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Developmental difficulties with reading comprehension are not uncommon. This article examines the nature of reading comprehension deficits in three groups of children: children identified as having relatively specific impairments in reading comprehension, children with autism spectrum disorder, and children with specific language impairment. Our review emphasizes that in all three groups, poor reading comprehension is often associated with weaknesses in oral language. We conclude that a useful framework for understanding the complex relationship between language and reading in children with developmental disorders is provided by a model that sees variations in phonological and nonphonological language skills relating to different patterns of reading behavior. This framework also provides a useful basis for identifying children with poor reading comprehension, and for planning appropriately targeted interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Children's Communication Checklist (CCC 1998) was revised in 2003 (CCC-2) to provide a general screen for communication disorder and to identify pragmatic/social interaction deficits. Two validation studies were conducted with different populations of children with language and communication impairments. METHODS & PROCEDURES: In Study 1, the questionnaire was given to families of 87 children attending full-time special education for specific language impairment, pragmatic language impairments or autistic spectrum disorders. In addition, the teachers of half the sample completed CCC-2 forms for the same children, providing evidence for interrater agreement. In Study 2, the sample was increased to include 24 children with similar diagnoses in educational contexts in Scotland and 27 children referred for clinical evaluation at a neurodevelopment centre. OUTCOMES & RESULTS: The CCC-2 distinguished children with communication impairments from non-impaired peers. Furthermore, the social-interaction deviance composite (SIDC) of the CCC-2 identified children with disproportionate pragmatic and social difficulties in relation to their structural language impairments. This measure also had good interrater agreement (r=0.79). CONCLUSIONS: CCC-2 provides a useful screening measure for communication impairment and can be helpful in identifying children who should be referred for more detailed assessment of possible autistic spectrum disorder. However, the present data highlight substantial overlap amongst groups with 'distinct' diagnoses. It is suggested that it is unrealistic to use the CCC-2 to make categorical distinctions on this continuum of disorder. [ABSTRACT FROM AUTHOR]

Research on children's reading has emphasized the importance of phonological processing. This study set out to investigate the contribution semantic intervention might make to word recognition in an 8 year old child with language impairment, WS, who exhibited weak phonological skills and relative strengths in semantic processing. Words selected for the study were divided into a treatment group and a no treatment control group. Words in the treatment group were sub-divided into targets, which received active semantic processing intervention, and foils, which received exposure only. Following intervention, target words were read significantly better than controls. This improvement was maintained at follow-up. The results of this study lend tentative support to the idea that intervention emphasizing semantic processing may integrate a range of strategies to support phonological processing. [ABSTRACT FROM AUTHOR]

We report a preregistered analysis to test whether children meeting diagnostic criteria for language disorder (LD) have higher self-reported and/or parent-reported mental health symptoms during the transition from primary to secondary education. Data are from a UK-based longitudinal cohort study, The Surrey Communication and Language in Education Study (SCALES). SCALES oversampled children at risk of LD at school entry. Language was measured using a battery of standardised assessments in Year 1 (age 5-6 years, n  = 529), and mental health symptoms were measured using self and parent report in Year 6 (age 10-11 years, n  = 384) and Year 8 (age 12-13 years, n  = 246). Social experiences were also measured using self-report measures in Year 6. Mental health symptoms were stable during the transition from primary to secondary school. Symptom rates did not differ between children with and without LD based on self-report, but children with LD had higher parent-reported mental health symptoms than their peers with typical language. Similarly, early language was negatively associated with parent-reported but not self-reported mental health symptoms. Early language was associated with fewer child-reported positive social experiences in Year 6, but social experiences did not mediate the association between language and mental health. We found poor agreement between parent and self-reported child mental health symptoms across language groups. Future studies should aim to determine sources of disagreement between parent and child report, particularly for children with communication difficulties who may struggle to accurately self-report mental health symptoms., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: Children and adolescents who stutter may be at risk of elevated anxiety and depression symptoms, although studies have indicated variability in reported internalizing symptoms in this population. This study considers the association between anxiety and depression symptoms and stuttering, as well as child, family, and contextual factors that may affect this association., Method: Thirty-five school-age children who stutter completed the Revised Children's Anxiety and Depression Scale-Short Version. We fitted regression models to examine the association between anxiety and depression symptoms with bullying, stuttering severity, family history of adverse mental health, and age in children who stutter., Results: Family history of adverse mental health was found to significantly predict anxiety and depression scores. Age also predicted depression scores, with older children reporting higher scores., Conclusions: Family history of adverse mental health is associated with higher self-reported internalizing symptoms in children who stutter. The interaction between child, family, and contextual factors may change with age, and this requires further exploration in larger, longitudinal studies. The association between bullying and anxiety scores indicates the importance of anti-bullying initiatives in promoting psychosocial development in school-age children who stutter. This study also highlights the contribution of known risk factors for mental health, such as family history, to variability in symptom reporting.

