"A place where I can be me": a role for social and leisure provision to support young people with language impairment

The long-term well-being of children with language impairment is an area of increasing interest to families, educators and employers as language impairment is often life-long. Furthermore, language impairment and psychiatric difficulty are known to overlap in both populations originally diagnosed as having language impairment and those receiving mental health services. However, there are currently little data available about the wider quality of life for people with language impairment, especially from the perspective of the young people themselves. There is a dearth of information about community-based activities provided for the support and leisure of this population. The Afasic Youth Project meets once a week and is one of only a handful of such groups across the United Kingdom

Narrative in adolescent specific language impairment (SLI): a comparison with peers across two different narrative genres

Background: Narrative may provide a useful way in which to assess the language ability of adolescents with specific language impairment and may be more ecologically valid than standardized tests. However, the language of this age group is seldom studied and, furthermore, the effect of narrative genre has not been explored in detail. Methods & Procedures: A total of 99 typically developing adolescents and 19 peers with specific language impairment were given two different types of narrative task: a story-telling condition and a conversational condition. Four areas of narrative (productivity, syntactic complexity, syntactic errors and performance) were assessed. Outcomes & Results: The group with specific language impairment was poorer on most aspects of narrative confirming recent research that specific language impairment is a long-term disorder. A number of measures also showed interactions between group and genre, with story-telling proving to be a disproportionately more difficult task for the specific language impairment group. Error analysis also suggested that the specific language impairment group was making qualitatively different errors to the typically developing group, even within a genre. Conclusions: Adolescents with specific language impairment are not only poorer at both types of narrative than peers, but also show different patterns of competence and error, and require more support from the narrative-partner. Clinical Implications: Assessments of adolescents are less frequent than at younger ages. This is partly because of the sparsity of tests available in this age range. Qualitative analysis of narrative might prove a useful alternative. The findings suggest that in every-day conversation, young people with specific language impairment manage their difficulties more discreetly and this might make them harder to identify in a mainstream setting

Written language skills in children with specific language impairment

Background. Young children are often required to carry out writing tasks in an educational context. However, little is known about the patterns of writing skills that children with Specific Language Impairment (CwSLI) have relative to their typically developing peers

The Composition Of Normative Groups And Diagnostic Decision Making: Shooting Ourselves In The Foot

Purpose: The normative group of a norm-referenced test is intended to provide a basis for interpreting test scores. However, the composition of the normative group may facilitate or impede different types of diagnostic interpretations. This article considers who should be included in a normative sample and how-this decision must be made relative to the purpose for which a test is intended. Method: The way in which the composition of the normative sample affects classification accuracy is demonstrated through a test review followed by a simulation study. The test review examined the descriptions of the normative group in a sample of 32 child language tests. The mean performance reported in the test manual for the sample of language impaired children was compared with the sample's norms, which either included or excluded children with language impairment. For the simulation, 2 contrasting normative procedures were modeled. The first procedure included a mixed group of representative cases (language impaired and normal cases). The second procedure excluded the language impaired cases from the norm. Results: Both the data obtained from test manuals and the data simulation based on population characteristics supported our claim that use of mixed normative groups decreases the ability to accurately identify language impairment. Tests that used mixed norms had smaller differences between the normative and language impaired groups in comparison with tests that excluded children with impairment within the normative sample. The simulation demonstrated mixed norms that lowered the group mean and increased the standard deviation, resulting in decreased classification accuracy. Conclusions: When the purpose of testing is to identify children with impaired language skills, including children with language impairment in the normative sample can reduce identification accuracy.Communication Sciences and Disorder

Language support model for teachers

There are seven documents that comprise this resource pack. They were written for teachers who are working with speech and language therapists (SLTs) to support children in mainstream primary schools who have language difficulties with no known cause (primary language impairment)

Investigating speech and language impairments in delirium: a preliminary case-control study

<div><p>Introduction</p><p>Language impairment is recognized as as part of the delirium syndrome, yet there is little neuropsychological research on the nature of this dysfunction. Here we hypothesized that patients with delirium show impairments in language formation, coherence and comprehension.</p><p>Methods</p><p>This was a case-control study in 45 hospitalized patients (aged 65–97 years) with delirium, dementia without delirium, or no cognitive impairment (N = 15 per group). DSM-5 criteria were used for delirium. Speech was elicited during (1) structured conversational questioning, and (2) the "Cookie Theft" picture description task. Language comprehension was assessed through standardized verbal and written commands. Interviews were audio-recorded and transcribed.</p><p>Results</p><p>Delirium and dementia groups scored lower on the conversational assessment than the control group (p<0.01, moderate effect sizes (r) of 0.48 and 0.51, resp.). In the Cookie Theft task, the average length of utterances (i.e. unit of speech), indicating language productivity and fluency, distinguished patients with delirium from those with dementia (p<0.01, r = 0.50) and no cognitive impairment (p<0.01, r = 0.55). Patients with delirium performed worse on written comprehension tests compared to cognitively unimpaired patients (p<0.01, r = 0.63), but not compared to the dementia group.</p><p>Conclusions</p><p>Production of spontaneous speech, word quantity, speech content and verbal and written language comprehension are impaired in delirious patients compared to cognitively unimpaired patients. Additionally, patients with delirium produced significantly less fluent speech than those with dementia. These findings have implications for how speech and language are evaluated in delirium assessments, and also for communication with patients with delirium. A study limitation was that the delirium group included patients with co-morbid dementia, which precludes drawing conclusions about the specific language profile of delirium.</p></div

