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Background: Disfluency is a multifactorial concept that can be linked to several of the language production levels, in both typical and atypical populations. In children, the language system is still developing and few studies have explored disfluency patterns. In typical development (TD), in particular, studies have shown discrepancies according to the language being considered. In neurodevelopmental disorders, such as developmental dyslexia (DD), it is still unclear whether the pattern of disfluency is similar to TD. Aims: To analyse the type of disfluency and their evolution in French children aged 8–12 years. Also to compare the pattern of disfluency in DD and TD, and to test whether disfluencies were correlated with reading difficulties. Methods & Procedures: A total of 25 children with DD and 21 children with TD aged 8–12.6 years produced an autobiographical narrative. Seven types of disfluencies were coded: part‐word repetitions; repetitions of monosyllabic words; other types of repetitions (words and phrases); filled pauses; revisions—substitutions; revisions—additions; and abandoned utterances. We compared the proportion of each disfluency in DD and TD. Spearman correlations were then performed between disfluencies, reading performance and age. Outcomes & Results: The results showed that both DD and TD children mainly produced filled pauses, repetitions of monosyllabic words and substitutions. Both groups displayed a high rate of disfluency (> 10%). No correlations with age were found. Correlations with reading performance were significant in the TD group only. Conclusions & Implications: The study showed that DD is not characterized by a specific pattern of disfluency. Additionally, disfluency rates were similar in children aged 8–12 years. In contrast to other languages, the current study suggests that French‐speaking children have a high rate of disfluency. The study also suggests that disfluency should be interpreted with caution in DD, given that TD children also have a high rate of disfluency. Therefore, it seems important to adapt the pathological threshold of disfluency to the language being spoken in order to avoid an overestimation of the prevalence of these deficits in French‐speaking children. WHAT THIS PAPER ADDS: What is already known on this subject: TD children produce a high rate of disfluency, which is also influenced by the language being spoken. No study looked at the effect of DD on disfluency production. Nonetheless, problems in reading comprehension and reduced reading experience may impact lexical development and speech fluency. What this paper adds to the existing knowledge: In our study, both groups (French‐speaking children) produced a substantial amount of disfluency as compared with other languages (> 10%). Additionally, the pattern of disfluency was similar in TD and DD (namely, filled pauses, prolongations repetitions of monosyllabic words and substitutions). In the DD group, disfluency production was not correlated with reading performance. What are the potential or actual clinical implications of this work?: These results indicate that it is crucial to consider the language being spoken when examining disfluency in order to avoid an overestimation of language difficulties in some languages, such as in French. Moreover, the production of disfluencies in DD should not be considered as language dysfunction since the pattern of disfluency what quite similar in TD and DD, and did not correlate with their reading difficulties. [ABSTRACT FROM AUTHOR]

Background: There is a lack of evidence relating to cognitive‐communication difficulties following traumatic brain injury (TBI) sustained in older adulthood. A prominent area in which post‐TBI cognitive‐communication difficulties manifest is at the level of social communication. An investigation of social communication focusing on comparison of those injured in older and younger adulthood is a practical starting point for age‐related cognitive‐communication outcome comparison. Aims: The overall objective of this study was to explore the social communication of individuals who sustained severe TBI in an early period of older adulthood (50–70 years) compared to younger adulthood (18–40 years), as informed by self and close other reports. Methods & Procedures: This exploratory controlled group comparison study involved analysis of self‐reported and close other reported La Trobe Communication Questionnaire data for 22 adults with severe TBI (11 older at injury; 11 younger at injury) and 22 control participants (11 older; 11 younger). TBI participants were matched for injury variables and participant groups were matched for sex, age and education. Outcomes & Results: The close others of the older and younger adults with TBI reported them to have significantly more frequent difficulty with social communication than the close others of age‐matched control groups. Older adults with TBI reported significantly more frequent difficulty with social communication than uninjured older adults. In contrast, younger adults with TBI and uninjured younger adults reported a similar frequency of difficulty with social communication. No age‐based difference in the frequency of social communication difficulty was evident when comparing the self or close other reports of older and younger adults with TBI. Awareness of social communication difficulty, as indexed by comparing self and close other perceptions, showed a different pattern across the TBI groups. The older TBI group rated themselves as having significantly less frequent social communication difficulty than was perceived by their close others. In contrast, no statistically significant difference was evident between the self and close other social communication ratings of the younger TBI group. Conclusions and Implications: Where possible clinicians need to work with close communication partners to understand the nature and degree of social communication difficulty following severe TBI. This may be especially important when working with people who sustain TBI in older adulthood if future research shows that this population have greater difficulty with self‐awareness of social communication difficulty. What this paper adds: What is already known on the subject: Cognitive‐communication difficulties are a common consequence of traumatic brain injury (TBI) that can have long‐term impact on everyday functioning. These challenges have primarily been investigated in individuals who sustained TBI in younger adulthood. What this paper adds to existing knowledge: Individuals who sustain severe TBI in early older adulthood have a higher frequency of reported social communication difficulty to non‐injured adults of a similar age, albeit they may underreport such difficulties potentially in the context of reduced self‐awareness. What are the potential or actual clinical implications of this work?: Social communication difficulty is an issue for people who sustain severe TBI in early older adulthood. However, a poorer overall social communication outcome in comparison to those injured in younger adulthood should not be assumed. Clinical service delivery for these challenges is most optimally delivered in a collaborative manner with the individual and their close others. Future research is required to investigate the identified trends from this study. [ABSTRACT FROM AUTHOR]

Background: Much has been written about the changes in use and perspectives of telepractice among speech and language therapists (SLTs) during the global COVID‐19 pandemic. However, no long‐term study has been done to examine whether there is a permanent shift in attitudes towards telepractice as the world adjusts to new norms and endemic COVID‐19. Aims: To compare the speech telepractice use and perspectives of SLTs at two time points of the pandemic: during and after the height of the pandemic. Methods & Procedures: Two online surveys were distributed a year apart among SLTs in Singapore. The first survey was disseminated during an initial lockdown period in 2020 and the second survey was done in 2021 when Singapore was starting to reduce strict quarantine and safe‐distancing regulations. These surveys were distributed via communication channels of the local speech therapy association. A total of 115 and 71 responses to the survey were collected in 2020 and 2021, respectively. Responses were captured and analysed using descriptive statistics and statistical analysis while qualitative content analysis was used to derive key themes from open‐ended questions. Outcomes & Results: Telepractice use across all age groups and client types peaked at the height of the pandemic. Even as lockdown measures were eased, telepractice utilization was still higher than what it was before the pandemic. Dysphagia management was the only area where SLTs reduced their use of telepractice during the stabilization phase. After more experience with telepractice during the height of the pandemic, SLTs acknowledged the benefit of being able to use a wide range of media through telepractice and were less worried about not having the resources or knowledge to set up telepractice. SLTs also reported increased confidence in providing telepractice, which was reflected in their willingness to continue to provide telepractice even after the pandemic ends. Conclusions & Implications: The increase in use of telepractice during this pandemic is likely to be sustained as a majority of respondents believed they would continue to provide this mode of service delivery even after the pandemic ends. However, clinicians will still have to assess for client suitability, as clients with more complex medical or behavioural issues may still require in‐person therapy. Additionally, dysphagia management via telepractice will still be limited given that swallow presentations may be more variable. Lastly, although generic resources are helpful for clinicians, the long‐term sustainability of telepractice can be boosted by the sharing of resources that are suitable for the local context. WHAT THIS PAPER ADDS: What is already known on this subject: Current studies have examined telepractice use and perspectives of SLTs before and during the COVID‐19 pandemic. Despite the evidence for the efficacy of telepractice, uptake was low due to perceived lack of training and resources. Although more clinicians provided telepractice during the pandemic, many still doubted its efficacy over in‐person therapy and most studies concluded that longer term studies are required to ascertain if SLTs will continuing providing telepractice after the pandemic. What this paper adds to existing knowledge: This study shows that there is a definitive shift in perspectives in favour of telepractice after the pandemic, as clinicians continued to provide telepractice across most service areas even without lockdown restrictions. The previous challenges of insufficient resources, knowledge and privacy concerns were reduced with more experience in providing telepractice. Although client suitability remained a major barrier, more clinicians saw benefits of easy access to therapy and range of resources used as benefits that they could harness from telepractice. What are the potential or actual clinical implications of this work?: A majority of respondents stated that they are more confident in providing telepractice and would want to continue providing this service delivery mode after the pandemic, so more training and resources suitable for the local contexts can be provided by national associations to sustain this. More research and resources can be gathered to make telepractice more efficacious for dysphagia management and clients who may be deemed unsuitable for telepractice. [ABSTRACT FROM AUTHOR]

