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This study investigated the relationship between parenting behaviours and specific language impairment (SLI) in children. Using a case-control design, data on 177 kindergarten children with SLI and 925 kindergarten children who were typically developing were collected using a parental questionnaire. Parents were interviewed about parenting practices classified into the following categories: conversing with children, teaching behaviours, the child's daily routine and discipline. The results revealed that parents of children who were normally developing had engaged their children in particular conversational activities more frequently than had parents with children with SLI. Parents of children diagnosed with SLI tended to teach their children school readiness skills (the alphabet and colours) and discipline their children more frequently. These relationships continued to hold after controlling for maternal education and family economic need with the exception of teaching children colour names. The results suggested that additional investigations that examine the association between these parental behaviours and children's language status through direct observation are warranted.

The aim of the present study was to investigate the speed with which children with specific language impairment (SLI) respond on a range of tasks. Seventy-seven third-grade children participated in 10 different tasks (involving a total of 41 conditions), including nonlinguistic and linguistic activities. Mean response times (RTs) of children with SLI (n = 29) increased as a function of mean RTs of children with normal language (NLD, n = 29) under each of three different regression models; children with SLI responded more slowly across all task conditions, and also when linguistic and nonlinguistic tasks were analyzed separately. Children with nonspecific language impairment (NLI) were also included (n = 19). The results were similar to those for children with SLI, but the degree of slowing was greater. The results of the group analyses support the hypothesis that speed of processing in children with SLI is generally slower than that of children with normal language. However, some children with SLI do not appear to show deficits of this type.

This study examined nonword repetition performance in a population-based sample of school-age children. A total of 581 second graders who were participating in a longitudinal, epidemiologic investigation of specific language impairment (SLI) were administered the Nonword Repetition Task (NRT) developed by Dollaghan & Campbell (1998). Performance was examined according to second-grade diagnostic category, presence/absence of language impairment, and treatment status. Results indicated that children with language impairment, as well as those in intervention, exhibited deficient nonword repetition skills compared to normal language controls. Findings also confirmed that the NRT is a culturally nonbiased measure of language processing. Results from likelihood ratio analyses indicated that NRT performance, though not sufficient on its own, may provide a useful index to assist in ruling in or ruling out language disorder.

Children with language impairment (LI) have been shown to be at risk for reading disability (RD) and behavior disorder (BD). Previous research has not determined the specific pattern of these conditions associated with LI. This study sought to determine if the behavior disorder and reading problems represented different outcomes or if these conditions occurred together when found with LI. A group of 581 second-grade children, including 164 children with LI, were examined for spoken language, reading, and behavior disorder. The data for each of these areas were examined as dimensional traits and as clinical categorical traits. Reading and spoken language were found to be strongly correlated (r = .68); RD was found in 52 % of the children with LI and in only 9 % of the controls. Scores of parent ratings for BD were also significantly correlated with spoken language scores (r = .29). Clinical levels of BD were found in 29% of the children with LI and 19% of the controls. An examination of the co-occurrence of clinical levels of BD, RD, and LI showed BD in children with LI to be conditioned by the child's reading status. The data indicated that whereas RD was directly associated with BD, the association of LI with BD required the mediation of RD.

We estimate the prevalence of speech delay (L.D. Shriberg, D. Austin, B. A. Lewis, J. L. McSweeny, & D. L. Wilson, 1997b) in the United States on the basis of findings from a demographically representative population subsample of 1,328 monolingual English-speaking 6-year-old children. All children's speech and language had been previously assessed in the "Epidemiology of Specific Language Impairment" project (see J. B. Tomblin et al., 1997), which screened 7,218 children in stratified cluster samples within 3 population centers in the upper Midwest. To assess articulation, the Word Articulation subtest of the Test of Language Development-2: Primary (Newcomer & Hammill, 1988) was administered to each of the 1,328 children, and conversational speech samples were obtained for a subsample of 303 (23%) children. The 6 primary findings are as follows: (a) The prevalence of speech delay in 6-year-old children was 3.8%; (b) speech delay was approximately 1.5 times more prevalent in boys (4.5%) than girls (3.1%); (c) cross-tabulations by sex, residential strata, and racial/cultural backgrounds yielded prevalence rates for speech delay ranging from 0% to approximately 9%; (d) comorbidity of speech delay and language impairment was 1.3%, 0.51% with Specific Language Impairment (SLI); (e) approximately 11-15% of children with persisting speech delay had SLI; and (f) approximately 5-8% of children with persisting SLI had speech delay. Discussion includes implications of findings for speech-language phenotyping in genetics studies.

