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Twice-exceptionality (2e), broadly defined as the co-occurrence of a gift or talent and a disability, has been a part of the educational lexicon since the 1990s, although its empirical backing is limited. We conducted a comprehensive review of the empirical literature on 2e and created a simulation study of 2e. For the latter, we constructed population distribution functions that represent indicators of ability using a range of correlations and identification criteria guided by the reviewed literature. We observed the theoretical occurrence of 2e, even at its most relaxed definitions, to be much rarer than prevailing literature implies (probability = 0.148). As correlations and factor loadings increase, the prevalence estimates of 2e drop considerably. Our results demonstrated the need for a more informed, standardized, and quantifiable approach to the identification of individuals with 2e.

Many states now mandate early screening for dyslexia, but vary in how they address these mandates. There is confusion about the nature of screening versus diagnostic assessments, risk versus diagnosis, concurrent versus predictive validity, and inattention to indices of classification accuracy as the basis for determining risk. To help define what constitutes a screening assessment, we summarize efforts to develop short (3-5 min), teacher-administered screens that used multivariate strategies for variable selection, item response theory to select items that are most discriminating at a threshold for predicting risk, and statistical decision theory. These methods optimize prediction and lower the burden on teachers by reducing the number of items needed to evaluate risk. A specific goal of these efforts was to minimize decision errors that would result in the failure to identify a child as at risk of dyslexia/reading problems (false negatives) despite the inevitable increase in identifications of children who eventually perform in the typical range (false positives). Five screens, developed for different periods during kindergarten, Grade 1, and Grade 2, predicted outcomes measured later in the same school year (Grade 2) or in the subsequent year (Grade 1). The results of this approach to development are applicable to other screening methods, especially those that attempt to predict those children at risk of dyslexia prior to the onset of reading instruction. Without reliable and valid early predictive screening measures that reduce the burden on teachers, early intervention and prevention of dyslexia and related reading problems will be difficult.

Purpose: This study aimed to examine changes in English and Spanish morphosyntactic standardized scores over time in bilingual children. Method: One hundred bilingual children participated in this longitudinal study. The average age of the children at the beginning of the study was 5;11 (years; months). A subset of the participants was identified as children with developmental language disorder (DLD, n = 43). Children completed behavioral testing in Spanish and English at three time points over a period of 2 years. Growth curve modeling was employed to analyze longitudinal data. Results: Distinct patterns of Spanish and English language growth were observed. While the average standard score in English increased, the average score in Spanish decreased over time for both groups. Children with DLD showed persistent language difficulties in both Spanish and English over time in comparison to their peers. Conclusions: The results of this study provide evidence of a shift in language proficiency from Spanish to English for bilingual children with and without language disorders. This study also shows that bilingual children with DLD show a protracted but parallel growth in morphosyntactic skills in comparison to children without DLD

Few studies have systematically investigated the reading skill profiles of English learners (ELs) in late elementary school, a critical developmental period for language and literacy and the most common grades for initial identification with specific learning disabilities (O'Connor et al., "Learning Disabilities Research & Practice," 28(3), 98-112, 2013). We investigated the reading skill profiles of 331 ELs in 3rd and 4th grades, including ELs with and without risk for dyslexia due to significant deficits in word and pseudo-word reading accuracy and fluency. We utilized latent profile analysis and factor mixture modeling to investigate (1) the nature and distribution of reading skill profiles; (2) whether these profiles were associated with differences in reading comprehension growth across one academic year; and (3) the stability of reading profiles across an academic year. We selected a two-class solution (reading disabled and typically developing) based on model fit indices, theoretical considerations, pattern of results across profile-solutions and time-points, and parameterizations, making the approach stronger and more generalizable. These classes demonstrated clear, consistent differences in performance across reading component skills, with the RD class scoring consistently below the TD class across code-based and meaning-based domains of reading. Across the year, the TD class demonstrated significantly higher patterns of growth in reading comprehension (X[subscript 2] (1) = 206.21, p < 0.001). Class membership was largely stable (97% of participants maintain class membership). These results suggest that ELs with risk for dyslexia demonstrate multiple component skill deficits that may require long-term, comprehensive, intensive interventions to remediate.

OBJECTIVES: To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients. METHODS: Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of the North American Airway Collaborative (NoAAC) and via an online iSGS support community on Facebook. Patient-specific SDH factors included highest educational attainment (self-reported), median household income (matched from home zip code via U.S. Census data), and number of close friends (self-reported) as a measure of social support. Main outcomes of interest were time to disease diagnosis (years from symptom onset), treatment selection (endoscopic dilation [ED] vs cricotracheal resection [CTR] vs endoscopic resection with adjuvant medical therapy [ERMT]), and time to recurrent surgical intervention (number of days from initial surgical procedure) as a surrogate for disease recurrence. RESULTS: The total 810 participants were 98.5% female, 97.2% Caucasian, and had a median age of 50 years (IQR, 43-58). The cohort had a median household income of $62 307 (IQR, $50 345-$79 773), a median of 7 close friends (IQR, 4-10), and 64.7% of patients completed college or graduate school. Education, income, and number of friends were not associated with time to diagnosis via multivariable linear regression modeling. Univariable multinominal logistic regression demonstrated an association between education and income for selecting ED versus ERMT, but no associations were noted for CTR. No associations were noted for time to recurrent surgical procedure via Kaplan Meier modeling and Cox proportional hazards regression. CONCLUSIONS: Patient education, income, and social support were not associated with time to diagnosis or time to disease recurrence. This suggests additional patient, procedure, or disease-specific factors contribute to the observed variations in iSGS surgical outcomes.