Background: As delays or disorders in early language and communication are the most prevalent symptom in children with disabilities, early screening is crucial to promote prevention, early diagnosis, and intervention. However, to the best of our knowledge, no screening tool is available for the joint assessment of early language and social communication skills in European Portuguese (EP)‐learning children, which is critical for screening, monitoring and enrolment in appropriate early intervention services. Aims: (1) To adapt and validate the EP version of the Communication and Symbolic Behaviour Scales Developmental Profile™ (CSBS DP™) Infant–Toddler Checklist, a parental report for the screening of early language and social communication skills. (2) To conduct a cross‐cultural comparison between the EP adaptation and the original US version. Methods & Procedures: A total of 611 EP‐learning children (ages 6–24 months) were assessed on the CSBS DP Infant–Toddler Checklist. Normative data, psychometric characteristics (i.e., internal consistency and test–retest reliability), and cross‐cultural comparison between the EP and the original version were explored. Outcomes & Results: Internal consistency ranged from good to excellent and the test–retest reliability was excellent. The performance of the EP and US samples matched on almost all scores. However, EP children performed significantly better than their American peers in the Social compositive at 22 months and in the Symbolic composite at 20 months. No further differences were found. Conclusions & Implications: These findings showed that the EP CSBS DP Infant–Toddler Checklist seems to be a reliable screening tool of communicative and symbolic behaviours for EP‐learning children, which can be particularly relevant for decision‐making in clinical practice. WHAT THIS PAPER ADDS: What is already known on the subject: Early communication skills are known to be related to later language outcomes. Thus, screening tools for the early identification of children at risk for language and communication impairments, which may lead to monitoring and early intervention, have the potential to promote better outcomes. However, to the best of our knowledge, no screening tool is available for the assessment of early communication abilities in EP‐learning children. What this paper adds to existing knowledge: This study adapted and validated the EP CSBS DP Infant–Toddler Checklist, the first published parental report checklist for the assessment of early communication skills in EP. It described the psychometric characteristics of the adapted checklist, summarized the newly available normative data for EP‐learning infants and toddlers, and compared the performance of EP‐learning children with the original standardization sample reported for American English. The results demonstrated that this tool is a reliable instrument for the early screening of language, communicative and symbolic behaviours for EP‐learning children between 6 and 24 months of age. What are the potential or actual clinical implications of this work?: Given that early screening is crucial to promote prevention, early diagnosis and intervention, the availability of this tool is particularly relevant for children monitoring and their enrolment in appropriate early intervention services, helping decision‐making in clinical practice, in line with current guidelines regarding early monitoring and intervention to promote and support better outcomes. Thus, the tool and related normative data will be useful for paediatricians, family doctors, primary healthcare providers, developmental psychologists and speech–language therapists, among other professionals in the healthcare and educational fields, concerned with speech, language, and communication development and impairments. [ABSTRACT FROM AUTHOR]

Background: Vocabulary scores increase until approximately age 65 years and then remain stable or decrease slightly, unlike scores on tests of other cognitive abilities that decline significantly with age. Aims: To review the findings on ageing‐related changes in vocabulary, and to discuss four methodological issues: research design; test type; measurement; and vocabulary ability as a proxy for general intelligence. Main Contribution: A discussion of cross‐sectional and longitudinal research designs shows that cohort membership accounts for some but not all ageing‐related changes in vocabulary, and that drop‐out and test–retest effects do not alter conclusions regarding these changes. Test type affects age trends in vocabulary, and if researchers use only one test, they should choose a multiple‐choice synonym test. While some authors suggest that vocabulary tests do not measure the same underlying ability in younger and older adults, more research of this suggestion is needed. A brief examination of the use of vocabulary ability as a proxy for general intelligence in healthy ageing and for premorbid abilities in dementia indicates that such practice is often questionable. Conclusions: Vocabulary knowledge increases through the mid‐60s regardless of measurement method. However, there is little information on how word knowledge serves other verbal skills in old age, how and when adults learn new words, or how much exposure is necessary for meanings to remain in storage for a lifetime. Research of these issues may require new methodologies, as well as novel theoretical accounts of ageing‐related effects on vocabulary. WHAT THIS PAPER ADDS: What is already known on this subject: Unlike many cognitive abilities that decline with ageing, vocabulary knowledge continues to increase until approximately age 65, and then remains stable or decreases slightly. These findings have been replicated in different research designs and across languages. What this paper adds to existing knowledge: The article presents a summary of findings on changes in vocabulary across adulthood, and a discussion of four key methodological issues: research design, test type, measurement, and the use of vocabulary ability as a proxy for general intelligence. What are the potential or actual clinical implications of this work?: To better understand changes in vocabulary knowledge across adulthood, clinicians must be aware of methodological considerations that affect the field. Such considerations have direct clinical implications regarding the choice of vocabulary tests and their use as a proxy for other abilities in both healthy older adults and in individuals with dementia. [ABSTRACT FROM AUTHOR]

Background: Variations in communicative participation of children with developmental language disorder (DLD) cannot be wholly explained by their language difficulties alone and may be influenced by contextual factors. Contextual factors may support or hinder communicative participation in children, which makes their identification clinically relevant. Aims: To investigate which contextual (environmental and personal) factors in early childhood are protective, risk or neutral factors for communicative participation among school‐aged children with DLD, and to identify possible gaps in knowledge about this subject. Methods & Procedures: A scoping review was conducted based on a systematic search of studies published from January 2007 to March 2022 in Pubmed, Embase (without MEDLINE), CINAHL and PsycINFO. In total, 8802 studies were reviewed using predefined eligibility criteria, of which 32 studies were included for data extraction and critically appraised using the Critical Appraisal Skills Programme (2021) tools. Main Contribution: The methodological quality of included studies was adequate to strong. Personal protective factors identified are being a preschool girl, reaching school age and being prosocial, while personal risk factors are becoming a teenager or adolescent, having low socio‐cognitive skills and experiencing comorbid mobility impairment or behavioural problems. Gender after the preschool years and non‐verbal abilities were not found to be of influence, and the role of socio‐emotional skills is inconclusive. Receiving therapy is an environmental protective factor, while the association between socio‐economical family characteristics with communicative participation is inconclusive. Conclusions & Implications: Limited research has been conducted on which risk and protective factors present in early childhood are associated with later communicative participation of children with DLD. The influence of co‐occurring health conditions, social background variables, individual psychological assets, interpersonal relationships and attitudes of other people represent knowledge gaps. In addition, knowledge about the comparative effectiveness of different types of interventions and service delivery models, and the impact of administrative control, organizational mechanisms and standards established by governments on children's communicative participation is lacking. More longitudinal research is needed focusing on the identification of relevant personal and environmental factors and the interactions between them in relation to communicative participation outcomes. WHAT THIS PAPER ADDS: What is already known on this subject: Children with DLD experience varying degrees of communicative participation restrictions. Insight into contextual factors that influence communicative participation can help to identify children at risk and inform family and child‐centred therapy. Systematic research on contextual factors that facilitate or hinder communicative participation in children with DLD is currently lacking. What this paper adds to existing knowledge: Knowledge of protective factors can guide the development of interventions for children and young people with DLD that boost resilience and facilitate communicative participation, while insight into the risk factors can help professionals identify the most vulnerable children and develop interventions that can lift or neutralize barriers present in the life of these children. Specific groups potentially at risk are young boys, children with co‐morbid mobility impairment, children with conduct problems, and children reaching adolescence. In contrast, potentially protective factors are reaching school age and being prosocial. In addition, the development of socio‐cognitive skills may be beneficial for the communicative participation of children with DLD. What are the potential or actual clinical implications of this work?: To support communicative participation, it is important that professionals who work with children with DLD understand which groups are at risk for communicative participation restrictions, and which factors can foster resilience. In the absence of evidence‐based instruments for the systematic assessment of personal and environmental factors, consulting parents and children on the contextual factors that they perceive as important remains critical. [ABSTRACT FROM AUTHOR]

Background: Ultrasound (US) is not widely used as part of the speech and language therapy (SLT) clinical toolkit. The COVID‐19 pandemic has intensified interest in US as an alternative to SLT instrumental tools such as the videofluoroscopic swallowing study (VFSS), fibreoptic endoscopic evaluation of swallowing (FEES) and endoscopic evaluation of the larynx (EEL) as a non‐invasive, non‐aerosol‐generating procedure that can be delivered at the bedside to assess swallowing and/or laryngeal function. To establish the appropriacy of routine US use, and in response to a national professional body request for a position statement, a group of expert SLTs conducted a rapid review of the literature. Aim: To explore critically the clinical utility of US as an assessment tool for swallowing and laryngeal function in adults. Methods & Procedures: A rapid review of four databases was completed to identify articles using US to assess swallowing and/or laryngeal function in adults compared with reference tests (VFSS/FEES/EEL/validated outcome measure). Screening was completed according to predefined inclusion/exclusion criteria and 10% of abstracts were rescreened to assess reliability. Data were extracted from full texts using a predeveloped form. The QUADAS‐2 tool was used for quality ratings. Information from included studies was summarized using narrative synthesis and visual illustration. Outcomes & Results: Ten papers used US to assess swallowing, and 13 to assess laryngeal function. All were peer‐reviewed primary studies across a range of clinical populations and with a wide geographical spread. Four papers had an overall low risk of bias, but the remaining 19 had at least one domain where risk of bias was judged as high or unclear. Applicability concerns were identified in all papers. The papers that used US to assess swallowing varied widely in terms of the anatomical structures assessed and methodology employed. The papers assessing laryngeal function were more homogenous in their methodology. Sensitivity and specificity data were provided for 12 of the laryngeal function papers with ranges of 64.3–100% and 48.5–100%, respectively. Conclusions & Implications: There is burgeoning evidence to support the use of US as an adjunct to SLT clinical assessment of swallowing and laryngeal function. However, the current literature does not support its use as a tool in isolation. Further research is required to establish reliability in US assessment as well as clear SLT‐driven protocols and training. What this paper addsWhat is already known on the subjectUS has demonstrated potential as an assessment tool for objective parameters of swallowing. Its use for laryngeal assessment (gross vocal fold movement) is also widely recognized within the literature. This review appraised the literature related to US as an alternative or adjunctive tool for the assessment of swallowing and laryngeal function.What this paper adds to existing knowledgeThis paper identifies that the current evidence base for US as a swallowing or laryngeal assessment tool is heterogenous and of variable quality. No study combined the assessment of swallowing and laryngeal function, and only two studies assessed more than one parameter of swallowing, limiting the clinical application of the results.What are the potential or actual clinical implications of this work?This review shows that US is a non‐invasive accessible tool that can offer a detailed focal assessment of swallowing and laryngeal function, such as hyoid displacement and vocal fold mobility. With the development of protocols, training packages and competency standards, US has the potential to be used as an adjunct to SLT assessment of swallowing and laryngeal function. There is not currently enough evidence to support the use of US as a stand‐alone tool for SLT assessment of swallowing or laryngeal function. [ABSTRACT FROM AUTHOR]

