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This study provides a systematic description of French consonant acquisition in a large cohort of pre-school aged children: 156 children aged 20-53 months participated in a picture-naming task. Five analyses were conducted to study consonant acquisition: (1) consonant inventory, (2) consonant accuracy, (3) consonant acquisition, (4) a comparison of consonant inventory to consonant acquisition, and (5) a comparison to English cross-sectional data. Results revealed that more consonants emerge at an earlier age in word initial position, followed by medial position, and then word final position. Consonant accuracy underwent the greatest changes before the age of 36 months, and achieved a relative plateau towards 42 months. The acquisition of consonants revealed that four early consonants were acquired before the age of 36 months (i.e., /t, m, n, z/); 12 intermediate consonants were acquired between 36 and 53 months (i.e., /p, b, d, k, [Formula: see text], , f, v, [Formula: see text], l, w, /); and four consonants were acquired after 53 months (/s, , [integ], j/). In comparison to English data, language specific patterns emerged that influence the order and pace of phonological acquisition. These findings highlight the important role of language specific developmental data in understanding the course of consonant acquisition. [ABSTRACT FROM AUTHOR]

Theevaluation ofthelanguageskills offrancophone childrenforclinical andresearchpurposes is complicated by a lack of appropriate norm-referenced assessment tools. The purpose ofthis study was the collection of normative data for measures assessing major areas of language for 5-year-old monolingual speakers of Quebec French. Children in three age-groups (4;6,5;0 and 5;6 years, n=78) were administered tests of language knowledge and linguistic processing, addressingvocabulary, morphosyntax, syntax, narrative structure,nonword repetition, sentence imitation, rapid automatized naming, following directions, and short term memory. The assessment measures were drawn from existing tools and from tools developed for this study, and included formal tests as well as spontaneous language measures. Normative data are presented for the three age groups. Results showed a systematic increase with age for most of the measures. Correlationalanalysisrevealedrelationships ofvaryingstrengthbetweenthemeasures, indicating some overlap between the measures, but also suggesting that the measures differ in the linguistic skills they tap into. The normative data presented will facilitate the language assessmentofFrench-speaking 5-year-olds,permittingtheir performanceto becomparedtothe normal range oftypically developing monolingual French-speaking children and allowing the documentation of children's profiles of relative strengths and weaknesses within language. [ABSTRACT FROM AUTHOR]

Background: Bilingual assessment is particularly difficult in the very first period of children's second language (L2) exposure. This exploratory, longitudinal study examined L2 learning after 1 and 2 years of L2 exposure by young immigrants and how it is affected by their age at first exposure to the L2 (AoE)., Method: Participants were 18 immigrants ranging in age from 2;11 to 14;2 (years;months), all within their first year in Montreal at Time 1, enrolled in a French school or day care, and from a Mandarin first language background. Participants were tested again a year later. Measures included receptive and expressive French vocabulary tests and conversational language samples analyzed using traditional measures of mean length of utterance (MLU) and morphological accuracy as well as novel measures of semantic and sentence-level patterns., Results: Performance was relatively high already at Time 1 and increased significantly at Time 2 in both vocabulary and MLU. At Time 2, vocabulary scores were below normative values, whereas MLU was within expected values relative to monolingual and simultaneous bilinguals for the majority of the participants. However, higher MLUs were accompanied by more instances of both semantic errors and creative semantic strategies. French performance was strongly related to AoE; with amount of exposure equivalent, older participants outperformed the younger ones on MLU and vocabulary. Semantic errors and creative uses were strongly predicted by AoE; however, morphological accuracy and number of agrammatical utterances were not., Conclusions: This initial period of French learning involved a rapid growth spurt for most of the participants. We argue that the pattern observed, particularly among the older children, constitutes an early stage of L2 learning characterized by long utterances that are also frequently hard to understand as speakers encounter challenges and use creative strategies in their attempt to convey meaning. Comparison with normative reference bases for monolinguals and bilinguals with greater cumulative L2 exposure who have similar MLUs should be done with much caution during this early period.

