SLPs' perceptions of language learning myths about children who are DHH.

This article reports on speech-language pathologists' (SLPs') knowledge related to myths about spoken language learning of children who are deaf and hard of hearing (DHH). The broader study was designed as a step toward narrowing the research-practice gap and providing effective, evidence-based language services to children. In the broader study, SLPs (n = 106) reported their agreement/disagreement with myth statements and true statements (n = 52) about 7 clinical topics related to speech and language development. For the current report, participant responses to 7 statements within the DHH topic were analyzed. Participants exhibited a relative strength in bilingualism knowledge for spoken languages and a relative weakness in audiovisual integration knowledge. Much individual variation was observed. Participants' responses were more likely to align with current evidence about bilingualism if the participants had less experience as an SLP. The findings provide guidance on prioritizing topics for speech-language pathology preservice and professional development.

Conceptions and Misconceptions: What Do School-Based Speech-Language Pathologists Think About Dyslexia?

PURPOSE: The purpose of this exploratory study was to evaluate speech-language pathologists' (SLPs') conceptions and misconceptions about dyslexia. METHOD: Participants were 86 school-based SLPs. They completed an online survey on which they rated their agreement and disagreement with true and false statements related to the scientific evidence about the nature of dyslexia and interventions for dyslexia, as well as common misconceptions about dyslexia. RESULTS: There was considerable variability among SLPs' agreement and disagreement with the statements. Critically, despite abundant contrary evidence in the literature, many SLPs believe that dyslexia involves a visual processing deficit. CONCLUSIONS: These findings suggest that many school-based SLPs hold misconceptions about dyslexia, especially those related to dyslexia being a visual disorder. The identified misconceptions may contribute to some SLPs' reluctance to incorporate reading and prereading skills into speech-language assessment and intervention. SLPs need greater knowledge of dyslexia to provide more effective evaluations and intervention services.

Using Motor Tempi to Understand Rhythm and Grammatical Skills in Developmental Language Disorder and Typical Language Development.

Children with developmental language disorder (DLD) show relative weaknesses on rhythm tasks beyond their characteristic linguistic impairments. The current study compares preferred tempo and the width of an entrainment region for 5- to 7-year-old typically developing (TD) children and children with DLD and considers the associations with rhythm aptitude and expressive grammar skills in the two populations. Preferred tempo was measured with a spontaneous motor tempo task (tapping tempo at a comfortable speed), and the width (range) of an entrainment region was measured by the difference between the upper (slow) and lower (fast) limits of tapping a rhythm normalized by an individual's spontaneous motor tempo. Data from N = 16 children with DLD and N = 114 TD children showed that whereas entrainment-region width did not differ across the two groups, slowest motor tempo, the determinant of the upper (slow) limit of the entrainment region, was at a faster tempo in children with DLD vs. TD. In other words, the DLD group could not pace their slow tapping as slowly as the TD group. Entrainment-region width was positively associated with rhythm aptitude and receptive grammar even after taking into account potential confounding factors, whereas expressive grammar did not show an association with any of the tapping measures. Preferred tempo was not associated with any study variables after including covariates in the analyses. These results motivate future neuroscientific studies of low-frequency neural oscillatory mechanisms as the potential neural correlates of entrainment-region width and their associations with musical rhythm and spoken language processing in children with typical and atypical language development.

Speech-Language Pathologists' Endorsement of Speech, Language, and Literacy Myths Reveals Persistent Research-Practice Gap.

PURPOSE: We explore the extent to which speech-language pathologists (SLPs) are operating under assumptions about speech, language, and literacy that are not supported by evidence or are contradicted by evidence. METHOD: SLPs (N = 106) marked the degree to which they endorsed or rejected four true and 11 myth (i.e., false) statements on a visual analog scale via an online survey. We analyzed the degree to which participants agreed or disagreed with these statements related to speech, language, and literacy development and impairment. RESULTS: Based on results of one-sample t tests, participants as a group correctly rejected seven myth statements and correctly endorsed three true statements. Participants as a group provided equivocal responses to the remaining four myth statements and one true statement. Scores for each statement spanned all or nearly all of the possible range. Even when participants overall showed relatively strong disagreement with a particular myth statement, at least a few participants endorsed the myth statement. CONCLUSIONS: The findings indicate areas of relative strength for SLPs' knowledge of current evidence for augmentative and alternative communication, bilingualism, and language input that supports language development. Identified areas of relative weakness include knowledge of the expected grammatical and speech production skills of children with typical development and the influence of ear infections in childhood on language impairment. Additional research is needed to evaluate efforts to enhance SLPs' knowledge and use of evidence-based practices.