Background: Some data call into question the persistence of developmental language disorders (DLDs) identified during the preschool period. For this reason, speech–language pathologists (SLPs) often reassess children. However, it is unclear if the instability of the profiles documented in community sample studies is present in children referred to specialized clinics. Given the scarcity of SLP resources, is re‐evaluating the language skills of these children a good use of clinical time? Aim: To examine the stability of the findings from two SLP assessments in a sample of Canadian preschool children referred to a tertiary clinic between the ages of 2 and 6 years. It was hypothesized that children under the age of 4 years at first assessment and children with less severe initial deficits would show less stability of DLD diagnosis. Methods & Procedures: The clinical files of children referred to an early childhood psychiatric clinic in Canada were reviewed. For 149 children with two SLPs assessment reports, persistence of language deficits was documented and tested with McNemar's statistics. Differences between preschoolers under the age of 4 versus 4 years and over, as well as between mildly and severely impaired children, were examined. Outcomes & Results: High level of agreement (94%) and McNemar's test (p = 0.180) supported the stability of initial diagnosis. The stability for children assessed before the age of 4 (n = 64) was 100%, and was significantly different from older children's (n = 85) stability of 89% (Fisher's exact test, p = 0.01; bilateral). The stability for children with mild impairments (n = 18) was 78%, which was significantly lower than the stability (97%) in children with severe impairments (n = 114) (Fisher's exact test, p = 0.007; bilateral). Conclusions & Implications: No instability of language status was observed in children assessed before 4 years of age, which could be related to the significant severity of the difficulties that children in this age group presented and be specific to this type of clinical sample. The great stability of language status observed in preschoolers referred to a specialized clinic suggests that clinicians should limit reassessments to devote available resources to intervention efforts. What this paper adds: What is already known on this subject?: Previous research that has demonstrated important instability in the classification of language impairment before 4 years of age gathered data mainly by screening the general population or was not based on a comprehensive clinical assessment. What this paper adds to existing knowledge?: This study investigated the classification stability of DLD between two comprehensive SLP assessments in a clinical sample of Canadian preschoolers. The results indicate great stability of language status assessed before 4 years old in this population, suggesting that severity of impairments may trump the age factor in this group. What are the potential or actual clinical implications of this work?: In the case of children referred to a specialized clinic, clinicians and policymakers should be aware that DLD diagnosis made before 4 years of age remains stable during preschool age, and that a best practice with this population would be to abandon unnecessary testing in favour of early intervention. [ABSTRACT FROM AUTHOR]

Background: Diadochokinetic rates tasks are frequently used for the assessment of diadochokinesia (DKK) in young and elderly adults. However, there is scarce research on healthy elderly adults over 65 years old, and little is known about the effect of different types of stimuli (non‐words/real words) in this specific population. Furthermore, the current research supports significant language variations, highlighting the need for language‐specific norms. Aims: To investigate the effect of age, gender and type of stimuli (non‐words versus real words) in DDK rates in healthy elderly adults of over 65 years of age, and to provide normative data for the Greek language. Methods & Procedures: The participants were 791 healthy monolingual Greek‐speaking adults (531 adults, aged 20–39 years; 157 participants aged 65–74 years; and 103 participants aged over 75 years). All participants were monolingual speakers of Greek and had normal hearing acuity, which allowed them to understand and follow instructions. Participants with a medical condition, which would affect DDK rates' performance, were excluded from the study. The time‐by‐count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non‐words (/′gaba/, /′taka/, /′kata/, /′baga/); (2) four disyllabic real words (/′kapa/, /′tapa/, /ka′la/, /′paka/); and (3) two trisyllabic non‐words (/′pataka/, /′badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Outcomes & Results: Age affected DDK rates significantly, with older adults achieving slower DDK rates for all speech stimuli (non‐words/real words). Gender did not have an effect on the performance of DDK rates. The type of speech stimuli affected DDK rates significantly for all age groups. Analytically, trisyllabic non‐word stimuli were articulated more slowly than disyllabic non‐word stimuli, and real words were produced faster than non‐words. A linear regression analysis revealed that only the repetition of non‐words predicted 68.4% of the performance on the repetition of trisyllabic non‐words. Conclusions & Implications: The above results complement prior research, which supports that real word stimuli yield faster performance than non‐word stimuli. Clinicians should keep in mind that age, language and type of stimuli (non‐words/real words) affect significantly the performance of DDK rates, as well as the fact that different types of stimuli tap distinct underlying levels of speech. The current research highlights the need for language‐specific norms for different populations. What this paper adds: What is already known on the subject: DDK rates are significantly affected by the types of stimuli and language used. Moreover, the normal ageing process decreases performance in terms of DDK rates, but scarce evidence exists for healthy elderly adults over 65 years old. What this paper adds to existing knowledge: Most studies have examined DDK rates in healthy elderly people with restricted samples and using non‐word stimuli. The current study administered different types of stimuli (non‐words/words) in a large sample of healthy elderly participants. This is also the first study to attempt to provide DDK normative data for this population in the Greek language. What are the potential or actual clinical implications of this work?: The results of this study strongly suggest that clinicians should bear in mind the significant impact age and language have on performance in terms of DDK rates, especially when normative data are not available for a certain language or age group. Furthermore, non‐word and real‐word stimuli cannot be used interchangeably since they tap into distinct underlying levels of speech, thus providing clinicians with useful information about the level of breakdown and the proper treatment plan. [ABSTRACT FROM AUTHOR]

Background: The majority of children with cerebral palsy (CP) experience challenges in functional communication from a young age. A pivotal aspect of functional communication is language comprehension. A variety of classification systems and questionnaires are available to classify and describe functional communication skills in children with CP. A better understanding of the convergent validity of (subsections of) these tools, as well as their relationship with spoken language comprehension, will be valuable in both clinical practice and research. Aims: To investigate the convergent validity of (subsections of) functional communication tools and the relationship with spoken language comprehension in children with CP. Methods & Procedures: Cross‐sectional data on 138 children were subdivided into three developmental stages based on (Dutch) educational phases: ages 18 months–3;11y (n = 59), 4;0–5;11 years (n = 37) and 6;0–8;11 years (n = 42). The following functional communication tools were used to classify and describe functional communication: Communication Function Classification System (CFCS), subscales of the Caregivers Priorities and Child Health Index of Life with Disabilities—Dutch Version (CPCHILD‐DV) and the Focus on Communication Under Six‐34 (FOCUS‐34) questionnaire. Spoken language comprehension was assessed with the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT). Correlations between the functional communication tools, and with the C‐BiLLT, were calculated using Pearson's and Spearman's correlation coefficients. It was hypothesized a priori that correlations of at least 0.60 suggest good convergent validity. Outcomes & Results: At all developmental stages, a significant ordered decreasing tendency of communication outcomes was found across CFCS levels; lower CFCS levels were associated with lower scores on the CPCHILD‐DV and FOCUS‐34, and with a lower level of spoken language comprehension (C‐BiLLT). Correlation coefficients of the functional communication tools exceeded 0.60 at all developmental stages. Correlations between C‐BiLLT raw scores and the functional communication tools varied between 0.351 and 0.591 at developmental stage 18 months–3;11 years, between 0.781 and 0.897 at developmental stage 4;0–5;11 years, and between 0.635 and 0.659 at developmental stage 6;0–8;11 years. Conclusions & Implications: The functional communication tools assessed in this study showed convergent validity at all developmental stages. The CFCS, currently most widely used in paediatric rehabilitation, is adequate in the classification of functional communication. However, for more detailed clinical goal setting and evaluation of change in functional communication, the additional use of FOCUS‐34 or CPCHILD‐DV is recommended. What this paper adds: What is already known on the subject: A range of functional communication tools are available that help describe and classify functional communication in children with CP. These include the CFCS, subsections of CPCHILD‐DV and FOCUS‐34. The CFCS classifies functional communication in daily life with familiar and unfamiliar partners. Specific subsections of the CPCHILD‐DV and FOCUS‐34 include items that pertain to communicative participation. The innovative C‐BiLLT provides a standardized method to assess spoken language comprehension in children with CP and significant motor impairments. What this paper adds to existing knowledge: In the present study, convergent validity was confirmed between CFCS and specific subsections of the CPCHILD‐DV and FOCUS‐34. Correlations between these functional communication tools and the C‐BiLLT were moderate to strong. What are the potential or actual clinical implications of this work?: For clinical and research purposes (for instance, accurate prescription of augmentative and alternative communication—AAC), healthcare and educational professionals together with parents need to know how functional communication tools converge and how functional communication levels relate to the comprehension of spoken language. The CFCS provides a valid classification of functional communication abilities in children with CP. However, to measure change in functional communication and to evaluate treatment outcomes, use of additional functional communication tools such as the CPCHILD‐DV and FOCUS‐34 is recommended. When discrepancies are found between communicative abilities and spoken language comprehension, it is strongly recommended that valid tools are used in a more detailed examination of the child's spoken language comprehension skills and functional communication. [ABSTRACT FROM AUTHOR]