Background: To employ patient-reported speech outcome data collected on head and neck cancer (HNC) surveys, there is a need to determine (1) the relationship of patient ratings to speech language pathologist (SLP) ratings and (2) whether patients' attitudes toward their speech are an important element of speech measurements., Methods: Associations were analyzed between (1) patients' ratings of speech function on surveys and equivalent SLP ratings and (2) patients' ratings of speech function and their satisfaction with speech function., Results: Patient-reported survey ratings were significantly associated with comparable SLP ratings. The associations were stronger for intelligibility than for voice quality. Patients' functional and attitudinal ratings were also significantly associated. The associations were relatively strong for composite speech items and intelligibility and moderate for voice quality., Conclusions: Patient-reported speech outcomes can be interpreted as being fairly equivalent to SLP evaluations. Attitudinal ratings appear to contribute an important aspect of the patients' perspective, with substantially different variances between function and attitude.

English language achievement of 29 prelingually deaf children with 3 or more years of cochlear implant (CI) experience was compared to the achievement levels of prelingually deaf children who did not have such CI experience. Language achievement was measured by the Rhode Island Test of Language Structure (RITLS), a measure of signed and spoken sentence comprehension, and the Index of Productive Syntax (IPSyn), a measure of expressive (signed and spoken) English grammar. When the CI users were compared with their deaf age mates who contributed to the norms of the RITLS, it was found that CI users achieved significantly better scores. Likewise, we found that CI users performed better than 29 deaf children who used hearing aids (HAs) with respect to English grammar achievement as indexed by the IPSyn. Additionally, we found that chronological age highly correlated with IPSyn levels only among the non-CI users, whereas length of CI experience was significantly correlated with IPSyn scores for CI users. Finally, clear differences between those with and without CI experience were found by 2 years of post-implant experience. These data provide evidence that children who receive CIs benefit in the form of improved English language comprehension and production.

Three simulation experiments were conducted to determine the basis of the high predictive accuracy (98%) of temporal processing variables for the identification of language impairment obtained by Tallal, Stark, and Mellits (1985). In the first two experiments, the stepwise discriminant analysis using a set of 160 arrays of random numbers to predict a dichotomous language status (either normal or disordered) resulted in an average accuracy rate of 86.3% in contrast with the 98% rate obtained by Tallal, Stark, and Mellits. The third experiment showed that a 95% accuracy rate could be obtained from an array of 160 variables that each may only account for about 1.5% variance in the language ability. These results emphasize the need for confirmatory studies when large data sets are used to identify a small set of predictor variables., (Copyright 1998 Academic Press.)

Studies on specific language impairments (SLI) have demonstrated that SLI aggregate in families. This may be due to the presence of prenatal and postnatal features of a shared environment, such as parental smoking, that has been associated with lowered cognitive and language outcomes in children of smokers. This study explored the relationship between parental smoking and specific language impairments (SLI) in children. Using a case-control design, data on 177 children with SLI and 925 children who were typically developing were collected using a parental questionnaire concerning parental smoking habits. Maternal and paternal smoking during pregnancy, during children's development and continuous smoking during pregnancy and development were significantly related to SLI. However, when parental education was controlled for, these significant associations no longer existed. It is suggested that parental smoking, although not independently associated with SLI, may be an indicator of a parenting environment that places children at risk for language impairments.

