Enhancing Syntactic Knowledge in School-Age Children With Developmental Language Disorder: The Promise of Syntactic Priming.

PURPOSE: We propose that implicit learning, including syntactic priming, has therapeutic promise to enhance the syntactic knowledge of children with developmental language disorder (DLD). METHOD: We review the chunk-based learning framework of syntactic learning, the developmental evidence in support of it, and the developmental literature on syntactic priming as an instance of chunk-based statistical learning. We use this framework to help understand the nature of the syntactic learning difficulties of children with DLD. We then briefly review the available explicit treatments for syntactic deficits and end by proposing an implicit training activity that integrates syntactic priming with the principles of statistical learning. RESULTS: Statistically induced chunk-based learning is a powerful driver of syntactic learning, and syntactic priming is a form of this learning. Repeated priming episodes during everyday language interactions lead children to create abstract and global syntactic representations in long-term memory. We offer some thoughts on an implicit language intervention approach with syntactic priming at its center. CONCLUSIONS: Children's learning of syntactic structures is influenced by repeated syntactic priming experiences. Including a syntactic priming activity in our language intervention toolbox has the promise to enhance children's syntactic knowledge and sentence comprehension and production abilities.

Cognitive Processes Related to Memory Capacity Explain Nearly All of the Variance in Language Test Performance in School-Age Children With and Without Developmental Language Disorder.

The purpose of this study was to investigate the dimensionality of the cognitive processes related to memory capacity and language ability and to assess the magnitude of the relationships among these processes in children developing typically (TD) and children with developmental language disorder (DLD). Participants were 234 children between the ages of 7;0 and 11;11 (117 TD and 117 DLD) who were propensity matched on age, sex, mother education and family income. Latent variables created from cognitive processing tasks and standardized measures of comprehension and production of lexical and sentential aspects of language were tested with confirmatory factor analysis (CFA) and structural regression. A five-factor CFA model that included the constructs of Fluid Intelligence, Controlled Attention, Working Memory, Long-Term Memory for Language Knowledge and Language Ability yielded better fit statistics than two four-factor nested models. The four cognitive abilities accounted for more than 92% of the variance in the language measures. A structural regression model indicated that the relationship between working memory and language ability was significantly greater for the TD group than the DLD group. These results are consistent with a broad conceptualization of the nature of language impairment in older, school-age children as encompassing a dynamic system in which cognitive abilities account for nearly all of the variance in linguistic abilities.

A New Memory Perspective on the Sentence Comprehension Deficits of School-Age Children With Developmental Language Disorder: Implications for Theory, Assessment, and Intervention.

Purpose The nature of the relationship between memory and sentence comprehension in school-age children with developmental language disorder (DLD) has been unclear. We present a novel perspective that highlights the relational influences of fluid intelligence, controlled attention, working memory (WM), and long-term memory (LTM) on sentence comprehension in children with and without DLD. This perspective has new and important implications for theory, assessment, and intervention. Method We review a large-scale study of children with and without DLD that focused on the connections between cognition, memory, and sentence comprehension. We also summarize a new model of these relationships. Results Our new model suggests that WM serves as a conduit through which syntactic knowledge in LTM, controlled attention, and general pattern recognition indirectly influence sentence comprehension in both children with DLD and typically developing children. For typically developing children, language-based LTM and fluid intelligence indirectly influence sentence comprehension. However, for children with DLD, controlled attention plays a larger indirect role. Conclusions WM plays a key role in children's ability to apply their syntactic knowledge when comprehending canonical and noncanonical sentences. Our new model has important implications for the assessment of sentence comprehension and for the treatment of larger sentence comprehension deficits.

A Comparison of the Storage-Only Deficit and Joint Mechanism Deficit Hypotheses of the Verbal Working Memory Storage Capacity Limitation of Children With Developmental Language Disorder.