Background: The aim of this study was to evaluate the Children's Communication Checklist-2 (CCC-2) for measuring social-pragmatic communication deficits and to ascertain their prevalence and functional impact in a community sample., Methods: We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for social (pragmatic) communication disorder (SPCD). We tested the prevalence of social-pragmatic deficits in a population-based sample of children (n = 386) aged 5-6 years old using CCC-2 algorithms. We also investigated the academic and behavioural profiles of children with broadly defined limitations in social-pragmatic competence on the CCC-2., Results: Regardless of the diagnostic algorithm used, the resulting prevalence rates for social-pragmatic deficits indicated that very few children had isolated social-communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this profile was associated with a range of adverse academic and behavioural outcomes., Conclusions: A considerable proportion of children in the early years of primary school has social-pragmatic deficits that interfere with behaviour and scholastic activity; however, these rarely occur in isolation. Exclusionary criteria that include structural language may lead to underidentification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention., (© 2022 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

The formation of new phonological representations is key in establishing items in the mental lexicon. Phonological forms become stable with repetition, time and sleep. Atypicality in the establishment of new word forms is characteristic of children with developmental language disorder (DLD) and autism spectrum disorder (ASD), yet neural changes in response to novel word forms over time have not yet been directly compared in these groups. This study measured habituation of event-related-potentials (ERPs) to novel and known words within and between two sessions spaced 24 hours apart in typically developing (TD) children, and their peers with DLD or ASD. We hypothesised that modulation of the auditory N400 amplitude would mark real-time changes in lexical processing with habituation evident within and across sessions in the TD group, while the DLD group would show attenuated habituation within sessions, and the ASD group attenuated habituation between sessions. Twenty-one typically developing children, 19 children with ASD, and 16 children with DLD listened passively to known and novel words on two consecutive days, while ERPs were recorded using dry electrodes. Counter to our hypotheses, no habituation effect emerged within sessions. However, responses did habituate between sessions, with this effect being reduced in the DLD group, indicating less pre-activation of lexical representations in response to words encountered the previous day. No differences in change over time were observed between the TD and ASD groups. These data are in keeping with theories stressing the importance of sleep-related consolidation in word learning., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2022 The Author(s).)

Children with developmental language disorder (DLD) are at risk for social, emotional, and behavioral (SEB) maladjustment throughout development, though it is unclear if poor language proficiency per se can account for this risk as associations between language and SEB appear more variable among typical-language children. This study investigated whether the relationship between language and SEB problems is stronger at very low levels of language and considered confounders including socioeconomic status, sex, and nonverbal intelligence. These were examined using a population-based survey design, including children with a wide range of language and cognitive profiles, and assessed using the Strengths and Difficulties Questionnaire and six standardized language measures (n = 363, weighted n = 6,451). Structural equation models adjusted for prior levels of SEB revealed that the relationship of language at age 5-6 years to SEB at 7-9 years was nonlinear. Language more strongly predicted all clusters of SEB at disordered language levels relative to typical language levels, with standardized betas of -.25 versus .03 for behavioral, -.31 versus -.04 for peer, and .27 versus .03 for prosocial problems. Wald tests between these pairs of betas yielded p values from .049 to .014. Sex moderated the nonlinear association between language and emotional symptoms. These findings indicate a clinical need to support language development in order to mitigate against problems of SEB and to carefully monitor the mental health needs of children with DLD, particularly in the context of multiple, and potentially sex-specific, risks. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A recent study by Ponari, Norbury, and Vigliocco (2018), showed that emotional valence (i.e. whether a word evokes positive, negative, or no affect) predicts age-of-acquisition ratings and that up to the age of 8-9, children know abstract emotional words better than neutral ones. On the basis of these findings, emotional valence has been argued to provide a bootstrapping mechanism for the acquisition of abstract concepts. However, no previous work has directly assessed whether words' valence, or valence of the context in which words are used, facilitates learning of unknown abstract words. Here, we investigate whether valence supports acquisition of novel abstract concepts. Seven to 10 year old children were taught novel abstract words and concepts (words typically learned at an older age that the children did not know); words were either valenced (positive or negative) or neutral. We also manipulated the context in which words were presented: For 1 group of children, the teaching strategy emphasized emotional information; for the other, it emphasized encyclopedic, nonemotional information. Abstract words with emotional valence were learned better than neutral abstract words by children up to the age of 8-9, replicating previous findings; no effect of teaching strategy was found. These results indicate that emotional valence supports abstract concepts acquisition and further suggest that it is the valence information intrinsic to the word's meaning to have a role, rather than the valence of the context in which the word is learned. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The ability to accurately identify and label emotions in the self and others is crucial for successful social interactions and good mental health. In the current study we tested the longitudinal relationship between early language skills and recognition of facial and vocal emotion cues in a representative UK population cohort with diverse language and cognitive skills ( N  = 369), including a large sample of children that met criteria for Developmental Language Disorder (DLD, N  = 97). Language skills, but not non-verbal cognitive ability, at age 5-6 predicted emotion recognition at age 10-12. Children that met the criteria for DLD showed a large deficit in recognition of facial and vocal emotion cues. The results highlight the importance of language in supporting identification of emotions from non-verbal cues. Impairments in emotion identification may be one mechanism by which language disorder in early childhood predisposes children to later adverse social and mental health outcomes., Competing Interests: The authors declare there are no competing interests., (©2020 Griffiths et al.)

