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

Parents of deaf children must decide whether to raise their child using spoken and/or signed language. Multilingual parents have the additional decision of whether to use multiple spoken languages (with or without a signed language as well). These communication choices -- which can be both explicit and implicit -- can change over time and are known as a Family Language Policy (FLP). This study provides a reflexive thematic analysis of semi-structured interviews with multilingual parents of deaf children who chose spoken language multilingualism (SLM), and with multilingual parents of hearing children who also chose to raise their children with more than one language. We identified four key themes which influenced the decisions parents made on SLM: (1) additional benefits for the child; (2) knowledge and professional advice; (3) family and social influences; and (4) family dynamics and negotiation. The results highlight the complexity of the decisions behind FLPs for multilingual parents of deaf children and the strong influence that factors within and outside the family can have.

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

Background: Speech and language acquisition can be a challenge for young children with Down syndrome (DS), and while early intervention is important, we do not know what early interventions exist and how effective they may be. Aims: To systematically review existing early speech, language and communication interventions for young children with DS from birth up to 6 years, and to investigate their effectiveness in improving speech, language and communication outcomes in children with DS. Other outcomes are changes in parental behaviour and their responsiveness. Methods & Procedures: We conducted a systematic search of relevant electronic databases to identify early intervention studies targeting speech, language and communication outcomes in children with DS published up to May 2020. A total of 11 studies that met the inclusion criteria were synthesized and appraised for quality using the PEDro-P scale. There were a total of 242 children. We identified three types of intervention: communication training and responsive teaching, early stimulation programme, and dialectic-didactic approach. Main contribution: The findings from nine out of the 11 studies reported positive outcomes for children's language and communication up to 18 months following the intervention. All nine studies reported interventions that were co-delivered by parents and clinicians. However, there was also a de-accelerated growth in requesting behaviours in the intervention group reported by one study as well as a case of no improvement for the intervention group. Three studies provided some evidence of improvements to parent outcomes, such as increased parental language input and increased responsiveness. However, there was a moderate to high risk of bias for all studies included. Conclusions: The findings from this review suggest that interventions that have high dosage, focus on language and communication training within a naturalistic setting, and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with DS between 0 and 6 years of age. Due to the limited number of studies, limited heterogeneous data and the moderate to high risk of bias across studies, there is an urgent need for higher quality intervention studies in the field to build the evidence base.

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

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

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

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

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

Background: Aims: Methods & Procedures: Main contribution: Conclusions & Implications: WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Speech sound disorders (SSDs) are broadly defined as difficulty producing speech sounds in childhood. Reported prevalence of SSD varies from 2.3% to 24.6%, depending on how SSD is defined and the included age range. SSDs that do not resolve before age 8 can have a lasting impact on a child's academic achievements. The intensity of intervention for SSD is important to ensure effectiveness. However, there is a gap between the evidence base for intensity and speech and language therapists’ (SLTs) clinical practice. One way that SLTs try to bridge this gap is by working with parents. SLTs believe that working with parents/caregivers is vital for a child with SSD to make progress.To conduct a scoping review of the literature to provide a comprehensive picture of the perceptions, experiences and strategies underpinning collaborative working between SLTs and parents/caregivers of children (aged ≤ 5 years 11 months) with SSD to increase intervention intensity at home.This scoping review was completed in accordance with PRISMA‐ScR guidelines. A systematic search of PubMed, PsycInfo, CINHAL, Web of Science, EBSCOhost and EThOS was conducted using synonyms of three key terms: SSD, Therapy, Parents. Key journals and papers were hand searched for unique papers. A total of 29 papers were included for review. Data were analysed using thematic synthesis to develop themes. These themes are discussed using the PAGER framework to identify advances, gaps, evidence for practice and areas for future research.Seven key themes were identified: individualization, setting expectations, daily life, parental knowledge, parental involvement, therapeutic relationships and supporting parents to deliver home practice. There has been an acceleration of research around working with parents of children with SSD, with increased consideration of effective adult coaching techniques. Parents value the parental and child relationship with the SLT and feel this supports the success of home practice. There is a need for further research, and guidance for SLTs working with parents of children with SSD to enable them to support parents to deliver home practice effectively.Emerging evidence supports the value of SLTs and parents working together to support home practice for children with SSD. The review highlighted the importance of SLTs allocating time to build positive therapeutic relationships with parents to support engagement in therapy. Approaching intervention, in particular, home practice, flexibly and in collaboration with parents, allows parents to fit home practice into their daily lives. Providing clear information to parents supports the fidelity of, and engagement in, home practice. There is a gap between what is recommended in the evidence base for intervention intensity for children with SSD and current clinical practice worldwide. SLTs try to bridge this gap through home practice and believe that working with parents/caregivers is vital for children with SSD to make progress. However, little is known about the best ways for SLTs to work with parents for this population. Training parents to be implementers of intervention in a personalized and flexible way is important and valued by parents and SLTs. Parents value understanding the clinical rationale behind the intervention approach and benefit from explicit instructions for home practice, including discussion, written information, observation and feedback. Therapeutic relationships take time to develop and impact parental engagement in home practice. The findings of this study highlight existing knowledge which will support SLTs to work optimally with parents to implement home practice for their child with SSD. It highlights the importance of taking time to foster working relationships with parents to support effective home practice. The review identifies gaps in the current skills and knowledge of SLTs, highlighting the need for further research, support and guidance for SLTs in their work with parents, as well as implications for the development of the SLT pre‐registration curriculum. [ABSTRACT FROM AUTHOR]

