The model of access to speech-language pathology services.

PURPOSE: Within Australia, some families face challenges in accessing paediatric speech-language pathology services. This research sought to investigate the factors that impact access to paediatric speech-language pathology services within Western Australia. METHOD: Researchers used constructivist grounded theory to investigate the construct of access, as experienced and perceived by service decision-makers, namely caregivers of children with communication needs and speech-language pathologists who provide communication services. Eleven speech-language pathologists and 16 caregivers took part in 32 semi-structured in-depth interviews. Researchers used layers of coding of interviews transcripts and the constant comparative method to investigate data. RESULT: Findings outline the factors that impact access to speech-language pathology services, as organised into the seven categories of the Model of Access to Speech-Language Pathology Services (MASPS). The categories and properties of this model are grounded within experiences and perspectives that participants contributed to the dataset. CONCLUSION: MASPS provides a theoretical structure that has been constructed using inductive and abductive reasoning. This model can be used by service designers and decision-makers to reflect upon and improve experiences of service for a range of consumers. MASPS can also be used as a basis for further investigation into aspects of service access.

Understanding mental health in developmental dyslexia through a neurodiversity lens: The mediating effect of school-connectedness on anxiety, depression and conduct problems.

Dyslexia, a neurocognitive difference characterised by poor word-reading, is associated with elevated risk for internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns, the reasons are largely unknown. We took a neurodiversity perspective and explored whether school-connectedness mediated these associations. A total of 283 primary school children (87 with dyslexia) and their caregivers (95.4% mothers) completed a battery of well-validated connectedness and mental health measures. Two mediation models (one for child-report and one for caregiver-report) tested direct and indirect effects of dyslexia on anxiety, depression and conduct problems via several domains of school-connectedness. After controlling for gender and neurodevelopmental conditions other than dyslexia, there were no direct effects of dyslexia on child- or caregiver-reported internalising symptoms or child-reported conduct problems. Dyslexia was associated with child and caregiver reported anxiety, depression and conduct problems via low levels of school (but not teacher, friend or peer) connectedness. Findings highlight school-connectedness as an important intervention target for the mental health of children with dyslexia. Future research is needed to test associations between dyslexia, school-connectedness and mental health over time.

The grammaticality judgement of inflectional morphology in children with and without Developmental Language Disorder.

To explore the clinical potential of grammaticality judgement tasks, this study investigated whether a Grammaticality Judgment Task (GJT) of inflectional morphology could differentiate between a clinically selected sample of children with DLD and children in mainstream (i.e. regular education) schools. We also explored the relationship between grammaticality judgement and measures of receptive vocabulary, receptive grammar, and nonword repetition. Children with DLD (n = 30; age range = 69-80 months) and mainstream children in Pre-primary, Year 1, and Year 2 (n = 89, age range = 61-96 months) were assessed on a GJT of regular past tense, third person singular, and possessive 's. The GJT was sensitive to developmental differences in mainstream children and differentiated children with DLD from Year 1 and 2 mainstream children, with DLD results consistent with a one-year delay in performance compared to controls. The GJT was the strongest discriminator of membership to a clinically selected sample of children with DLD (ROC curve analysis, area under the curve = 88%). Receptive grammar, receptive vocabulary, and nonword repetition were related to performance on the GJT. The grammaticality judgement of inflectional morphology shows promise as a reliable indicator of DLD and a measure sensitive to developmental differences in mainstream children. GJTs should continue to be explored for clinical application as a potential tool for both assessment and intervention.

Update on Identification and Treatment of Infants and Toddlers With Suspected Childhood Apraxia of Speech.