Purpose The storage-only deficit and joint mechanism deficit hypotheses are 2 possible explanations of the verbal working memory (vWM) storage capacity limitation of school-age children with developmental language disorder (DLD). We assessed the merits of each hypothesis in a large group of children with DLD and a group of same-age typically developing (TD) children. Method Participants were 117 children with DLD and 117 propensity-matched TD children 7-11 years of age. Children completed tasks indexing vWM capacity, verbal short-term storage, sustained attention, attention switching, and lexical long-term memory (LTM). Results For the DLD group, all of the mechanisms jointly explained 26.5% of total variance. Storage accounted for the greatest portion (13.7%), followed by controlled attention (primarily sustained attention; 6.5%) and then lexical LTM (5.6%). For the TD group, all 3 mechanisms together explained 43.9% of total variance. Storage accounted for the most variance (19.6%), followed by lexical LTM (16.0%), sustained attention (5.4%), and attention switching (3.0%). There was a significant LTM × Group interaction, in which stronger LTM scores were associated with significantly higher vWM capacity scores for the TD group as compared to the DLD group. Conclusions Results support a joint mechanism deficit account of the vWM capacity limitation of children with DLD. Results provide substantively new insights into the underlying factors of the vWM capacity limitation in DLD. Supplemental Material https://doi.org/10.23641/asha.9932312.

Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment.

Purpose: This paper summarises the clinical ramification of a large-scale study of the direct and indirect (mediated) influences of four cognitive mechanisms that are relevant to the comprehension of syntactic structure by school-age children with and without developmental language disorder (DLD). Method: A total of 117 children with DLD and 117 propensity-matched typically-developing (TD) children completed sentence comprehension tasks and cognitive tasks related to fluid reasoning, controlled attention, speed of processing, phonological short-term memory (pSTM), complex working memory (cWM) and language knowledge in long-term memory (LTM). Result: Results of confirmatory factor analysis (CFA) indicated that the most salient characteristics of cognitive processing in children with and without DLD were represented by a measurement model that included four latent variables: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. Structural equation modelling (SEM) indicated that complex WM mediated the relationship between sentence comprehension and fluid reasoning, controlled attention and long-term memory for language knowledge. Conclusion: Our research suggests that the most salient characteristics of cognitive processing in children with and without DLD can be condensed to four cognitive factors: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. We suggest a few measures that clinicians can use to reliably assess these factors, and we summarise a functional intervention programme that is designed to promote the strategic organisation of information in ways that challenge verbal complex WM and LTM processes that support language comprehension and use.

Structural Relationship Between Cognitive Processing and Syntactic Sentence Comprehension in Children With and Without Developmental Language Disorder.

Purpose: We assessed the potential direct and indirect (mediated) influences of 4 cognitive mechanisms we believe are theoretically relevant to canonical and noncanonical sentence comprehension of school-age children with and without developmental language disorder (DLD). Method: One hundred seventeen children with DLD and 117 propensity-matched typically developing (TD) children participated. Comprehension was indexed by children identifying the agent in implausible sentences. Children completed cognitive tasks indexing the latent predictors of fluid reasoning (FLD-R), controlled attention (CATT), complex working memory (cWM), and long-term memory language knowledge (LTM-LK). Results: Structural equation modeling revealed that the best model fit was an indirect model in which cWM mediated the relationship among FLD-R, CATT, LTM-LK, and sentence comprehension. For TD children, comprehension of both sentence types was indirectly influenced by FLD-R (pattern recognition) and LTM-LK (linguistic chunking). For children with DLD, canonical sentence comprehension was indirectly influenced by LTM-LK and CATT, and noncanonical comprehension was indirectly influenced just by CATT. Conclusions: cWM mediates sentence comprehension in children with DLD and TD children. For TD children, comprehension occurs automatically through pattern recognition and linguistic chunking. For children with DLD, comprehension is cognitively effortful. Whereas canonical comprehension occurs through chunking, noncanonical comprehension develops on a word-by-word basis. Supplemental Material: https://doi.org/10.23641/asha.7178939.

Cognitive Predictors of Spoken Word Recognition in Children With and Without Developmental Language Disorders.

