. They could complete rhyming tasks and were able to complete sound-based tasks using standard test materials provided by a commercial test distributor. The CI children completed tasks measuring PP, but there were performance differences between the CI users and the hearing children. The process of learning phonological awareness (PA) for the children with CIs was characterized by a longer, more protracted learning phase than their counterparts with hearing. Tests of phonological memory skills indicated that when the tasks were controlled for presentation method and response modality, there were no differences between the performance of children with CIs and their counterparts with hearing. Tests of rapid naming revealed that there were no differences between rapid letter and number naming between the two groups. Results yielded a possible PP test battery for children with CI experience.

Purpose: The aims of this study were (a) to locate the breakpoints of a balanced translocation (7;13) within a mother (B) and daughter (T); (b) to describe the language and cognitive skills of B and T; and (c) to compare this profile with affected family members of the KE family who have a mutation within FOXP2., Method: The breakpoint locations for T and B were identified by use of fluorescent in situ hybridization analysis followed by DNA sequencing using long-range polymer chain reaction amplification methods. The cognitive and language characteristics were obtained via the use of standardized tests of intelligence, receptive and expressive vocabulary and sentence use, and a spontaneous language sample., Results: The translocation breakpoints in T and B were found in FOXP2 on chromosome 7 and in RFC3 on chromosome 13. T and B's pattern of relative strengths and weaknesses across their cognitive and language performance was found to be similar to descriptions of the affected KE family members., Conclusions: Prior reports of individuals with chromosomal rearrangements of FOXP2 have emphasized their speech impairment. This study provides additional evidence that language-in particular, grammar-is likely to be influenced by abnormalities of FOXP2 function.

In response to the commentaries on our paper (Spencer et al., 2009) we summarize what a developmental systems perspective offers for a twenty-first century science of development by highlighting five insights from developmental systems theory. Where applicable, the discussion is grounded in a particular example-the emergence of ocular dominance columns in early development. Ocular dominance columns are a paragon of epigenesis and are inconsistent with the nativist view. We conclude with optimism that developmental science can move beyond the nativist-empiricist debate armed with both modern technological tools and strong theory to guide their use.

Purpose: Syntactic development in adolescents was examined using a spoken discourse task and standardized testing. The primary goal was to determine whether adolescents with a history of language impairments would differ from those with a history of typical language development (TLD). This is a companion study to one that examined these same adolescents 2 years earlier (M. A. Nippold, T. C. Mansfield, J. L. Billow, & J. B. Tomblin, 2008)., Method: The participants were 15-year-old adolescents with a history of specific language impairment (SLI; n = 102), nonspecific language impairment (NLI; n = 77), or TLD (n = 247). A sample of spoken discourse was elicited using a Peer Conflict Resolution (PCR) task and analyzed for mean length of T-unit, clausal density, and subordinate clause use. In addition, 2 subtests from the Clinical Evaluation of Language Fundamentals, Third Edition (E. Semel, E. H. Wiig, & W. A. Secord, 1995), Concepts and Directions and Recalling Sentences, were administered., Results: On the PCR task, the TLD group outperformed the SLI and NLI groups on mean length of T-unit, clausal density, and nominal clause use, and the TLD group outperformed the NLI group on relative clause use. On the standardized testing, the TLD group outperformed the SLI and NLI groups, and the SLI group outperformed the NLI group. Correlation coefficients calculated between the nonstandardized and standardized measures of syntax were statistically significant and positive., Conclusions: Speech-language pathologists may wish to employ the PCR task to examine syntactic development in adolescents as a supplement to standardized testing.

The nativist-empiricist debate and the nativist commitment to the idea of core knowledge and endowments that exist without relevant postnatal experience continue to distract attention from the reality of developmental systems. The developmental systems approach embraces the concept of epigenesis, that is, the view that development emerges via cascades of interactions across multiple levels of causation, from genes to environments. This view is rooted in a broader interpretation of experience and an appreciation for the nonobvious nature of development. We illustrate this systems approach with examples from studies of imprinting, spatial cognition, and language development, revealing the inadequacies of the nativist-empiricist debate and the inconvenient truths of development. Developmental scientists should no longer abide the nativist-empiricist debate and nativists' ungrounded focus on origins. Rather, the future lies in grounding our science in contemporary theory and developmental process.