A pilot study assessing listening comprehension and reading comprehension in children with down syndrome: Construct validity from a multi-method perspective.

Obtaining valid assessments of language and literacy skills in children with Down syndrome (DS) presents a challenge as there is a paucity of information about the psychometrics of measures that are commonly used to measure listening and reading comprehension in this population. Evaluating the construct validity of measures that employ different methods is essential to ascertain the optimal method of assessment in individuals with DS and with typical developmental histories (TD). This pilot study aimed to evaluate the construct validity of four parallel measures of listening and reading comprehension. Participants included 19 individuals with DS (M = 17 years, 3 months; SD = 3 years, 6 months) and 19 word-level reading-matched children with TD (M = 7 years, 2 months; SD = 7 months). Participants completed norm-referenced assessments for four parallel measures of listening and reading comprehension. The four measurement methods were: (1) non-verbal response, (2) cloze procedure, (3) passage-level with close-ended questions, and (4) passage-level with open-ended questions. Participants completed additional assessments (e.g., cognition, language, and speech) for descriptive purposes. Construct validity was assessed using the Multitrait-Multimethod Matrix, a correlation matrix arranged to facilitate the assessment and interpretation of construct validity of measures across various formats. For both study groups, we observed strong evidence of construct validity for three out of four measurement methods. Results using the multimethod perspective also indicated that the listening and reading comprehension constructs were not separable. The findings from this pilot study represent a first step toward determining optimal methods of listening and reading comprehension assessment for individuals with DS. Additionally, these results can inform outcome measure selection in future language and literacy research with children with DS.

Reading and Listening Comprehension in Individuals With Down Syndrome and Word Reading-Matched Typically Developing Children.

PURPOSE: The purpose of this study was to explore the reading comprehension and listening comprehension performance of English-speaking children with Down syndrome (DS) compared with word reading-matched typically developing (TD) children. METHOD: Participants included 19 individuals with DS (M age = 17;2 [years;months], range: 11;1-22;9) and 19 word reading-matched TD children (M age = 7;2, range: 6;6-8;1). Participants completed three norm-referenced measures of reading comprehension and three norm-referenced measures of listening comprehension. Dependent variables were raw scores on each measure, with the exception of scaled scores on one reading comprehension measure. RESULTS: Independent-samples t tests with Bonferroni-adjusted alpha levels of .008 revealed a significant between-groups difference for two of three reading comprehension measures. The mean raw scores were lower for the DS group than the TD group, with large effect sizes. Independent-samples t tests with Bonferroni-adjusted alpha levels of .008 revealed a significant between-groups difference for three of three listening comprehension measures. The mean raw scores on the three measures were lower for the DS group than the TD group, with large effect sizes. CONCLUSIONS: The DS group, despite being matched on word reading to the TD group, demonstrated reduced reading comprehension skills as compared with the TD group. Thus, as individuals with DS acquire word reading skills, it appears that they are unable to translate word reading success to achieve reading comprehension at the expected level (i.e., as indexed by typical readers). The between-groups differences in listening comprehension suggest that deficits in listening comprehension likely are a barrier to reading comprehension proficiency for children with DS. Listening comprehension may be a malleable factor that can be targeted to improve reading comprehension outcomes for individuals with DS.

Tense Marking in the Kindergarten Population: Testing the Bimodal Distribution Hypothesis.

Purpose The purpose of this study was to explore whether evidence for a bimodal distribution of tense marking, previously documented in clinically referred samples, exists in a population-based sample of kindergarten children from a rural county in Tennessee. Method A measure of tense marking, the Test of Early Grammatical Impairment (TEGI) Screening Test, was individually administered to consented kindergarten students (N = 153) across three elementary schools in a single school district. The consented children constituted 73% of kindergartners in the district. Cluster analysis was used to evaluate the number and composition of latent classes that best fit the distribution of the TEGI Screening Test scores. Results Analysis of the scores revealed a distribution that deviated significantly from normality. Cluster analyses (Ward's, k-means, single linkage) revealed a two-cluster solution as the best fitting model. The very large effect-size difference in mean TEGI Screening Test score between the two clusters (d = 4.77) provides validation of an identifiable boundary delineating typical from atypical tense marking in this sample of kindergartners. The difference in tense marking across the two clusters was not attributable to child chronological age. The percentage of the sample comprising the low-performing cluster aligns with specific language impairment and developmental language disorder prevalence estimates. Conclusion Additional demonstrations of a bimodal distribution of tense marking in future studies with carefully defined samples could strengthen the clinical marker evidence and utility of this linguistic feature.