Purpose: This study examined the influence of cognitive factors on spoken word recognition in children with developmental language disorder (DLD) and typically developing (TD) children. Method: Participants included 234 children (aged 7;0-11;11 years;months), 117 with DLD and 117 TD children, propensity matched for age, gender, socioeconomic status, and maternal education. Children completed a series of standardized assessment measures, a forward gating task, a rapid automatic naming task, and a series of tasks designed to examine cognitive factors hypothesized to influence spoken word recognition including phonological working memory, updating, attention shifting, and interference inhibition. Results: Spoken word recognition for both initial and final accept gate points did not differ for children with DLD and TD controls after controlling target word knowledge in both groups. The 2 groups also did not differ on measures of updating, attention switching, and interference inhibition. Despite the lack of difference on these measures, for children with DLD, attention shifting and interference inhibition were significant predictors of spoken word recognition, whereas updating and receptive vocabulary were significant predictors of speed of spoken word recognition for the children in the TD group. Conclusion: Contrary to expectations, after controlling for target word knowledge, spoken word recognition did not differ for children with DLD and TD controls; however, the cognitive processing factors that influenced children's ability to recognize the target word in a stream of speech differed qualitatively for children with and without DLDs.

Children's Comprehension of Object Relative Sentences: It's Extant Language Knowledge That Matters, Not Domain-General Working Memory.

Purpose: The aim of this study was to determine whether extant language (lexical) knowledge or domain-general working memory is the better predictor of comprehension of object relative sentences for children with typical development. We hypothesized that extant language knowledge, not domain-general working memory, is the better predictor. Method: Fifty-three children (ages 9-11 years) completed a word-level verbal working-memory task, indexing extant language (lexical) knowledge; an analog nonverbal working-memory task, representing domain-general working memory; and a hybrid sentence comprehension task incorporating elements of both agent selection and cross-modal picture-priming paradigms. Images of the agent and patient were displayed at the syntactic gap in the object relative sentences, and the children were asked to select the agent of the sentence. Results: Results of general linear modeling revealed that extant language knowledge accounted for a unique 21.3% of variance in the children's object relative sentence comprehension over and above age (8.3%). Domain-general working memory accounted for a nonsignificant 1.6% of variance. Conclusions: We interpret the results to suggest that extant language knowledge and not domain-general working memory is a critically important contributor to children's object relative sentence comprehension. Results support a connectionist view of the association between working memory and object relative sentence comprehension. Supplemental Materials: https://doi.org/10.23641/asha.5404573.

"Whatdunit?" Sentence Comprehension Abilities of Children With SLI: Sensitivity to Word Order in Canonical and Noncanonical Structures.

PURPOSE: With Aim 1, we compared the comprehension of and sensitivity to canonical and noncanonical word order structures in school-age children with specific language impairment (SLI) and same-age typically developing (TD) children. Aim 2 centered on the developmental improvement of sentence comprehension in the groups. With Aim 3, we compared the comprehension error patterns of the groups. METHOD: Using a "Whatdunit" agent selection task, 117 children with SLI and 117 TD children (ages 7:0-11:11, years:months) propensity matched on age, gender, mother's education, and family income pointed to the picture that best represented the agent in semantically implausible canonical structures (subject-verb-object, subject relative) and noncanonical structures (passive, object relative). RESULTS: The SLI group performed worse than the TD group across sentence types. TD children demonstrated developmental improvement across each sentence type, but children with SLI showed improvement only for canonical sentences. Both groups chose the object noun as agent significantly more often than the noun appearing in a prepositional phrase. CONCLUSIONS: In the absence of semantic-pragmatic cues, comprehension of canonical and noncanonical sentences by children with SLI is limited, with noncanonical sentence comprehension being disproportionately limited. The children's ability to make proper semantic role assignments to the noun arguments in sentences, especially noncanonical, is significantly hindered.

Syntactic Versus Memory Accounts of the Sentence Comprehension Deficits of Specific Language Impairment: Looking Back, Looking Ahead.