Autism spectrum disorder (ASD) and specific language impairment (SLI) are developmental disorders exhibiting language deficits, but it is unclear whether they arise from similar etiologies. Language impairments have been described in family members of children with ASD and SLI, but few studies have quantified them. In this study, we examined IQ, language, and reading abilities of ASD and SLI children and their first-degree relatives to address whether the language difficulties observed in some children with ASD are familial and to better understand the degree of overlap between these disorders and their broader phenotypes. Participants were 52 autistic children, 36 children with SLI, their siblings, and their parents. The ASD group was divided into those with (ALI, n=32) and without (ALN, n=20) language impairment. Relationships between ASD severity and language performance were also examined in the ASD probands. ALI and SLI probands performed similarly on most measures while ALN probands scored higher. ALN and ALI probands' language scores were not related to Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule algorithm scores. SLI relatives scored lowest on all measures, and while scores were not in the impaired range, relatives of ALI children scored lower than relatives of ALN children on some measures, though not those showing highest heritability in SLI. Given that ALI relatives performed better than SLI relatives across the language measures, the hypothesis that ALI and SLI families share similar genetic loading for language is not strongly supported.

Purpose: This study examined the reading achievement growth of children with language impairments (LI) across the school grades. The authors sought to determine whether children with LI demonstrate a delayed, deficit, or cumulative pattern of reading achievement growth when compared with children with typical language (TL)., Method: A group of 225 children with LI and a group of 379 children with TL were identified in kindergarten and were administered multiple measures of word recognition and reading comprehension in 2nd, 4th, 8th, and 10th grades., Results: Confirmatory factor analyses indicated that the constructs of word recognition and reading comprehension were invariant across grades and groups of children with LI and TL. Further analyses indicated that a multiple group latent growth curve analysis was appropriate. This analysis showed that children with LI differed significantly from children with TL in initial level (2nd grade) of word recognition and reading comprehension, but they did not differ significantly in the shape of their growth trajectories., Conclusion: These results are consistent with a deficit model of reading growth in children with LI. Findings are discussed in terms of implications for early identification.

Purpose: This study examined syntactic development in a large cohort of adolescents. At kindergarten, each participant had been identified as having specific language impairment (SLI), nonspecific language impairment (NLI), or typical language development (TLD)., Method: The participants (n = 444) had a mean age of 13;11 (years;months; range = 12;10-15;5). Language samples were elicited in 2 genres, conversational and expository, and analyzed for mean length of T-unit and subordinate clause production., Results: Mean length of T-unit and the use of nominal, relative, and adverbial clauses were greater during the expository task than the conversational task for all groups. Thus, even the SLI and NLI groups produced longer sentences containing greater amounts of subordination when speaking in the expository genre than in the conversational genre. No group differences were revealed by the conversational task. However, on the expository task, the TLD group outperformed both the SLI and NLI groups on mean length of T-unit, and the TLD group outperformed the NLI group on relative clause use., Conclusions: Speech-language pathologists may wish to employ expository discourse tasks rather than conversational tasks to examine syntactic development in adolescents.

Autism and specific language impairment (SLI) are developmental disorders that, although distinct by definition, have in common some features of both language and social behavior. The goal of this study was to further explore the extent to which specific clinical features of autism are seen in SLI. The children with the two disorders, matched for non-verbal IQ, were compared on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). In the SLI group, 41% met autism or autism spectrum cut-offs for social or communication domains either on the ADI or ADOS or both. No relationship was found between the language deficits exhibited by the children with SLI and their scores on the ADI and ADOS. These findings contribute to evidence that there is some overlap in social and communicative deficits between autism and SLI, supporting the view that autism and SLI share etiologic factors. This continuum of pathology between SLI and autism appears to range from structural language abnormalities as seen in individuals with SLI to individuals with SLI with both structural and social abnormalities to individuals with autism with pragmatic impairment and language abnormalities.

Purpose: This study characterized the development of speech sound production in prelingually deaf children with a minimum of 8 years of cochlear implant (CI) experience., Method: Twenty-seven pediatric CI recipients' spontaneous speech samples from annual evaluation sessions were phonemically transcribed. Accuracy for these speech samples was evaluated in piecewise regression models., Results: As a group, pediatric CI recipients showed steady improvement in speech sound production following implantation, but the improvement rate declined after 6 years of device experience. Piecewise regression models indicated that the slope estimating the participants' improvement rate was statistically greater than 0 during the first 6 years postimplantation, but not after 6 years. The group of pediatric CI recipients' accuracy of speech sound production after 4 years of device experience reasonably predicts their speech sound production after 5-10 years of device experience., Conclusions: The development of speech sound production in prelingually deaf children stabilizes after 6 years of device experience, and typically approaches a plateau by 8 years of device use. Early growth in speech before 4 years of device experience did not predict later rates of growth or levels of achievement. However, good predictions could be made after 4 years of device use.

