Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment.

This paper summarises the clinical ramification of a large-scale study of the direct and indirect (mediated) influences of four cognitive mechanisms that are relevant to the comprehension of syntactic structure by school-age children with and without developmental language disorder (DLD). A total of 117 children with DLD and 117 propensity-matched typically-developing (TD) children completed sentence comprehension tasks and cognitive tasks related to fluid reasoning, controlled attention, speed of processing, phonological short-term memory (pSTM), complex working memory (cWM) and language knowledge in long-term memory (LTM). Results of confirmatory factor analysis (CFA) indicated that the most salient characteristics of cognitive processing in children with and without DLD were represented by a measurement model that included four latent variables: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. Structural equation modelling (SEM) indicated that complex WM mediated the relationship between sentence comprehension and fluid reasoning, controlled attention and long-term memory for language knowledge. Our research suggests that the most salient characteristics of cognitive processing in children with and without DLD can be condensed to four cognitive factors: fluid reasoning, controlled attention, complex WM and language knowledge in LTM. We suggest a few measures that clinicians can use to reliably assess these factors, and we summarise a functional intervention programme that is designed to promote the strategic organisation of information in ways that challenge verbal complex WM and LTM processes that support language comprehension and use.