Purpose Establishing stable and flexible phonological representations is a key component of language development and one which is thought to vary across children with neurodevelopmental disorders affecting language acquisition. Sleep is understood to support the learning and generalization of new phonological mappings in adults, but this remains to be examined in children. This study therefore explored the time course of phonological learning in childhood and how it varies by structural language and autism symptomatology. Method Seventy-seven 7- to 13-year-old children, 30 with high autism symptomatology, were included in the study; structural language ability varied across the sample. Children learned new phonological mappings based on synthesized speech tokens in the morning; performance was then charted via repetition (without feedback) over 24 hr and followed up 4 weeks later. On the night following learning, children's sleep was monitored with polysomnography. Results A period of sleep but not wake was associated with improvement on the phonological learning task in childhood. Sleep was associated with improved performance for both trained items and novel items. Structural language ability predicted overall task performance, though language ability did not predict degree of change from one session to the next. By contrast, autism symptomatology did not explain task performance. With respect to sleep architecture, rapid eye movement features were associated with greater phonological generalization. Conclusions Children's sleep was associated with improvement in performance on both trained and novel items. Phonological generalization was associated with brain activity during rapid eye movement sleep. This study furthers our understanding of individual differences in the acquisition of new phonological mappings and the role of sleep in this process over childhood. Supplemental Material https://doi.org/10.23641/asha.11126732.

The causal role of speed of processing (SOP) in developmental language disorder (DLD) is unclear given that SOP has been implicated in other neurodevelopmental disorders such as attention-deficit/hyperactivity disorder. This study investigated associations between SOP, language, and inattention/hyperactivity in a U.K. epidemiological cohort (N = 528). Monolingual children from a range of socioeconomic backgrounds were assessed longitudinally; at ages 5-6 (2012/2013) and 7-8 years (2014/2015). Persistent weaknesses in SOP characterized children with DLD but did not predict language longitudinally. Ratings of inattention/hyperactivity moderated the association between SOP and language, indicating that SOP deficits are particularly detrimental for language when coupled with poor attention/hyperactivity. SOP may be a shared risk factor for DLD and inattention/hyperactivity or a general marker of neurodevelopmental disorder., (© 2019 The Authors. Child Development published by Wiley Periodicals, Inc. on behalf of Society for Research in Child Development.)