PURPOSE: The purpose of this tutorial is to (a) provide an updated review of the literature pertaining to proposed early features of childhood apraxia of speech (CAS), (b) discuss the findings of recent treatment studies of infants and toddlers with suspected CAS (sCAS), and (c) present evidence-based strategies and tools that can be used for the identification of and intervention for infants and toddlers with sCAS or at high risk for the disorder. METHOD: Since Davis and Velleman's (2000) seminal work on assessment and intervention in infants and toddlers with sCAS, limited research has guided clinicians in the complex task of identifying and treating early speech motor difficulties prior to a definitive diagnosis of CAS. Following the structure of Davis and Velleman, we explore the proposed early characteristics of CAS with reference to contemporary research. Next, we describe the limited treatment studies that have investigated intervention for infants and toddlers at risk of or suspected of having CAS. Finally, we present practical suggestions for integrating this knowledge into clinical practice. CONCLUSIONS: Many of the originally proposed correlates of CAS in infants and toddlers now have research supporting their presence. However, questions remain about the developmental trajectory of the disorder. Although limited in number and restricted by lack of experimental control, emerging treatment studies can help guide clinicians in providing appropriate intervention to infants and toddlers with sCAS who need not wait for a definitive diagnosis to initiate intervention.

"I struggle at times to see her struggle": Mothers' perspectives on dyslexia-related school struggles and the inter-connected nature of mother and child well-being.

INTRODUCTION: Parents of children with dyslexia may be at elevated risk for parenting stress and mental health concerns. Our aim was to explore the emotional experience of growing up with dyslexia in Australia from parents' perspectives. In so doing, we also developed an understanding of parents' own mental health and support needs informed by their lived experience. METHODOLOGY: Seventeen interviews with mothers of children (9-14 years; 16 with a diagnosis of dyslexia) were analysed using Braun and Clarke's reflexive thematic analysis approach. ANALYSIS: Five themes were developed to address our aim: Theme 1: Years in the wilderness: Life before diagnosis; 2: "I struggle at times to see her struggle"; 3. School struggles: Advocating for our children and managing distress; 4. "It's a full-time job" and a "long slog"; 5: Care for the carer: Social support and coping strategies. CONCLUSIONS: Our analysis suggests that mothers of children with dyslexia may be at elevated risk for mental health concerns. Specifically, chronic worry and stress, secondary distress, challenges to parenting self-efficacy, and lack of support and understanding (feeling isolated) were highlighted as plausible risk factors. Mothers described coping strategies at the community level (e.g., school connectedness) and at the individual level (e.g., "acceptance") as protective.

Complex Language Use in Children With Hearing Loss: A Scoping Review.

PURPOSE: Understanding what is known about the language profiles of children with hearing loss (CHL) is vital so that researchers and teachers can identify the specific complex syntactic structures that CHL may struggle to master. An understanding of which aspects of complex syntax pose difficulties for CHL is necessary to inform the kind of intervention that will facilitate learning complex syntax for this cohort of children. This scoping review aims to identify what is currently known about the complex syntax use of CHL who communicate through spoken language, and uncover gaps in the literature to guide further research. METHOD: Ascoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The Covidence software was utilized to manage the initial and full-text screening process for the search. RESULTS: From a total of 304 studies, 42 studies were identified that met the eligibility criteria. The review highlights the use of broad-based language assessments and limited use of specific descriptions of the types of complex syntactic structures and skills. CONCLUSIONS: Findings highlight the need for assessment protocols and analysis methods that better support the description of complex syntax profiles for CHL. School-age CHL continue to display challenges with complex syntax development. The review highlighted the need for further research to improve understanding of the complex syntax strengths and vulnerabilities of CHL. Further investigation is needed to better understand their ability to combine ideas and build complexity in their language use, which in turn can inform teaching in schools and interventions for children who require support. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21980177.

Understanding Mental Health in Developmental Dyslexia: A Scoping Review.

Children with dyslexia are at elevated risk of internalising and externalising mental health concerns. Our aim was to scope the extent and nature of the literature investigating factors which may influence this association. We systematically searched the peer-reviewed and grey literature with no restrictions on the date. We included both qualitative and quantitative studies. Inclusion criteria included: (1) a focus on childhood (≤18 years) reading/learning difficulties; (2) internalising and/or externalising symptoms; and (3) a potentially modifiable third factor (e.g., self-esteem). Ninety-eight studies met the inclusion criteria. We organised the studies according to individual, family, and community-level third factors. Whilst a range of third factors were identified, relatively few researchers tested associations between the third factor and mental health in the context of dyslexia. Furthermore, there was a focus on primary rather than secondary school experience and a reliance, in many cases, on teacher/parent perspectives on children's mental health. Future researchers are encouraged to explore links between socio-emotional skills, coping strategies, school connectedness, and mental health in the context of dyslexia. Research of this nature is important to assist with the identification of children who are more (or less) at risk of mental health concerns and to inform tailored mental health programs for children with dyslexia.

