Maximizing Treatment Efficiency in Developmental Language Disorder: Positive Effects in Half the Time.
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ABSTRACT:
SUBMITTER: Plante E
PROVIDER: S-EPMC6802914 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Eight to 11% of children have a clinical disorder in oral language (Developmental Language Disorder, DLD). Language deficits in DLD can affect all levels of language and persist through adulthood. Word-level processing may be critical as words link phonology, orthography, syntax and semantics. Thus, a lexical deficit could cascade throughout language. Cognitively, word recognition is a competition process: as the input (e.g., lizard) unfolds, multiple candidates (liver, wizard) compete for recognition. Children with DLD do not fully resolve this competition, but it is unclear what cognitive mechanisms underlie this. We examined lexical inhibition-the ability of more active words to suppress competitors-in 79 adolescents with and without DLD. Participants heard words (e.g. net) in which the onset was manipulated to briefly favor a competitor (neck). This was predicted to inhibit the target, slowing recognition. Word recognition was measured using a task in which participants heard the stimulus, and clicked on a picture of the item from an array of competitors, while eye-movements were monitored as a measure of how strongly the participant was committed to that interpretation over time. TD listeners showed evidence of inhibition with greater interference for stimuli that briefly activated a competitor word. DLD listeners did not. This suggests deficits in DLD may stem from a failure to engage lexical inhibition. This in turn could have ripple effects throughout the language system. This supports theoretical approaches to DLD that emphasize lexical-level deficits, and deficits in real-time processing.
| S-EPMC6988176 | biostudies-literature
Project description:BackgroundReading comprehension draws on both decoding and linguistic comprehension, and poor reading comprehension can be the consequence of a deficit in either of these skills.MethodsUsing outcome data from the longitudinal Wellcome Language and Reading Project, we identified three groups of children at age 8 years: children with dyslexia (N = 21) who had deficits in decoding but not oral language, children with Developmental Language Disorder (DLD; N = 38) whose decoding skills were in the normal range, and children who met criteria for both dyslexia and DLD (N = 29).ResultsAll three groups had reading comprehension difficulties at the ages of 8 and 9 years relative to TD controls though those of the children with dyslexia were mild (relative to TD controls, d = 0.51 at age 8, d = 0.60 at age 8); while the most severe problems were found in the comorbid dyslexia + DLD group (d = 1.79 at age 8, d = 2.06 at age 9) those with DLD also had significant difficulties (d = 1.56 at age 8, d = 1.56 at age 9).ConclusionsThese findings confirm that children with dyslexia or DLD are at-risk for reading comprehension difficulties but for different reasons, because of weak decoding in the case of dyslexia or weak oral language skills in the case of DLD. Different forms of intervention are required for these groups of children, targeted to their particular area(s) of weakness.
| S-EPMC7317952 | biostudies-literature
Project description:We provide evidence that children with Developmental Language Disorder (DLD) are impaired in predictive syntactic processing. In the current study, children listened passively to auditorily-presented sentences, where the critical condition included an unexpected "filled gap" in the direct object position of the relative clause verb. A filled gap is illustrated by the underlined phrase in "The zebra that the hippo kissed the camel on the nose…", rather than the expected "the zebra that the hippo kissed [e] on the nose", where [e] denotes the gap. Brain responses to the filled gap were compared to a control condition using adverb-relative clauses with identical substrings: "The weekend that the hippo kissed the camel on the nose [e]…". Here, the same noun phrase is not unexpected because the adverb gap occurs later in the structure. We hypothesized that a filled gap would elicit a prediction error brain signal in the form of an early anterior negativity, as we have previously observed in adults. We found an early (bilateral) anterior negativity to the filled gap in a control group of children with Typical Development (TD), but the children with DLD exhibited no brain response to the filled gap during the same early time window. This suggests that children with DLD fail to predict that a relativized object should correspond to an empty position after the relative clause verb, suggesting an impairment in predictive processing. We discuss how this lack of a prediction error signal can interact with language acquisition and result in DLD.
