Impaired Cortical Tracking of Speech in Children with Developmental Language Disorder.

In developmental language disorder (DLD), learning to comprehend and express oneself with spoken language is impaired, but the reason for this remains unknown. Using millisecond-scale magnetoencephalography recordings combined with machine learning models, we investigated whether the possible neural basis of this disruption lies in poor cortical tracking of speech. The stimuli were common spoken Finnish words (e.g., dog, car, hammer) and sounds with corresponding meanings (e.g., dog bark, car engine, hammering). In both children with DLD (10 boys and 7 girls) and typically developing (TD) control children (14 boys and 3 girls), aged 10-15 years, the cortical activation to spoken words was best modeled as time-locked to the unfolding speech input at ∼100 ms latency between sound and cortical activation. Amplitude envelope (amplitude changes) and spectrogram (detailed time-varying spectral content) of the spoken words, but not other sounds, were very successfully decoded based on time-locked brain responses in bilateral temporal areas; based on the cortical responses, the models could tell at ∼75-85% accuracy which of the two sounds had been presented to the participant. However, the cortical representation of the amplitude envelope information was poorer in children with DLD compared with TD children at longer latencies (at ∼200-300 ms lag). We interpret this effect as reflecting poorer retention of acoustic-phonetic information in short-term memory. This impaired tracking could potentially affect the processing and learning of words as well as continuous speech. The present results offer an explanation for the problems in language comprehension and acquisition in DLD.

Assessment of Developmental Language Disorder in Multilingual Children: Results from an International Survey.

INTRODUCTION: The Multilingual-Multicultural Affairs Committee of the International Association of Communication Disorders (IALP) conducted a survey of diagnostic criteria for developmental language disorder (DLD) in multilingual children to discover how clinicians apply terminology and diagnostic criteria to multilingual children in different parts of the world. METHODS: An international web survey was used to survey 354 participants from 44 countries about their assessment practices, and clinical opinions about assessing multilingual children for DLD. RESULTS: The findings show that most clinicians felt confident in assessing multilingual children, and they applied the DLD terminology and inclusionary criteria to multilingual children with difficulty learning language. Clinicians used different procedures to assess heritage and societal languages. Barriers to access to services included a lack of knowledge by parents and referral sources about services available and typical multilingual development, with additional reasons differing by geographical region. DISCUSSION: Speech pathologists across the globe have many similarities in the way that they assess multilingual children. Differences may be attributed to clinical experience, professional education, the clinician's role, the system they work in, and the clinician's own language skills. This paper advances knowledge of current clinical practices, which can be used to evaluate frameworks in international and national contexts, with implications for policy and practice to improve access to clinical services.

Is epileptiform activity related to developmental language disorder? Findings from the HelSLI study.

Objective: To study if interictal epileptiform discharges (IEDs) are associated with language performance or pre-/perinatal factors in children with developmental language disorder (DLD). Methods: We recorded routine EEG in wake and sleep in 205 children aged 2.9-7.1 years with DLD, without neurologic diseases or intellectual disability. We examined the language performance of the children and collected data on pre-/perinatal factors. Results: Interictal epileptiform discharges were not associated with lower language performance. Children with so-called "rolandic", i.e. centrotemporoparietal, IEDs had better language skills, but age explained this association. Most pre-/perinatal factors evaluated did not increase the risk of rolandic IEDs, except for maternal smoking (OR 4.4, 95% CI 1.4-14). We did not find electrical status epilepticus during slow-wave sleep (ESES)/spike-and-wave activation in sleep (SWAS) in any children. Conclusions: Interictal epileptiform discharges are not associated with lower language performance, and ESES/SWAS is not common in children with DLD. Significance: Routine EEGs do not bring additional information about language performance in children with DLD who do not have any neurologic diseases, seizures, intellectual disability, or regression of language development.

Cross-Sectional and Longitudinal Associations Between Quality of Parent-Child Interaction and Language Ability in Preschool-Age Children With Developmental Language Disorder.