Growing up with dyslexia: Child and parent perspectives on school struggles, self-esteem, and mental health.

Children with dyslexia, compared with typically reading peers, are at increased risk of internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns; why this is the case is largely unknown. Our aim was to explore the socio-emotional experience of growing up with dyslexia from both child and parent perspectives. In so doing, we aimed to gain a better understanding of self-esteem and mental health in the context of dyslexia. One-to-one semi-structured interviews with 17 children with reading difficulties (aged 9-14 years; 16 with a diagnosis of dyslexia) and their mothers (interviewed separately) were analysed using Braun and Clarke's reflexive thematic analysis approach with a neurodiversity lens. We developed three themes to address the research aim: (1) Different in a good/bad way; (2) Exhausted and overwhelmed; and (3) It takes a community: Family school connections. Children discussed having "worries" and experiencing school-related stress and embarrassment. Mothers perceived children's internalising and externalising behaviour (meltdowns), school refusal, and homework resistance as emotional responses to children's school struggles due to poor "person-environment fit." Our analysis highlights the particular importance of parent support, friendship, and school-connectedness for the wellbeing of children with dyslexia.

The Engage with Developmental Language Disorder (E-DLD) project: Cohort profile.

BACKGROUND: Public awareness of Developmental Language Disorder (DLD) is lower than other neurodevelopmental disorders, despite its high prevalence of 7.6%. This lower awareness means recruitment for DLD research studies is difficult. DLD is both underfunded and under-researched, resulting in relatively limited research investigating individuals with DLD. Engage with Developmental Language Disorder (E-DLD) is a response to these considerations. E-DLD is the first international participant database of those affected by DLD. Parents of children with DLD under 16 and young people and adults over 16 from anywhere in the world can sign up to be a part of the E-DLD. AIMS: This paper aims to describe the families of children with DLD and adults with DLD in the database thus far. METHODS & PROCEDURES: E-DLD members sign up via our website, reporting demographic characteristics as part of this procedure. We request all E-DLD members subsequently fill in a yearly survey. The content of the yearly survey changes dependent on the age of the child, while the yearly survey for adults remains consistent. We measure a wide range of domains, such as speech and language therapy (SLT) support, school support, socialisation skills, and early developmental milestones for our youngest members, and health care support and mental well-being measurements for our adults. We also collect parent and self-reported reflections on strengths and challenges for the person with DLD using open-ended questions and the Strengths and Difficulties Questionnaire. OUTCOMES & RESULTS: The database currently consists of 196 parents of children with DLD and 20 individuals over the age of 16 with DLD or suspected DLD across a range of socioeconomic status (SES) backgrounds. Our initial results confirm that E-DLD members meet the linguistic profile of DLD in relation to self- or parent-rated language difficulties. Both children and adults show increased rates of psychosocial difficulties compared to established norms, consistent with past research on clinical samples of people with DLD. CONCLUSIONS & IMPLICATIONS: The findings indicate that a participant database for DLD research is feasible and useful. The rates of emotional, behavioural and sleep difficulties among the child probands are higher than reported rates amongst typically developing children. Initial data indicate that adults with DLD have poorer well-being than their peers. The E-DLD is a useful collection of data on those affected by DLD and is a promising method for connecting people with DLD with academic researchers. WHAT THIS PAPER ADDS: What is already known on this subject Developmental Language Disorder (DLD) is characterised by expressive and/or receptive language difficulties in the absence of another biomedical condition that could explain these difficulties. It is critically under-researched and underfunded. As such, there is a lack of public awareness and difficulty recruiting sufficient sample sizes for DLD research studies. What this paper adds to existing knowledge Engage with Developmental Language Disorder (E-DLD) is the first international participant database of individuals with DLD. This paper provides a preliminary report on the profile of linguistic and psychosocial skills among the individuals on the database, adding to current understanding of DLD across age groups. What are the potential or actual clinical implications of this work? Our aim is that the E-DLD will provide much-needed facilitation of research into DLD. E-DLD will enable those with DLD and their families more readily to shape research agendas and to participate in studies that interest them. Families may be recruited into research that could directly translate to better clinical treatment of DLD. We also believe that the E-DLD yearly survey holds potential to provide key information on the development and longitudinal experience of children and adults with DLD.