Many autistic pupils are educated within mainstream settings, due to positive changes in inclusive education policies and legislation worldwide. It is acknowledged that teachers’ attitudes can be a facilitator and a barrier to the success of an inclusive classroom, and teachers’ knowledge of autism and training received on different educational needs are potential factors influencing attitudes. Few studies have assessed teachers’ attitudes to social communication and interaction (SCI) differences in autistic students, or factors associated with these attitudes, yet SCI differences can significantly impact student-teacher and student-peer relationships in the classroom. The present study examined teachers’ attitudes to SCI differences to understand how these relate to their general knowledge of autism, and the hours of training received on different educational needs. Data were collected via an online survey and semi-structured interviews. The results showed teachers’ attitudes to SCI differences were significantly positively correlated with knowledge of autism, but not with hours of training received. The interviews generated four themes: (1) manifestation of SCI differences in the classroom, (2) inclusive practices and barriers to inclusion, (3) the role of a teacher and (4) the value of training, and highlighted generally positive teachers’ attitudes towards autistic students with SCI differences, while acknowledging challenges. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the prosodic profiles of English- and Spanish-speaking children with Williams syndrome (WS), examining cross-linguistic differences. Two groups of children with WS, English and Spanish, of similar chronological and nonverbal mental age, were compared on performance in expressive and receptive prosodic tasks from the Profiling Elements of Prosody in Speech-Communication Battery in its English or Spanish version. Differences between the English and Spanish WS groups were found regarding the understanding of affect through prosodic means, using prosody to make words more prominent, and imitating different prosodic patterns. Such differences between the two WS groups on function prosody tasks mirrored the cross-linguistic differences already reported in typically developing children.

The aim of the article is to provide preliminary data on the use of auxiliaries and clitics in Serbian-speaking children with developmental language impairment. Two groups of children (a group of 30 children with developmental language impairment and a group of 30 typically developing children) aged between 48 and 83 months and matched on IQ took part in the study. They were asked to tell a story from a series of four pictures. The results showed that the children with language impairment omitted significantly more auxiliary verbs and clitics than the controls. In addition, the rate of omission of auxiliaries and clitics did not decrease with increasing chronological age. We conclude that, as in other languages, auxiliary verbs and clitics are particularly difficult for Serbian-speaking children with language impairment. (Contains 5 notes and 4 tables.)

Specific language impairment (SLI) is usually defined as a developmental language disorder which does not result from a hearing loss, autism, neurological and emotional difficulties, severe social deprivation, low non-verbal abilities. Children affected with SLI typically have difficulties with the acquisition of different aspects of language and by definition, their impairment is specific to language and no other skills are affected. However, there has been a growing body of literature to suggest that children with SLI also have non-linguistic deficits, including impaired motor abilities. The aim of the current study is to investigate language and motor abilities of a group of thirty children with SLI (aged between 4 and 7) in comparison to a group of 30 typically developing children matched for chronological age. The results showed that the group of children with SLI had significantly more difficulties on the language and motor assessments compared to the control group. The SLI group also showed delayed onset in the development of all motor skills under investigation in comparison to the typically developing group. More interestingly, the two groups differed with respect to which language abilities were correlated with motor abilities, however Imitation of Complex Movements was the unique skill which reliably predicted expressive vocabulary in both typically developing children and in children with SLI. (Contains 9 tables and 4 figures.)

Despite ample research into the language skills of children with specific reading disorder no studies so far have investigated whether there may be a difference between expressive and receptive language skills in this population. Yet, neuro-anatomical models would predict that children who have specific reading disorder which is not associated with movement or attention difficulties, would have lower receptive language skills than expressive. This study investigates the difference between expressive and receptive language skills in a sample of 17 children with specific reading difficulty aged between 7 and 12 years. They were administered a battery of two receptive and two expressive language measures. The results showed that as the neuro-anatomical model would predict, the children scored significantly lower on tests of receptive than on tests of expressive language skills. (Contains 3 tables.)