Purpose: Bilingual development has been shown to be highly dependent on language-specific exposure. This study extended the study of bilingual development to adolescence and to the production of complex syntax in two contexts: conversation and expository discourse., Method: English-French bilinguals (EFbil; n = 27) and French L1 speakers ( n = 14) aged 12 to 17 years produced French and English conversational and expository samples. Measures of mean length of T-units and clausal density were used, as well as a measure of detailed subordinate clause diversity developed in this study., Results: Both groups produced more complex syntax in expository discourse compared to conversation and performed very similarly overall. Significant group differences were found in French subordinate clause diversity but not in sentence length or clause density. For EFbil, differences between languages were unexpectedly greater in conversation. Previous language exposure impacted both languages of the EFbil and in both contexts., Conclusions: This study is the first to report on the spontaneous syntactic use of bilingual adolescents in both their languages. Subtle but significant differences were found in the syntactic skills of the two groups. Expository and conversational contexts each provided unique information on aspects of complex syntactic development, calling into question the idea that the ability to produce a more complex context guarantees conversational abilities. Finally, for the EFbil, previous language exposure impacted both languages, particularly in conversation., Supplemental Material: https://doi.org/10.23641/asha.23713152.

Background: Novel interventions should be developed for people who have undergone psychological trauma. In a previous case study, we found that the number of intrusive memories of trauma could be reduced with a novel intervention. The intervention included a brief memory reminder, a visuospatial task and mental rotation, and targeted trauma memory hotspots one at a time in separate sessions., Objective: This case series (N=3) extended the first case study with 3 new cases to determine whether a similar pattern of beneficial results is observed. We explored whether the brief intervention would result in reduced numbers of intrusive memories and whether it would impact symptoms of posttraumatic stress, depression and anxiety, and general functioning. Acceptability of the intervention was also explored., Methods: A total of 3 women completed the study: 2 with posttraumatic stress disorder and other comorbidities and 1 with subthreshold posttraumatic stress disorder. The primary outcome was the change in the number of intrusive memories from the baseline phase to the intervention phase and at the 1-month follow-up, with an assessment of the intrusion frequency at 3 months. Participants monitored the number of intrusive memories in a daily diary for 1 week at baseline, for maximum of 6 weeks during the intervention phase and for 1 week at the 1-month and 3-month follow-ups. The intervention was delivered in person or digitally, with guidance from a clinical psychologist. A repeated AB design was used (A was a preintervention baseline phase and B intervention phase). Intrusions were targeted individually, creating repetitions of an AB design., Results: The total number of intrusive memories was reduced from the baseline to the intervention phase for all participants. The total number for participant 3 (P3) reduced from 38.8 per week during the baseline phase to 18.0 per week in the intervention phase. It was 13 at the 3-month follow-up. The total number for P4 reduced from 10.8 per week at baseline to 4.7 per week in the intervention phase. It was 0 at the 3-month follow-up. The total number for P5 was reduced from 33.7 at baseline to 20.7 per week in the intervention phase. It was 8 at the 3-month follow-up. All participants reported reduction in posttraumatic stress symptoms in the postintervention phase. Depression and anxiety symptoms reduced in 2 of the 3 participants in the postintervention phase. Acceptability was favorable., Conclusions: We observed good compliance with the intervention and intrusive memory diary in all 3 cases. The number of intrusive memories was reduced for all participants during the intervention phase and at the 1-month follow-up, with some improvement in other symptoms and functioning. Further research should explore the remote delivery of the intervention and whether nonspecialists can deliver the intervention effectively., (©Kristjana Thorarinsdottir, Emily A Holmes, Johann Hardarson, Elin S Stephenssen, Marianna H Jonasdottir, Marie Kanstrup, Laura Singh, Arna Hauksdottir, Thorhildur Halldorsdottir, Berglind Gudmundsdottir, Edda Thordardottir, Unnur Valdimarsdottir, Andri Bjornsson. Originally published in JMIR Formative Research (https://formative.jmir.org), 20.07.2022.)