Editorial Perspective: Maximising the benefits of intervention research for children and young people with developmental language disorder (DLD) - a call for international consensus on standards of reporting in intervention studies for children with and at risk for DLD.

Current methods for reporting interventions do not allow key questions of importance to practitioners, service providers, policy-makers and people with DLD to be answered, and hence limit the implementation of effective interventions in the real world. To extend the existing EQUATOR guidelines to the context of speech language therapy/pathology for children with language disorder and to provide more specific guidance on participants, interventions and outcomes within the CONSORT checklist (used to improve the reporting of randomised controlled trials) and TIDieR (Template for Intervention Description and Replication) to ensure consistency of reporting. We will develop a core team to include representatives from each of the key groups who will either use or be influenced by the final reporting guidance across different countries. To achieve each set of aims, we will conduct reviews of the literature (which present typologies of intervention characteristics in (D)LD and related disorders); carry out focus groups; and use systematic consensus methods such as the Delphi technique, nominal group technique or consensus development conferences. Through the development and adoption of standard intervention reporting criteria, we anticipate that we will overcome the numerous barriers for practitioners, services and policy-makers in applying intervention evidence to practice. We believe that establishing international consensus on reporting guidelines would significantly accelerate progress in DLD research and the ease with which it can be used in clinical practice, by capitalising on the growth in intervention studies to enable international collaboration and new methodologies of data pooling, meta-analyses and cross-study comparisons.

Assessing children's vocabulary: An exploratory cross-sectional survey of speech-language pathologists.

Purpose: Past research highlights the importance of evaluating word learning abilities to build understanding of an individual's language-learning capacity and make evidence-informed decisions in speech-language pathology practice. However, little research has explored vocabulary and word learning assessment practices among speech-language pathologists (SLPs). This pilot, exploratory study aimed to explore current assessment practices and guide translation of research to practice among SLPs who work with children of all ages.Method: SLPs (N = 127) from three predominantly English-speaking countries (Australia, USA, and UK) completed an online survey. The survey explored methods and purposes for assessing vocabulary knowledge and word learning skills via binary and multiple-choice questions. Responses to three open-ended questions were analysed using conventional content analysis. The survey also asked about perspectives regarding assessment practices with individuals from culturally and linguistically diverse (CALD) backgrounds.Result: Of the surveyed SLPs, 118 (92%) reported using norm-referenced measures of vocabulary, with 27 reporting additional use of non-normed measures. Seventy-seven SLPs (61%) reported that they measure word learning skills, and 20 of these SLPs used dynamic assessment procedures to evaluate word learning. Responding SLPs across all three countries reported using vocabulary and word learning assessment data in a variety of ways (e.g. to support diagnostic decision-making). Regarding the use of standardised, norm-referenced vocabulary assessments with individuals from CALD backgrounds, SLPs reported concerns regarding poor cultural sensitivity and limited access to alternative methods.Conclusion: The findings highlight the need for further development and dissemination of accessible resources to support SLPs' implementation of word learning assessment, including resources for dynamic assessment. This is especially critical considering the established limitations associated with using standardised, norm-referenced tests with minority groups who are underrepresented in standardisation samples.

A profile of expressive inflectional morphology in early school-age children with developmental language disorder.