When Will He Talk? An Evidence-Based Tutorial for Measuring Progress Toward Use of Spoken Words in Preverbal Children With Autism Spectrum Disorder.

Purpose Professionals face substantial challenges determining whether and when children with autism spectrum disorder (ASD) who are not yet using spoken words will use spoken language as their primary means of communication. This tutorial provides speech-language pathologists with practical guidance on how to measure expressive language predictors for progress monitoring and making intervention decisions for children with ASD who are preverbal. Method This tutorial is a repackaging effort that seeks to make the research accessible to clinicians wishing to implement evidence-based practice. Results We describe intentional communication, consonant inventory in communication acts, and responding to joint attention as particularly valuable prelinguistic skills to measure. We explain how and when to efficiently assess progress using published assessments periodically and using brief (5-min) communication samples for more frequent progress monitoring. Conclusions Communication samples can be used to show how a child performs within a therapeutic setting during teaching (treatment data) and outside of the therapeutic setting (generalization probe data). Both types of data are critical for determining whether the child is exhibiting progress and which aspects of intervention are facilitating progress toward use of spoken words. These recommendations also balance the evidence for best practices for progress monitoring and the demands on clinicians' time and effort. To encourage the measurement of prelinguistic skills of children with ASD who are preverbal in clinical practice, we include (a) example data collection documents, (b) examples with hypothetical data and interpretation, and (c) guidance on communication sampling procedures. Supplemental Material https://doi.org/10.23641/asha.13557836.

Individualized Narrative Intervention for School-Age Children With Specific Language Impairment.

Purpose This study extends the research on narrative intervention by evaluating the effect of a standard treatment protocol, Story Champs (Petersen & Spencer, 2012), on personal narrative generations of school-age children with specific language impairment (SLI). Method Four second-grade, 8- to 9-year-old boys with SLI participated in this multiple baseline across behaviors, single-case design study that was repeated across participants. Each one-on-one intervention session involved eight steps across two intervention segments: story retell and personal story generation. The interventionist provided systematic scaffolding (visual and verbal supports) that was faded within each session. Three individualized story grammar elements per participant were targeted sequentially across the weeks of intervention based on each participant's needs identified in baseline. The dependent variable probe (personal narrative generation) was administered at the beginning of each twice-weekly session, and individualized story grammar elements were scored on a 4-point rubric (dependent variable). Results In this single-case research design study, a functional relation was evaluated for each participant (i.e., replication of an effect across three story grammar elements). A functional relation between Story Champs intervention and the dependent variable was observed for two participants. Conclusion Results provide preliminary evidence for the efficacy of individually administered Story Champs intervention for children with SLI.

Toward Understanding the Lexical-Morphological Networks of Children With Specific Language Impairment: Analysis of Responses on a Morphological Production Task.

Purpose The purpose of this study was to characterize the lexical-morphological networks of children with specific language impairment (SLI) compared to children with typical language by analyzing responses on a morphological derived form production task. Method School-age children with SLI (n = 32) and peers with typical language (n = 40) completed an oral cloze derived form production task (Carlisle, 2000). On this task, children were expected to complete verbally presented sentences with a derived form of a provided morphological stem. Responses were coded as correct or incorrect following Carlisle's (2000) stated correct responses. Incorrect responses were coded as scorable or unscorable, and then scorable responses were coded as pseudowords or real words. Real words were further coded according to whether they were repetitions of the given stem. Results There was a statistically significant between-group difference for mean correct responses (d = 1.43). The scorable incorrect responses of children with SLI included a lower mean proportion of pseudowords than did the incorrect responses of children with typical language (d = 0.76). Conclusion Because children with SLI produced a lower proportion of pseudowords as scorable incorrect responses than peers with typical language, we conclude that they have less developed lexical-morphological networks and, thus, less derivational morphology knowledge than peers with typical language.