Background: Aims: To describe typical phonological development of Brazilian Portuguese (BP)‐speaking children, considering the following parameters: age of customary production, acquisition and mastery. Methods & Procedures: Data were collected from 857 children aged between 3 years and 8 years 11 months with typical language and speech development. The sample was grouped into 6‐month age bands. The data were analysed using one‐way analysis of variance (ANOVA) followed by Games–Howell post‐hoc tests. Outcomes & Results: Stops (/p, b, t, d, k, g/), nasals (/m, n, ɲ/) and some fricatives (/f, v, s, z/) were mastered before the age of 3 years (age of mastery). The age of acquisition for phonemes /ʃ, ʒ/ was 3;6, though both were only mastered at 4;0 years. The liquid /l/ was acquired at 3;0 and mastered at age 3;6, while /x/ was acquired and mastered at age 3;6. The phoneme /ʎ/ was acquired at 7;0 and mastered at age 8;6. The tap /ɾ/ was acquired between the ages of 4;0 and 4;6, and mastered at 4;6. In coda position, /n, l/ were acquired at 3;0, while /s/ was mastered at 4;6 and /ɾ/ between 4;6 and 5;0 years. Clusters involving /ɾ/ were acquired at 6;0, while those with /l/ were acquired between the ages of 6;6 and 7;0. Conclusions & Implications: This study presented acquisition for consonants in BP and can be used as a reference for the assessment of developmental speech disorders. In this study, stops and nasals were acquired first, followed by fricatives and, lastly, liquids. This finding is corroborated by previous studies in BP and other languages. What this paper adds: What is already known on the subject: What this paper adds to existing knowledge: What are the potential or actual clinical implications of this work?: [ABSTRACT FROM AUTHOR]

Background: Difficulties in language development are related to social and emotional problems, lower academic outcomes, and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. The introduction of systematic screening for language delay (LD) in 3‐year‐old children in Hungary was based on the recent adaptation of the MacArthur–Bates CDI‐III (HCDI‐III). Aims: To explore the relevant psychometric properties of the HCDI‐III; to identify factors characteristic of the families and children influencing language development at the age group under investigation; and to evaluate the adequacy of the tool for the purpose of screening LD in kindergarten at the age of 3 years. Methods & Procedures: The norming study of the HCDI‐III was conducted in a collaborative research project with the Metropolitan Pedagogical Services in Budapest. HCDI‐III parent report forms along with a demographic survey form were distributed to parents of all Hungarian‐speaking children between the ages of 2;0 and 4;2 without special education needs. The normative sample comprised data from 1424 children aged 2;0–4;2 with 51.1% boys and 48.9% girls. The data set contained information including language skills, basic demographics, birth conditions, health issues and socio‐economic status (SES). Outcomes & Results: In the HCDI‐III form, six outcome variables were created to cover the domains of expressive vocabulary, morphosyntax and language use. Statistical analyses revealed appropriate psychometric properties of five outcome variables that showed a normal distribution and were strongly correlated to age. Outcomes of girls were slightly (but significantly) higher on scales corresponding to vocabulary, syntax, language use and productivity. Most variables were highly correlated with one another even with age partialled out. Multiple regression analyses revealed significant effect of age, gender and parental education on all main outcome variables. Neither one of the other eight predictors, including familial and birth‐related factors, affected linguistic outcomes in our sample. Conclusions & Implications: The results are consistent with the majority of Communicative Development Inventory (CDI) studies, and support the psychometric eligibility of the instrument for screening purposes between 30 and 50 months. As certain regions of Hungary are characterised by a high prevalence of low‐SES families, more research is needed to adapt the screening procedure and subsequent measures to their needs. What this paper adds: What is already known on the subject: Difficulties in language development are related to lower social and academic outcomes and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. Structured parent report forms such as the MacArthur–Bates CDI are widely accepted methods for screening children with LD. What this paper adds to existing knowledge: This study reports the Hungarian adaptation and norming of the CDI‐III form. Statistical analyses revealed appropriate psychometric properties of most of its sections. Language outcomes were affected by age, gender and parental education on all main outcome variables in children between 2 and 4 years of age. What are the potential or actual clinical implications of this work?: The results support the psychometric eligibility of the HCDI‐III instrument for screening purposes. The introduction of the screening procedure in clinical practice is expected to improve early support of children with language difficulties and reduce risks of developmental problems related to language disorders. [ABSTRACT FROM AUTHOR]

Background: Intelligibility can be defined as the speakers' ability to convey a message to the listener and it is considered the key functional measure of speech. The Intelligibility in Context Scale (ICS) is a parent rating scale used to assess intelligibility in children. Aims: To describe normative and validation data on the ICS in Swedish and to investigate how these are related to age, gender and multilingualism. Methods & Procedures: Two studies were included. Study 1 included ICS forms from 319 Swedish‐speaking children (3:2–9:2 years:months). Study 2 included video recordings and ICS forms from 14 children with speech sound disorder (SSD) and two with typical speech. The video recordings were transcribed in the validation process, resulting in intelligibility reference scores to which ICS scores were correlated. Outcomes & Results: Study 1: The mean value of the ICS for the 319 children was 4.73. There were no differences in ICS score related to age or gender. The children in the multilingual group were significantly older than the monolingual group and had significantly lower ICS scores than the group of monolinguals. Study 2: There was a moderate correlation between the ICS score and the transcription‐based intelligibility score, with the two children with typical speech excluded; however, this correlation was not significant. Conclusions & Implications: We contribute mean scores and percentiles on the ICS for Swedish‐speaking children. The finding that the ICS does not provide valid measures of intelligibility for the included children with SSD suggests that the instrument measures a different construct. What this paper adds: What is already known on the subject: The ICS has been translated to numerous languages and validated against articulation measures in several previous studies. The validity of the Swedish version has been investigated against intelligibility based on transcription of single words. What this paper adds to existing knowledge: The study provides normative values of the Swedish version of the ICS for children aged 3–9 years. This is the first study to use a gold standard measure of intelligibility in continuous speech to validate the ICS. The results show a somewhat dubious validity regarding ICS for the group of children with SSD included in the study. What are the potential or actual clinical implications of this work?: The ICS's suitability as a measure of intelligibility is questionable; however, it might be of use for speech and language pathologists to give an overview of the parents' view of their child's ability to communicate, in order to make a decision on possible further assessment and intervention. The normative values of the Swedish version of the ICS could be of use in this decision process. [ABSTRACT FROM AUTHOR]

Background: The ability to understand figurative language, including metaphors and proverbs, decreases with age, although the phenomenon is not universal. Cognitive capacities and education play an important role in the competence connected with figurative language use and comprehension in people during the second half of life. Aims: To identify possible similarities and differences in task performance by subjects representing middle adulthood (40–49 and 50–59 years old) and late adulthood (60–69 and 70–92 years old). Additionally, the analyses took into account factors significantly affecting the results, that is, tasks type (metaphors versus proverbs), the way the answer is given (open‐ended versus multiple choice) and types of answers (abstract and concrete). This study also aimed to identify some cognitive correlates of task completion. Methods & Procedures: A total of 86 Caucasian subjects, aged 40–92 years, participated in this study (Mwhole group = 62.37, SD = 15.53); the group included 20 subjects aged 40–49 years (Mage = 45.4; SD = 3.05), 20 aged 50–59 years (Mage = 55.50; SD = 2.64), 20 aged 60–69 years (Mage = 64.40; SD = 2.78), and 26 aged 70–92 years (Mage = 79.15; SD = 6.27). A total of 20 well‐known Polish metaphors and 20 popular Polish proverbs were used to assess the level of proverb and metaphor comprehension. The Montreal Cognitive Assessment Scale and Vocabulary subtest of the Polish version of WAIS‐R were applied to assess the cognitive functions. Outcomes & Results: The results of the analyses suggest that there are differences as well as certain similarities between the groups. At 70+ years of age, the ability to explain and comprehend metaphors and proverbs decreases when compared with younger adults. In the 70+ group, the ability to grasp the meaning of both metaphors and proverbs is similar, unlike in the younger groups which present a better ability to explain and comprehend metaphors than proverbs. The conditions related to the types of tasks, that is, spontaneous interpretation and choice of responses, do not affect scores of the oldest subjects. Conclusions: The analysis of response types, that is, abstract versus concrete, shows that, compared with younger groups, people aged 70+ years tend to less frequently provide abstract explanations and more often give concrete (but correct) responses, referring to situational data or examples from everyday life. Moreover, attention, short‐term/delayed memory and lexical reserve influence the ability to use and comprehend figurative language to a varied degree. What this paper adds: What is already known on the subject: Studies focusing on metaphor and proverb interpretation by people in middle and late adulthood are rather scarce, and what is more, they provide inconclusive results. Research has shown that the capacities related to attention and memory, as well as language resources and executive functions, all deteriorate in older people, which negatively affects their ability to understand metaphors and proverbs. However, varied methods are applied to assess these skills, which may explain why the related findings are inconsistent. What this paper adds to existing knowledge: The novelty of this study lies in the fact that the analyses took into account the type of task (metaphors versus proverbs), the method of responding (open‐ended versus multiple‐choice) and the nature of the answer (abstract versus concrete). This allowed us to highlight intergroup differences and to show specific characteristics of proverb and metaphor spontaneous interpretation and choice of correct answers. The results were compared among the participants representing relatively narrow age ranges classified as middle and late adulthood. What are the potential or actual clinical implications of this work?: Analysis of how people in middle and late adulthood interpret metaphors and proverbs might constitute an element of preliminary screening assessment showing whether a decrease in this capacity is in the normal range or if it reflects a serious cognitive decline. It would be worthwhile if the diagnostic process included varied task designs, that is, both metaphors and proverbs, as well as spontaneous interpretation and multiple‐choice, as well as varied types of responses. [ABSTRACT FROM AUTHOR]