Previous research has established that children with developmental language disorder (DLD) have difficulties producing inflectional morphology, in particular, finiteness marking. However, other categories of inflectional morphology, such as possessive 's nominal inflection remain relatively unexplored. Analyses of the characteristics for marking inflection, such as allomorphic categories, may increase our understanding of patterns within disordered grammar to inform the design of interventions and target selection. Data from n = 30 early school-aged children (M = 75 months, SD = 3.38, range = 69-81 months) with DLD were analysed to develop a profile of inflectional morphology skills. Morphological categories included expressive regular past tense, third person singular, and possessive 's. Skills were profiled using an elicitation task. The relationships between expressive morphosyntax, and phonological short-term memory and working memory were also explored. Children demonstrated low accuracy in performance across all inflectional categories, including possessive 's. There were no significant differences between productions of different morphemes, but syllabic allomorphs ([əd]; [əz]) were produced with significantly lower accuracy than segmental allomorphs ([d], [t]; [z], [s]) across all morphological categories. All correlations between expressive morphosyntax and measures of memory were non-significant. Children with DLD show broad deficits in the ability to mark for inflection, including possessive 's; this has implications for theories explaining DLD. Findings may contribute to the design of urgently needed interventions for this clinical population.

Evaluating two different dose frequencies and cumulative intervention intensities to improve past tense production for early school-aged children with developmental language disorder.

AIMS: This study compared two dose frequency conditions of an explicit intervention with 50 trials per session designed to improve past tense marking in early school-aged children with developmental language disorder (DLD). The influence of allomorphs on intervention effects was also examined. METHODS: Data from previously conducted intervention studies were combined and analysed. Participants included nine children (mean age = 6;5 years) who received 20-30-min intervention sessions provided twice per week for 10 weeks (1000 trials; 400-600 min) and 20 children (mean age = 6;6) who received 20-30-min intervention sessions provided once per week for 10 weeks (500 trials; 200-300 min). Repeated measures included criterion-referenced probes for production of untrained past tense verbs collected throughout baseline, intervention, and maintenance phases. The rate of progress in each phase was analysed using logistic regression. The proportion of participants who produced past tense allomorphs correctly at pre-intervention, post-intervention, and maintenance testing points was analysed. RESULTS: Logistic regression showed a stable baseline, highly significant progress during the intervention phase, and a marginally significant shallow decline during the maintenance phase. Those in the twice per week group showed a greater rate of progress during the intervention phase leading to significantly higher scores in the maintenance period when compared with the once per week group. The allomorphic category of past tense verbs did not appear to influence outcomes. CONCLUSIONS: Participants receiving intervention twice per week appeared to demonstrate a greater rate of progress with intervention than those receiving it once per week, although once per week was also effective. However, these results should be interpreted with caution. Limitations to study design indicate that a larger randomised controlled trial is required. All past tense allomorphs improve to a similar degree when treated with this intervention. WHAT THIS PAPER ADDS: What is already known on the subject Understanding the parameters of dosage and intensity are important for clinical practice. Research evaluating the efficacy and/or effectiveness of interventions delivered in different dose/intensity conditions is scarce. There appears to be different interpretations of what constitutes dosage and intensity in published research. What this paper adds to existing knowledge This study retrospectively compared dosage and intensity conditions of intervention provided twice per week to intervention provided once per week. Both dose frequencies could be delivered in clinical settings. Results from this study were analysed by grouping data from multiple testing points, rather than comparing pre-post results. This approach demonstrated the variability of individual performance that would otherwise be lost with conventional methods of analysis. This study demonstrated that all past tense allomorphs improve to a similar degree when treated with this intervention. What are the potential or actual clinical implications of this work? Parameters of dosage and intensity are still not clearly defined well enough for translation to clinical practice. In consideration of current research, this intervention may be more effective if delivered twice per week. If clinicians are treating past tense, all allomorphs should be considered as priorities for intervention targets.

Oral and written communication skills of adolescents with prenatal alcohol exposure (PAE) compared with those with no/low PAE: A systematic review.