A Multiyear Population-Based Study of Kindergarten Language Screening Failure Rates Using the Rice Wexler Test of Early Grammatical Impairment.

Purpose: The purpose of this study was to evaluate, over 2 separate school years, the school-district-wide failure rate of kindergartners on a screener of grammatical tense marking-the Rice Wexler Test of Early Grammatical Impairment (TEGI) Screening Test (Rice & Wexler, 2001)-composed of past tense (PT) and third-person singular (3S) probes. Method: In the fall of 2 consecutive school years, consented and eligible kindergartners (n = 148 in Year 1, n = 126 in Year 2) in a rural southern school district were administered the TEGI Screening Test. Children who failed the screening test or either of the individual probes (PT or 3S) were administered the Primary Test of Nonverbal Intelligence. All children also completed the Test of Articulation Performance-Screen (Bryant & Bryant, 1983) and, in Year 2, the Get Ready to Read! emergent literacy screener (Whitehurst & Lonigan, 2001). Results: The screening tool outcome most closely and consistently aligned with the recommended failure rate of approximately 30% (Oetting, Gregory, & Rivière, 2016; based on Tomblin et al., 1997) was the TEGI PT probe. TEGI Screening Test and 3S probe failure rates fell below the recommended level. Most children who failed the PT probe demonstrated nonverbal intelligence skills within the average range. In addition, most children who failed the PT probe would not have been readily identified on the basis of only the results of their articulation or emergent literacy screenings. Conclusions: The TEGI PT probe is an efficient and reliable screener that identifies children for monitoring or additional language assessment. Children with language vulnerabilities are not necessarily identified by articulation or emergent literacy screenings at entry to kindergarten. To identify children at risk for language impairment, it is therefore necessary to directly screen oral language.

The Potential of Past Tense Marking in Oral Reading as a Clinical Marker of Specific Language Impairment in School-Age Children.

Purpose: The purpose of this study was twofold. The first aim was to explore differences in profiles of past tense marking in oral reading of school-age children with specific language impairment (SLI). The second aim was to explore the potential of past tense marking in oral reading as a clinical marker of SLI in school-age children. Method: This study examined oral readings of connected text to describe the frequency and type of reading errors on regular and irregular past tense verbs for 21 children with SLI as compared to 30 children with typical language in Grades 2 and 3. Each past tense verb token was categorized into 1 of 6 mutually exclusive response types: (a) correctly marked past tense, (b) overmarked past tense, (c) bare stem, (d) other verb inflection, (e) nonverb, or (f) no response. Performance across groups was compared. Additionally, classification statistics were calculated at several cutoffs for regular past tense accuracy and regular past tense finiteness marking. Results: For regular past tense, there was a significant group difference on accuracy. Children with SLI were less accurate at marking past tense when in oral reading than typical language peers; other response types did not differ. For irregular past tense, there were no group differences. In addition, there was a significant group difference on finiteness marking; this difference was driven by regular but not irregular verbs. A cutoff of 90% for regular past tense accuracy yielded moderate sensitivity and specificity; no cutoff for regular past tense finiteness marking yielded sensitivity above 70%. Conclusions: Regular past tense accuracy in oral reading provides promise as a clinical marker for diagnosing SLI in school-age children.

Word-learning performance of children with and without cochlear implants given synchronous and asynchronous cues.

This study sought to evaluate the effects of synchronous and asynchronous auditory-visual cues on the word-learning performance of children with cochlear implants and children with normal hearing matched for chronological age. Children with cochlear implants (n = 9) who had worn the implant for less than one year and children matched for chronological age (n = 9) participated in rapid word-learning trials. Children with cochlear implants did not learn words in either the synchronous or asynchronous condition (U = 49.5, p = .99; d = 0.05). Children with normal hearing learned more words in the synchronous rather than asynchronous condition (U = 78.5, p = .04; d = 0.95). These findings represent a first step toward determining how task-level factors influence the lexical outcomes of children with cochlear implants.

Perspectives on the rhythm-grammar link and its implications for typical and atypical language development.

