Effectiveness of cloud-based rehabilitation in children with developmental language disorder during the COVID-19 pandemic: A prospective cohort study.

During the coronavirus disease 2019 pandemic, we considered the case of a child with developmental language disorder (DLD) who could not go to the hospital on time to receive timely rehabilitation treatment due to disrupted hospital operations. The application of cloud-based rehabilitation platforms has provided significant advantages and convenience for children with DLD in-home remote rehabilitation. Among them, the JingYun Rehab Cloud Platform is the most widely used in mainland China. It is an interactive telerehabilitation system developed by Weixin Huang that delivers personalized home rehabilitation for special education children. In this study, we used the JingYun Rehab Cloud Platform to investigate the extent to which cloud-based rehabilitation is effective for children with DLD in terms of language and cognitive outcomes. This was a prospective cohort study including all children who were evaluated and diagnosed with DLD through Sign-Significant Relations and were followed up at the rehabilitation clinic of our institute. We followed 162 children with DLD for 3 months, including 84 children with DLD who participated in remote cloud-based rehabilitation on the JingYun Rehab Cloud Platform and 78 children with DLD as the control group who underwent home-based rehabilitation. Language abilities of both groups were assessed using the Chinese version of the Peabody Picture Vocabulary Test-Revised. Several measures of training performance (language, memory, and cognition tasks) were assessed before and after cloud-based rehabilitation in the remote cloud-based rehabilitation group. Children with DLD in the cloud-based rehabilitation group performed significantly better in language abilities, as assessed by the Peabody Picture Vocabulary Test-Revised, than children with DLD in the control group. Furthermore, for children who participated in remote cloud-based rehabilitation, the frequency of training sessions was proportional to their performance on language, memory, and cognition tasks. This study demonstrated the effectiveness of cloud-based rehabilitation on the JingYun Rehab Cloud Platform in treating children with DLD.

Examining the Associations Between Parent Concerns and School-Age Children's Language and Reading Abilities: A Comparison of Samples Recruited for In-School Versus Online Participation.

PURPOSE: The purpose of this study was to examine the relationship between parent concerns about children's oral language, reading, and related skills and their children's performance on standardized assessments of language and reading, with a particular focus on whether those relationships differed between children recruited for in-school versus online participation. METHOD: This study used data from a larger, longitudinal project focused on children with and without developmental language disorder (DLD) and/or dyslexia. The "in-school" sample (n = 133) completed assessments in-person before school closures, and the "online" sample (n = 84) recruited via advertisements completed assessments online. Parents completed a checklist of concerns. All children completed norm-referenced assessments of language and reading. RESULTS: The two recruitment strategies yielded samples that differed in racial diversity (higher in the in-school sample), caregiver education levels (higher in the online sample), and word reading test scores (higher in the online sample). Parents in both samples reported higher levels of concerns about literacy skills than oral language skills, and the correlation between parent concerns about literacy and children's word reading test scores was stronger than the correlation between parent concerns about oral language and children's language test scores. CONCLUSIONS: Researchers and clinicians should be aware of how recruitment strategies and assessment modalities (e.g., in-person vs. tele-assessment) may impact participation in studies and clinical service. A reliance on parent concerns about oral language to prompt a language evaluation may contribute to low rates of identification of children who meet criteria for DLD. Future research can consider parent concerns about literacy, attention, and executive functions as indicators of a need for language evaluation, especially considering the high comorbidity between language and other developmental disorders.

Is Bilingual Receptive Vocabulary Assessment via Telepractice Comparable to Face-to-Face?

PURPOSE: This study investigated the effect of delivery method (face-to-face or telepractice), time, home language, and language ability on bilingual children's receptive vocabulary scores in Spanish and English. METHOD: Participants included bilingual children with (n = 32) and without (n = 57) developmental language disorders (DLD) that were assessed at 2 time points about 1 year apart. All children participated in face-to-face assessment at Time 1. At Time 2, 41 children were assessed face-to-face and 48 children were assessed using telepractice. RESULTS: Delivery method was not a significant predictor of receptive scores in either Spanish or English. Spanish and English receptive vocabulary increased over time in both children with and without DLD. Children with DLD had lower receptive vocabulary raw scores than children with typical development. Children who spoke English-only at home had significantly higher English receptive scores than children who spoke Spanish-only or both Spanish and English at home. CONCLUSIONS: Face-to-face and telepractice assessments seem to be comparable methods for the assessments of Spanish and English receptive skills. Spanish and English receptive skills increased over time in children with and without DLD. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.17912297.

Translating Enhanced Conversational Recast to a Telepractice Setting.

PURPOSE: This investigation adapted a well-studied language treatment method, Enhanced Conversational Recast, paired with auditory bombardment to a teletherapy format. METHOD: The study used a single case series approach (n = 7) to determine the feasibility of teletherapy with children ages 5 and 6 years of age. Treatment targeted grammatical errors in the context of dialogic reading and craft activities. Clinicians administered 24 doses in the form of focused conversational recasting, followed by 12 doses consisting of simple sentences containing the grammatical forms targeted for remediation. Children were treated for up to 26 sessions, with four children treated on consecutive weekdays and three treated twice a week. Treatment progress was operationalized as generalization of target grammatical forms to untreated linguistic contexts, as well as spontaneous use of the treated form. To control for nontreatment effects, generalization of an untreated form was also tracked throughout the treatment period. RESULTS: Six of the seven children showed clinically meaningful gains in the use of the grammatical forms targeted for treatment within the treatment period. This was true for children enrolled in both treatment schedules. Learning for treated forms was retained after treatment was discontinued. In comparison, no change was seen for untreated forms for six of the seven children. CONCLUSIONS: The results suggest that this treatment method is feasible in a telepractice format, even with young children. The range of individual results is generally comparable to previous face-to-face versions of this treatment.