BACKGROUND: Prenatal alcohol exposure (PAE) is associated with growth deficits and neurodevelopmental impairment including foetal alcohol spectrum disorder (FASD). Difficulties with oral and written communication skills are common among children with PAE; however, less is known about how communication skills of adolescents who have PAE compare with those who do not. Adolescence is a critical time for development, supporting the transition into adulthood, but it is considered a high-risk period for those with FASD. AIMS: We conducted a systematic review to synthesize evidence regarding oral and written communication skills of adolescents with PAE or FASD and how they compare with those with no PAE. METHODS & PROCEDURES: A comprehensive search strategy used seven databases: Cochrane Library, Cinahl, Embase, Medline, PsycInfo, Eric and Web of Science. Included studies reported on at least one outcome related to oral and written communication for a PAE (or FASD) group as well as a no/low PAE group, both with age ranges of 10-24 years. Quality assessment was undertaken. MAIN CONTRIBUTION: Communication skills most often assessed in the seven studies included in this review were semantic knowledge, semantic processing, and verbal learning and memory. These communication skills, in addition to reading and spelling, were commonly weaker among adolescents with PAE compared with those with no/low PAE. However, the findings were inconsistent across studies, and studies differed in their methodologies. CONCLUSIONS & IMPLICATIONS: Our results emphasize that for adolescents with PAE, communication skills in both oral and written modalities should be comprehensively understood in assessment and when planning interventions. A key limitation of the existing literature is that comparison groups often include some participants with a low level of PAE, and that PAE definitions used to allocate participants to groups differ across studies. WHAT THIS PAPER ADDS: What is already known on the subject PAE and FASD are associated with deficits in oral and written communication skills. Studies to date have mostly focused on children with a FASD diagnosis as well as combined groups of children and adolescents with FASD or PAE. There is a gap in what is known about oral and written communication skills of adolescents, specifically, who have PAE or FASD. This has implications for the provision of assessment and supports during a period of increased social and academic demands. What this study adds to existing knowledge This review provides systematic identification, assessment and synthesis of the current literature related to oral and written communication skills of adolescents with PAE compared with those with no/low PAE. The review revealed a small knowledge base with inconsistent methodologies and findings across studies. However, the findings overall highlight that adolescents with PAE have weaker skills in oral and written language than those with no/low PAE. Results are discussed in relation to education, social and emotional well-being, and forensic contexts. What are the potential or actual clinical implications of this work? Findings emphasize that for adolescents with PAE, comprehensive assessment of both oral and written communication skills, through both standardized and functional tasks, should be undertaken. Speech-language pathologists have a key role in assessment with individuals who have PAE.

The oral and written narrative language skills of adolescent students in youth detention and the impact of language disorder.

BACKGROUND: Unmet language and literacy needs are common among young people who are involved with youth justice systems. However, there is limited research regarding the functional text-level language skills of this population with regard to narrative macrostructure (story grammar) and microstructure (semantics and syntax) elements. METHODS: In this study, we examined macrostructure and microstructure elements in the oral and written narrative texts of 24 adolescent students of a youth detention centre. The students, who were aged 14- to 17- years, were all speakers of Standard Australian English, and 11 (46%) students met criteria for language disorder (LD). FINDINGS: When we compared the narratives according to modality of language, the students demonstrated stronger narrative language skills in the written modality compared to the oral. However, when we compared the narratives according to language ability, we found that the impact of LD on inclusion of macrostructure elements was greater in the oral modality, and for microstructure elements, was greater in the written modality. Errors in written conventions were common among both students with and without LD. CONCLUSIONS: Our results indicate that both the modality of language as well as the presence of LD should be considered when young people are required to participate in forensic contexts including programs that address educational and rehabilitation needs. Our results indicate a need for consistent text-level language assessment to better identify and respond to functional difficulties within language and literacy. There is potential for speech-language pathology services to enhance comprehensive assessment as well as inform educational and rehabilitation programs for young people who are involved with youth justice systems.

Piloting 'Clever Kids': A randomized-controlled trial assessing feasibility, efficacy, and acceptability of a socioemotional well-being programme for children with dyslexia.