PURPOSE: This study explores whether the quality of parent-child interaction is associated with language abilities cross-sectionally and longitudinally up to preschool-age among children with developmental language disorder (DLD). METHOD: Participants were 97 monolingual children with DLD and their parents from the Helsinki Longitudinal SLI study, HelSLI (baseline, age in years;months, M = 4;3, SD = 0;10), of which 71 pairs were followed longitudinally (age in years;months, M = 6;6, SD = 0;5). Video recordings from three play sessions were scored for child, parent, and dyadic behavior using Erickson's sensitivity scale protocol and mutually responsive orientation at baseline. Children's expressive and receptive language and language reasoning ability were assessed at baseline, and expressive and receptive language were assessed at follow-up. RESULTS: At baseline, engaged child behavior, parent's supportive guidance, and fluent and attuned dyadic behavior were associated with better receptive language ability, and engaged child behavior and dyadic synchrony were positively associated with language reasoning ability in 3- to 6-year-olds. The child's positive engagement and fluent and attuned dyadic behavior at baseline were associated with better expressive and receptive language abilities at follow-up in 6- to 7-year-olds, respectively. CONCLUSIONS: Fluent and attuned dyadic behavior is associated with better receptive language ability in preschool-age children. Parent behavior alone was not associated with language ability. A connected and mutually attuned parent-child relationship could be a protective factor for language development for children with DLD.

Language acquisition of early sequentially bilingual children is moderated by short-term memory for order in developmental language disorder: Findings from the HelSLI study.

BACKGROUND: The role of domain-general short-term memory (STM) in language development remains controversial. A previous finding from the HelSLI study on children with developmental language disorder (DLD) suggested that not only verbal but also non-verbal STM for temporal order is related to language acquisition in monolingual children with DLD. AIMS: To investigate if a similar relationship could be replicated in a sample of sequentially bilingual children with DLD. In addition to the effect of age, the effect of cumulative second language (L2) exposure was studied. METHODS & PROCEDURES: Sixty-one 4-6-year-old bilingual children with DLD and 63 typically developing (TD) bilingual children participated in a cross-sectional study conducted in their L2. Children completed novel game-like tests of visual and auditory non-verbal serial STM, as well as tests of cognitive functioning and language. Interactions of STM for order with age and exposure to L2 (Finnish) were explored as explanatory variables. OUTCOMES & RESULTS: First, the improvement of non-verbal serial STM with age was faster in sequentially bilingual TD children than in bilingual children with DLD. A similar effect was observed for L2 exposure. However, when both age and exposure were considered simultaneously, only age was related to the differential growth of non-verbal STM for order in the groups. Second, only in children with DLD was better non-verbal serial STM capacity related to an improvement in language scores with age and exposure. CONCLUSIONS & IMPLICATIONS: The results suggest that, as previously found in Finnish monolingual children, domain-general serial STM processing is also compromised in bilingual children with DLD. Further, similar to the monolingual findings, better non-verbal serial STM was associated with greater language improvement with age and exposure, but only in children with DLD, in the age range studied here. Thus, in clinical settings, assessing non-verbal serial STM of bilingual children could improve the detection of DLD and understanding of its non-linguistic symptoms. WHAT THIS PAPER ADDS: What is already known on the subject Both phonological and non-verbal STM have been associated with DLD in monolingual and sequentially bilingual children. Monolingual children with DLD have also shown slower non-verbal serial STM development than TD children. What this study adds to existing knowledge Sequentially bilingual TD children's non-verbal serial STM improves more between ages 4 and 7 years than that of their peers with DLD, replicating a finding for monolingual children with DLD. Better non-verbal serial STM was especially associated with early receptive language development in sequentially bilingual children with DLD. L2 exposure showed largely comparable effects with age. These results support the hypothesis that a domain-general serial STM deficit is linked to DLD. What are the potential or actual clinical implications of this work? Non-verbal assessment of STM for serial order in sequentially bilingual children with DLD could benefit the development of better tailored therapeutic interventions.

Structure of Cognitive Functions in Monolingual Preschool Children With Typical Development and Children With Developmental Language Disorder.

Purpose Developmental language disorder (DLD) is defined by persistent difficulties with language, but a growing body of evidence suggests that it is also associated with domain-general and nonverbal information-processing deficits. However, the interconnections between cognitive functions, both nonverbal and language related, are still unclear. With the aim of gaining more comprehensive insight into the cognitive deficits related to DLD, we investigated and compared the cognitive structure of children with DLD and typically developing (TD) children. Method As a part of the Helsinki longitudinal SLI study, monolingual Finnish preschoolers (N = 154; TD group: n = 66, DLD group: n = 88) were assessed with 23 tasks measuring nonverbal and verbal reasoning, language processing, memory, visuomotor functions, attention, and social cognition. Exploratory factor analysis and structural equation modeling were performed to examine latent constructs and to test measurement invariance between the TD and DLD groups. Results Measurement invariance was not found across the TD and DLD groups. Best fitting structure for TD children included factors reflecting verbal abilities, processing speed/short-term memory, visuomotor functions, and visuoconstructive abilities/nonverbal reasoning. The DLD group's structure comprised nonverbal abilities, naming/expressive language, verbal comprehension, and verbal/declarative memory. Conclusions The findings suggest that the structure of cognitive functions differs in TD children and children with DLD already at preschool age. Nonverbal functions seem more unified, whereas verbal functions seem more varying in preschoolers with DLD compared to TD children. The results can be used in future research for prognosis of DLD and planning interventions.