This study examined the long-term language outcomes of adolescents in the complex multilingual context of Iceland, where children learn Icelandic as a first (L1) or second language (L2), in a background of incidental English from internet and media sources., Method: 50 adolescents enrolled in grades 8, 9 and 10 in Reykjavik (Iceland) public schools (27 L1 speakers and 23 L2 speakers) participated. Standardized language tests and language samples were collected in Icelandic and English. Self-ratings and parent ratings of language proficiency were obtained in Icelandic, English and, for L2 speakers, in the home language as well., Results: As in previous studies, L2 speakers scored far below L1 speakers on formal tests of Icelandic, and also in conversation. The groups were similar in their English skills, with both groups scoring far below L1 English norms. Self-rated performance agreed well with measured performance. For the L2 speakers, self-rated performance in the home language was similar to performance in Icelandic and English. L1 speakers demonstrated much higher performance in Icelandic than English; L2 speakers' performance was more evenly distributed over their three languages., Discussion: The considerable English exposure available in Iceland leads to similar English skills for both L1 and L2 groups, but affects their overall language development in different ways. L1 adolescents maintain a clear dominance in Icelandic, whereas the proficiency of the L2 group is more equally distributed across their three languages, leading to unpredictable patterns of language dominance and at the group level, low performance compared to native speaker expectations in all three languages. These language outcomes in adolescence are of great concern as they do not equip the L2 speakers with the functional communication skills they require for further schooling and jobs. The study calls for a reconsideration of typical multilingual outcomes as necessarily implying unproblematic language skills and suggest that language policy changes are required in Iceland to ensure that children graduate compulsory education with solid language skills that allow them to pursue their goals., (Copyright © 2020 The Author. Published by Elsevier Inc. All rights reserved.)

Public awareness of language impairment in childhood (Developmental Language Disorder (DLD)) has been identified as an important determiner of research and clinical service delivery, yet studies directly assessing public awareness are lacking. This study surveyed awareness across 18 countries of Europe., Method: A questionnaire developed by an international team asked whether respondents had heard of language impairment affecting children, what they thought its manifestations and causes were and where they had heard of it. Respondents were also asked whether they had heard of autism, dyslexia, ADD/ADHD and speech disorder. The questionnaire was administered to members of the public in 18 European countries. A total of 1519 responses were obtained, spanning 6 age groups, 4 educational level groups and 3 income level groups., Results: Across all but one country, significantly fewer people had heard of language impairment than any of the other disorders (or 60 % compared to over 90 % for autism). Awareness tended to be lowest in Eastern Europe and greatest in North-Western Europe, and was influenced by education level, age and income level. People in countries with overall low and overall high awareness differed in their views on manifestations and causes. People had heard of language impairment and autism the same way - most frequently through the media, including Internet, and less frequently through their child's school or a medical professional., Discussion: The study confirms that awareness of language impairment and knowledge of the breadth of its manifestations are low. It also suggests opportunities for how to increase awareness, including greater media coverage of language impairment and more efficient use of venues such as schools and healthcare. Ways in which cultural and linguistic differences may influence public awareness efforts are discussed, including the translatability of clinical labels and scientific terms. These may impact the acceptance of a common term and definition across all countries. As awareness campaigns are gaining momentum, the findings of this study can serve as a baseline against which to compare future findings., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

We present a new set of subjective age-of-acquisition (AoA) ratings for 299 words (158 nouns, 141 verbs) in 25 languages from five language families (Afro-Asiatic: Semitic languages; Altaic: one Turkic language: Indo-European: Baltic, Celtic, Germanic, Hellenic, Slavic, and Romance languages; Niger-Congo: one Bantu language; Uralic: Finnic and Ugric languages). Adult native speakers reported the age at which they had learned each word. We present a comparison of the AoA ratings across all languages by contrasting them in pairs. This comparison shows a consistency in the orders of ratings across the 25 languages. The data were then analyzed (1) to ascertain how the demographic characteristics of the participants influenced AoA estimations and (2) to assess differences caused by the exact form of the target question (when did you learn vs. when do children learn this word); (3) to compare the ratings obtained in our study to those of previous studies; and (4) to assess the validity of our study by comparison with quasi-objective AoA norms derived from the MacArthur-Bates Communicative Development Inventories (MB-CDI). All 299 words were judged as being acquired early (mostly before the age of 6 years). AoA ratings were associated with the raters' social or language status, but not with the raters' age or education. Parents reported words as being learned earlier, and bilinguals reported learning them later. Estimations of the age at which children learn the words revealed significantly lower ratings of AoA. Finally, comparisons with previous AoA and MB-CDI norms support the validity of the present estimations. Our AoA ratings are available for research or other purposes.