Background: Quantitative measures can increase precision in describing swallowing function, improve interrater and test–retest reliability, and advance clinical decision‐making. The Test of Mastication and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST) are functional tests for swallowing that provide quantitative results. Aims: To explore the relationship between TOMASS and TWST; evaluate test–retest and interrater reliability; explore age and gender effects; and gather normative data. Methods & Procedures: Healthy community dwelling participants (n = 298, ≥ 20 years old) were recruited. Of those, 126 were included in the reliability study. Participants completed the TWST and TOMASS. Outcomes & Results: Associations between TWST and TOMASS measures were found using Pearson's correlation coefficient. Age was positively associated with an increase in the number of bites (n = 292, r = 0.15, p = 0.009), masticatory cycles (n = 291, r = 0.33, p < 0.0001) and duration (n = 292, r = 0.32, p < 0.0001) for the TOMASS. For the TWST, age was positively associated with an increase in duration (n = 296, r = 0.23, p < 0.0001), and negatively associated with volume (n = 296, r = −0.205, p < 0.0001), and swallowing capacity (n = 296, r = −0.24, p < 0.0001). Females required more bites, masticatory cycles, swallows and longer time than males in TOMASS. In TWST, females required more swallows, longer time, and had lower volume per swallow and reduced swallowing capacity than males. Intraclass correlation coefficient (ICC) revealed good test–retest reliability and moderate to excellent interrater reliability. Conclusions & Implications: This study provides support for the validity of the TOMASS and TWST. Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Extended chewing time and increased number of masticatory cycles might be compensatory behaviours for reduced oral processing abilities that are motor, sensory and/or mechanical. WHAT THIS PAPER ADDS: The TOMASS and TWST are functional tests of swallowing that provide quantitative results. They are easy to incorporate as part of the clinical evaluation of swallowing due to low cost and quick administration. Age and gender effects were found for the TWST and TOMASS, but they were only tested on relative measures rather than absolute measures. Different types of crackers used for TOMASS led to differences in performance and in normative values. What is already known on the subject: Associations between performance during TWST and TOMASS were found: time, number of swallows and time per swallow were correlated, meaning that need for more time and more swallows is reflected in both drinking and chewing. The study provides further support for age and gender effects in TWST and TOMASS, on both relative and also on absolute measures, which were not investigated previously. Longer durations in TOMASS and TWST with an increase in age, are likely to be the result of compensatory behaviours to allow safe swallowing. Normative data for a country‐specific cracker are presented (Israel). What are the potential or actual clinical implications of this work?: Reduced efficiency in one of the tests might indicate a need to evaluate performance in the other. Establishing country specific norms for commonly available crackers is necessary, since crackers size and ingredients, such as fat content and moisture, influence chewing and swallowing. There is a balancing act between safety and efficiency in older adults' swallowing behaviour. Reducing pace in eating and drinking probably supports safer swallowing. [ABSTRACT FROM AUTHOR]

Background: The impact of hearing impairment is typically studied in terms of its effects on speech perception, yet this fails to account for the interactive nature of communication. Recently, there has been a move towards studying the effects of age‐related hearing impairment on interaction, often using referential communication tasks; however, little is known about how interaction in these tasks compares to everyday communication. Aims: To investigate utterances and requests for clarification used in one‐to‐one conversations between older adults with hearing impairment and younger adults without hearing impairment, and between two younger adults without hearing impairment. Methods & Procedures: A total of 42 participants were recruited to the study and split into 21 pairs, 10 with two younger adults without hearing impairment and 11 with one younger adult without hearing impairment and one older participant with age‐related hearing impairment (hard of hearing). Results from three tasks—spontaneous conversation and two trials of a referential communication task—were compared. A total of 5 min of interaction in each of the three tasks was transcribed, and the frequency of requests for clarification, mean length of utterance and total utterances were calculated for individual participants and pairs. Outcomes & Results: When engaging in spontaneous conversation, participants made fewer requests for clarification than in the referential communication, regardless of hearing status/age (p ≤ 0.012). Participants who were hard of hearing made significantly more requests for clarification than their partners without hearing impairment in only the second trial of the referential communication task (U = 25, p = 0.019). Mean length of utterance was longer in spontaneous conversation than in the referential communication task in the pairs without hearing impairment (p ≤ 0.021), but not in the pairs including a person who was hard of hearing. However, participants who were hard of hearing used significantly longer utterances than their partners without hearing impairment in the spontaneous conversation (U = 8, p < 0.001) but not in the referential communication tasks. Conclusions & Implications: The findings suggest that patterns of interaction observed in referential communication tasks differ to those observed in spontaneous conversation. The results also suggest that fatigue may be an important consideration when planning studies of interaction that use multiple conditions of a communication task, particularly when participants are older or hard of hearing. WHAT THIS PAPER ADDS: What is already known on this subject: Age‐related hearing impairment is known to affect communication; however, the majority of studies have focused on its impact on speech perception in controlled conditions. This indicates little about the impact on everyday, interactive, communication. What this study adds to the existing knowledge: We investigated utterance length and requests for clarification in one‐to‐one conversations between pairs consisting of one older adult who is hard of hearing and one younger adult without hearing impairment, or two younger adults without hearing impairment. Results from three tasks (two trials of a referential communication task and spontaneous conversation) were compared. The findings demonstrated a significant effect of task type on requests for clarification in both groups. Furthermore, in spontaneous conversation, older adults who were hard of hearing used significantly longer utterances than their partners without hearing impairment. This pattern was not observed in the referential communication task. What are the potential or actual clinical implications of this work?: These findings have important implications for generalizing results from controlled communication tasks to more everyday conversation. Specifically, they suggest that the previously observed strategy of monopolizing conversation, possibly as an attempt to control it, may be more frequently used by older adults who are hard of hearing in natural conversation than in a more contrived communication task. [ABSTRACT FROM AUTHOR]

Background: Although previous research studies have defined several prognostic factors that affect cognitive‐communication performance in patients with all traumatic brain injury (TBI) severity, little is known about what variables are associated with cognitive‐communication impairment in complicated mild TBI (mTBI) specifically. Aims: To determine which demographic and trauma‐related factors are associated with cognitive‐communication performance in the early recovery phase of acute care following a complicated mTBI. Methods & Procedures: Demographic and accident‐related data as well as the scores on cognitive‐communication skill measures in the areas of auditory comprehension (complex ideational material subtest of the Boston Diagnostic Aphasia Examination), verbal reasoning (verbal absurdities subtest of the Detroit Test of Learning Aptitude), confrontation naming (short form of the Boston Naming Test), verbal fluency (semantic category and letter category naming), and conversational discourse (conversational checklist of the Protocole Montréal d'évaluation de la communication) were retrospectively collected from the medical records of 128 patients with complicated mTBI admitted to a tertiary care trauma hospital. Multiple linear regressions analyses were carried out on the variables sex, age, education level, Glasgow Coma Scale (GCS) score, lesion site and bilingualism. Outcomes & Results: Females performed better than males on letter‐category naming, while those more advanced in age performed worse on most cognitive‐communication measures. Patients with higher education achieved better confrontation and letter‐category naming, whereas reading comprehension results were worse with a lower GCS score. Bilingual individuals presented more difficulty in conversational discourse skills than those who spoke only one language. In terms of site of lesion, the presence of a right frontal injury was associated with worse auditory and reading comprehension and an occipital lesion was related to worse confrontation naming. Conclusions & Implications: Cognitive‐communication skills should be evaluated early in all patients with complicated mTBI, but especially in those who are advanced in age, those with fewer years of education and those who present with lower GCS scores, in order to determine rehabilitation needs. The findings of this study will allow acute care clinicians to better understand how various demographic and injury‐related factors affect cognitive‐communication skills after complicated mTBI and to better nuance the interpretation of their evaluation results in order to improve clinical care. Further study is required regarding the influence of lesion location, sex and bilingualism following complicated mTBI. What this paper addsWhat is already known on the subjectIn early acute recovery studies including all severity of TBI, cognitive‐communication performance was poorer in individuals with more advanced age, those with fewer years of education and with more severe TBI. It is not yet known which demographic and injury‐related variables predict cognitive‐communication performance after a complicated mTBI specifically.What this paper adds to existing knowledgeWe confirmed that age, level of education and TBI severity, as measured with the GCS score, were associated with some areas of cognitive‐communication performance for a group of patients in the acute stage of recovery from a complicated mTBI. We also identified that sex, bilingualism and site of lesion were new variables that show an influence on aspects of cognitive‐communication skills in this group of patients.What are the potential or actual clinical implications of this work?The findings of this study on prognostic factors in the case of complicated mTBI will help acute care clinicians to better understand evaluation results knowing the variables that can influence cognitive‐communication performance and to nuance the interpretation of these results with the goal of determining rehabilitation needs and enhancing clinical care. [ABSTRACT FROM AUTHOR]

