Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Laasonen M

PROVIDER: S-EPMC5963016 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Publications

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

Laasonen Marja M Smolander Sini S Lahti-Nuuttila Pekka P Leminen Miika M Lajunen Hanna-Reetta HR Heinonen Kati K Pesonen Anu-Katriina AK Bailey Todd M TM Pothos Emmanuel M EM Kujala Teija T Leppänen Paavo H T PHT Bartlett Christopher W CW Geneid Ahmed A Lauronen Leena L Service Elisabet E Kunnari Sari S Arkkila Eva E

BMC psychology 20180521 1

<h4>Background</h4>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 multi ...[more]

PMID: 29784061

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Project description:Previous studies have shown that most English-speaking children with language difficulties show academic difficulties during their schooling. The present study aimed to describe the academic achievement of children speaking Spanish and Catalan with developmental language disorder (DLD) during their primary education and to predict their academic outcomes using several processing skills assessed at the beginning of their schooling. To this end, we followed 28 children during their schooling (6-12 years of age). Participants were divided into two groups, one with DLD (n = 14) and a control group (n = 14) paired by age, gender, socio-economic status (SES), family language (L1), and classroom. All participants were assessed through different processing skills with the Spanish version of the NEPSY at the beginning of their schooling (age 6): attention (visual attention, auditory attention, and response set), phonological awareness, verbal short-term memory (sentence repetition, and narrative memory), access to language (semantic verbal fluency and rapid naming), and language comprehension (comprehension of verbal commands). At the end of primary education, schools reported the official academic marks at the 1st cycle (6-8 years), 2nd cycle (8-10 years) and 3rd cycle (10-12 years). Direct scores of the processing skills and academic results were used for statistical analyses. Results showed that children with DLD had more frequent grade retention, and their academic marks were significantly lower than those of their peers in all the cycles and for all academic subjects with a high language dependency (all except physical education and mathematics). Those subjects with lower language dependence did not show significant differences (physical education and mathematics). Rapid naming accounted for most of the variance of academic outcomes, followed by phonological awareness, and language comprehension when both groups were taken together. Only rapid naming accounted for academic results in the DLD group and phonological awareness did so for the control group. In sum, children with DLD experienced more academic difficulties during their primary education. Those children (with and without DLD) who experienced difficulties not only with rapid naming but also with phonological awareness and oral language comprehension at the beginning of their schooling showed a higher probability of academic failure.

Project description:BackgroundThere is considerable variability in the presentation of developmental language disorder (DLD). Disagreement amongst professionals about how to characterize and interpret the variability complicates both the research on understanding the nature of DLD and the best clinical framework for diagnosing and treating children with DLD. We describe and statistically examine three primary possible models for characterizing the variability in presentation in DLD: predictable subtypes; individual differences; and continuum/spectrum.AimsTo test these three models of DLD in a population-based sample using two distinct types of cluster analyses.Methods & proceduresThis study included children with DLD (n = 505) from the US Epidemiological Study of Language Impairment database. All available language and cognitive measures were included. Two cluster methods were used: Ward's method and K-means. Optimal cluster sizes were selected using Bayesian information criteria (BIC). Bootstrapping and permutation methods were used to evaluate randomness of clustering.Outcomes & resultsBoth clustering analyses yielded more than 10 clusters, and the clusters did not have spatial distinction: many of these clusters were not clinically interpretable. However, tests of random clustering revealed that the cluster solutions obtained did not arise from random aggregation.Conclusions & implicationsNon-random clustering coupled with a large number of non-interpretable subtypes provides empirical support for the continuum/spectrum and individual differences models. Although there was substantial support for the continuum/spectrum model and weaker support for the individual differences model, additional research testing these models should be completed. Based on these results, clinicians working with children with DLD should focus on creating treatment plans that address the severity of functioning rather than seeking to identify and treat distinct subtypes. Additional consideration should be given to reconceptualizing DLD as a spectrum condition.

Project description:BackgroundDevelopmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD.AimsTo test the predictive relationship between parent-reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population-based sample.MethodsData were leveraged from the prospective Raine Study (n = 1626 second-generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well-established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years.ResultsNo single parent-reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85-1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59-1.32, p = 0.563) were also non-significant.ConclusionsParent reports of early indicators of DLD are well-intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed.What this paper addsWhat is already known on the subject DLD is a relatively common childhood condition; however, children with DLD are under-identified and under-served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge No one parent-reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work? The broad dissemination and use of 'red flags' is well-intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation-based interventions.

Dataset Information

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

Background

Methods

Discussion

Publications

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

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