This paper reviews the mounting evidence for shared cognitive mechanisms and neural resources for rhythm and grammar. Evidence for a role of rhythm skills in language development and language comprehension is reviewed here in three lines of research: (1) behavioral and brain data from adults and children, showing that prosody and other aspects of timing of sentences influence online morpho-syntactic processing; (2) comorbidity of impaired rhythm with grammatical deficits in children with language impairment; and (3) our recent work showing a strong positive association between rhythm perception skills and expressive grammatical skills in young school-age children with typical development. Our preliminary follow-up study presented here revealed that musical rhythm perception predicted variance in 6-year-old children's production of complex syntax, as well as online reorganization of grammatical information (transformation); these data provide an additional perspective on the hierarchical relations potentially shared by rhythm and grammar. A theoretical framework for shared cognitive resources for the role of rhythm in perceiving and learning grammatical structure is elaborated on in light of potential implications for using rhythm-emphasized musical training to improve language skills in children.

Synchrony of maternal auditory and visual cues about unknown words to children with and without cochlear implants.

OBJECTIVES: The purpose of this study was to compare types of maternal auditory-visual input about word referents available to children with cochlear implants, children with normal hearing matched for age, and children with normal hearing matched for vocabulary size. Although other works have considered the acoustic qualities of maternal input provided to children with cochlear implants, this study is the first to consider auditory-visual maternal input provided to children with cochlear implants. DESIGN: Participants included 30 mother-child dyads from three groups: children who wore cochlear implants (n = 10 dyads), children matched for chronological age (n = 10 dyads), and children matched for expressive vocabulary size (n = 10 dyads). All participants came from English-speaking families, with the families of children with hearing loss committed to developing listening and spoken language skills (not sign language). All mothers had normal hearing. Mother-child interactions were video recorded during mealtimes in the home. Each dyad participated in two mealtime observations. Maternal utterances were transcribed and coded for (a) nouns produced, (b) child-directed utterances, (c) nouns unknown to children per maternal report, and (d) auditory and visual cues provided about referents for unknown nouns. Auditory and visual cues were coded as either converging, diverging, or auditory-only. RESULTS: Mothers of children with cochlear implants provided percentages of converging and diverging cues that were similar to the percentages of mothers of children matched for chronological age. Mothers of children matched for vocabulary size, on the other hand, provided a higher percentage of converging auditory-visual cues and lower percentage of diverging cues than did mothers of children with cochlear implants. Groups did not differ in provision of auditory-only cues. CONCLUSIONS: The present study represents the first step toward identification of environmental input characteristics that may affect lexical learning outcomes of children with cochlear implants. Given that children with cochlear implants demonstrate slower rates of lexical growth than children with normal hearing, the findings from this study provide an important direction for further investigation of how environmental factors affect lexical outcomes for this population. If mothers can provide auditory and visual cues to increase the salience of a relevant object in word-learning contexts, they may be able to facilitate the language growth of their children.

The influence of two cognitive-linguistic variables on incidental word learning in 5-year-olds.

The relation between incidental word learning and two cognitive-linguistic variables--phonological memory and phonological awareness--is not fully understood. Thirty-five typically developing, 5-year-old, preschool children participated in a study examining the association between phonological memory, phonological awareness, and incidental word learning. Children were exposed to target words in a read-aloud story that accompanied a wordless picture book. Target word comprehension was assessed before and after two readings of the story. Phonological awareness predicted incidental word learning but phonological memory did not. The influence of phonological awareness and phonological memory on word learning may be dependent on the demands of the word learning task.

Mother-child communication and maternal depressive symptoms in families of children with cancer: integrating macro and micro levels of analysis.

OBJECTIVES: This study examines associations between maternal depressive symptoms and macro- and micro-level aspects of mothers' communication about their children's cancer. METHODS: Mothers reported depressive symptoms after diagnosis or relapse (child mean age = 10.4 years; 53% male). Mother-child dyads (N = 94) were subsequently observed discussing the child's cancer and maternal communication was coded. RESULTS: Macro-level indicators (positive and negative communication) were associated with certain micro-level indicators of communication (topic maintenance, reflections, reframes, and imperatives). Higher depressive symptoms predicted lower positive communication and higher negative communication. Maternal reflections and imperatives predicted positive communication, and topic maintenance and reframes predicted negative communication, beyond child age, family income, and depressive symptoms. CONCLUSIONS: Findings suggest concrete targets for improving communication in families after diagnosis or relapse.