Background: There is very little awareness of the speech, language and communication needs (SLCN) of rough sleepers. The small amount of documentation that does exist involves a wider group of homeless adults (not just rough sleepers), and reports that communication needs are an area of concern. Aims: To investigate: (1) the reported prevalence of SLCN amongst UK nationals recorded on the Combined Homeless and Information Network (CHAIN) as sleeping on the streets of London; (2) whether rough sleepers with reported SLCN differ from those without; and (3) what factors best predict patterns of rough sleeping and accommodation stays. Methods & Procedures: A data set of 513 participants was provided by CHAIN, which contained information relating to all new rough sleepers and people with long‐term histories of rough sleeping (UK nationals only) recorded by street outreach teams in London between 1 April and 30 June 2013. Also included was data about UK nationals provided with support by the Homelessness and Brain Injury Project. The data set contained information including basic demographics, communication skills, health and social care needs, and institutional background and extended to a 5‐year period. Outcomes & Results: (1) SLCN data were often not recorded with data available for only 62% of individuals on the CHAIN databases. However, for those with SLCN data, the prevalence of SLCN was significantly higher than for the general population (17.1%; p < 0.001). (2) There were no significant differences between those with and without SLCN on additional risk factors, quarters rough sleeping, accommodation stays or staff‐recorded alerts. (3) There was a positive correlation between rough sleeping and additional risk factors for those with SLCN (r = 0.32, p < 0.001) and for those without (r = 0.25, p < 0.001). Regression analysis indicated that additional risk factors were more predictive than SLCN in explaining the number of quarters rough sleeping and accommodation stays. Conclusions & Implications: SLCN are highly prevalent amongst rough sleepers and significantly greater than for the UK general population. SLCN are not clearly related to rough sleeping behaviour, but the presence of additional risk factors is highly significant in this regard. Homelessness organizations should provide training for staff in SLCN in order to promote better recording of SLCN, inclusive communication and appropriate support to people who are homeless. Further research is also needed to understand better the communication needs of rough sleepers. What this study addsWhat is already known on the subjectThere is very little literature concerning the SLCN of rough sleepers, but that which exists suggests that communication needs are an area of concern. There is relatively little awareness of SLCN in practice in this field.What this paper adds to existing knowledgeThis study is the first to provide information on SLCN recording in this population. It reports large‐scale prevalence data on SLCN in rough sleepers, showing a significantly higher risk in this group. Unexpectedly, SLCN did not clearly relate to patterns of rough sleeping and accommodation, but this may be due to the relatively crude data available in routine practice.What are the potential or actual clinical implications of this work?Wider awareness and training on SLCN in the homelessness sector is needed coupled with more systematic and objective assessment of communication in rough sleepers. [ABSTRACT FROM AUTHOR]

Background: Light verbs are highly frequent and semantically impoverished words. It is currently not known whether light verb production in discourse tasks differs by age or for people with dementia of the Alzheimer's type (DAT). Aims: The purpose of the current study was two‐fold: (1) to determine whether there is a relationship between age and the proportion of light verbs produce during a narrative discourse task; and (2) to determine whether people with DAT produce a different proportion of light verbs compared with neurotypical adults. Methods & Procedures: A total of 469 neurotypical adults and 12 participants with DAT produced narratives from a wordless picture book. Outcome & Results: The results indicated that light verb production increases as a function of age, even when controlling for education, and people with DAT produced a higher light verb–word ratio compared with neurotypical adults when matched for age and education. Conclusion & Implication: Light verb use may increase as a function of age due to declines in retrieval ability. These declines are not only more pronounced in people with DAT, but also semantic knowledge deficits may contribute to a reliance on light verbs. What this paper adds: Light verbs are typically some of the first verbs learned due to their simple semantic construction and high frequency. However, two things are unknown: (1) how light verbs changed across the adult lifespan; and (2) whether cognitive impairment changes light verb production. The study found that light verb production increases as a function of age, and that people with DAT used a higher ratio of light verbs to words in a narrative task compared with neurotypical adults. However, despite the findings, more research is needed to determine their clinical utility. Future research may wish to investigate whether light verbs (1) facilitate comprehension in older adults or (2) may be used in cognitive–linguistic assessments for cognitive impairments. [ABSTRACT FROM AUTHOR]

Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono‐ and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results: Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children. What this paper addsWhat is already known on the subjectIdentifying language disorders before children enter school can foster the initiation of early interventions before these problems interfere with formal education and behavioural adjustment. Information on caseload characteristics is important to plan speech and language therapy service provision. There are only a few studies on the caseload characteristics of children at first referral for language assessment.What this paper adds to existing knowledgeThis study provides a detailed description of the caseload characteristics of children referred to Dutch speech and hearing centres. The results reveal an age bias in referral: boys were referred earlier than girls, and monolingual children were revealed earlier than bilingual children. On top of that, bilingual children seemed to have more complex problems at referral.What are the potential or actual clinical implications of this work?This study indicates that it is important to be aware of bias in the age of referral of subgroups of children with language disorders. Solutions might be to implement a language screening instrument designed for use by non‐speech–language therapists, and training in early recognition of girls and multilingual children with (less complex) language disorders for health professionals in key positions in child healthcare. In addition, it might be worthwhile to assign speech and language therapists with diverse ethnic and language backgrounds and/or with experience with bilingual/cultural children in a regional mentoring function to support referral agents and parents. [ABSTRACT FROM AUTHOR]

Background: The role of domain-general short-term memory (STM) in language development remains controversial. A previous finding from the HelSLI study on children with developmental language disorder (DLD) suggested that not only verbal but also non-verbal STMfor temporal order is related to language acquisition in monolingual children with DLD. Aims: To investigate if a similar relationship could be replicated in a sample of sequentially bilingual children with DLD. In addition to the effect of age, the effect of cumulative second language (L2) exposure was studied. Methods & Procedures: Sixty-one 4-6-year-old bilingual children with DLD and 63 typically developing (TD) bilingual children participated in a crosssectional study conducted in their L2. Children completed novel game-like tests of visual and auditory non-verbal serial STM, as well as tests of cognitive functioning and language. Interactions of STM for order with age and exposure to L2 (Finnish) were explored as explanatory variables. Outcomes & Results: First, the improvement of non-verbal serial STMwith age was faster in sequentially bilingual TD children than in bilingual children with DLD.Asimilar effectwas observed for L2 exposure. However, when both age and exposurewere considered simultaneously, only agewas related to the differential growth of non-verbal STMfor order in the groups. Second, only in children with DLD was better non-verbal serial STM capacity related to an improvement in language scores with age and exposure. Conclusions & Implications: The results suggest that, as previously found in Finnish monolingual children, domain-general serial STM processing is also compromised in bilingual children with DLD. Further, similar to the monolingual findings, better non-verbal serial STM was associated with greater language improvement with age and exposure, but only in children with DLD, in the age range studied here. Thus, in clinical settings, assessing non-verbal serial STM of bilingual children could improve the detection of DLD and understanding of its non-linguistic symptoms. [ABSTRACT FROM AUTHOR]