Background: A number of different systems have been suggested for classifying language impairment in children but, to date, no one system has been widely accepted., Method: This paper outlines an alternative system looking for distinct patterns of change in receptive language skills across time, involving a secondary analysis of children identified as having specific language impairment. Participants The participants were 184 children age-assessed at 3 time points--7, 8, and 11 years of age., Results: The pattern of receptive language development is highly predictable. The dominant pattern of growth is consistent with declining rates of growth over time for all children. The primary way in which the children differ is with respect to their initial severity. The testing of the 2 classification systems revealed some statistically significant differences among the subtypes with regard to the shape of the growth rates, but the effect sizes associated with these differences were very small. Thus, it is possible to conclude that beyond the dominant pattern of growth, some subtypes of language impairment at 7 years of age showed only subtle differences in receptive language change across time. The results are discussed in terms of the sample selection and the age of the children who were studied.

Purpose: This study examined the types, frequencies, and distribution of speech disruptions in the spoken narratives of children with specific language impairment (SLI) and their age-matched (CA) and language-matched (LA) peers., Method: Twenty 4th-grade children with SLI, 20 typically developing CA children, and 20 younger typically developing LA children were included in this study. Speech disruptions (i.e., silent pauses and vocal hesitations) occurring in the narratives of these children were analyzed., Results: Children with SLI exhibited speech disruption rates that were higher than those of their age-matched peers but not higher than those of their language-matched peers. The difference in disruption rates between the SLI and CA groups was restricted to silent pauses of 500-1000 ms. Moreover, children with SLI produced more speech disruptions than their peers before phrases but not before sentences, clauses, or words., Conclusions: These findings suggest that there is a relationship between language ability and speech disruptions. Higher disruption rates at phrase boundaries in children with SLI than in their age-matched peers reflect lexical and syntactic deficits in children with SLI.

Purpose: This study investigated the acoustic characteristics of pediatric cochlear implant (CI) recipients' imitative production of rising speech intonation, in relation to the perceptual judgments by listeners with normal hearing (NH)., Method: Recordings of a yes-no interrogative utterance imitated by 24 prelingually deafened children with a CI were extracted from annual evaluation sessions. These utterances were perceptually judged by adult NH listeners in regard with intonation contour type (non-rise, partial-rise, or full-rise) and contour appropriateness (on a 5-point scale). Fundamental frequency, intensity, and duration properties of each utterance were also acoustically analyzed., Results: Adult NH listeners' judgments of intonation contour type and contour appropriateness for each CI participant's utterances were highly positively correlated. The pediatric CI recipients did not consistently use appropriate intonation contours when imitating a yes-no question. Acoustic properties of speech intonation produced by these individuals were discernible among utterances of different intonation contour types according to NH listeners' perceptual judgments., Conclusions: These findings delineated the perceptual and acoustic characteristics of speech intonation imitated by prelingually deafened children and young adults with a CI. Future studies should address whether the degraded signals these individuals perceive via a CI contribute to their difficulties with speech intonation production.

Research on pediatric cochlear implantation has frequently shown that speech perception, speech production, and language outcomes are better for children who are implanted earlier in life than later. These findings are often explained on the grounds that earlier implantation takes advantage of a critical or sensitive period. This paper reviews the literature concerning sensitive periods within the framework of speech and language development. It particularly emphasizes two alternate mechanisms proposed for these periods: an experience-independent mechanism, and an experience-dependent mechanism. Based on this literature review we proposed that research in the field of pediatric cochlear implantation needs to carefully define what kind of evidence is needed to reflect a sensitive period for speech and language learning. The field also needs to consider designing studies that allow the viability of these two mechanisms to be tested. An example of such a study is provided within.

Purpose: Children with language impairment (LI) often perform below the level of typically developing peers on measures of both processing speed and working memory. This study examined the relationship between these 2 types of measures and attempted to determine whether such measures can account for the LI itself., Method: Fourteen-year-old children with LI and their typically developing peers participated in a wide range of processing speed and working memory tasks and were administered a comprehensive language test battery. Confirmatory factor analyses were used to compare 3 nested models designed to examine the dimensionality of the speed and working memory measures. A model that included a general speed factor was also evaluated., Results: The models meeting our evaluation criteria treated speed and working memory as separable factors. Furthermore, nonverbal as well as verbal processing factors emerged from these analyses. Latent variable regression analyses showed that each of the appropriate models accounted for 62% of the variance in the children's concurrent composite language test scores, with verbal working memory making the largest contribution., Conclusions: These findings shed light on the relationship among different types of processing and suggest that processing factors can contribute to the understanding of language disorders.