Background: Centile curves and standard scores are common in epidemiological research. However, standardised norms and centile growth curves for language disorder that reflect the entire UK local school population do not exist., Methods: Scores on six language indices assessing receptive and expressive functioning of children were obtained from the SCALES population survey. Monolingual English speaking participants were aged between five and nine years. Children who attended special schools at study intake, or who were learning English as an additional language were excluded. We constructed language norms using the LMS method of standardisation which allows for skewed measurements. We made use of probability weights that were produced from a two-step logistic model. Distributions of estimated standard scores from an intensively assessed sub-population and from the full population were contrasted to demonstrate the role of weights., Results: Non-overlapping centile curves and standardised scores at each age were obtained for the six language indices. The use of weights was essential at retrieving the target distribution of the scores. An online calculator that estimates standardised scores for the measures was constructed and made freely available., Conclusions: The findings highlight the usefulness and flexibility of the LMS method at dealing with the standardisation of linguistic and educational measures that are sufficiently continuous. The paper adds to the existing literature by providing population norms for a number of language tests that were calculated from the same group of individuals., Competing Interests: The authors have declared that no competing interests exist.

Background: Paediatric speech and language therapist (SLT) roles often involve planning individualized intervention for specific children, working collaboratively with families and education staff, providing advice, training and coaching and raising awareness. A tiered approach to service delivery is currently recommended whereby services become increasingly specialized and individualized for children with greater needs., Aims: To stimulate discussion regarding delivery of SLT services by examining evidence regarding the effectiveness of (1) intervention for children with language disorders at different tiers and (2) SLT roles within these tiers; and to propose an evidence-based model of SLT service delivery and a flowchart to aid clinical decision-making., Methods & Procedures: Meta-analyses and systematic reviews, together with controlled, peer-reviewed group studies where recent systematic reviews were not available, of interventions for children with language disorders are discussed, alongside the differing roles SLTs play in these interventions. Gaps in the evidence base are highlighted., Main Contribution: The service-delivery model presented resembles the tiered model commonly used in education services, but divides individualized (Tier 3) services into Tier 3A: indirect intervention delivered by non-SLTs, and Tier 3B: direct intervention by an SLT. We report evidence for intervention effectiveness, which children might best be served by each tier, the role SLTs could take within each tier and the effectiveness of these roles. Regarding universal interventions provided to all children (Tier 1) and those targeted at children with language weaknesses or vulnerabilities (Tier 2), there is growing evidence that approaches led by education services can be effective when staff are highly trained and well supported. There is currently limited evidence regarding additional benefit of SLT-specific roles at Tiers 1 and 2. With regard to individualized intervention (Tier 3), children with complex or pervasive language disorders can progress following direct individualized intervention (Tier 3B), whereas children with milder or less pervasive difficulties can make progress when intervention is managed by an SLT, but delivered indirectly by others (Tier 3A), provided they are well trained and supported, and closely monitored., Conclusions & Implications: SLTs have a contribution to make at all tiers, but where prioritization for clinical services is a necessity, we need to establish the relative benefits and cost-effectiveness at each tier. Good evidence exists for SLTs delivering direct individualized intervention and we should ensure that this is available to children with pervasive and/or complex language disorders. In cases where service models are being provided which lack evidence, we strongly recommend that SLTs investigate the effectiveness of their approaches., (© 2018 Royal College of Speech and Language Therapists.)

Some explanations of abstract word learning suggest that these words are learnt primarily from the linguistic input, using statistical co-occurrences of words in language, whereas concrete words can also rely on non-linguistic, experiential information. According to this hypothesis, we expect that, if the learner is not able to fully exploit the information in the linguistic input, abstract words should be affected more than concrete ones. Embodied approaches instead argue that both abstract and concrete words can rely on experiential information and, therefore, there might not be any linguistic primacy. Here, we test the role of linguistic input in the development of abstract knowledge with children with developmental language disorder (DLD) and typically developing children aged 8-13. We show that DLD children, who by definition have impoverished language, do not show a disproportionate impairment for abstract words in lexical decision and definition tasks. These results indicate that linguistic information does not have a primary role in the learning of abstract concepts and words; rather, it would play a significant role in semantic development across all domains of knowledge.This article is part of the theme issue 'Varieties of abstract concepts: development, use and representation in the brain'., (© 2018 The Author(s).)

There is considerable lack of evidence concerning the linguistic and cognitive skills underpinning abstract vocabulary acquisition. The present study considers the role of emotional valence in providing an embodied learning experience in which to anchor abstract meanings. First, analyses of adult ratings of age-of-acquisition, concreteness and valence demonstrate that abstract words acquired early tend to be emotionally valenced. Second, auditory Lexical Decision accuracies of children aged 6-7, 8-9, and 10-11 years (n = 20 per group) complement these analyses, demonstrating that emotional valence facilitates processing of abstract words, but not concrete. These findings provide the first evidence that young, school-aged children are sensitive to emotional valence and that this facilitates acquisition of abstract words., (© 2017 John Wiley & Sons Ltd.)