Children with dyslexia are at elevated risk of internalizing (emotional) and externalizing (behavioural) problems. Clever Kids is a nine-week socioemotional well-being programme developed specifically for upper primary school children with dyslexia. In a small randomized-controlled trial, we tested the feasibility, efficacy, and acceptability of the Clever Kids programme. 'Forty children (Mage  = 10.45 years, 65% male) with clinically diagnosed dyslexia too part in the study. Children were randomized to either attend Clever Kids (n = 20) or to a wait-list control condition (n = 20). Coping skills, self-esteem, resilience, emotion regulation, and internalizing and externalizing symptoms were measured at pre-programme, post-programme, and at three-month follow-up. Recruitment and retention rates indicate high feasibility for further evaluation of the programme. There was a significant interaction between intervention condition and time for non-productive coping [F(2, 76) = 4.29, p = 0.017, f2  = 0.11]. Children who attended Clever Kids significantly reduced their use of non-productive coping strategies, and this was maintained at three-month follow-up assessment. For all other outcomes, the interactions between intervention condition and time were non-significant. The programme appears acceptable to children with dyslexia and their families, but may be improved by further reducing the number of activities involving reading and writing. Clever Kids improved the coping skills of children with dyslexia; however, a larger trial is needed to replicate this finding and investigate whether programme attendance is associated with additional improvements in children's socioemotional well-being.

The Efficacy of an Explicit Intervention Approach to Improve Past Tense Marking for Early School-Age Children With Developmental Language Disorder.

Purpose The aim of the study was to evaluate the efficacy of a theoretically motivated explicit intervention approach to improve regular past tense marking for early school-age children with developmental language disorder (DLD). Method Twenty-one children with DLD (ages 5;9-6;9 [years;months]) were included in a crossover randomized controlled trial (intervention, n = 10; waiting control, n = 11). Intervention included once-weekly sessions over 10 weeks using the SHAPE CODING system, in combination with a systematic cueing hierarchy to teach past tense marking. Once the first group completed intervention, the waiting control group crossed over to the intervention condition. The primary outcome was criterion-referenced measures of past tense marking with standardized measures of expressive and receptive grammar as the secondary outcome. Ancillary analyses on extension and behavioral control measures of morphosyntax were also conducted. Results There was a significant Time × Group interaction (p < .001) with a significant difference in pre-post intervention improvement in favor of the intervention group (p < .001, d = 3.03). Further analysis once both groups had received the intervention revealed no improvement for either group on past tense production during the 5-week pre-intervention period, significant improvement pre-post intervention (p < .001, d = 1.22), with gains maintained for 5 weeks postintervention. No significant differences were found on pre- to postintervention standardized measures of grammar, or on extension or control measures. Conclusions The efficacy of the theoretically motivated explicit grammar intervention was demonstrated. Results contribute to the evidence base supporting this intervention to improve past tense production in early school-age children with DLD, suggesting it is a viable option for clinicians to select when treating morphosyntactic difficulties for this population. Supplemental Material https://doi.org/10.23641/asha.13345202.

Word learning and verbal working memory in children with developmental language disorder.