Background: This study is a longitudinal follow‐up to prior work examining the important pragmatic skill of communication repair (i.e., the ability to respond effectively to a request for clarification of an unclear message) across three neurodevelopmental disabilities in which language skills are impaired: fragile X syndrome with and without autism spectrum disorder (FXS‐ASD; FXS‐O), idiopathic ASD (ASD‐O), Down syndrome (DS) and controls with typical development (TD). Prior work examining communication repair skills at younger ages indicated impairments in boys with FXS‐ASD and ASD‐O, with females performing comparably with each other across groups. Aims: To characterize communication repair skills in young individuals with FXS‐ASD, FXS‐O, ASD‐O, DS and TD, across groups and over development. A secondary aim included documenting sex differences in FXS (with and without ASD) and DS. Methods & Procedures: Sixty young individuals with FXS‐ASD (49 males, 11 females), 38 with FXS‐O (13 males, 25 females), 38 with ASD‐O (males only), 42 with DS (21 males, 21 females) and 41 with TD (21 males, 20 females) participated in the study, with a subsample reported on here who were retested at a second time point 2.7 years later on average. Participants completed a structured, picture‐based task designed to assess the ability to repair breakdowns in communication. Participants' responses were compared across groups and sexes at the second time point, and interpreted with respect to previously published (Time 1) findings. Outcomes & Results: Key findings included that, with age, male groups (including those with FXS‐ASD and ASD‐O, who showed difficulty at Time 1) performed more comparably, decreasing their use of inappropriate responses, in spite of relatively little change observed in general cognitive or structural language abilities in the clinical groups. However, girls with FXS and DS became more non‐responsive with age, and differences between boys and girls with FXS‐ASD emerged over time as well. Conclusions & Implications: Findings suggest that impairments in a critical pragmatic skill—the ability to repair communication breakdown—show significant change with age across three neurodevelopmental disabilities, with important sex‐specific patterns. These developments were often observed in spite of a relative plateau in cognitive and language growth, suggesting that repair skills may be more malleable and therefore an excellent target for intervention. Findings not only inform the nature of pragmatic impairment across groups but also can importantly inform clinical practice, suggesting that clinicians should monitor pragmatic skills such as repairs throughout development and also consider the role of sex in clinical efforts. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the discourse performance of non‐brain‐damaged individuals is critical not only for its differentiation from disordered expression but also for more accurate models of ageing and communication. The effect of ageing and cognitive skills on the cohesive adequacy of discourse has, until now, presented a confusing and ambiguous picture. Aims: To examine comprehensively the effects of both age and cognitive skills on the discourse cohesion of 32 non‐brain‐damaged males divided into four age groups. Methods & Procedures: A large body of narrative and procedural samples (394 samples) was elicited from the participants. Their cognitive skills were determined using three tests, whilst their discourse cohesion was analyzed and correlated with the cognitive test results. Outcomes & Results: This extensive investigation of ageing effects on discourse cohesion and their relationship to cognitive behaviour did not provide neat generalizable results. It showed that ageing significantly increases the number of cohesive errors and reduces the quantity of referential ties in picture‐sequence narratives. The changes with age were limited to two aspects of cohesion and not linear across age groups. The participants' cognitive skills declined with age. Correlations between some cognitive tests and certain cohesive changes suggest co‐occurring deficits rather than a causal explanation of cohesive decline with age. Conclusions & Implications: With ageing there are increased cohesive errors and decreased referential ties, co‐occurring with declining cognitive skills. This study yields important guidance for future research, suggesting that picture‐sequence narrative is the most effective tool for clinical evaluation of discourse, but also that findings from one discourse sample may be misleading. [ABSTRACT FROM AUTHOR]

Background: Variations in parenting, more specifically less responsive and more directive parenting, contribute to language difficulties for children experiencing adversity. Further investigation of associations between specific responsive and directive behaviours and child language is required to understand how behaviours shape language over time within different populations. As language is dyadic, further exploration of how mother–child interactions moderate associations is also important. Aims: To investigate associations between specific responsive and directive maternal behaviours, the quality of mother–child interaction (fluency and connectedness) and child language in a cohort experiencing adversity. Methods & Procedures: Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, videos of mother–infant free play were collected. Videos were coded for maternal behaviours and fluency and connectedness (n = 249). At 36 months, child language was measured using a standardized language test. Linear regression models were used to examine associations and the moderating role of fluency and connectedness was explored. Outcomes & Results: Responsive yes/no questions were positively associated with language scores. Unsuccessful redirectives were negatively associated with language scores. The moderation effect of fluency and connectedness was equivocal in the current data. Conclusions & Implications: Findings reproduce and extend previous research highlighting key features of mother–child interactions associated with child language trajectories. Findings also augment knowledge of risk and protective factors related to language for children experiencing adversity and highlight where targeted interventions might be successful. [ABSTRACT FROM AUTHOR]

Background: Discourse analysis procedures are time consuming and impractical in a clinical setting. Critical to clinicians are simple and informative discourse measures that require minimal time and labour to complete. Many studies, however, have overlooked difficulties that clinicians face. We recently developed core lexicon lists for nouns, verbs, adjectives and adverbs for two narrative discourse tasks with healthy control groups. Core lexicon lists consist of important lexical items required to produce coherently meaningful discourse in response to discourse tasks. Measuring core lexicon is useful for quantifying word retrieval impairments at the discourse level in clinical populations. Aims: To apply an age‐based core lexicon list for nouns, verbs, adjectives and adverbs for the wordless picture books Good Dog Carl (1985) and Picnic (1984) and to determine how well the lists measured linguistic impairments in persons with aphasia (PWA). Materials & Methods: Lemma forms were extracted from 470 control participants who were divided into seven age groups. Twenty‐five core lexicons were identified for four word classes (nouns, verbs, adjectives and adverbs) among the seven age groups. The nouns, verbs, adjectives and adverbs for each PWA (N = 11) were then compared with the core lexicon for their respective age group. Per cent agreement was computed by comparing the number of total items within each list to the number of items that PWA produced. A Spearman's correlation coefficient was computed between the WAB‐R AQ and the per cent agreement for each word type for PWA. Outcomes & Results: The percentage of agreement for each word type among the age cohorts ranged between 56% and 96%. Of the four word types, core verbs significantly correlated with the WAB AQs for both discourse tasks. A post‐hoc analysis found significant differences between fluent and non‐fluent aphasia for core verbs. Conclusions & Implications: Core lexicon analysis appears to be a practical way to capture impairments in word retrieval at the discourse level. Core verbs may be a better indicator to understand holistic language performances for PWA. Use of the core lexicon checklist can serve as an option to reconcile ecological validity with clinical usability. [ABSTRACT FROM AUTHOR]

Background Past reports on the speech production of individuals with Williams syndrome (WS) suggest that their prosody is anomalous and may lead to challenges in spoken communication. While existing prosodic assessments confirm that individuals with WS fail to use prosodic emphasis to express contrast, those reports typically lack detailed phonetic analysis of speech data. The present study examines the acoustic properties of speech prosody, aiming for the future development of targeted speech interventions. Aims The study examines the three primary acoustic correlates of prosodic emphasis (duration, intensity, F0) and determines whether individuals with WS have difficulty in producing all or a particular set of the three prosodic cues. Methods & Procedures Speech produced by 12 individuals with WS and 12 chronological age (CA)-matched typically developing individuals were recorded. A sequential picture-naming task elicited production of target phrases in three contexts: (1) no contrast: gorilla with a racket → rabbit with a balloon; (2) contrast on the animal: fox with a balloon → rabbit with a balloon; and (3) contrast on the object: rabbit with a ball → rabbit with a balloon. The three acoustic correlates of prosodic prominence (duration, intensity and F0) were compared across the three referential contexts. Outcomes & Results The two groups exhibited striking similarities in their use of word duration and intensity for expressing contrast. Both groups showed the reduction and enhancement of final lengthening, and the enhancement and reduction of intensity difference for the animal contrast and for the object contrast conditions, respectively. The two groups differed in their use of F0: the CA group produced higher F0 for the animal than for the object regardless of the context, and this difference was enhanced when the animal noun was contrastive. In contrast, the WS group produced higher F0 for the object than for the animal when the object was contrastive. Conclusions & Implications The present data contradict previous assessment results that report a lack of prosodic skills to mark contrast in individuals with WS. The methodological differences that may account for this variability are discussed. The present data suggest that individuals with WS produce appropriate prosodic cues to express contrast, although their use of pitch may be somewhat atypical. Additional data and future speech comprehension studies will determine whether pitch modulation can be targeted for speech intervention in individuals with WS. [ABSTRACT FROM AUTHOR]

Background Comprehension is critical for classroom learning and educational success. Inferences are integral to good comprehension: successful comprehension requires the listener to generate local coherence inferences, which involve integrating information between clauses, and global coherence inferences, which involve integrating textual information with background knowledge to infer motivations, themes, etc. A central priority for the diagnosis of comprehension difficulties and our understanding of why these difficulties arise is the development of valid assessment instruments. Aims We explored typically developing children's ability to make local and global coherence inferences using a novel assessment of listening comprehension. The aims were to determine whether children were more likely to make the target inferences when these were asked during story presentation versus after presentation of the story, and whether there were any age differences between conditions. Methods & Procedures Children in Years 3 ( n = 29) and 5 ( n = 31) listened to short stories presented either in a segmented format, in which questions to assess local and global coherence inferences were asked at specific points during story presentation, or in a whole format, when all the questions were asked after the story had been presented. Outcomes & Results There was developmental progression between age groups for both types of inference question. Children also scored higher on the global coherence inference questions than the local coherence inference questions. There was a benefit of the segmented format for younger children, particularly for the local inference questions. Conclusions & Implications The results suggest that children are more likely to make target inferences if prompted during presentation of the story, and that this format is particularly facilitative for younger children and for local coherence inferences. This has implications for the design of comprehension assessments as well as for supporting children with comprehension difficulties in the classroom. [ABSTRACT FROM AUTHOR]