Background & Aims: We evaluated a structured intervention programme aimed at preparing adolescents with developmental language disorders for job interviews. Our primary outcome measures included change in ratings of verbal and non-verbal social communication behaviours evident during mock interviews., Methods & Procedures: In study 1, 12 participants, aged 17-19 years, from a specialist sixth-form college completed the intervention and two mock interviews, one pre- and one post-intervention. In study 2, 34 participants, aged 17-19 years, completed a modified intervention programme and three mock interviews, one at baseline (included to control for possible practise effects), one pre- and one post-intervention. In both studies, interviews were video recorded and social communication behaviours were coded by independent assessors blind to interview time, participant diagnosis and therapy content. A repeated-measures design was employed to measure change in communication behaviours., Outcomes & Results: In study 1, a significant increase in the number of 'positive' verbal and non-verbal social communication behaviours was observed from pre- to post-intervention. However, there was no significant change in the number of 'negative' behaviours (i.e., fidgeting, irrelevant remarks). In study 2, there were no significant changes in verbal behaviours, but significant group differences (though wide individual variation) in both positive and negative non-verbal social communication behaviours., Conclusions & Implications: Our findings suggest that training specific social communication skills that are important for interview success, and consistently reinforcing those behaviours during therapy practice, can increase the use of those skills in an interview setting, though in this heterogeneous population there was considerable variation in therapy outcome. The skills of the interviewer were identified as a potential source of variation in outcome, and a target for future research and practice., (© 2017 Royal College of Speech and Language Therapists.)

Background: Language development has been characterised by significant individual stability from school entry. However, the extent to which trajectories of language growth vary in children with language disorder as a function of co-occurring developmental challenges is a question of theoretical import, with implications for service provision., Methods: SCALES employed a population-based survey design with sample weighting procedures to estimate growth in core language skills over the first three years of school. A stratified sample (n = 529) received comprehensive assessment of language, nonverbal IQ, and social, emotional and behavioural difficulties at 5-6 years of age and 95% of the sample (n = 499) were assessed again at ages 7-8. Language growth was measured using both raw and standard scores in children with typical development, children with language disorder of unknown origin, and children with language disorders associated with a known clinical condition and/or intellectual disability., Results: Overall, language was stable at the individual level (estimated ICC = 0.95) over the first three years of school. Linear mixed effects models highlighted steady growth in language raw scores across all three groups, including those with multiple developmental challenges. There was little evidence, however, that children with language disorders were narrowing the gap with peers (z-scores). Adjusted models indicated that while nonverbal ability, socioeconomic status and social, emotional and behavioural deficits predicted initial language score (intercept), none predicted language growth (slope)., Conclusions: These findings corroborate previous studies suggesting stable language trajectories after ages 5-6 years, but add considerably to previous work by demonstrating similar developmental patterns in children with additional nonverbal cognitive deficits, social, emotional, and behavioural challenges, social disadvantage or clinical diagnoses., (© 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Developmental language disorders (DLD) are common and have far-reaching developmental consequences. Nevertheless, public awareness of DLD is poor, and one goal of this special issue is to showcase a set of papers that provide a clear and coherent message about the nature and impact of DLD, and the potential of intervention to mitigate these impacts. In this editorial, we highlight seminal papers JCPP has published on language disorders over the last 40 years. Many of the issues raised then are still relevant now; however, the papers that comprise this special issue exemplify how far the field has come in achieving consensus on terminology and diagnostic criteria, and producing highly consistent findings on the stability and impact of DLD, and the potential for language change in response to targeted interventions. The editorial concludes with a road map for future research and clinical priorities that includes the need for randomised controlled trials that specifically address the impact of co-morbidities on response to treatment, impacts of intervention on broader developmental outcomes, and the experiences of adults with DLD., (© 2017 Association for Child and Adolescent Mental Health.)