Purpose: Compared with same-age typically developing peers, school-age children with specific language impairment (SLI) exhibit significant deficits in spoken sentence comprehension. They also demonstrate a range of memory limitations. Whether these 2 deficit areas are related is unclear. The present review article aims to (a) review 2 main theoretical accounts of SLI sentence comprehension and various studies supporting each and (b) offer a new, broader, more integrated memory-based framework to guide future SLI research, as we believe the available evidence favors a memory-based perspective of SLI comprehension limitations. Method: We reviewed the literature on the sentence comprehension abilities of English-speaking children with SLI from 2 theoretical perspectives. Results: The sentence comprehension limitations of children with SLI appear to be more fully captured by a memory-based perspective than by a syntax-specific deficit perspective. Conclusions: Although a memory-based view appears to be the better account of SLI sentence comprehension deficits, this view requires refinement and expansion. Current memory-based perspectives of adult sentence comprehension, with proper modification, offer SLI investigators new, more integrated memory frameworks within which to study and better understand the sentence comprehension abilities of children with SLI.

A Proof of Concept Study of Function-Based Statistical Analysis of fNIRS Data: Syntax Comprehension in Children with Specific Language Impairment Compared to Typically-Developing Controls.

Functional near infrared spectroscopy (fNIRS) is a neuroimaging technology that enables investigators to indirectly monitor brain activity in vivo through relative changes in the concentration of oxygenated and deoxygenated hemoglobin. One of the key features of fNIRS is its superior temporal resolution, with dense measurements over very short periods of time (100 ms increments). Unfortunately, most statistical analysis approaches in the existing literature have not fully utilized the high temporal resolution of fNIRS. For example, many analysis procedures are based on linearity assumptions that only extract partial information, thereby neglecting the overall dynamic trends in fNIRS trajectories. The main goal of this article is to assess the ability of a functional data analysis (FDA) approach for detecting significant differences in hemodynamic responses recorded by fNIRS. Children with and without SLI wore two, 3 × 5 fNIRS caps situated over the bilateral parasylvian areas as they completed a language comprehension task. FDA was used to decompose the high dimensional hemodynamic curves into the mean function and a few eigenfunctions to represent the overall trend and variation structures over time. Compared to the most popular GLM, we did not assume any parametric structure and let the data speak for itself. This analysis identified significant differences between the case and control groups in the oxygenated hemodynamic mean trends in the bilateral inferior frontal and left inferior posterior parietal brain regions. We also detected significant group differences in the deoxygenated hemodynamic mean trends in the right inferior posterior parietal cortex and left temporal parietal junction. These findings, using dramatically different approaches, experimental designs, data sets, and foci, were consistent with several other reports, confirming group differences in the importance of these two areas for syntax comprehension. The proposed FDA was consistent with the temporal characteristics of fNIRS, thus providing an alternative methodology for fNIRS analyses.

Children's verbal working memory: relative importance of storage, general processing speed, and domain-general controlled attention.

This study evaluated multiple constraints of verbal working memory in typically developing 7- to 11-year-olds. Multiple measures of verbal working memory and the predictors-short-term memory storage, general speed, and domain-general controlled attention were used. General linear modeling (GLM) showed that storage and the efficiency of controlled attention (i.e., speed of updating information during attention switching) contributed to significant variance in children's verbal working memory. In a secondary analysis verbal storage and domain-general attention (focus switching accuracy and speed of updating on switch) emerged as significant predictors. Results suggest domain-general attention and verbal storage mechanisms to be independent constraints of verbal working memory.

Children's verbal working memory: role of processing complexity in predicting spoken sentence comprehension.

PURPOSE: This study investigated the role of processing complexity of verbal working memory tasks in predicting spoken sentence comprehension in typically developing children. Of interest was whether simple and more complex working memory tasks have similar or different power in predicting sentence comprehension. METHOD: Sixty-five children (6- to 12-year-olds) completed a verbal working memory (listening) span task that varied in syntactic processing difficulty (simple sentences representing a "simple working memory task," complex sentences representing a "complex working memory task") and a standardized sentence comprehension test. RESULTS: Word recall on the simple and complex working memory tasks correlated with each other. Both memory tasks also correlated with children's sentence comprehension. Regression analyses showed that the simple working memory task remained a significant predictor of comprehension even after accounting for variance associated with age and performance on the complex working memory task. CONCLUSIONS: Results were interpreted to suggest that relative to more complex verbal working memory tasks, simple tasks are more robust predictors of children's sentence comprehension because they represent a basic yet robust index of working memory that sufficiently captures controlled attentional focus.