Severity of specific language impairment predicts delayed development in number skills

The extent to which mathematical development is dependent upon language is controversial. This longitudinal study investigates the role of language ability in children's development of number skills. Participants were 229 children with specific language impairment (SLI) who were assessed initially at age 7 and again 1 year later. All participants completed measures of psycholinguistic development (expressive and receptive), performance IQ, and the Basic Number Skills subtest of the British Ability Scales. Number skills data for this sample were compared with normative population data. Consistent with predictions that language impairment would impact on numerical development, average standard scores were more than 1 SD below the population mean at both ages. Although the children showed improvements in raw scores at the second wave of the study, the discrepancy between their scores and the population data nonetheless increased over time. Regression analyses showed that, after controlling for the effect of PIQ, language skills explained an additional 19 and 17% of the variance in number skills for ages 7 and 8, respectively. Furthermore, logistic regression analyses revealed that less improvement in the child's language ability over the course of the year was associated with a greater odds of a drop in performance in basic number skills from 7 to 8 years. The results are discussed in relation to the interaction of linguistic and cognitive factors in numerical development and the implications for mathematical education

Pragmatic language disorder in Parkinson's disease and the potential effect of cognitive reserve

It is known that patients with Parkinson\u2019s Disease (PD) may show deficits in several areas of cognition, including speech and language abilities. One domain of particular interest is pragmatics, which refers to the capacity of using language in context for a successful communication. Several studies showed that some specific aspects of pragmatics \u2013 both in production and in comprehension \u2013 might be impaired in patients with PD. However, a clear picture of pragmatic abilities in PD is still missing, as most of the existing studies focused on specific aspects of the pragmatic competence rather than on sketching a complete pragmatic profile. Moreover, little is known on the potential role of protective factors in compensating the decline of communicative skills as the disease progresses. The present study has two aims: (1) to provide a complete picture of pragmatic abilities in patients with PD, by using a comprehensive battery (Assessment of Pragmatic Abilities and Cognitive Substrates, APACS) and by investigating the relationship with other aspects of cognitive functioning (e.g., working memory and Theory of Mind) and (2) to investigate whether Cognitive Reserve, i.e., the resilience to cognitive impairment provided by life experiences and activities, may compensate for the progressive pragmatic deficits in PD. We found that patients with PD, compared to healthy matched controls, had worse performance in discourse production and in the description of scenes, and that these impairments were tightly correlated with the severity of motor impairment, suggesting reduced intentionality of engaging in a communicative exchange. Patients with PD showed also an impairment in comprehending texts and humor, suggesting a problem in inferring from stories, which was related to general cognitive impairment. Notably, we did not find any significant difference between patients and controls in figurative language comprehension, a domain that is commonly impaired in other neurodegenerative diseases. This might be indicative of a specific profile of pragmatic impairment in patients with PD, worth of further investigation. Finally, Cognitive Reserve measures showed a high degree of association with pragmatic comprehension abilities, suggesting that the modification of life-styles could be a good candidate for compensating the possible problems in understanding the pragmatic aspects of language experienced by patients with PD

Production of tense marking in successive bilingual children: when do they converge with their monolingual peers?

Children with English as a second language (L2) with exposure of 18 months or less exhibit similar difficulties to children with Specific Language Impairment in tense marking, a marker of language impairment for English. This paper examines whether L2 children with longer exposure converge with their monolingual peers in the production of tense marking. 38 Turkish-English L2 children with a mean age of 7;8 and 33 monolingual age-matched controls completed the screening test of the Test of Early Grammatical Impairment (TEGI). The L2 children as a group were as accurate as the controls in the production of -ed, but performed significantly lower than the controls in the production of third person –s. Age and YoE affected the children’s performance. The highest age-expected performance on the TEGI was attested in eight and nine year-old children who had 4-6 YoE. L1 and L2 children performed better in regular compared to irregular verbs, but L2 children overregularized more than L1 children and were less sensitive to the phonological properties of verbs. The results show that tense marking and the screening test of the TEGI may be promising for differential diagnosis in eight and nine year-old L2 children with at least four YoE

Associated reading skills in children with a history of Specific Language Impairment (SLI)

A large cohort of 200 eleven-year-old children with Specific Language Impairment (SLI) were assessed on basic reading accuracy and on reading comprehension as well as language tasks. Reading skills were examined descriptively and in relation to early language and literacy factors. Using stepwise regression analyses in which age and nonverbal IQ were controlled for, it was found that a single word reading measure taken at 7 years was unsurprisingly a strong predictor of the two different types of reading ability. However, even with this measure included, a receptive syntax task (TROG) entered when reading accuracy score was the DV. Furthermore, a test of expressive syntax/narrative and a receptive syntax task completed at 7 years entered into the model for word reading accuracy. When early reading accuracy was excluded from the analyses, early phonological skills also entered as a predictor of both reading accuracy and comprehension at 11 years. The group of children with a history of SLI were then divided into those with no literacy difficulties at 11 and those with some persisting literacy impairment. Using stepwise logistic regression, and again controlling for IQ and age, 7 years receptive syntax score (but not tests of phonology, expressive vocabulary or expressive syntax/narrative) entered as a positive predictor of membership of the ‘no literacy problems’ group regardless of whether early reading accuracy was controlled for in step one. The findings are discussed in relation to the overlap of SLI and dyslexia and the long term sequelae of language impairment