Purpose: Grammatical morphology continues to be widely regarded as an area of extraordinary difficulty in children with Specific Language Impairment (SLI). A main argument for this view is the purported high diagnostic accuracy of morphological errors for the identification of SLI. However, findings are inconsistent across age groups and across languages. Studies show morphological difficulty to be far less pronounced in more highly inflected languages and the diagnostic accuracy of morphology in such languages is largely unknown. This study examines the morphological use of Icelandic children with and without SLI in a cross-sectional sample of children ranging from preschool age to adolescence and assesses the usefulness of morphology as a clinical marker to identify SLI., Methods: Participants were 57 monolingual Icelandic-speaking children age 4-14 years; 31 with SLI and 26 with typical language development (TD). Spontaneous language samples were coded for correct and incorrect use of grammatical morphology. The diversity of use of grammatical morphemes was documented for each group at different age and MLU levels. Individual accuracy scores were plotted against age as well as MLU and diagnostic accuracy was calculated., Results: MLU and morphological accuracy increased with age for both children with SLI and TD, with the two groups gradually approaching each other. Morphological diversity and sequence of acquisition was similar across TD and SLI groups compared based on age or MLU. Morphological accuracy was overall high, but was somewhat lower in the SLI group, in particular at ages below 12 years and MLU levels below 6.0. However, overlap between the groups was important in all age groups, involving a greater tendency for errors in both groups at young ages and scores close to or at ceiling at older ages. Sensitivity rates as well as likelihood ratios for each morpheme were all below the range considered acceptable for clinical application, whereas better specificity rates in some age groups for some morphemes indicated that very low scores are indicative of SLI whereas high scores are uninformative. Age effects were evident in that the morphemes varied in the age at which they separate the groups most accurately., Conclusions: The findings of this study show that Icelandic children with SLI are somewhat more prone to making morphological errors than their TD counterparts. However, great overlap exists between the groups. The findings call into question the view that grammatical morphology is a central area of deficit in SLI., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: The amount of language exposure is correlated with bilingual lexical development, but findings are mixed on how exposure relates to nonword repetition (NWR), a complex skill involving both short-term processing and long-term vocabulary knowledge. We extend previous work to a younger age group by investigating the role of exposure on NWR versus vocabulary, along with the effect of item construction and scoring., Method: Sixty typically developing children (ages 2;5-3;6[years;months]) were assessed for NWR and receptive and expressive vocabulary. Participants ranged in amount of previous exposure to English and French from 0% to 100% and were tested in both languages if able to participate, even with very limited exposure (28 completed testing in both languages, 11 completed testing in English only, 21 completed testing in French only)., Results: Correlational analyses showed moderate to strong associations between the amount of exposure and vocabulary in that language, whereas the relationship of exposure with NWR was weak or nonsignificant, depending on scoring method. NWR correlated with vocabulary in English only. Performance on NWR was affected by nonword length but unaffected by wordlikeness., Conclusions: NWR and vocabulary were differently related to language exposure. The underlying mechanisms of NWR at this age appeared mainly reliant on short-term processes, in contrast to long-term vocabulary knowledge.

Purpose: The study examined the effect of bilingual input on the grammatical development of bilingual children in comparison to monolingual peers., Method: Spontaneous language samples were collected in English and French from typically-developing bilingual and monolingual pre-schoolers aged 3 years (n = 56) and 5 years (n = 83). Within each age group, children varied in bilingual exposure patterns but were matched on age, non-verbal cognition, maternal education and language status, speaking two majority languages. Measures included mean length of utterance (MLU) in words and morphemes, and accuracy and diversity of morphological use., Result: Grammatical development in each language was strongly influenced by amount of same-language experience. Children with equal exposure to both languages scored comparably to monolingual children in both languages, whereas children with unequal exposure evidenced similarly unequal performance across languages and scored significantly lower than monolinguals in their weaker language. Scoring significantly lower than monolinguals in both languages may, therefore, be a sign of language impairment. Each language followed a strongly language-specific sequence of acquisition and error patterns. Five-year-old children with low exposure to English displayed an optional infinitive pattern, a strong clinical marker for Primary Language Impairment in monolingual English-speaking children., Conclusion: Descriptive normative data are presented that permit more accurate interpretation of bilingual assessment data.