In order to examine the basis of familial associations with poor language achievement, 62 twinship pairs and 3 sets of triplets were studied in which at least one member presented poor oral language status in the absence of other developmental or sensory impairments. Rates of concordance for poor language were compared between the monozygotic (MZ) and dizygotic (DZ) pairs. Concordance for the MZ pairs was .96, whereas it was .69 for the DZ pairs. The DeFries-Fulker method for computing heritability of extreme scores was employed yielding a h2g of .45. Similar results were obtained for those pairs containing only children with performance IQs above 85, but with at least one member having language below -1 SD. A comparison of DZ twins with singleton sibling pairs with at least one affected member and of similar age showed that DZ twins were more similar with respect to language achievement than singleton pairs. Thus, twinning appeared to have influenced twin resemblance among those where at least one member presented poor language achievement. These results support the hypothesis that genetic factors contribute to the liability of poor language achievement in children who do not present other developmental or sensory disorders.

This epidemiologic study estimated the prevalence of specific language impairment (SLI) in monolingual English-speaking kindergarten children. From a stratified cluster sample in rural, urban, and suburban areas in the upper midwest, 7,218 children were screened. The language screening failure rate was 26.2%. Children who failed the screening and a similar number of controls were then administered a diagnostic battery (n = 2,084) that provided for a diagnosis of SLI using common diagnostic standards. Results provided an estimated overall prevalence rate of 7.4%. The prevalence estimate for boys was 8% and for girls 6%. Variation in prevalence was found among children of different racial/cultural backgrounds; however, these background variables were found to be correlated with parental education, which was also associated with SLI. The parents of 29% of the children identified as SLI reported they had previously been informed that their child had a speech or language problem. The prevalence estimates obtained fell within recent estimates for SLI, but demonstrated that this condition is more prevalent among females than has been previously reported. Also, the clinical identification of these children remains low among kindergarteners.

A valid and reliable diagnostic standard for language impairment is required for the conduct of epidemiologic research on specific language disorder. A rationale is provided for such a diagnostic system labeled the EpiSLI system. This system employed five composite scores representing norm-referenced performance in three domains of language (vocabulary, grammar, and narration) and two modalities (comprehension and production). Children who have two or more composite scores below-1.25 standard deviations were considered as children with language disorder. The performance of the EpiSLI diagnostic system was examined on a sample of 1,502 kindergarten children and it was shown that this diagnostic system yielded results that were consistent with clinician rating and previous research results.

Averaged cortically evoked potentials to frequency-modulated tones (+/- 100 Hz around a center frequency of 1 kHz) were obtained from 12 children with SLI and 12 age-matched children who were normal language learners. It was hypothesized, based on Stefanatos, Green, and Ratcliff (1989), that the children with receptive and expressive specific language impairment (SLI) would show very small or no measurable averaged response amplitudes. Also, it was predicted that children who were normal language learners would show large response amplitudes that were both significantly greater than those obtained during a stimulus control condition and greater than those obtained from the children with SLI. The prediction concerning children with SLI proved incorrect. The responses of the children with SLI were no different from those obtained from the normal language learners, and responses from both groups were significantly greater than those obtained in the control condition. These results indicate that, with respect to neural systems involved with selective response to auditory frequency shifts of approximately 100 Hz and occurring over 250 msec, children with SLI are not different from children who are normal language learners.

The diagnostic decision-making standards used by practicing clinicians to determine language impairment were investigated. Randomly selected ASHA members who worked with children were asked to review hypothetical and real case profiles of children ages 4 to 9:11 (years: months) with language performance skills ranging from slightly above average to substantially below average. Based on the child's age and language and intelligence test information, clinicians were asked to decide if the child was language impaired (LI) and, if so, to provide a severity rating. Results show significant interrater agreement among the 27 clinicians' LI decisions (generalized kappa = 0.14, p < .0001) and moderate intrarater reliability within clinician's LI decisions (phi = .68). Most of the clinicians' diagnostic decision-making standards could be modeled using stepwise logistic regression. These decision rules can provide guidance for those who wish to employ diagnostic standards that reflect those used in clinical practice. Also, these results provide insight into the manner in which clinicians use information for the determination of language impairment.