Background and aims: Previous research into word learning in children with developmental language disorder (DLD) indicates that the learning of word forms and meanings, rather than form-referent links, is problematic. This difficulty appears to arise with impaired encoding, while retention of word knowledge remains intact. Evidence also suggests that word learning skills may be related to verbal working memory. We aimed to substantiate these findings in the current study by exploring word learning over a series of days. Methods: Fifty children with DLD (mean age 6; 11, 72% male) and 54 age-matched typically developing (TD) children (mean age 6; 10, 56% male) were taught eight novel words across a four-day word learning protocol. Day 1 measured encoding, Days 2 and 3 measured re-encoding, and Day 4 assessed retention. At each day, word learning success was evaluated using Naming, Recognition, Description, and Identification tasks. Results: Children with DLD showed comparable performance to the TD group on the Identification task, indicating an intact ability to learn the form-referent links. In contrast, children with DLD performed significantly worse for Naming and Recognition (signifying an impaired ability to learn novel word forms), and for Description, indicating problems establishing new word meanings. These deficits for the DLD group were apparent at Days 1, 2, and 3 of testing, indicating impairments with initial encoding and re-encoding; however, the DLD and TD groups demonstrated a similar rate of learning. All children found the retention assessments at Day 4 difficult, and there were no significant group differences. Finally, verbal working memory emerged as a significant moderator of performance on the Naming and Recognition tasks, such that children with DLD and poor verbal working memory had the lowest levels of accuracy. Conclusions: This study demonstrates that children with DLD struggle with learning novel word forms and meanings, but are unimpaired in their ability to establish new form-referent links. The findings suggest that the word learning deficit may be attributed to problems with encoding, rather than with retention, of new word knowledge; however, further exploration is required given the poor performance of both groups for retention testing. Furthermore, we found evidence that an impaired ability to learn word forms may only be apparent in children who have DLD and low levels of verbal working memory. Implications: When working with children with DLD, speech-language pathologists should assess word learning using tasks that evaluate the ability to learn word forms, meanings, and form-referent links to develop a profile of individual word learning strengths and weaknesses. Clinicians should also assess verbal working memory to identify children at particular risk of word learning deficits. Future research should explore the notion of optimal intervention intensity for facilitating word learning in children with poor language and verbal working memory.

Working, Declarative, and Procedural Memory in Children With Developmental Language Disorder.

Purpose Previous research into the working, declarative, and procedural memory systems in children with developmental language disorder (DLD) has yielded inconsistent results. The purpose of this research was to profile these memory systems in children with DLD and their typically developing peers. Method One hundred four 5- to 8-year-old children participated in the study. Fifty had DLD, and 54 were typically developing. Aspects of the working memory system (verbal short-term memory, verbal working memory, and visual-spatial short-term memory) were assessed using a nonword repetition test and subtests from the Working Memory Test Battery for Children. Verbal and visual-spatial declarative memory were measured using the Children's Memory Scale, and an audiovisual serial reaction time task was used to evaluate procedural memory. Results The children with DLD demonstrated significant impairments in verbal short-term and working memory, visual-spatial short-term memory, verbal declarative memory, and procedural memory. However, verbal declarative memory and procedural memory were no longer impaired after controlling for working memory and nonverbal IQ. Declarative memory for visual-spatial information was unimpaired. Conclusions These findings indicate that children with DLD have deficits in the working memory system. While verbal declarative memory and procedural memory also appear to be impaired, these deficits could largely be accounted for by working memory skills. The results have implications for our understanding of the cognitive processes underlying language impairment in the DLD population; however, further investigation of the relationships between the memory systems is required using tasks that measure learning over long-term intervals. Supplemental Material https://doi.org/10.23641/asha.13250180.

The information score as a measure of oral discourse comprehension in the early school years.

Purpose: Oral discourse comprehension is a fundamental skill that is predictive of future reading comprehension. The ability to identify important semantic propositions, in a narrative text, and their attachment to a mental model is an essential component of discourse comprehension. This study aimed to pilot a measure of free-recall in a narrative retell across three age groups to explore development. A secondary aim compared measures of free-recall and cued-recall.Method: One hundred and thirty-two (132) typically developing children aged 4-7 years provided a retell of the Squirrel Story narrative and completed the Narrative Comprehension Assessment (NCA). The Squirrel Story Information Score (SSIS) was used as a novel measure of free-recall calculated from the narrative retells. The NCA, which involves literal and inferential comprehension questions, was used as a measure of cued-recall. Scoring reliability was calculated to ensure test-retest validity.Result: Correlation analysis found excellent reliability of the SSIS measure. The difference between 4 and 5 year olds, and 5 and 6 year olds, was significant, with a large effect size. The difference between the 5 and 6 year olds was not significant. A large positive correlation was found between the measures of SSIS and NCA.Conclusion: The measure of SSIS proved sensitive to developmental progression, with a positive relationship found between the measures of free-recall and cued-recall. Variability between the measures highlights the need to consider both measures to ensure an accurate representation of discourse comprehension skills.