Department of Communication Disorders and Sciences, Rush University, Chicago, IL.
School of Speech, Language, and Hearing Sciences, San Diego State University, CA.
Am J Speech Lang Pathol. 2019 Aug 9;28(3):932-944. doi: 10.1044/2019_AJSLP-IDLL-18-0208.
Purpose Accurate identification of developmental language disorder (DLD) remains challenging, particularly for children who speak different dialects, languages, or more than 1 language. Children with DLD, on average, have shown subtle deficits on nonlinguistic cognitive processing tasks, and performance on such tasks may be minimally influenced by language experience. This study explores whether nonlinguistic cognitive processing tasks can contribute to the identification of DLD in children from diverse linguistic backgrounds. Method Study 1 combined data from 4 U.S.-based investigations to yield a sample of 395 children, ages 6-10 years, who spoke only English or both Spanish and English. Study 2 consisted of an international sample of 55 kindergarten children living in Vietnam. Each study included children with DLD and children with typical development. Participants completed nonlinguistic cognitive tasks of processing speed, auditory working memory, and attentional control. Data analysis compared typically developing to DLD groups by age and language background. Then, we empirically derived cut-points to report diagnostic accuracy (sensitivity, specificity, and positive and negative likelihood ratios). Results For all 3 tasks, adequate sensitivity or specificity (but not both in most cases) was achieved in nearly all age groups. Likelihood ratios reached moderately to very informative levels in several instances. Diagnostic results were maintained when monolingual and bilingual samples were combined into a single group. Conclusions Nonlinguistic cognitive processing tasks may contribute to accurate identification of DLD in combination with other measures. Further research is needed to refine tasks, confirm cut-points established here, and extend findings to children from additional language backgrounds.
目的 准确识别发育性语言障碍(DLD)仍然具有挑战性,特别是对于讲不同方言、语言或多种语言的儿童。DLD 儿童在非语言认知加工任务上平均表现出细微的缺陷,而此类任务的表现受语言经验的影响最小。本研究探讨了非语言认知加工任务是否可以帮助识别来自不同语言背景的儿童的 DLD。
方法 研究 1 结合了来自 4 项美国研究的数据,得出了一个 395 名儿童的样本,年龄在 6-10 岁之间,他们只说英语或同时说英语和西班牙语。研究 2 由 55 名居住在越南的幼儿园儿童组成,他们来自国际样本。每个研究都包括 DLD 儿童和具有典型发展的儿童。参与者完成了非语言认知任务,包括加工速度、听觉工作记忆和注意力控制。数据分析比较了按年龄和语言背景分组的典型发育和 DLD 组。然后,我们通过经验推导了报告诊断准确性(敏感性、特异性和阳性和阴性似然比)的切点。
结果 在所有 3 项任务中,在几乎所有年龄组中,都达到了足够的敏感性或特异性(但在大多数情况下两者都没有)。在几种情况下,似然比达到了中等至非常有信息的水平。当将单语和双语样本组合成一个单一的组时,诊断结果得以维持。
结论 非语言认知加工任务可能有助于与其他措施相结合,准确识别 DLD。需要进一步研究来完善任务,确认此处建立的切点,并将研究结果扩展到来自其他语言背景的儿童。