Two sets of diagnostic measures were administered to a group of 35 adults with well-documented histories of specific language impairment and to a control group of 35 normal language users. These measures involved the comprehension and production of words and sentences in formal and spontaneous speaking activities as well as measures of verbal memory and auditory temporal perceptual ability. One set of tasks was administered in a standard face-to-face setting and the other set was given over the telephone. Multivariate and univariate tests indicated that the adults with a history of specific language impairment performed more poorly on all tasks administered. A discriminant analysis of the two sets of measures indicated that four measures in each set identified language-impaired individuals with 97% accuracy for the face-to-face battery and 95% accuracy for the telephone battery. These results suggest that it should be possible to diagnose specific language impairment in the adult family members of children with specific language impairment and therefore permit accurate construction of pedigrees for specific language impairment.

The speech and language status of 662 children between the ages of 30 months and 5 years was determined through the use of parent report information. Twelve of these children were reported by their parents to have been diagnosed as having a speech-language disorder, and 50 of these children were found to be at or below the 10th percentile in language development for children of their age. Information about family background and birth history obtained when these children were born was evaluated with respect to its power to predict speech-language status in these preschool children. A set of risk criteria was found to accurately predict 55% of those children with poor communication skills and 76% of those with normal communication development. This prediction was improved by the addition of data about the child's birth order. These results suggest that programs of preschool identification should consider the inclusion of a registry of children who are at risk for a communication disorder.

This two-part study explored the influence that a preschool-aged child's communication behavior has on the impression he or she makes on adults. First, the semantic differential technique was used to reveal the dimensions that describe the adults' judgments of these children. Four adult judges listened to 140 2-min samples of children conversing with an adult and rated the children on 24 bipolar adjective scales. Factor analysis of the ratings produced a three-dimensional structure (Dynamism, Maturity, and Appeal) that accounted for 80% of the total variance in the judgement data. Next, the association between six selected speech and language behaviors and the judgements on each of these dimensions were examined. Rate of speech, fluency of speech, participation in the conversation, complexity of sentences, and grammaticality of utterances were not highly correlated with adults' impressions. However, level of phonological accuracy did correlate with adults' perceptions of degree of maturity.

The birth order of second-grade children with and without developmental language impairment was obtained to determine if language-impaired children were more likely to be later born than earlier born. In this study the family size and socioeconomic status of the families for the language-impaired and normal groups were very similar. Comparison of the distribution of birth ranks between second-grade language-impaired and normal second-grade children failed to show a difference in birth ranks. Further, the distribution of birth ranks of all language-impaired children within the sibships was not found to show evidence favouring either early or later born birth ranks. Thus, contrary to previous research in which family size and socioeconomic status were not controlled, this study did not provide evidence in support of a birth order effect in developmental language impairment.

Previous research on the effect of syntactic order on the memory performance of hearing-impaired subjects has indicated that in contrast to normal-hearing subjects the deaf do not make use of the syntactic order of a word string to facilitate retention and recall. The present study used an immediate serial recall paradigm rather than a paired associate paradigm requiring longer term retention. Using this paradigm, 10 normal-hearing, 10 hearing-impaired subjects trained with manual communication, and 10 hearing-impaired trained with oral communication were presented with word strings of four, six, and eight words in length. One set of word strings was syntactically well formed while another was randomly ordered. The subjects were presented the stimuli over nine trials. An analysis of the number of errors for each list length and order condition revealed facilitation due to syntactic order at the eight-word length for all subjects and at the six-word length for the hearing-impaired populations. An error analysis further supported the use of syntactic order by the hearing impaired to facilitate their retention of the word strings. Two ways of resolving the conflict between these results and prior results showing no facilitation are presented. The first recognizes the possible use of an order of mention strategy and its effect upon performance in these two studies. The second notes the differences in the involvement of semantic versus syntactic information in the tasks used in these studies.

Four children demonstrating speech and language impairments were examined with respect to their ability to learn to identify certain auditory temporal perceptual information. These children listened to six-element temporal patterns and made judgments about the temporal proximity of two of the elements. Subjects listened to the patterns over a number of exposures ranging from 6 to 14, depending on the subject. Performance on the task improved significantly with repeated exposures. However, the disordered subjects' best performance was still significantly poorer than normal children who had only 1 exposure to the task. These results suggest that, in part, performance differences on temporal perceptual tasks between speech and language disordered children and normal children can be accounted for by differences in perceptual learning. However, because the disordered children never reached normal levels, learning differences may be associated with a fundamental deficit in temporal processing or some other mechanism such as impaired attention.