Short-Term Memory for Serial Order Moderates Aspects of Language Acquisition in Children With Developmental Language Disorder: Findings From the HelSLI Study.

Previous studies of verbal short-term memory (STM) indicate that STM for serial order may be linked to language development and developmental language disorder (DLD). To clarify whether a domain-general mechanism is impaired in DLD, we studied the relations between age, non-verbal serial STM, and language competence (expressive language, receptive language, and language reasoning). We hypothesized that non-verbal serial STM differences between groups of children with DLD and typically developing (TD) children are linked to their language acquisition differences. Fifty-one children with DLD and sixty-six TD children participated as part of the HelSLI project in this cross-sectional study. The children were 4-6-year-old monolingual native Finnish speakers. They completed several tests of language and cognitive functioning, as well as new game-like tests of visual and auditory non-verbal serial STM. We used regression analyses to examine how serial STM moderates the effect of age on language. A non-verbal composite measure of serial visual and auditory STM moderated cross-sectional development of receptive language in the children with DLD. This moderation was not observed in the TD children. However, we found more rapid cross-sectional development of non-verbal serial STM in the TD children than in the children with DLD. The results suggest that children with DLD may be more likely to have compromised general serial STM processing and that superior non-verbal serial STM may be associated with better language acquisition in children with DLD.

L2 vocabulary acquisition of early sequentially bilingual children with TD and DLD affected differently by exposure and age of onset.

BACKGROUND: Language exposure is known to be a key factor influencing bilingual vocabulary development in typically developing (TD) children. There is, however, a lack of knowledge in terms of exposure effects in children with developmental language disorder (DLD) and, especially, in interaction with age of onset (AoO) of second language acquisition. AIMS: In the Helsinki longitudinal SLI study (HelSLI), we investigated the receptive and expressive second language (L2) vocabulary performance and cross-sectional vocabulary development of sequentially bilingual children with TD and DLD in order to resolve whether the groups could be differentiated based on their vocabulary performance. More importantly, we examined the effects of AoO and exposure in the vocabulary performance of these two bilingual groups. METHODS & PROCEDURES: A total of 70 children with DLD from a hospital clinic and 82 with TD from kindergartens were recruited. Children were 3-7 years old with different AoOs for the L2 and varying degrees of language exposure. Multiple regression analysis was used to compare the groups in two receptive and three expressive vocabulary tests while considering the effects of AoO and language exposure. OUTCOMES & RESULTS: Children with TD outperformed children with DLD in both receptive and expressive vocabulary measures. Exposure predicted vocabulary but AoO did not. The effect of exposure was different in TD and DLD groups in receptive but not in expressive vocabulary. Additionally, the interaction of exposure and AoO was found for receptive vocabulary, but similarly in both groups. With increasing exposure, a difference in performance between the groups became more notable in receptive vocabulary compared with the expressive vocabulary. CONCLUSIONS & IMPLICATIONS: Bilingual children with TD and DLD can be differentiated by using L2 vocabulary tests when exposure is taken into consideration. Non-significant AoO effects in 3-7 year olds suggest flexibility in terms of when to start L2 immersion. However, exposure is important, and especially children with DLD would need a substantial amount of it relative to their TD peers, so that they would not fall even further behind over time. Differences in benefiting from exposure in receptive mode might offer clinicians and kindergarten personnel an insight for evaluating challenges in bilingual development. Severe challenges in vocabulary development in the DLD group also call for both individually targeted small-group activities for learning words as well as strategies for strengthening vocabulary in various environments and everyday life situations. What this paper adds What is already known on the subject Language exposure is often found to explain more of the variation compared with AoO in early L2 vocabulary. On the other hand, it has been suggested by some researchers, but not all, that AoO effects would be found. Exposure and AoO might also interact differently depending on the task and whether the development is typical or disordered. Contrary to the clinical observation, diagnostic value of receptive vocabulary has often been questioned. What this paper adds to existing knowledge This study indicates that receptive vocabulary might be useful in differentiating bilingual TD and DLD. Language exposure effects differ between TD and DLD groups, but depending on task. Lower performance, but also slower cross-sectional development, is found in receptive vocabulary for children with DLD. Interaction between language exposure and AoO stresses the importance of taking both into consideration when studying bilingual development. What are the potential or actual clinical implications of this work? L2 vocabulary tests can be used in differentiating bilingual children with TD and DLD when exposure is taken into consideration. Difficulties using exposure and, hence, slower development in children with DLD suggest that especially receptive vocabulary might be diagnostic by the accumulating exposure. Investing in ways of supporting vocabulary development through small-group activities and in everyday situations of bilingual children at risk of DLD is highly recommended. This is important to prevent them from incrementally falling further behind their TD peers over time. A limited AoO effect suggests that families have more flexibility in terms of when to place their child in L2 immersion in their early years.