Working memory and specific language impairment: an update on the relation and perspectives on assessment and treatment.

PURPOSE: Children with specific language impairment (SLI) demonstrate significant language impairments despite normal-range hearing and nonverbal IQ. Many of these children also show marked deficits in working memory (WM) abilities. However, the theoretical and clinical characterization of the association between WM and language limitations in SLI is still sparse. Our understanding of this association would benefit greatly from an updated and thorough review of the literature. METHOD: We review the newest developments in these areas from both a theoretical and clinical perspective. Our intent is to provide researchers and practicing clinicians (a) a conceptual framework within which the association between WM and language limitations of children with SLI can be understood and (b) potentially helpful suggestions for assessing and treating the memory-language difficulties of children with SLI. CONCLUSIONS: In the past 10 years, important new theoretical insights into the range and nature of WM deficits and relation between these limitations and the language difficulties in SLI have occurred. New, robust diagnostic assessment tools and computerized treatment methods designed to enhance children's WM functioning have also been developed. The assessment, diagnosis, and treatment of the language difficulties in SLI should consider the potential influence of WM.

Complex sentence comprehension and working memory in children with specific language impairment.

PURPOSE: This study investigated the association of 2 mechanisms of working memory (phonological short-term memory [PSTM], attentional resource capacity/allocation) with the sentence comprehension of school-age children with specific language impairment (SLI) and 2 groups of control children. METHOD: Twenty-four children with SLI, 18 age-matched (CA) children, and 16 language- and memory-matched (LMM) children completed a nonword repetition task (PSTM), the competing language processing task (CLPT; resource capacity/allocation), and a sentence comprehension task comprising complex and simple sentences. RESULTS: (1) The SLI group performed worse than the CA group on each memory task; (2) all 3 groups showed comparable simple sentence comprehension, but for complex sentences, the SLI and LMM groups performed worse than the CA group; (3) for the SLI group, (a) CLPT correlated with complex sentence comprehension, and (b) nonword repetition correlated with simple sentence comprehension; (4) for CA children, neither memory variable correlated with either sentence type; and (5) for LMM children, only CLPT correlated with complex sentences. CONCLUSIONS: Comprehension of both complex and simple grammar by school-age children with SLI is a mentally demanding activity, requiring significant working memory resources.

Role of working memory in typically developing children's complex sentence comprehension.

The influence of three mechanisms of working memory (phonological short-term memory (PSTM capacity), attentional resource control/allocation, and processing speed) on children's complex (and simple) sentence comprehension was investigated. Fifty two children (6-12 years) completed a nonword repetition task (indexing PSTM), concurrent verbal processing-storage task (indexing resource control/allocation), auditory-visual reaction time (RT) task (indexing processing speed), and a sentence comprehension task that included complex and simple sentences. Correlation and regression analyses were run to determine the association between the memory variables and sentence comprehension accuracy. Results revealed: (1) none of the memory variables correlated with simple sentence comprehension, (2) resource control/allocation and processing speed correlated significantly with complex sentence comprehension, even after covarying for age, and (3) attentional functioning and processing speed predicted complex sentence comprehension (after accounting for age). Results were interpreted to suggest that working memory is significantly involved in school age children's comprehension of familiar complex sentence structures.

Role of auditory attention in the real-time processing of simple grammar by children with specific language impairment: a preliminary investigation.

