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Purpose: Unlike traditional implicit approaches used to improve grammatical forms used by children with developmental language disorder, explicit instruction aims to make the learner consciously aware of the underlying language pattern. In this study, we compared the efficacy of an explicit approach to an implicit approach when teaching 3 novel grammatical forms varying in linguistic complexity. Method: The study included twenty-five 5- to 8-year-old children with developmental language disorder, 13 of whom were randomized to receive an implicit-only (I-O) intervention whereas the remaining 12 participants were randomized to receive a combined explicit-implicit (E-I) intervention to learn 3 novel grammatical forms. On average, participants completed 4.5 teaching sessions for each form across 9 days. Acquisition was assessed during each teaching session. Approximately 9 days posttreatment for each form, participants completed probes to assess maintenance and generalization. Results: Analyses revealed a meaningful and statistically significant learning advantage for the E-I group on acquisition, maintenance, and generalization measures when performance was collapsed across the 3 novel targets (p < 0.02, [phi]s > 0.60). Significant differences between the groups, with the E-I group outperforming the I-O group, only emerged for 1 of the 3 target forms. However, all effect sizes ranged from medium to large ([phi]s = 0.25-0.76), and relative risk calculations all exceeded 0, indicating a greater likelihood of learning the target form with E-I instruction than I-O instruction. Conclusions: Study findings indicate that, as compared to implicit instruction, children are more likely to acquire, maintain, and generalize novel grammatical forms when taught with explicit instruction. Further research is needed to evaluate the use of explicit instruction when teaching true grammatical forms to children with language impairment.

Indirect answers are a common type of non-literal language that do not provide an explicit “yes” or “no” to a question (e.g., “I have to work late” indirectly answered “Are you going to the party?” with a negative response). In the current study, we examined the developmental trajectory of comprehension of indirect answers among 5- to 10-year-old children with typical development. Forty-eight children, 23 boys and 25 girls, between the ages of 5 years; 0 months and 10 years; 11 months ( M  = 8;2,  SD  = 19.77 months) completed an experimental task to judge whether a verbally presented indirect answer meant yes or no (Comprehension Task) and then explain their choice (Explanation Task). Responses were scored for accuracy and coded for error analysis. On the Comprehension Task, the 5- to 8-year-olds performed with approximately 85% accuracy, while the 9- and 10-year-olds achieved 95% accuracy. On the Explanation Task, the cross-sectional trajectory revealed three stages: the 5- and 6-year-olds adequately explained indirect answers 32% of the time, the 7- and 8-year-olds performed significantly higher at 55%, and the 9- and 10-year-olds made significant gains than the younger children at 66%. Error analysis revealed that when children fail to interpret speaker intentions appropriately, they repeat the speaker’s utterance or provide an insufficient explanation 80% of the time. Other responses, such as those irrelevant to the context, indicating “I don’t know” or no response, or that were made-up interpretations each accounted for 2%-10% of total inadequate explanations. Study findings indicate discrepancies between task performances and offer two separate sets of baseline data for future comparisons that investigate comprehension or explanation of indirect answers by children with different cultural and linguistic backgrounds and by those with varying cognitive and language profiles.

The aim of this study was to better understand current grammatical intervention approaches. Despite grammatical language being a common weakness among children with language impairment, relatively little is known about current grammatical intervention practices of speech-language pathologists (SLPs). Such information is needed to guide the development and evaluation of grammatical interventions and to identify areas in which the current practice is not empirically supported. Participants included 338 SLPs working primarily with children. Participants completed an online survey regarding their implementation of nine different grammatical intervention components, including goals, procedures, dosage, agents, contexts, goal attack strategies, service delivery models, activities, and outcome measurements. Participants also indicated how they would alter the intervention setting and dosage if resources were unlimited. We grouped participants based on the ages of children that represent the largest percentage of their caseload resulting in an early education group (n = 114) and an elementary group (n = 224). We aggregated responses from each question to gain an estimate of current implementation practices associated with each intervention component queried. This study provides general guidelines of current clinical practices to help guide research on grammatical interventions for children and to promote successful translation and implementations of evidence-based treatment approaches. Results may also help clinicians and researchers better understand misalignments between empirically supported intervention approaches and current approaches for treating grammatical weaknesses.

