Child Language Teaching and Therapy

Children with speech, language, and communication needs (SLCN) form a highly heterogeneous group, including those with an unexplained delay in language development known as specific language impairment (SLI). There is growing recognition that multiple mechanisms underlie the range of profiles observed in these children. Broadly speaking, both the domain-general executive attentional system known as working memory and domain-specific linguistic processing have been implicated in children with SLI. It has been challenging to tease apart these influences, however, due to the symbiotic relationship between working memory and language learning. For example, working memory limits might constrain the linguistic detail encoded, whereas poor language knowledge would place greater demands on working memory for retaining unfamiliar phonological information. There is growing evidence for separable impairments in these processing resources leading to relative deficits in linguistic or working memory processes in different children. Such findings have important clinical implications for both the assessment and treatment of children with SLCN.

Children with developmental language impairments (DLI) are often reported to show difficulties with working memory. This review describes the four components of the well-established working memory model, and considers whether there is convincing evidence for difficulties within each component in children with DLI. The emphasis is on the most demanding form of working memory that draws on central executive (CE) resources, requiring concurrent processing and storage of information. An evaluation of recent research evidence suggests that, not only are children with DLI impaired on verbal CE measures, but they also show difficulties on non-verbal CE tasks that cannot be assumed to tap language. Therefore, it seems increasingly likely that children with DLI show domain-general CE impairments, along with their more established impairments in verbal short-term memory. Implications for potential working memory interventions and classroom learning are discussed.

While little is known about why children make speech errors, it has been hypothesized that cognitive-linguistic factors may underlie phonological speech sound disorders. This study compared the phonological short-term and phonological working memory abilities (using immediate memory tasks) and receptive vocabulary size of 14 monolingual preschool children with phonological delay with individually matched peers with typical speech development. The immediate memory tasks examined forward recall of familiar words (pointing response), reverse recall of familiar words (pointing response), and reverse recall of digits (spoken response). The results indicated that children with typical speech development had larger receptive vocabularies and performed significantly better than children with phonological delay on all immediate memory tasks. Qualitative error analyses revealed that while the two groups made similar errors on the forward memory task, children with phonological delayed performed differently on reverse recall of spoken digits. These findings suggest a link between immediate memory and delayed phonological development.

The aim of this study was to evaluate the effectiveness of a computer-based executive function (EF) training in children with specific language impairment (SLI). Ten children with SLI, ages 8 to 12 years, completed a 25-session training of visuospatial working memory, inhibition and cognitive flexibility over a 6-week period. Treatment outcome was examined directly after training and at 6 months follow-up by tasks of the three trained EF, tasks of untrained neurocognitive functions (verbal working memory, attention, planning and fluency), and ratings of EF and behavioral problems by parents and teachers. Directly after training, results showed significant improvement on cognitive flexibility and a positive trend for visuospatial storage and inhibition. At 6 months follow-up, the children performed significantly better on tasks of all three trained EFs. Furthermore, the results showed significant improvement on sustained attention, attention control, parent- and teacher-rated attention behavior and parent-rated EF and externalizing behavior with medium effect sizes. The results of this pilot study highlight the importance of a large-scale, randomized controlled trial examining the possible effects of EF training in children with SLI.

Language comprehension delays in pre-schoolers are predictive of difficulties in a range of developmental domains. In England, early years practitioners are required to assess the language comprehension of 2-year-olds in their care. Many use a format based on the Early Years Foundation Stage Unique Child Communication Sheet (EYFS:UCCS) in which the child’s language comprehension is assigned to an age band based on written guidance. Seventy 2½–3-year-olds were assessed on the comprehension component of the Preschool Language Scale (PLS) by psychology graduates. Early years practitioners assessed language comprehension in the same children using the EYFS:UCCS and the WellComm, which involves some direct testing. The EYFS:UCCS had poor sensitivity and specificity, and the understanding section did not correlate with the PLS. The WellComm had good to acceptable levels of sensitivity and specificity and significantly correlated with the PLS. Early years setting staff can accurately assess the language comprehension of 2-year-olds if provided with a tool which gives specific instructions on administration, but current frequently used procedures (EYFS:UCCS) are not fit for this purpose.

Foetal growth restriction is associated with problems in neurocognitive development. In the present study, prospectively collected cohorts of foetal growth restricted (FGR) and appropriate for gestational age grown (AGA) children were examined at early school-age by using the Children’s Communication Checklist-2 (CCC-2) to test the hypothesis that FGR children demonstrate poorer communication skills than AGA children. Furthermore, potential differences between FGR children born prematurely and at term were evaluated, as well as the effect of assessment age on CCC-2 performance. The FGR-children demonstrated poorer language structure and language use than the AGA group. Nineteen percent of the FGR children scored below the 15th percentile threshold value in General Communication Composite, compared to 7% of the AGA children, indicating clinically significant problems in communication skills. Furthermore, impaired communication skills became more evident as the FGR children reached ⩾ 9 years of age. Prematurity was associated with low CCC-2 scores. We conclude that FGR, especially in combination with prematurity, is associated with reduced communication skills. With advancing age and increased academic demands the problems become more evident, indicating a need for early recognition, timely interventions and continuous linguistic evaluations of FGR children in order to optimize their long-term outcome in academic and communication skills.