Purpose: This study investigated the clinical effectiveness of monolingual versus bilingual language intervention, the latter involving speech-language pathologist-parent collaboration. The study focuses on methods that are currently being recommended and that are feasible within current clinical contexts., Method: Bilingual children with primary language impairment who speak a minority language as their home language and French as their second (n=29, mean age=5 years) were randomly assigned to monolingual treatment, bilingual treatment, and no-treatment (delayed-treatment) conditions. Sixteen sessions of individual language intervention were offered, targeting vocabulary and syntactic skills in French only or bilingually, through parent collaboration during the clinical sessions. Language evaluations were conducted before and after treatment by blinded examiners; these evaluations targeted French as well as the home languages. An additional evaluation was conducted 2 months after completion of treatment to assess maintenance of gains. Both monolingual and bilingual treatment followed a focused stimulation approach., Results: Results in French showed a significant treatment effect for vocabulary but no difference between treatment conditions. Gains were made in syntax, but these gains could not be attributed to treatment given that treatment groups did not improve more than the control group. Home language probes did not suggest that the therapy had resulted in gains in the home language., Conclusions: The intervention used in this study is in line with current recommendations of major speech-language pathology organizations. However, the findings indicate that the bilingual treatment created through collaboration with parents was not effective in creating a sufficiently intense bilingual context to make it significantly different from the monolingual treatment. Further studies are needed to assess the gains associated with clinical modifications made for bilingual children and to search for effective ways to accommodate their unique needs.

Purpose: Nonword repetition (NWR) and sentence imitation (SI) are increasingly used as diagnostic tools for the identification of Primary Language Impairment (PLI). They may be particularly promising diagnostic tools for bilingual children if performance on them is not highly affected by bilingual exposure. Two studies were conducted which examined (1) the effect of amount of bilingual exposure on performance on French and English nonword repetition and sentence imitation in 5-year-old French-English bilingual children and (2) the diagnostic accuracy of the French versions of these measures and of receptive vocabulary in 5-year-old monolingual French-speakers and bilingual speakers with and without PLI, carefully matched on language exposure., Method: Study 1 included 84 5-year-olds acquiring French and English simultaneously, differing in their amount of exposure to the two languages but equated on age, nonverbal cognition and socio-economic status. Children were administered French and English tests of NWR and SI. In Study 2, monolingual and bilingual children with and without PLI (four groups, n=14 per group) were assessed for NWR, SI, and receptive vocabulary in French to determine diagnostic accuracy., Results: Study 1: Both processing measures, but in particular NWR, were less affected by previous exposure than vocabulary measures. Bilingual children with varying levels of exposure were unaffected by the length of nonwords. Study 2: In contrast to receptive vocabulary, NWR and SI correctly distinguished children with PLI from children with typical development (TD) regardless of bilingualism. Sensitivity levels were acceptable, but specificity was lower., Conclusions: Bilingual children perform differently than children with PLI on NWR and SI. In contrast to children with PLI, bilingual children with a large range of previous exposure levels achieve high NWR scores and are unaffected by the length of the nonwords., Learning Outcomes: Readers will recognize the effect of language input on the rate of language development, focusing specifically on how bilingual exposure affects the language learning of each language of bilingual children., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: Research on the diagnostic accuracy of different language measures has focused primarily on English. This study examined the sensitivity and specificity of a range of measures of language knowledge and language processing for the identification of primary language impairment (PLI) in French-speaking children. Because of the lack of well-documented language measures in French, it is difficult to accurately identify affected children, and thus research in this area is impeded., Method: The performance of 14 monolingual French-speaking children with confirmed, clinically identified PLI (M = 61.4 months of age, SD = 7.2 months) on a range of language and language processing measures was compared with the performance of 78 children with confirmed typical language development (M age = 58.9 months, SD = 5.7). These included evaluations of receptive vocabulary, receptive grammar, spontaneous language, narrative production, nonword repetition, sentence imitation, following directions, rapid automatized naming, and digit span. Sensitivity, specificity, and likelihood ratios were determined at 3 cutoff points: (a) -1 SD, (b) -1.28 SD, and (b) -2 SD below mean values. Receiver operator characteristic curves were used to identify the most accurate cutoff for each measure., Results: Significant differences between the PLI and typical language development groups were found for the majority of the language measures, with moderate to large effect sizes. The measures differed in their sensitivity and specificity, as well as in which cutoff point provided the most accurate decision. Ideal cutoff points were in most cases between the mean and -1 SD. Sentence imitation and following directions appeared to be the most accurate measures., Conclusions: This study provides evidence that standardized measures of language and language processing provide accurate identification of PLI in French. The results are strikingly similar to previous results for English, suggesting that in spite of structural differences between the languages, PLI in both languages involves a generalized language delay across linguistic domains, which can be identified in a similar way using existing standardized measures.