Purpose: In this study, the authors examined the expressive language abilities of a subset of highly verbally expressive adolescents and young adults with Down syndrome (DS) and those with fragile X syndrome (FXS) for evidence of syndrome-related differences. FXS gender differences were also examined in an exploratory fashion. Method: The authors evaluated 24 adolescents and young adults with DS, 17 adolescents and young adults with FXS, and 21 children with typical development (TD), with the groups matched on nonverbal mental age. Language ability was examined using the Oral and Written Language Scales (OWLS; Carrow-Woolfolk, 1995) and Developmental Sentence Scoring (DSS; Lee, 1974) scores derived from an oral narrative language sample. Results: Study analyses revealed the following group differences: The FXS group outperformed the DS and TD groups on the OWLS measure; the TD group outperformed both other groups on some of the DSS measures; the FXS group outperformed the DS group on the DSS Sentence Point measure; and females with FXS outperformed males with FXS on several measures. Conclusions: Results contribute to the ongoing construction of the language phenotypes of individuals with DS and individuals with FXS and support the conclusion that there are quantitative rather than qualitative differences in their expressive language profiles.

Purpose: Conducting in-depth grammatical analyses based on language samples can be time consuming. Developmental Sentence Scoring (DSS) and the Index of Productive Syntax (IPSyn) analyses provide detailed information regarding the grammatical profiles of children and can be conducted using free computer-based software. Here, we provide a tutorial to support clinicians' use of computer-based analyses to aid diagnosis and develop and monitor treatment goals. Method: We analyzed language samples of a 5-year-old with developmental language disorder and an adolescent with Down syndrome using computer-based software, Computerized Language Analysis. We focused on DSS and IPSyn analyses. The tutorial includes step-by-step procedures for conducting the analyses. We also illustrate how the analyses may be used to assist in diagnosis, develop treatment goals focused on grammatical targets, and monitor progress on these treatment goals. Conclusion: Clinicians should consider using Computerized Language Analysis's IPSyn and DSS analyses to support grammatical language assessments used to aid diagnosis, develop treatment goals, and monitor progress on these treatment goals.

Purpose: Previous investigations reveal that children with attention-deficit/hyperactivity disorder (ADHD) produce elevated rates of linguistic mazes (i.e., filled pauses, repetitions, revisions, and/or abandoned utterances) in expressive language samples (Redmond, 2004). The current study aimed to better understand maze use of children and adolescents with ADHD with a focus on the specific maze types produced in different language sampling contexts based on the Autism Diagnostic Observation Schedule (ADOS-2; Lord et al., 2012). Method: Participants included twenty-five 4- to 13-year-olds with a confirmed diagnosis of ADHD. Each participant completed the ADOS to provide narrative and conversational language samples. Research assistants transcribed at least 100 utterances from the ADOS using Systematic Analysis of Language Transcripts (Miller & Chapman, 2000) conventions. Dependent variables included the rates of repetitions, revisions, filled pauses, content mazes (Thordardottir & Ellis Weismer, 2002), and stalls (Rispoli, 2003; Rispoli, Hadley, & Holt, 2008) produced in narrative and conversational portions of the ADOS. Results: In the full sample, participants produced a significantly greater rate of revisions than filled pauses (p = 0.01) and repetitions (p < 0.01). Participants also produced a significantly lower rate of filled pauses than content mazes (p < 0.01). Across contexts, participants produced a higher rate of filled pauses in conversational versus narrative contexts. Age was positively correlated with revisions and content mazes. Mean length of utterance was positively correlated with revisions, repetitions, and context mazes. Expressive language ability was positively correlated with filled pauses and stalls. Conclusion: The children and adolescents in our sample demonstrated a unique profile of maze use. Sampling context had a limited influence on maze use, whereas maze use was impacted by age, mean length of utterance, and expressive language ability. Study findings highlight the importance of analyzing maze types separately rather than as a single category.