Purpose: The authors investigated expressive and receptive intonation abilities in children with Williams syndrome (WS) and the relation of these abilities to other linguistic abilities. Method: Fourteen children with WS, 14 typically developing children matched to the WS group for receptive language (LA), and 15 typically developing children matched to the WS group for chronological age (CA) were compared on a range of receptive and expressive intonation tasks from the Profiling Elements of Prosodic Systems-Child version (PEPS-C) battery. Results: The WS group performed similarly to the LA group on all intonation tasks apart from the long-item imitation task, on which the WS group scored significantly lower than the LA group. When compared with the CA group, the WS group was significantly poorer on all aspects of intonation. Whereas there were a number of significant correlations between the intonation and language measures in the control groups, in the WS group, there was only 1 significant correlation between a PEPS-C task and one of the language measures. Conclusion: As a result of this study, the authors concluded that children with WS have expressive and receptive intonation abilities as expected for their level of language comprehension and that intonation and other linguistic abilities in WS are not strongly related.

The aim of the current study was to investigate expressive affect in children with Williams syndrome (WS) in comparison to typically developing children in an experimental task and in spontaneous speech. Fourteen children with WS, 14 typically developing children matched to the WS group for receptive language (LA) and 15 typically developing children matched to the WS groups for chronological age (CA) were recruited. Affect was investigated using an experimental Output Affect task from the Profiling Elements of Prosodic Systems-Child version (PEPS-C) battery, and by measuring pitch range and vowel durations from a spontaneous speech task. The children were also rated for level of emotional involvement by phonetically naive listeners. The WS group performed similarly to the LA and CA groups on the Output Affect task. With regard to vowel durations, the WS group was no different from the LA group; however both the WS and the LA groups were found to use significantly longer vowels than the CA group. The WS group differed significantly from both control groups on their range of pitch range and was perceived as being significantly more emotionally involved than the two control groups. (Contains 1 table and 4 figures.)

Williams syndrome (WS) is a rare genetic disorder resulting from a deletion on chromosome 7. A number of studies have shown that individuals with WS have a superior linguistic profile compared to their non-verbal abilities, however the evidence has been inconclusive, as many studies have disputed such a profile. The vast majority of studies on WS have assumed a single, homogeneous WS linguistic profile in order to support various theoretical viewpoints. The present study investigated the linguistic profiles of 5 individuals with WS on a number of standardized verbal measures and in conversational settings. The results indicated substantially variable performance in all aspects of the verbal domain, which supports the view that WS, linguistically, is a rather heterogeneous condition and this should be taken into consideration when referring to it in theoretical accounts of language acquisition and debates on modularity. (Contains 5 tables.)

This paper investigates whether people with Williams syndrome (WS) have prosodic impairments affecting their expression and comprehension of four main uses of intonation. Two adolescent males with WS were assessed using the PEPS-C battery, which considers prosodic abilities within a psycholinguistic framework, assessing prosodic form and function in both the input and output domains. The performances of the subjects with WS were compared with control data for age and language-comprehension matched children. The results revealed significant prosodic impairment affecting all areas of the profile. Crucially, however, different profiles of strengths and weaknesses were revealed for the two subjects. The results support the growing view that WS is a heterogeneous population in terms of linguistic abilities. (Contains 4 tables.)

Williams syndrome (WS) is characterized by apparent relative strengths in language, facial processing and social cognition but by profound impairment in spatial cognition, planning and problem solving. Following recent research which suggests that individuals with WS may be less linguistically able than was once thought, in this paper we begin to investigate why and how they may give the impression of linguistic proficiency despite poor standardized test results. This case study of Brendan, a 12-year-old boy with WS, who presents with a considerable lack of linguistic ability, suggests that impressions of linguistic competence may to some extent be the result of conversational strategies which enable him to compensate for various cognitive and linguistic deficits with a considerable degree of success. These conversational strengths are not predicted by his standardized language test results, and provide compelling support for the use of approaches such as Conversation Analysis in the assessment of individuals with communication impairments. (Contains 1 table and 1 note.)

Background: The superiority of language and communication skills in children and adults with Williams syndrome (WS) is currently being debated. Whilst there have been a number of reports of precursors of language in WS in children who have already developed language, there have not been many studies that have prospectively investigated precursors of language in pre-verbal children with WS. Aims: To investigate the development of early social communication skills before the onset of language in WS. Methods & Procedures: A short-term longitudinal single case study was carried out spanning 10 months. The child was assessed five times using parent report, observation of mother-child interactions and by administering the Pre-verbal Communication Schedule, the Pragmatics Profile of Early Communication Skills and the Pre-School Language Scale-3. Outcomes & Results: Longitudinal comparisons showed that the level of verbal communication in the child with WS always lagged behind the level of motor and cognitive development. Conclusions: The results indicate that rather than being a strength, social communication was an area of weakness relative to other aspects of development in this case. This case raises the potential desirability for early speech and language assessment and intervention in infants with WS. (Contains 3 notes and 3 tables.)