| S-EPMC8887879 | biostudies-literature
Project description:Purpose This study examines the effects of enhanced conversational recast for treating morphological errors in preschoolers with developmental language disorder. The study assesses the effectiveness of this treatment in an individual or group ( n = 2) setting and the possible benefits of exposing a child to his or her partner's treatment target in addition to his or her own. Method Twenty children were assigned to either an individual ( n = 10) or group ( n = 10, 2 per group) condition. Each child received treatment for 1 morpheme (the target morpheme) for approximately 5 weeks. Children in the group condition had a different target from their treatment partner. Pretreatment and end treatment probes were used to compare correct usage of the target morpheme and a control morpheme. For children in the group condition, the correct usage of their treatment partner's target morpheme was also examined. Results Significant treatment effects occurred for both treatment conditions only for morphemes treated directly (target morpheme). There was no statistically significant difference between the treatment conditions at the end of treatment or at follow-up. Children receiving group treatment did not demonstrate significant gains in producing their partner's target despite hearing the target modeled during treatment. Conclusions This study provides the evidence base for enhanced conversational recast treatment in a small group setting, a treatment used frequently in school settings. Results indicate the importance of either attention to the recast or expressive practice (or both) to produce gains with this treatment. Supplemental Material https://doi.org/10.23641/asha.7859975.
| S-EPMC6802871 | biostudies-literature
Project description:BackgroundChildren with developmental language disorder (DLD) have deficits in verbal and non-verbal processing relative to typically developing (TD) peers, potentially reflecting difficulties in working memory, processing speed and inhibition of interference. We examined working memory in children with DLD using the serial-order-in-a-box-complex span (SOB-CS) interference-based model, which posits a time-based mechanism, free time, that governs how interference affects processing performance.Aims(1) To determine the degree to which children with DLD and TD children differ in the amount of free time available during working memory tasks, and whether potential group differences in free time differ depending on the domain of task demands? (2) To determine the relationship between free time and interference effects on working memory accuracy in children with DLD relative to TD peers.Methods & proceduresWe examined the relationship between free time and working memory in children aged 9-13 years with DLD relative to age-matched TD peers. Working memory tasks involved five conditions that varied verbal versus non-verbal task demands in an interference processing phase relative to a recall test phase. Free time was the time between response on the interference processing task and onset of the recall test phase.Outcomes & resultsDLD and TD groups did not differ in total free time in any condition. Results indicated group differences in the relationship between free time and accuracy in the conditions involving verbal recall, but not non-verbal recall. In the verbal-only condition, relatively more free time was associated with worse accuracy for the DLD group, but with better accuracy for the TD group. In the condition with verbal recall paired with non-verbal interference processing, relatively more free time was associated with better accuracy for the DLD group, but not for the TD group.Conclusions & implicationsThe overall findings suggest that free time between cognitive operations is positively associated with working memory for both verbal and non-verbal recall, except in the presence of high verbal interference for the DLD group (i.e., verbal interference paired with verbal recall). This finding may reflect poor encoding and attention under particularly challenging verbal processing demands for the DLD group. This study also demonstrates the importance of considering the interrelationships between processing speed and interference in working memory performance.What this paper addsWhat is already known on the subject DLD is characterized by core deficits in verbal processing, but also deficits in non-verbal processing. Processing-based hypotheses of DLD-limited verbal working memory, slowed processing speed and inefficient inhibition-do not fully account for behavioural profiles in DLD when considered separately, yet there is evidence suggesting interrelationships among these factors. What this paper adds to existing knowledge The current study tests the key mechanism posited by a theoretical framework that has the potential to integrate these processing-based hypotheses. Our findings indicate that the effect of this mechanism differed in DLD relative to TD peers in the presence of high verbal task demands. Our findings also demonstrate the importance of considering the interrelationships among cognitive processes in children with DLD. What are the potential or actual clinical implications of this work? In practice, results from the current study suggest that children with DLD may benefit from supplementing verbal information with non-verbal information and from pauses between successive presentations of verbal information. These strategies may support their ability to maintain and act on information during verbal processing.
| S-EPMC9509408 | biostudies-literature
Project description:Purpose For over two decades, we have known that children with developmental language disorder (DLD) are underserved. We have also known that DLD does not attract the research attention that it merits given its prevalence and impact. The purposes of this clinical focus article are to present evidence that these failures continue, explore the reasons behind these failures, and propose solutions. Method I reviewed the literature and applied bibliometric analysis procedures from Bishop (2010) to quantify research efforts aimed at DLD compared to other neurodevelopmental disorders. Results The percentage of children who are deemed eligible for clinical services because of DLD continues to fall well short of estimates based on the prevalence of DLD in community samples. The amount of research conducted on DLD relative to other neurodevelopmental disorders remains low. Contributing factors include a lack of awareness of DLD, the hidden nature of DLD, entrenched policies, and the dissonance created when speech-language pathologists must diagnose DLD in school settings. Conclusions Expanded approaches to supporting children with DLD are required. These might include engagement in advocacy and awareness campaigns; clearer communication with the families we serve and enhanced collaborations with classroom teachers; the implementation of school-based language screenings; participation in policymaking; and the development of service delivery models that operate alongside those that exist in our schools and complement their function. Supplemental Material https://doi.org/10.23641/asha.12743273.