Purpose: Caregiver-implemented interventions are frequently used to support the early communication of young children with language impairment. Although there are numerous studies and meta-analyses supporting their use, there is a need to better understand the intervention approaches and identify potential gaps in the research base. With that premise, we conducted a scoping review to synthesize existing data with an end goal of informing future research directions. Method: We identified relevant studies by comprehensively searching four databases. After deduplication, we screened 5,703 studies. We required included studies (N = 59) to evaluate caregiver-implemented communication interventions and include at least one caregiver communication outcome measure. We extracted information related to the (a) study, child, and caregiver characteristics; (b) intervention components (e.g., strategies taught, delivery method and format, and dosage); and (c) caregiver and child outcome measures (e.g., type, quality, and level of evidence). Results: We synthesized results by age group of the child participants. There were no studies with children in the prenatal through 11-month-old age range identified in our review that yielded a caregiver language outcome measure with promising or compelling evidence. For the 12- through 23-month group, there were seven studies, which included eight communication intervention groups; for the 24- through 35-month group, there were 21 studies, which included 26 intervention groups; and for the 36- through 48-month group, there were 21 studies, which included 23 intervention groups. Across studies and age groups, there was considerable variability in the reporting of study characteristics, intervention approaches, and outcome measures. Conclusion: Our scoping review highlights important research gaps and inconsistencies in study reporting that should be addressed in future investigations.

Purpose: When breakdowns in communication occur, children may request a repair to increase understanding of the message. Unrepaired communication breakdowns may cause confusions, limit conversational exchanges, and restrict children's learning opportunities. Relatively little is known regarding the conditions under which children produce repair requests. Thus, this study examined the verbal communication repair requests produced by typically developing children and evaluated the relationship between children's repair requests and performance on a theory of mind task. Method: Participants included 25 typically developing 4-year-old children who completed standardized, norm-referenced assessments of their expressive language, receptive language, and IQ; a theory of mind task; and a shared book reading task. In the shared book reading task, the examiner elicited child repair requests using questions and statements that contained insufficient information. Results: Participants produced a statistically significant greater number of repair requests when presented with questions with insufficient information compared to statements with insufficient information (p < 0.001). There were no differences in total repair requests between participants who passed or failed the theory of mind task (p = 0.45). Conclusion: Among preschool-age children, the shared book reading task provided a naturalistic medium that facilitated the examination of children's repair requests. Results from this study provide baseline information to which the repair requests produced by other populations, such as children with autism spectrum disorder, can be compared.

Purpose: To gain a better understanding of language abilities, the expressive macrostructural narrative language abilities of verbally expressive adolescents and young adults with Down syndrome (DS) and those with fragile X syndrome (FXS) were examined. Method: The authors evaluated 24 adolescents and young adults with DS, 12 male adolescents and young adults with FXS, and 21 younger children with typical development (TD). Narrative samples were assessed at the macrostructural level using the narrative scoring scheme (Heilmann, Miller, Nockerts, & Dunaway, 2010). Three group comparisons were made using (a) the full sample matched on nonverbal mental age, (b) a subset of the participants individually matched on nonverbal mental age, and (c) a subset of participants individually matched on mean length of utterance. Results: Study analyses revealed that the DS and FXS groups significantly outperformed the TD group on a limited number of narrative scoring scheme measures. No significant differences emerged between the DS and FXS groups. Conclusions: The study's results suggest that some aspects of macrostructural narrative language may be relative strengths for adolescents and young adults with DS and those with FXS. These results can be used to create more nuanced and informed approaches to assessment and intervention for these populations. (Contains 1 figure and 4 tables.)

Parents play an important role in creating home language environments that promote language development. A nonequivalent group design was used to evaluate the effectiveness of a community-based implementation of LENA Start™, a parent-training program aimed at increasing the quantity of adult words (AWC) and conversational turns (CT). Parent-child dyads participated in LENA Start™ (n = 39) or a generic parent education program (n = 17). Overall, attendance and engagement in the LENA StartTM program were high: 72% of participants met criteria to graduate from the program. Within-subject gains were positive for LENA Start™ families. Comparison families declined on these measures. However, both effects were non-significant. Between-group analyses revealed small to medium-sized effects favoring LENA Start™ and these were significant for child vocalizations (CV) and CT but not AWC. These results provide preliminary evidence that programs like LENA StartTM can be embedded in community-based settings to promote quality parent-child language interactions.