The Reliability of Telepractice Administration of the Western Aphasia Battery-Revised in Persons With Primary Progressive Aphasia.

PURPOSE: The use of telepractice in the field of communication disorders offers an opportunity to provide care for those with primary progressive aphasia (PPA). The Western Aphasia Battery-Revised (WAB-R) is used for differential diagnosis, to assess severity of aphasia, and to identify a language profile of strengths and challenges. Telehealth administration of the WAB-R is supported for those with chronic aphasia due to stroke but has not yet been systematically explored in neurodegenerative dementia syndromes. To fill this gap, in-person and telehealth performance on the WAB-R from participants with mild to moderate PPA was compared. METHOD: Nineteen participants with mild to moderate PPA were administered the WAB-R in person and over videoconferencing. Videoconferencing administration included modifications to the testing protocol to ensure smooth completion of the assessment. Subtest and Aphasia Quotient (WAB-AQ) summary scores were compared using concordance coefficients to measure the relationship between the administration modes. RESULTS: In-person and telehealth scores showed strong concordance for the WAB-AQ, Auditory Verbal Comprehension subtest, and Naming & Word Finding subtest. The Spontaneous Speech test summary score had slightly lower concordance, indicating the need for caution when comparing these scores across administration modes. CONCLUSION: These findings support extending the use of telehealth administration of the WAB-R via videoconferencing to those with mild to moderate PPA given appropriate modifications to testing protocol.

Parental Report via a Mobile App in the Context of Early Language Trajectories: StarWords Study Protocol.

Social sciences researchers emphasize that new technologies can overcome the limitations of small and homogenous samples. In research on early language development, which often uses parental reports, taking the testing online might be particularly compelling. Due to logistical limitations, previous studies on bilingual children have explored the language development trajectories in general (e.g., by including few and largely set apart timepoints), or focused on small, homogeneous samples. The present study protocol presents a new, on-going study which uses new technologies to collect longitudinal data continuously from parents of multilingual, bilingual, and monolingual children. Our primary aim is to establish the developmental trajectories in Polish-British English and Polish-Norwegian bilingual children and Polish monolingual children aged 0-3 years with the use of mobile and web-based applications. These tools allow parents to report their children's language development as it progresses, and allow us to characterize children's performance in each language (the age of reaching particular language milestones). The project's novelty rests on its use of mobile technologies to characterize the bilingual and monolingual developmental trajectory from the very first words to broader vocabulary and multiword combinations.

Taking Language Samples Home: Feasibility, Reliability, and Validity of Child Language Samples Conducted Remotely With Video Chat Versus In-Person.

Purpose There has been increased interest in using telepractice for involving more diverse children in research and clinical services, as well as when in-person assessment is challenging, such as during COVID-19. Little is known, however, about the feasibility, reliability, and validity of language samples when conducted via telepractice. Method Child language samples from parent-child play were recorded either in person in the laboratory or via video chat at home, using parents' preferred commercially available software on their own device. Samples were transcribed and analyzed using Systematic Analysis of Language Transcripts software. Analyses compared measures between-subjects for 46 dyads who completed video chat language samples versus 16 who completed in-person samples; within-subjects analyses were conducted for a subset of 13 dyads who completed both types. Groups did not differ significantly on child age, sex, or socioeconomic status. Results The number of usable samples and percent of utterances with intelligible audio signal did not differ significantly for in-person versus video chat language samples. Child speech and language characteristics (including mean length of utterance, type-token ratio, number of different words, grammatical errors/omissions, and child speech intelligibility) did not differ significantly between in-person and video chat methods. This was the case for between-group analyses and within-child comparisons. Furthermore, transcription reliability (conducted on a subset of samples) was high and did not differ between in-person and video chat methods. Conclusions This study demonstrates that child language samples collected via video chat are largely comparable to in-person samples in terms of key speech and language measures. Best practices for maximizing data quality for using video chat language samples are provided.

Two clinical markers for DLD in monolingual Italian speakers: what can they tell us about second language learners with DLD?

A large number of children worldwide are only exposed to their L2 around 3 years of age and can exhibit linguistic behaviours that resemble those of a child with Developmental Language Disorder (DLD). This can lead to under- or over-identification of DLD in this population. This study endeavors to contribute to overcoming this problem, by determining whether two specific clinical markers used with the Italian monolingual population can also be used with early L2 acquiring children, namely clitic production and non-word repetition. Our study involved two groups of 5-year-old L2 learners of Italian from various language backgrounds; 18 children had been referred to Speech and Language Therapy (SLT) services (EL2_DLD), and 30 children were typically developing (EL2_TD). The participants completed an Italian clitic production task and a non-word repetition task based on Italian phonotactics. Data was also collected from the participants' caregivers with the ALDeQ Parental Questionnaire to obtain information about the children's L1. Our results suggest that non-word repetition and clitic production in Italian are potentially useful for identifying L2 learners of Italian with DLD, at the age of 5 years. The repetition of non-words is highly accurate in identifying children with DLD among the participants, while clitic production is somewhat less discriminative in this sample. This study is a first step towards uncovering clinical markers that could be used to determine the presence of DLD in children acquiring their L2.