Unlabelled: Evidence-based practice requires that clinical decisions be based on evidence from rigorously controlled research studies. At this time, very few studies have directly examined the efficacy of clinical intervention methods for bilingual children. Clinical decisions for this population cannot, therefore, be based on the strongest forms of research evidence, but must be inferred from other sources. This article reviews the available intervention research on bilingual children, the current clinical recommendations for this population, and the strength of the empirical and theoretical support on which these recommendations are based. Finally, future directions are suggested for documenting current methods of intervention and developing optimal methods for different groups of bilingual children. Although the current research base is limited, the few studies available to date uniformly suggest that interventions that include a focus on both languages are superior to those that focus on only one language. The available research offers little guidance, however, as to the particular treatment methods that may be most appropriate. Further research is required to examine efficacy with larger numbers of children and children of various bilingual backgrounds. It is suggested that efforts to develop and test intervention methods for bilingual children must carefully consider the linguistic heterogeneity of bilingual children and the cultural variation in communication styles, child rearing practices, and child rearing beliefs. This will lead to the development of methods that may involve treatment methods that are more suitable for other languages and cultures., Learning Outcomes: Readers will become familiar with current recommendations for the treatment of bilingual children with language impairment, including which language or languages to use, the requirement for cultural sensitivity, and specific procedures that may be beneficial for bilingual populations. The heterogeneity of the bilingual population of children is highlighted. Readers will gain an understanding of the strength of research evidence backing up recommended practices, as well as of gaps in our current knowledge base and directions for further development and research., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Neurologic and radiologic findings in children with well-defined developmental language impairment have rarely been systematically assessed. Children aged 7 to 13 years with developmental language impairment or normal language (controls) underwent language, nonverbal cognitive, motor and neurological assessments, standardized assessment for subtle neurological signs, and magnetic resonance imaging. Nine children with developmental language impairment and 12 controls participated. No focal abnormalities were identified on standard neurological examination. Age and developmental language impairment were independent predictors of neurological subtle signs scores (r(2) = 0.52). Imaging abnormalities were identified in two boys with developmental language impairment and no controls (P = .17). Lesions identified were predicted neither by history nor by neurological examination. Previously unsuspected lesions were identified in almost 25% of children with developmental language impairment. Constraints regarding cooperation and sedation requirements may limit the clinical application of imaging modalities in this population.

Purpose: Previous research has indicated that the manifestation of specific language impairment (SLI) varies according to factors such as language, age, and task. This study examined the effect of task demands on language production in children with SLI cross-linguistically., Method: Icelandic- and English-speaking school-age children with SLI and normal language (NL) peers (n = 42) were administered measures of verbal working memory. Spontaneous language samples were collected in contexts that vary in task demands: conversation, narration, and expository discourse. The effect of the context-related task demands on the accuracy of grammatical inflections was examined., Results: Children with SLI in both language groups scored significantly lower than their NL peers in verbal working memory. Nonword repetition scores correlated with morphological accuracy. In both languages, mean length of utterance (MLU) varied systematically across sampling contexts. Context exerted a significant effect on the accuracy of grammatical inflection in English only. Error rates were higher overall in English than in Icelandic, but whether the difference was significant depended on the sampling context. Errors in Icelandic involved verb and noun phrase inflection to a similar extent., Conclusions: The production of grammatical morphology appears to be more taxing for children with SLI who speak English than for those who speak Icelandic. Thus, whereas children with SLI in both language groups evidence deficits in language processing, cross-linguistic differences are seen in which linguistic structures are vulnerable when processing load is increased. Future research should carefully consider the effect of context on children's language performance.