Background The spoken language difficulties of children with moderate or severe to profound hearing loss are mainly related to limited auditory speech perception. However, degraded or filtered auditory input as evidenced in children with cochlear implants (CIs) may result in less efficient or slower language processing as well. To provide insight into the underlying nature of the spoken language difficulties in children with CIs, linguistic profiles of children with CIs are compared with those of hard-of-hearing (HoH) children with conventional hearing aids and children with specific language impairment (SLI). Aims To examine differences in linguistic abilities and profiles of children with CIs as compared with HoH children and children with SLI, and whether the spoken language difficulties of children with CIs mainly lie in limited auditory perception or in language processing problems. Methods & Procedure Differences in linguistic abilities and differential linguistic profiles of 47 children with CI, 66 HoH children with moderate to severe hearing loss, and 127 children with SLI are compared, divided into two age cohorts. Standardized Dutch tests were administered. Factor analyses and cluster analyses were conducted to find homogeneous linguistic profiles of the children. Outcomes & Results The children with CIs were outperformed by their HoH peers and peers with SLI on most linguistic abilities. Concerning the linguistic profiles, the largest group of children with CIs and HoH children shared similar profiles. The profiles observed for most of the children with SLI were different from those of their peers with hearing loss in both age cohorts. Conclusions & Implications Results suggest that the underlying nature of spoken language problems in most children with CIs manifests in limited auditory perception instead of language processing difficulties. However, there appears to be a subgroup of children with CIs whose linguistic profiles resemble those of children with SLI. [ABSTRACT FROM AUTHOR]

Background Social perception is an important skill. One assessment that is commonly used to assess social perception abilities is The Awareness of Social Inference Test (TASIT). The only normative data available for this test are for Australian younger adults. Despite no normative data being available for British adults, the test is widely used in the UK with older and younger adults. There is a growing body of research that suggests that older adults have difficulty with skills associated with social perception. There is therefore a need to determine whether British adults, and more specifically British older adults, perform similarly to the Australian normative TASIT scores available in the manual. Aims To explore the differences between older and younger British adults' performance on TASIT, and to determine whether younger and older British adults perform similarly to the data from Australian adults in TASIT manual. Methods & Procedures TASIT was administered to a total of 42 native British English speaking participants. The participants were split into two age groups 18-45 and 60-90 years. Comparisons were made between the two groups and the Australian data in TASIT manual. Outcomes & Results The younger British and Australian adults obtained similar scores on all parts of TASIT. The older British adults though, obtained significantly lower scores than the Australian younger adults on all parts of TASIT and when education was controlled for they obtained significantly lower scores than the British younger adults. Conclusions & Implications The findings are discussed in the light of previous research that has found that older adults are worse than younger adults at social inferences. The findings of the current study suggest that caution should be used when using TASIT with older British adults to assess social perception abilities. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that public awareness of aphasia is vital for extending services, research support, social inclusion and targeted raising of awareness. Earlier studies show that knowledge of aphasia varies across a range of variables, but is very low compared with other conditions. Aims: To report a series of surveys of public awareness of aphasia from six countries, the largest study conducted this far. Methods & Procedures: Surveys were conducted in Argentina ( N = 800), Canada ( N = 831), Croatia ( N = 400), Greece ( N = 800), Norway ( N = 251) and Slovenia ( N = 400) using the same methodology requesting information on age, sex and occupation, asking whether respondents had heard of aphasia and where they had heard of it. Respondents were tested on their levels of knowledge of aphasia. Outcomes & Results: Results revealed low levels of awareness of aphasia in countries surveyed with marked variability that appeared to interact with occupation, country, age and sex. We surveyed 3483 respondents (mean age = 43.16; SD = 17.68). Between 60% (Croatia) and 16% (Slovenia) said they had heard of aphasia (37.1% overall), but those with actual knowledge ranged from 13.9% (Norway) to 1.0% (Argentina). The combined mean of those with basic knowledge was 9.2%. Those who had heard of aphasia were younger; and females had higher levels of awareness. We also found associations between socio-economic status and awareness. Those working in health, social and educational spheres had the highest levels. Respondents mainly heard about aphasia through the media and work or personal contact with aphasia. Conclusions & Implications: Levels of awareness are low everywhere in absolute terms, and relative to the awareness of other conditions, with significant variability between countries, sex and socio-economic status. We examine how surveys can be utilized to plan ways to increase understanding and discuss the comparison of awareness of aphasia with other conditions. [ABSTRACT FROM AUTHOR]

Background The prevalence of speech-language impairments in children have been estimated for several languages, primarily in developed countries. However, prevalence data is lacking for developing countries, such as Nepal. Aims (1) To obtain teacher estimates of incidence and overall prevalence of speech-language impairments and its subtypes as a function of gender, age and grade level; and (2) to validate the screening instrument on Nepalese children. Methodology The adapted teachers' screening instrument, namely adapted Teachers' Speech and Language Referral Checklist (a-TSLRC), was administered in 2776 (690 and 2086) primary school children aged 5;00-11;11 years (mean = 8;11 years). The screening was conducted at four different points in time, i.e. Incidences I and II, and each incidence consisted of a testing and a retesting phase. Prior to this, teachers were trained in forum meetings, and an information sheet containing an overview of speech-language impairments, and guidelines/criteria for marking the occurrence of speech-language impairments in the TSLRC were disseminated. Outcomes & Results Overall prevalence of speech-language impairments in children was estimated as 8.11%. Specifically, overall speech problems were estimated as 4.68%, and language problems as 8.0%. Additionally, the prevalence by subtypes of speech-language impairments as categorized in the TSLRC were reported to be 2.95% for an articulation/phonological problems, 2.09% for stuttering, 3.42% for a voice problems, 4.97% for a receptive language problems and 7.74% for an expressive language problems. The internal consistency among items was sufficient and a good intra-rater reliability was obtained. Conclusions & Implications The study indicates that the overall results of speech-language impairments in children via the adapted in-Nepalese criterion-referenced instrument are supported by international studies. In addition, justifiable reliability and validity was obtained. Therefore, based on these overall evidence, this instrument can be useful for the screening of speech-language impairments in primary school children in Nepal. [ABSTRACT FROM AUTHOR]

Background A number of studies have suggested that language in individuals with Down syndrome (DS) may not be simply delayed compared with language in typically developing (TD) children, but deviant. The deviance has been detected in the comprehension of pronouns, and it has triggered proposals for the existence of a specific syntactic deficit in individuals with DS. However, the developmental path of pronoun comprehension in individuals with DS is unknown as there are no studies examining individuals of different ages. Aims To perform a pilot study examining pronoun comprehension in adolescents and adults with DS in comparison with TD children. Research questions include: Are some pronoun types more difficult than others for each of the two groups (DS and TD)? Is there a difference in performance between the two groups? Does performance correlate with chronological age in the DS group? Methods & Procedures Using a manual picture selection task, we examined the comprehension of different types of pronouns in 14 Greek-speaking individuals with DS, ranging from 10 to 34 years of age. We also tested a control group of TD children as well as a typical adult group. The TD and DS groups were recruited and tested in pre-schools and schools/centres for individuals with learning disabilities, respectively. Within- and between-group comparisons were performed for all conditions. For the DS group, correlations between chronological age and performance in each condition were also explored. Outcomes & Results Results reveal a significant positive correlation of age with performance in the DS group, but only in structures that also presented difficulties to TD children. Structures that presented difficulties only to individuals with DS do not appear to be less problematic for older participants. Conclusions & Implications These findings provide support to the deviance hypothesis by suggesting that the syntactic deficit in the comprehension of pronouns in individuals with DS is present in individuals of a wide age range. At the same time, the results, if corroborated by large-scale studies, suggest that some aspects of grammatical development in individuals with DS may continue even after adolescence and well into adulthood. We argue that these findings can contribute towards more targeted intervention practices by increasing our knowledge of the behavioural phenotype of DS. [ABSTRACT FROM AUTHOR]

Background Morphosyntax has been well researched in specific language impairment (SLI) and there is general agreement that children with SLI have particular difficulties with tense-marking. Less well researched is the role that aspect plays in the difficulties found in tense-marking, especially as tense and aspect are often confounded in English. Initial investigation of the understanding of aspect in preschool children with SLI suggests that they are less sensitive to aspect and its interaction with tense than typically developing (TD) children. It is unclear, however, what is the developmental trajectory of their understanding of aspect and its interaction with tense and whether these difficulties are still found in older children and adolescents with SLI. Aims To investigate comprehension of the grammatical aspect contrast between completed events using the simple past tense -ed/irregular (perfective grammatical aspect) and ongoing events using the past progressive (imperfective grammatical aspect). The role of lexical aspect was also investigated through the balanced use of verbs that were inherently telic (i.e. have a natural end-point) and verbs that required the addition of prepositional phrase for a telic interpretation when used in the perfective aspect condition. Methods & Procedures A sentence-picture matching task was administered to 10 participants with SLI (aged 12;10-16;8 years) and 30 language ability matched TD children who were split into three groups (mean ages: 5;10, 7;4 and 9;2). Outcomes & Results Adult-like performance was found by all groups on the perfective aspect condition, but only by the oldest group of TD children on the imperfective aspect condition. The performance of the group with SLI was consistent with their much younger language ability matched TD children in their understanding of the progressive -ing when used to describe ongoing events that have taken place in the past. The lexical aspect of the telicity of the verbs was not found to have any significant effect on performance. Conclusions & Implications Although further investigation of the understanding of aspect (both comprehension and production) is needed, the results have implications for therapy. The past progressive -ing construction is important, particularly for providing context and background information in narratives, but it is not explicitly taught in schools. Therefore, some focus on the temporal nature of tense-marking in therapy may be beneficial to individuals with SLI in understanding the temporal nature of events and how aspect interacts with tense. [ABSTRACT FROM AUTHOR]