Six children diagnosed as autistic and who also were reported to be using questions inappropriately in their conversations with adults were each placed in a conversational context in which the adult responses to their questions were systematically varied. The dependent variable was the occurrence and amount of appropriate conversational continuation associated with each type of adult response. Differential listener response did affect the occurrence of conversational continuation and to a lesser degree the amount of continuation. These data were interpreted to support the hypothesis that repetitive questioning in this population serves the communicative function of conversation initiation. Furthermore, it appears that the autistic conversants lack the conversational management skills to maintain the conversation following the listener's answer to the question.

A questionnaire concerning the history of treatment of developmental language disorder was used to evaluate the prevalence of these problems within the immediate family members of second-grade children with and without language impairment. The data obtained from these families revealed strong evidence that such language problems are not randomly distributed across families but rather tend to concentrate within families. Although all family members of the language-impaired second graders demonstrated substantially increased odds for language impairment over those who came from families with normal second graders, a considerable range of increased odds for language impairment existed among the family members. Specifically, brothers and to a lesser degree sisters had a higher familial association with language impairment than did the parents. These results suggest that the factors that contribute to developmental language disorders are at least in part associated with the family unit.

The extent to which the Minnesota Child Development Inventory (MCDI), could be used to estimate levels of language development in 2-year-old children was examined. Fifty-seven children between 23 and 28 months were given the Sequenced Inventory of Communication Development (SICD), and at the same time a parent completed the MCDI. In addition the mean length of utterance (MLU) was obtained for each child from a spontaneous speech sample. The MCDI Expressive Language scale was found to be a strong predictor of both the SICD Expressive scale and MLU. The MCDI Comprehension-Conceptual scale, presumably a receptive language measure, was moderately correlated with the SICD Receptive scale; however, it was also strongly correlated with the expressive measures. These results demonstrated that the Expressive Language scale of the MCDI was a valid predictor of expressive language for 2-year-old children. The MCDI Comprehension-Conceptual scale appeared to assess both receptive and expressive language, thus complicating its interpretation.

Thirty-six subjects, 18 language-impaired and 18 articulation-impaired children, were followed up with respect to communication skills and educational performance 13 to 20 years after their initial contact with the Speech and Hearing Clinic. According to their parents, nine language-impaired subjects continued to exhibit communication problems as adults, compared to only one of the articulation-impaired subjects. Standardized educational testing conducted while the subjects were in elementary and secondary schools indicated that the language-impaired group consistently achieved at a lower level than the articulation-impaired group, particularly in reading. Differences between the groups were also exhibited in the types of postsecondary education attempted by the subjects. Clinical, educational, and research implications of these results are discussed.

Articulatory positioning and movement characteristics were compared between /w/ and intended /r/ productions in three children exhibiting w/r substitutions and one normal control subject. High-speed lateral-view cineradiography was utilized. It was found that only the control subject demonstrated significant differences in lip, jaw, and tongue positioning for /w/ compared to /r/. However, systematic patterns of articulatory variability within and between subjects suggested that the experimental subjects were possibly differentiating between /w/ and intended /r/ even though the articulatory target configuration appeared to be nondiscriminatory. Perceptual judgmnets of the tape-recorded utterances mirrored the physiological data in that only those intended /r/ productions involving articulatory positioning clearly different from that of /w/ were perceived as /r/.

The hypothesis that the Repetition Task partially reflects the listener's level of perceptual learning was tested in this study. Specifically, it was predicted from data on auditory temporal processing that performance on the Repetition Task would improve with experience. Ten kindergarten children with no known communication problems were given 10 sets of the Repetition Task over a span of 5 days. Analysis of the data revealed a significant difference in performance across interstimulus intervals (ISI) and also over the training period. Performance improved as a function of increments in ISI and number of days of training. The data reflected a significant training effect, thereby supporting the experimental hypothesis. These results suggest the possibility that differences between dysphasic and normal children on the Repetition Task may result from differences in perceptual learning.