| S-EPMC7842848 | biostudies-literature
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.
| S-EPMC6684235 | biostudies-literature
Project description:This study assesses the impact of a working memory training program on the syntactic complexity of the spontaneous speech of French-speaking children with Developmental Language Disorder (DLD). Thirty-nine 6- to 12-year-old children with DLD were allocated to a WM training (DLDMM, N = 20) or an active control group (DLDSQULA, N = 19). The computerized training sessions took place three times a week, yielding 12 training hours per participant. Syntactic complexity was assessed in storytelling, measuring mean length of utterances, use of embedded clauses and rate of errors in complex utterances. The performance of participants with DLD was first compared to previous spontaneous data of 40 typically-developing (TD) children of the same age. Then, intragroup (pre- vs. post-test) and intergroup (DLDMM vs. DLDSQULA) comparisons were made to assess the impact of the working memory training on the language measures. Global results confirmed syntactic impairment in children with DLD, as opposed to TD children, with large differences for the use of embedded clauses. Findings also suggested gains in the mastery of embedded clauses in children who participated in the WM training, whereas no gains were observed in the DLD control group. These findings confirm deficits in complex syntax in children with DLD, in particular in embedded clauses, and may encourage the clinical use of language sample analysis, which provides an ecological account of children's language performance. While our results should be replicated on a larger scale, they also suggest positive transfer effects of working memory training on the capacity of participants with DLD to produce embedded clauses, in line with previous studies showing a positive effect of WM training on tasks of expressive syntax. It thus seems that working memory training can yield benefits for language, which leaves open the door to new therapeutic approaches for children with DLD.
| S-EPMC9846049 | biostudies-literature
Project description:Developmental language disorder (DLD), previously known as specific language impairment, is a neurodevelopmental disorder. It affects approximately 7% of school-age children. The affected children fail to develop normal speech and language skills. This is a major public health concern as it adversely impacts the communication, academic, and social skills of the affected individual. The human brain development is a complex process that involves the accurate orchestration of the expression of multiple genes. Precise temporal and spatial regulation of gene expression is essential for proper brain development. Epigenetic factors such as DNA methylation can modulate gene expression without altering the DNA sequence. They are, therefore, considered as key regulators of the expression of genes involved in neurodevelopment. In this study, we examined any altered DNA methylation between children affected with DLD and healthy control subjects. We looked into genome-wide methylation differences between the DLD and control groups using Infinium HumanMethylation850 (EPICarray). Twelve children with DLD and 12 healthy controls were recruited for the study. Five milliliters of peripheral blood samples were collected from the study subjects in EDTA vials. Genomic DNA (gDNA) was extracted from the blood samples using the standard salting out protocol. Five micrograms of each DNA at 50 ng/µl concentration were used for genome-wide methylation analysis. The gDNA samples were bisulfite-treated with EpiTect Bisulfite Kit. Further to this, the DNA samples were subjected to whole genome amplification and enzymatic fragmentation. Human Infinium Methylation EPIC BeadChip (Illumina), which covers more than 850,000 genome-wide methylation sites, was used for genome-wide methylation analysis. The DNA methylation profiles of each sample were visualized at the single-CpG level and for the genomic regions of interest.
2024-01-10 | E-MTAB-13583 | biostudies-arrayexpress
Project description:To characterize structural white matter substrates associated with language functions in children with language disorders (LD), a psychometry-driven diffusion tractography network was investigated with canonical correlation analysis (CCA), which can reliably predict expressive and receptive language scores from the nodal efficiency (NE) of the obtained network. The CCA found that the NE values of six regions: left inferior-frontal-opercular, left insular, left angular gyrus, left superior-temporal-gyrus, right hippocampus, and right cerebellar-lobule were highly correlated with language scores (ρexpressive/ρreceptive = 0.609/0.528), yielding significant differentiation of LD from controls using new imaging predictors uexpressive (F = 15.024, p = .0003) and ureceptive (F = 7.421, p = .009). This study demonstrates the utility of intrinsic language network analyses in distinguishing and potentially subtyping the type and severity of language deficit, especially in very young children (≤3 years) with LD. The use of structural imaging to identify children with persisting language disorder could prove useful in understanding the etiology of language disorder.
| S-EPMC9022213 | biostudies-literature