Results have been mixed as to whether dietary counseling improves clinical outcomes in cancer patients. This systematic review and meta-analysis of randomized trials assessed the effect of dietary counseling on quality of life (QOL). It included only randomized trials that focused on dietary counseling and that relied upon a standardized QOL measurement. Five trials that met these and all other a priori eligibility criteria were identified; they are the focus of this meta-analysis. When these five studies were examined in aggregate, the standardized mean difference in QOL scores among patients who received dietary counseling was 0.56 (95% confidence interval,-0.01-1.14; P = 0.06). Dietary counseling does not appear to improve QOL significantly in patients with cancer. However,an observed trend toward benefit underscores the need for further study.

Children with Down syndrome (DS) have cognitive disabilities resulting from trisomy 21. Language-learning difficulties, especially expressive language problems, are an important component of the phenotype of this population. Many individuals with DS are born into bilingual environments. To date, however, there is almost no information available regarding the capacity of these individuals to acquire more than 1 language. The present study compared the language abilities of 8 children with DS being raised bilingually with those of 3 control groups matched on developmental level: monolingual children with DS (n = 14), monolingual typically developing (TD) children (n = 18), and bilingual TD children (n = 11). All children had at least 100 words in their productive vocabularies but a mean length of utterance of less than 3.5. The bilingual children spoke English and 1 other language and were either balanced bilinguals or English-dominant. English testing was completed for all children using the following: the Preschool Language Scale, Third Edition; language sampling; and the MacArthur Communicative Development Inventories (CDI). Bilingual children were also tested in the second language using a vocabulary comprehension test, the CDI, and language sampling. Results provided evidence of a similar profile of language abilities in bilingual children as has been documented for monolingual children with DS. There was no evidence of a detrimental effect of bilingualism. That is, the bilingual children with DS scored at least as well on all English tests as their monolingual DS counterparts. Nonetheless, there was considerable diversity in the second-language abilities demonstrated by these individuals with DS. Clinical implications are addressed.

The Lidcombe Program is an operant treatment for early stuttering. Outcomes indicate that the program is effective; however, the underlying mechanisms leading to a successful reduction of stuttering remain unknown. The purpose of this study was to determine whether fluency achieved with the Lidcombe Program was accompanied by concomitant reduction of utterance length and decreases in linguistic complexity. Standardized language tests were administered pretreatment to 4 male preschool children. Spontaneous language samples were taken 2 weeks prior to treatment, at Weeks 1, 4, 8, and 12 during treatment, and 6 months after the onset of treatment. Samples were analyzed for mean length of utterance (MLU), percentage of simple and complex sentences, number of different words (NDW), and percentage of syllables stuttered. Analysis revealed that all participants presented with language skills in the average and above average range. The children achieved an increase in stutter-free speech accompanied by increases in MLU, percentage of complex sentences, and NDW. For these preschool children who stutter, improved stutter-free speech during treatment with the program appeared to be achieved without a decrease in linguistic complexity. Theoretical and clinical implications are discussed.

Low verb diversity and heavy reliance on a small set of high-frequency 'general all purpose (GAP)' verbs have been reported to characterize specific language impairment (SLI) in preschool children. However, discrepancies exist about the severity of this deficit, particularly in whether these children's verb diversity is commensurate with their MLU level and whether verb diversity is more severely affected than general lexical diversity. Conflicting findings have been reported regarding the use of GAP verbs. This relatively large (n = 100) study extended the investigation of lexical diversity and high-frequency verb use to school-age children with SLI and NL peers and examined a particular hypothesis concerning the role of high-frequency verbs in language development. No differences were found between groups in general lexical diversity or verb diversity in samples of a set number of tokens. The results did not suggest that verb diversity constitutes an area of specific deficit in spontaneous production for children with SLI. SLI and NL groups were indistinguishable in high-frequency verb use. Extensive use of high-frequency verbs by both groups indicates that their use is part of normal development. Results are reported that support the hypothesis that high-frequency verbs act as prototypes for major meaning categories, permitting semantic and syntactic simplification with minimal losses in information value.