Purpose: This study explored whether a monolingual-normed English language battery could identify children with English as an additional language (EAL) who have persistent English language learning difficulties that affect functional academic attainment., Method: Children with EAL (n = 43) and monolingual English-speaking children (n = 46) completed a comprehensive monolingual-normed English language battery in Year 1 (ages 5-6 years) and Year 3 (ages 7-8 years). Children with EAL and monolingual peers, who either met monolingual criteria for language impairment or typical development on the language battery in Year 1, were compared on language growth between Year 1 and Year 3 and on attainment in national curriculum assessments in Year 2 (ages 6-7 years)., Results: Children with EAL and monolingual peers who met monolingual criteria for language impairment in Year 1 continued to display comparably impaired overall language ability 2 years later in Year 3. Moreover, these groups displayed comparably low levels of academic attainment in Year 2, demonstrating comparable functional impact of their language difficulties., Conclusion: Monolingual-normed language batteries in the majority language may have some practical value for identifying bilingual children who need support with language learning, regardless of the origin of their language difficulties.

This study investigated whether children with autism spectrum disorders (ASD) can learn vocabulary from linguistic context. Thirty-five children with ASD (18 with age-appropriate structural language; 17 with language impairment [ALI]) and 29 typically developing peers were taught 20 Science words. Half were presented in linguistic context from which meaning could be inferred, whilst half were accompanied by an explicit definition. Children with ASD were able to learn from context. Condition did not influence phonological learning, but receptive semantic knowledge was greatest in the context condition, and expressive semantic knowledge greatest in the definitional condition. The ALI group learnt less than their peers. This suggests that at least some vocabulary should be taught explicitly, and children with ALI may need additional tuition.

Children learning English as an additional language (EAL) often experience lower academic attainment than monolingual peers. In this study, teachers provided ratings of English language proficiency and social, emotional, and behavioral functioning for 782 children with EAL and 6,485 monolingual children in reception year (ages 4-5). Academic attainment was assessed in reception and Year 2 (ages 6-7). Relative to monolingual peers with comparable English language proficiency, children with EAL displayed fewer social, emotional, and behavioral difficulties in reception, were equally likely to meet curriculum targets in reception, and were more likely to meet targets in Year 2. Academic attainment and social, emotional, and behavioral functioning in children with EAL are associated with English language proficiency at school entry., (© 2016 The Authors. Child Development published by Wiley Periodicals, Inc. on behalf of Society for Research in Child Development.)

Purpose: The aim of this study was to determine whether children with language impairment (LI) use gesture to compensate for their language difficulties., Method: The present study investigated gesture accuracy and frequency in children with LI (n = 21) across gesture imitation, gesture elicitation, spontaneous narrative, and interactive problem-solving tasks, relative to typically developing (TD) peers (n = 18) and peers with low language and educational concerns (n = 21)., Results: Children with LI showed weaknesses in gesture accuracy (imitation and gesture elicitation) in comparison to TD peers, but no differences in gesture rate. Children with low language only showed weaknesses in gesture imitation and used significantly more gestures than TD peers during parent-child interaction. Across the whole sample, motor abilities were significantly related to gesture accuracy but not gesture rate. In addition, children with LI produced proportionately more extending gestures, suggesting that they may use gesture to replace words that they are unable to articulate verbally., Conclusion: The results support the notion that gesture and language form a tightly linked communication system in which gesture deficits are seen alongside difficulties with spoken communication. Furthermore, it is the quality, not quantity of gestures that distinguish children with LI from typical peers.

Background: Rating scales are often used to identify children with potential Attention-Deficit/Hyperactivity Disorder (ADHD), yet there are frequently discrepancies between informants which may be moderated by child characteristics. The current study asked whether correspondence between parent and teacher ratings on the Strengths and Weakness of ADHD symptoms and Normal behaviour scale (SWAN) varied systematically with child language ability., Method: Parent and teacher SWAN questionnaires were returned for 200 children (aged 61-81 months); 106 had low language ability (LL) and 94 had typically developing language (TL). After exploring informant correspondence (using Pearson correlation) and the discrepancy between raters, we report inter-class correlation coefficients, to assess inter-rater reliability, and Cohen's kappa, to assess agreement regarding possible ADHD caseness., Results: Correlations between informant ratings on the SWAN were moderate. Children with LL were rated as having increased inattention and hyperactivity relative to children with TL; teachers, however, rated children with LL as having more inattention than parents. Inter-rater reliability of the SWAN was good and there were no systematic differences between the LL and TL groups. Case agreement between parent and teachers was fair; this varied by language group with poorer case agreement for children with LL., Conclusion: Children's language abilities affect the discrepancy between informant ratings of ADHD symptomatology and the agreement between parents and teachers regarding potential ADHD caseness. The assessment of children's core language ability would be a beneficial addition to the ADHD diagnostic process.