Background: Research on academic development has mainly focused on early time periods with less attention on individual differences in development in the later school years. Methods: To improve our knowledge of how students develop academically during later school years, this study used a multivariate growth model to investigate the developmental trajectories of literacy and math skills in a sample of Australian students in fifth through ninth grades (n = 114). Results: Students progressed at greater average rates in math from primary to secondary school than in literacy. Both literacy and math skills showed significant individual differences in growth rate at Grade 9. There was no evidence of an association between change in math and change in literacy. Primary school socioeconomic status was not a statistically significant predictor of inter-individual differences in the development of either literacy or math. Conclusions: These results, taken together, suggest that both domain-general and domain-specific influences act on the development of these academic skills.

We evaluate the direct and inferential mediation (DIME) model for reading comprehension with a sample of struggling readers in Grades 3 to 5 (N = 364) in the context of a large-scale randomized controlled trial (RCT) investigating two theoretically distinct reading interventions (text processing + foundational skills [n = 117] or text processing only [n = 120]) and a control condition (n = 127). We investigate whether the intervention affects not just reading comprehension levels, but also how variables within the reading system interrelate. This approach allows the focus to shift from intervention as influencing a change in reading comprehension status to a complex set of processes. We fit structural equation models (SEMs) to evaluate the DIME model at baseline and a change model that included reading comprehension and word reading at posttest. There were no significant mean differences between groups in reading comprehension. However, significant differences emerged on the direct and indirect effects of background knowledge, vocabulary, word reading, strategies, and inferencing on comprehension across grade levels and treatment conditions. Related to treatment groups, background knowledge, vocabulary, and inferencing were significantly related to comprehension at posttest for students who received text processing and/or foundational skills interventions. The results have implications for the direct instruction of higher-order reading skills in the context of multicomponent interventions.

Purpose: This study examined the relationship between utterance length, syntactic complexity, and the probability of making an error at the utterance level. Method: The participants in this study included 830 Spanish-speaking first graders who were learning English at school. Story retells in both Spanish and English were collected from all children. Generalized mixed linear models were used to examine within-child and between-children effects of utterance length and subordination on the probability of making an error at the utterance level. Results: The relationship between utterance length and grammaticality was found to differ by error type (omission vs. commission), language (Spanish vs. English), and level of analysis (within-child vs. between-children). For errors of commission, the probability of making an error increased as a child produced utterances that were longer relative to their average utterance length (within-child effect). Contrastively, for errors of omission, the probability of making an error decreased when a child produced utterances that were longer relative to their average utterance length (within-child effect). In English, a child who produced utterances that were, on average, longer than the average utterance length for all children produced more errors of commission and fewer errors of omission (between-children effect). This between-children effect was similar in Spanish for errors of commission but nonsignificant for errors of omission. For both error types, the within-child effects of utterance length were moderated by the use of subordination. Conclusion: The relationship between utterance length and grammaticality is complex and varies by error type, language, and whether the frame of reference is the child's own language (within-child effect) or the language of other children (between-children effect).

General academic words are those which are typically learned through exposure to school texts and occur across disciplines. We examined academic vocabulary assessment data from a group of English-speaking middle school students (N = 1,747). We tested how word frequency, complexity, proximity, polysemy, and diversity related to students' knowledge of target words across ability levels. Our results affirm the strong relation between vocabulary and reading at the individual level. Strong readers were more likely to know the meanings of words than struggling readers were, regardless of the features of the academic words tested. Words with more meanings were easier for all students, on average. The relation between word frequency and item difficulty was stronger among better readers, whereas the relation between word complexity and item difficulty was stronger among less proficient readers. Our examination of academic words' characteristics and how these characteristics relate to word difficulty across reading performance has implications for instruction.

Few studies have systematically investigated the reading skill profiles of English Learners (ELs) in late elementary school, a critical developmental period for language and literacy and the most common grades for initial identification with specific learning disabilities (O'Connor et al., "Learning Disabilities Research & Practice," 28(3), 98-112, 2013). We investigated the reading skill profiles of 331 ELs in 3rd and 4th grades, including ELs with and without risk for dyslexia due to significant deficits in word and pseudo-word reading accuracy and fluency. We utilized latent profile analysis and factor mixture modeling to investigate: (1) the nature and distribution of reading skill profiles; (2) whether these profiles were associated with differences in reading comprehension growth across one academic year; and (3) the stability of reading profiles across an academic year. We selected a two class solution (reading disabled and typically developing) based on model fit indices, theoretical considerations, pattern of results across profile-solutions and time-points, and parameterizations, making the approach stronger and more generalizable. These classes demonstrated clear, consistent differences in performance across reading component skills, with the RD class scoring consistently below the TD class across code-based and meaning-based domains of reading. Across the year, the TD class demonstrated significantly higher patterns of growth in reading comprehension (X[superscript 2] (1) = 206.21, p < 0.001). Class membership was largely stable (97% of participants maintain class membership). These results suggest that ELs with risk for dyslexia demonstrate multiple component skill deficits that may require long-term, comprehensive, intensive interventions to remediate. [This article was published in "Annals of Dyslexia" (EJ1338377).]