Quick reorganization of memory traces for morphologically complex words in young children.

Formation of neural mechanisms for morphosyntactic processing in young children is still poorly understood. Here, we addressed neural processing and rapid online acquisition of familiar and unfamiliar combinations of morphemes. Three different types of morphologically complex words - derived, inflected, and novel (pseudostem + real suffix) - were presented in a passive listening setting to 16 typically developing 3-4-year old children (as part of a longitudinal Helsinki SLI follow-up study). The mismatch negativity (MMN) component of event-related potentials (ERP), an established index of long-term linguistic memory traces in the brain, was analysed separately for the initial and final periods of the exposure to these items. We found MMN response enhancement for the inflected words towards the end of the recording session, whereas no response change was observed for the derived or novel complex forms. This enhancement indicates rapid build-up of a new memory trace for the combination of real morphemes, suggesting a capacity for online formation of whole-form lexicalized representations as one of the morphological mechanisms in the developing brain. Furthermore, this enhancement increased with age, suggesting the development of automatic morphological processing circuits in the age range of 3-4 years.

Understanding developmental language disorder - the Helsinki longitudinal SLI study (HelSLI): a study protocol.

BACKGROUND: Developmental language disorder (DLD, also called specific language impairment, SLI) is a common developmental disorder comprising the largest disability group in pre-school-aged children. Approximately 7% of the population is expected to have developmental language difficulties. However, the specific etiological factors leading to DLD are not yet known and even the typical linguistic features appear to vary by language. We present here a project that investigates DLD at multiple levels of analysis and aims to make the reliable prediction and early identification of the difficulties possible. Following the multiple deficit model of developmental disorders, we investigate the DLD phenomenon at the etiological, neural, cognitive, behavioral, and psychosocial levels, in a longitudinal study of preschool children. METHODS: In January 2013, we launched the Helsinki Longitudinal SLI study (HelSLI) at the Helsinki University Hospital ( http://tiny.cc/HelSLI ). We will study 227 children aged 3-6 years with suspected DLD and their 160 typically developing peers. Five subprojects will determine how the child's psychological characteristics and environment correlate with DLD and how the child's well-being relates to DLD, the characteristics of DLD in monolingual versus bilingual children, nonlinguistic cognitive correlates of DLD, electrophysiological underpinnings of DLD, and the role of genetic risk factors. Methods include saliva samples, EEG, computerized cognitive tasks, neuropsychological and speech and language assessments, video-observations, and questionnaires. DISCUSSION: The project aims to increase our understanding of the multiple interactive risk and protective factors that affect the developing heterogeneous cognitive and behavioral profile of DLD, including factors affecting literacy development. This accumulated knowledge will form a heuristic basis for the development of new interventions targeting linguistic and non-linguistic aspects of DLD.

[Multilingualism and specific language impairment]. / Monikielisyys ja kielellinen erityisvaikeus.

Specific language impairment is one of the most common developmental disturbances in childhood. With the increase of the foreign language population group an increasing number of children assimilating several languages and causing concern in language development attend clinical examinations. Knowledge of factors underlying the specific language impairment and the specific impairment in general, special features of language development of those learning several languages, as well as the assessment and support of the linguistic skills of a multilingual child is essential. The risk of long-term problems and marginalization is high for children having specific language impairment.

Voice problems experienced by Finnish comprehensive school teachers and realization of occupational health care.

A survey was conducted among teachers to explore 1) risk factors of voice disorders, 2) the number and nature of problems experienced, 3) the need for medical help, and 4) how occupational health care reacts to this need. Additionally, the knowledgeability of occupational health care physicians and the way treatment of voice disorders is currently organized was explored. Of the 181 teachers who responded, 42% reported voice symptoms occurring daily or weekly. Every tenth teacher also had vocal nodules, and 40% of those with recurring voice problems had been on sick-leave. The respondents suggested improvements in occupational health care: it should also cover prevention, waiting times need to be shortened and care chains established, and resources need to be allocated for voice therapy services.