Background: Diagnosis of 'specific' language impairment traditionally required nonverbal IQ to be within normal limits, often resulting in restricted access to clinical services for children with lower NVIQ. Changes to DSM-5 criteria for language disorder removed this NVIQ requirement. This study sought to delineate the impact of varying NVIQ criteria on prevalence, clinical presentation and functional impact of language disorder in the first UK population study of language impairment at school entry., Methods: A population-based survey design with sample weighting procedures was used to estimate population prevalence. We surveyed state-maintained reception classrooms (n = 161 or 61% of eligible schools) in Surrey, England. From a total population of 12,398 children (ages 4-5 years), 7,267 (59%) were screened. A stratified subsample (n = 529) received comprehensive assessment of language, NVIQ, social, emotional and behavioural problems, and academic attainment., Results: The total population prevalence estimate of language disorder was 9.92% (95% CI 7.38, 13.20). The prevalence of language disorder of unknown origin was estimated to be 7.58% (95% CI 5.33, 10.66), while the prevalence of language impairment associated with intellectual disability and/or existing medical diagnosis was 2.34% (95% CI 1.40, 3.91). Children with language disorder displayed elevated symptoms of social, emotional and behavioural problems relative to peers, F(1, 466) = 7.88, p = .05, and 88% did not make expected academic progress. There were no differences between those with average and low-average NVIQ scores in severity of language deficit, social, emotional and behavioural problems, or educational attainment. In contrast, children with language impairments associated with known medical diagnosis and/or intellectual disability displayed more severe deficits on multiple measures., Conclusions: At school entry, approximately two children in every class of 30 pupils will experience language disorder severe enough to hinder academic progress. Access to specialist clinical services should not depend on NVIQ., (© 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Changes have been made to the diagnostic criteria for autism spectrum disorder (ASD) in the recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and similar changes are likely in the WHO International Classification of Diseases (ICD-11) due in 2017. In light of these changes, a new clinical disorder, social (pragmatic) communication disorder (SPCD), was added to the neurodevelopmental disorders section of DSM-5. This article describes the key features of ASD, SPCD and the draft ICD-11 approach to pragmatic language impairment, highlighting points of overlap between the disorders and criteria for differential diagnosis., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Specific language impairment (SLI) has traditionally been characterized as a deficit of structural language (specifically grammar), with relative strengths in pragmatics. In this study, comprehensive assessment of production, comprehension, and metalinguistic judgment of referring expressions revealed that children with SLI have weaknesses in both structural and pragmatic language skills relative to age-matched peers. Correlational analyses highlight a relationship between their performance on the experimental tasks and their structural language ability. Despite their poor performance on the production and comprehension tasks, children with SLI were able to recognize pragmatically under-informative reference relative to other types of utterance, although they imposed a less severe penalty on such expressions than typically developing peers, a pattern that supports the pragmatic tolerance account. Our novel methodology (which probed structural abilities from both the speaker's and hearer's perspectives as well as metalinguistic and pragmatic skills in the same sample) challenges the assumption that pragmatic errors stem from deficits in social cognition and instead supports recent findings suggesting that when the impact of structural language is isolated, pragmatic deficits may be resolved., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Specific language impairment (SLI) is diagnosed when language is significantly below chronological age expectations in the absence of other developmental disorders, sensory impairments or global developmental delays. It has been suggested that gesture may enhance communication in children with SLI by providing an alternative means to convey words or extend utterances. However, gesture is a complex task that requires the integration of social, cognitive and motor skills, skills that some children with SLI may find challenging. In addition, there is reason to believe that language and gesture form an integrated system leading to the prediction that children with a SLI may also have difficulties with gestural communication., Aims: To explore the link between language and gesture in children with poor language skills., Methods & Procedure: Fifteen children with SLI and 14 age-matched typically developing children (TD) participated in this study. The children completed measures of expressive and receptive vocabulary, non-verbal cognition, motor control, gesture comprehension and gesture production., Outcomes & Results: TD children achieved significantly higher scores on measures of gesture production and gesture comprehension relative to children with SLI. Significant correlations between both measures of vocabulary and both measures of gesture suggest a tight link between language and gesture., Conclusions & Implications: The findings support the idea that gesture and language form one integrated communication system, rather than two separate communication modalities. This implies that children with SLI may have underlying deficits that impact not only on language but also on gesture production and comprehension., (© 2015 Royal College of Speech and Language Therapists.)