Purpose: This study asked if children's performance on language tests reflects different dimensions of language and if this dimensionality changes with development., Method: Children were given standardized language batteries at kindergarten and at second, fourth, and eighth grades. A revised modified parallel analysis was used to determine the dimensionality of these items at each grade level. A confirmatory factor analysis was also performed on the subtest scores to evaluate alternate models of dimensionality., Results: The revised modified parallel analysis revealed a single dimension across items with evidence of either test specific or language area specific minor dimensions at different ages. The confirmatory factor analysis tested models involving modality (receptive or expressive) and domain (vocabulary or sentence use) against a single-dimension model. The 2-dimensional model involving domains of vocabulary and sentence use fit the data better than the single-dimensional model; however, the single-dimension model also fit the data well in the lower grades., Conclusions: Much of the variance in standardized measures of language appears to be attributable to a single common factor or trait. There is a developmental trend during middle childhood for grammatical abilities and vocabulary abilities to become differentiated. These measures do not provide differential information concerning receptive and expressive abilities.

Purpose: To determine whether children with language impairment were slower than typically developing peers at age 14, and whether slowing, if present, was similar across task domains; whether differences in response time (RT) across domains were the same for children with specific language impairment (SLI) and nonspecific language impairment (NLI); and whether RT performance at age 9 predicted performance at age 14., Method: Fourteen-year-old children with SLI (n = 20), NLI (n = 15), and typical development (NLD; n = 31) were administered several linguistic and nonlinguistic speeded tasks. The children had received the same tasks at age 9. RT performance was examined., Results: Both the SLI and the NLI groups were significantly slower than the NLD group in motor, nonverbal cognitive, and language task domains, and there was no significant difference among domains. Individual analyses showed that most, but not all, children with SLI and NLI were slower than the NLD group mean. Slowing at age 9 and age 14 were moderately correlated., Conclusions: The results suggest that slow RT is a persistent characteristic of many children with language impairment; however, the nature of the relationship between RT and language performance requires further investigation.

Purpose: The primary goal of this case study was to describe the speech, prosody, and voice characteristics of a mother and daughter with a breakpoint in a balanced 7;13 chromosomal translocation that disrupted the transcription gene, FOXP2 (cf. J. B. Tomblin et al., 2005). As with affected members of the widely cited KE family, whose communicative disorders have been associated with a point mutation in the FOXP2 gene, both mother and daughter had cognitive, language, and speech challenges. A 2nd goal of the study was to illustrate in detail, the types of speech, prosody, and voice metrics that can contribute to phenotype sharpening in speech-genetics research., Method: A speech, prosody, and voice assessment protocol was administered twice within a 4-month period. Analyses were aided by comparing profiles from the present speakers (the TB family) with those from 2 groups of adult speakers: 7 speakers with acquired (with one exception) spastic or spastic-flaccid dysarthria and 14 speakers with acquired apraxia of speech., Results: The descriptive and inferential statistical findings for 13 speech, prosody, and voice variable supported the conclusion that both mother and daughter had spastic dysarthria, an apraxia of speech, and residual developmental distortion errors., Conclusion: These findings are consistent with, but also extend, the reported communicative disorders in affected members of the KE family. A companion article (K. J. Ballard, L. D. Shriberg, J. R. Duffy, & J. B. Tomblin, 2006) reports information from the orofacial and speech motor control measures administered to the same family; reports on neuropsychological and neuroimaging findings are in preparation.

Converging evidence supports the hypothesis that the most common subtype of childhood speech sound disorder (SSD) of currently unknown origin is genetically transmitted. We report the first findings toward a set of diagnostic markers to differentiate this proposed etiological subtype (provisionally termed speech delay-genetic) from other proposed subtypes of SSD of unknown origin. Conversational speech samples from 72 preschool children with speech delay of unknown origin from 3 research centers were selected from an audio archive. Participants differed on the number of biological, nuclear family members (0 or 2+) classified as positive for current and/or prior speech-language disorder. Although participants in the 2 groups were found to have similar speech competence, as indexed by their Percentage of Consonants Correct scores, their speech error patterns differed significantly in 3 ways. Compared with children who may have reduced genetic load for speech delay (no affected nuclear family members), children with possibly higher genetic load (2+ affected members) had (a) a significantly higher proportion of relative omission errors on the Late-8 consonants; (b) a significantly lower proportion of relative distortion errors on these consonants, particularly on the sibilant fricatives /s/, /z/, and //; and (c) a significantly lower proportion of backed /s/ distortions, as assessed by both perceptual and acoustic methods. Machine learning routines identified a 3-part classification rule that included differential weightings of these variables. The classification rule had diagnostic accuracy value of 0.83 (95% confidence limits = 0.74-0.92), with positive and negative likelihood ratios of 9.6 (95% confidence limits = 3.1-29.9) and 0.40 (95% confidence limits = 0.24-0.68), respectively. The diagnostic accuracy findings are viewed as promising. The error pattern for this proposed subtype of SSD is viewed as consistent with the cognitive-linguistic processing deficits that have been reported for genetically transmitted verbal disorders.