BACKGROUND: This study investigates the effects of two dimensions of attentional functioning, sustained focus of attention and resource capacity/allocation, on the real-time processing of simple sentences by children with specific language impairment (SLI) and typically developing (TD) children matched for age. METHODS & PROCEDURES: Thirty-six school-age children with SLI and 36 age-matched TD peers completed an auditory continuous performance task (ACPT) as a measure of sustained attention, a concurrent verbal processing-storage task as a measure of resource capacity/allocation, and a word-recognition reaction time (RT) task (index of sentence processing). Correlation and regression analyses were run to determine the association between the two measures of attention and word recognition RT. OUTCOMES & RESULTS: Children with SLI were outperformed by the TD children on each of the tasks. For each group, scores on both the ACPT and concurrent processing-storage tasks significantly correlated with word recognition RT. The partial correlations (with the effects of age removed) remained significant, but only for the SLI group. Results of a regression analysis for the SLI group showed that age predicted 12.3% of unique variance in word recognition RT, while ACPT score accounted for an additional significant 45.7% of unique variance and the processing-storage task score accounted for another significant 4.3% of unique variance. CONCLUSIONS: The real-time processing of simple grammar by children with SLI appears to involve significant use of sustained focus of attention and attentional resource capacity. In the case of TD children, however, neither sustained attention nor attentional resources appears to be significantly involved in simple sentence processing.

Examining the language performances of children with and without specific language impairment: contributions of phonological short-term memory and speed of processing.

PURPOSE: This study investigated the effects of processing speed and phonological short-term memory (PSTM) on children's language performance. METHOD: Forty-eight school-age children with specific language impairment (SLI) and age peers completed auditory detection reaction time (RT) and nonword repetition tasks, the Clinical Evaluation of Language Fundamentals-Revised (CELF-R; E. Semel, E. Wiig, & W. Secord, 1987), and a word recognition RT task. Correlation and regression were used to determine unique and shared contributions to variance among measures. RESULTS: Children with SLI were outperformed by age peers on each task. Auditory detection RT was correlated with nonword repetition (NWR) in each group. However, both variables covaried with age, and auditory detection RT did not contribute unique variance to NWR in either group. For the SLI group, NWR predicted unique variance in CELF-R performance (about 15%); auditory detection RT predicted a smaller amount of unique variance in the word recognition RT task (about 9%). CONCLUSION: Processing speed and PSTM measures covaried with chronological age. Processing speed was associated with offline language performance only through association with PSTM. Processing speed contributed to online language performance, suggesting that speed is associated with processing more familiar language material (i.e., lexical content and structure) than less familiar material (e.g., various content on the CELF-R).

Real-time language processing in school-age children with specific language impairment.

BACKGROUND: School-age children with specific language impairment (SLI) exhibit slower real-time (i.e. immediate) language processing relative to same-age peers and younger, language-matched peers. Results of the few studies that have been done seem to indicate that the slower language processing of children with SLI is due to inefficient higher-order linguistic processing and not to difficulties with more basic acoustic-phonetic processing. However, this claim requires further experimental verification. AIMS: It was investigated whether the real-time language processing deficit of children with SLI arises from inferior acoustic-phonetic processing, inefficient linguistic processing, or both poor sensory processing and linguistic processing. If these children's impaired online language processing is due to inferior acoustic-phonetic processing, then their reaction time (RT) for recognizing words presented in list fashion should be significantly longer relative to control children's RT. If, however, their impaired language processing relates to inefficient linguistic processing, then, relative to control children, their RT for word-list-presented words should be comparable and their sentence-embedded word-recognition RT should be significantly longer. METHODS & PROCEDURES: Sixteen school-age children with SLI, 16 age-matched (CA) typically developing children, and 16 receptive-syntax matched (RS) children completed two word-recognition RT tasks. In one task, children monitored word lists for the occurrence of a target word (isolated lexical processing task). In the second task, children monitored simple sentences for a target word (sentence-embedded lexical processing task). In both tasks, children made a timed response immediately upon recognizing the target. OUTCOMES & RESULTS: Children with SLI and CA children showed comparable RT in the isolated lexical processing task and both were faster than RS children. In the sentence-processing task, children with SLI were slower at lexical processing than CA and RS children, with CA children demonstrating the fastest processing. CONCLUSIONS: The real-time language processing of children with SLI appears to be attributable to inefficient higher-order linguistic processing operations and not to inferior acoustic-phonetic processing. The slower language processing of children with SLI relative to younger, language-matched children suggests that the language mechanism of children with SLI operates more slowly than what might otherwise be predicted by their linguistic competence.