Background: The youngest children in an academic year are reported to be educationally disadvantaged and overrepresented in referrals to clinical services. In this study we investigate for the first time whether these disadvantages are indicative of a mismatch between language competence at school entry and the academic demands of the classroom., Methods: We recruited a population sample of 7,267 children aged 4 years 9 months to 5 years 10 months attending state-maintained reception classrooms in Surrey, England. Teacher ratings on the Children's Communication Checklist-Short (CCC-S), a measure of language competence, the Strengths and Difficulties Questionnaire-Total Difficulties Score (SDQ), a measure of behavioural problems, and the Early Years Foundation Stage Profile (EYFSP), a measure of academic attainment, were obtained at the end of the reception year., Results: The youngest children were rated by teachers as having more language deficits, behaviour problems, and poorer academic progress at the end of the school year. Language deficits were highly associated with behaviour problems; adjusted odds ratio 8.70, 95% CI [7.25-10.45]. Only 4.8% of children with teacher-rated language deficits and 1.3% of those with co-occurring language and behaviour difficulties obtained a 'Good Level of Development' on the EYFSP. While age predicted unique variance in academic attainment (1%), language competence was the largest associate of academic achievement (19%)., Conclusion: The youngest children starting school have relatively immature language and behaviour skills and many are not yet ready to meet the academic and social demands of the classroom. At a population level, developing oral language skills and/or ensuring academic targets reflect developmental capacity could substantially reduce the numbers of children requiring specialist clinical services in later years., (© 2015 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Purpose: Many children with communication disorders have reading comprehension difficulties, and in order to target interventions effectively it is important to identify which specific components of comprehension are especially challenging. The current study explored the relationship between text-inferencing skill, autistic symptomatology, and language phenotype., Method: Typically developing children (n = 32), children with autism spectrum disorders (ASD) and age-appropriate structural language skills (n = 27), children with ASD and language impairment (n = 15), and nonautistic children with language impairment (n = 12) were administered the Neale Analysis of Reading Ability-Revised (Neale, 1997), and responses to literal and inferential questions were analyzed., Results: For the sample as a whole, inferencing competence was predicted by oral language skill, with autistic symptomatology not contributing significant variance. However, although only 12.5% of typically developing children found answering inferential questions disproportionally challenging relative to answering literal questions, one third of children with age-appropriate structural language skills demonstrated inferencing deficits, as did over 50% of children with language impairments, regardless of ASD status., Conclusion: These results indicate that children with language impairments are most likely to find inferencing challenging, but practitioners will also need to monitor the inferencing skills of children with ASD and good language and single-word reading skills.

Many children with autism spectrum disorders (ASD) have reading comprehension difficulties, but the level of processing at which comprehension is most vulnerable and the influence of language phenotype on comprehension skill is currently unclear. We explored comprehension at sentence and passage levels across language phenotypes. Children with ASD and age-appropriate language skills (n = 25) demonstrated similar syntactic and semantic facilitation to typically developing peers. In contrast, few children with ASD and language impairments (n = 25) could read beyond the single word level. Those who could read sentences benefited from semantic coherence, but were less sensitive to syntactic coherence. At the passage level, the strongest predictor of comprehension was vocabulary knowledge. This emphasizes that the intimate relationship between language competence and both decoding skill and comprehension is evident at the sentence, as well as the passage level, for children with ASD.

We aimed to disentangle contributions of socio-pragmatic and structural language deficits to narrative competence by comparing the narratives of children with autism spectrum disorder (ASD; n = 25), non-autistic children with language impairments (LI; n = 23), and children with typical development (TD; n = 27). Groups were matched for age (6½ to 15 years; mean: 10;6) and non-verbal ability; ASD and TD groups were matched on standardized language scores. Despite distinct clinical presentation, children with ASD and LI produced similarly simple narratives that lacked semantic richness and omitted important story elements, when compared to TD peers. Pragmatic errors were common across groups. Within the LI group, pragmatic errors were negatively correlated with story macrostructure scores and with an index of semantic-pragmatic relevance. For the group with ASD, pragmatic errors consisted of comments that, though extraneous, did not detract from the gist of the narrative. These findings underline the importance of both language and socio-pragmatic skill for producing coherent, appropriate narratives.