This study used neuroimaging and behavioral techniques to examine the claim that processing capacity limitations underlie specific language impairment (SLI). Functional magnetic resonance imaging (fMRI) was used to investigate verbal working memory in adolescents with SLI and normal language (NL) controls. The experimental task involved a modified listening span measure that included sentence encoding and recognition of final words in prior sets of sentences. The SLI group performed significantly poorer than the NL group for both encoding and recognition and displayed slower reaction times for correct responses on high complexity encoding items. fMRI results revealed that the SLI group exhibited significant hypoactivation during encoding in regions that have been implicated in attentional and memory processes, as well as hypoactivation during recognition in regions associated with language processing. Correlational analyses indicated that adolescents with SLI exhibited different patterns of coordinating activation among brain regions relative to controls for both encoding and recognition, suggesting reliance on a less functional network. These findings are interpreted as supporting the notion that constraints in nonlinguistic systems play a role in SLI.

Speech intelligibility of 24 prelingually deaf pediatric cochlear implant (CI) recipients with 84 months of device experience was investigated. Each CI participant's speech samples were judged by a panel of 3 listeners. Intelligibility scores were calculated as the average of the 3 listeners' responses. The average write-down intelligibility score was 71.54% (SD = 29.89), and the average rating-scale intelligibility score was 3.03 points (SD = 1.01). Write-down and rating-scale intelligibility scores were highly correlated (r = .91, p < .001). Linear regression analyses revealed that both age at implantation and different speech-coding strategies contribute to the variability of CI participants' speech intelligibility. Implantation at a younger age and the use of the spectral-peak speech-coding strategy yielded higher intelligibility scores than implantation at an older age and the use of the multipeak speech-coding strategy. These results serve as indices for clinical applications when long-term advancements in spoken-language development are considered for pediatric CI recipients.

In this study 538 children composed 1 oral and 1 written fictional story in both 2nd and 4th grades. Each child represented 1 of 4 diagnostic groups: typical language (TL), specific language impairment (SLI), nonspecific language impairment (NLI), or low nonverbal IQ (LNIQ). The stories of the TL group had more different words, more grammatical complexity, fewer errors, and more overall quality than either language-impaired group at either grade. Stories of the SLI and LNIQ groups were consistently stronger than were those of the NLI group. Kindergarten children with language impairment (LI) whose standardized test performance suggested normalization by 2nd grade also appeared to have recovered in storytelling abilities at that point. By 4th grade, however, these children's stories were less like the children with TL and more like those of children with persistent LI than they had been in 2nd grade. Oral stories were better than written stories in both grades, although the greatest gains from 2nd to 4th grade were generally made on written stories. Girls told stronger stories than did boys at both grades, regardless of group placement. It is concluded that story composition tasks are educationally relevant and should play a significant role in the evaluation of children with developmental LI.

The relationship between children's language acquisition and their nonverbal intelligence has a long tradition of scientific inquiry. Current attention focuses on the use of nonverbal IQ level as an exclusionary criterion in the definition of specific language impairment (SLI). Grammatical tense deficits are known as a clinical marker of SLI, but the relationship with nonverbal intelligence below the normal range has not previously been systematically studied. This study documents the levels of grammatical tense acquisition (for third-person singular -s, regular and irregular past tense morphology) in a large, epidemiologically ascertained sample of kindergarten children that comprises 4 groups: 130 children with SLI, 100 children with nonspecific language impairments (NLI), 73 children with low cognitive levels but language within normal limits (LC), and 117 unaffected control children. The study also documents the longitudinal course of acquisition for the SLI and NLI children between the ages of 6 and 10 years. The LC group did not differ from the unaffected controls at kindergarten, showing a dissociation of nonverbal intelligence and grammatical tense marking, so that low levels of nonverbal intelligence did not necessarily yield low levels of grammatical tense. The NLI group's level of performance was lower than that of the SLI group and showed a greater delay in resolution of the overgeneralization phase of irregular past tense mastery, indicating qualitative differences in growth. Implications for clinical groupings for research and clinical purposes are discussed.