Child Language Disorder: Identification Criteria & Terminology Susan Ellis Weismer, Ph.D. University of Wisconsin-Madison 2019 Symposium on Research in Child Language Disorders

Motivation and Vision You asked for it! SRCLD conference evaluation form feedback Special consideration relative to research Broader context of clinical practice and advocacy (ASHA) Listen to each other’s views No goal of forming recommendation to confirm or counter CATALISE Based on the variation in use of DLD/SLI terms last year and conversations during the conference, mentioned in closing remarks (tweet about it) ASHA convention presentations and ASHA Leader article has addressed this issue, but want to highlight research considerations given the focus of this conference To some extent clinical and advocacy issues intertwined with research – though some have argued in the past that not a problem to use different research terms (Kamhi, 1998, LSHSS)

Panel Presentations Selected 2 of the 6 US researchers involved in CATALISE project Represent differing views on terminology and identification criteria Rhea Paul – historical view of definitions; CATALISE project; outcomes and recommendations Mabel Rice – potential problems with switching terms; research data arguing against extending NVIQ down to 70 Regular SRCLD participants

My Mixed Views Specific Language Impairment is a misnomer Developmental Language Disorder is a descriptive term that is easily understood across contexts Different motivating forces in UK and US - SLI is not clinical label in US so not ‘leaving children out’ clinically Issues of terminology and identification criteria are intertwined Good person to moderate as I have mixed views on this issue Author of poster using term SLI; longitudinal project recruited using traditional criteria including NVIQ 85 On the other hand, created theme using DLD term for a group of submitted oral presentations based on authors use of that term SLI – dropping ‘specific’ seems like good idea; research showing deficits are not confined to linguistic system; Lived with this mischaracterization of the condition for years as an expedient way of referring to a certain subset of children with language disorders that had finally caught hold with NIH, a primary funding agency for research

Important RESEARCH Considerations Rigor and Reproducibility (per NIH) Building on prior literature and making appropriate comparisons Use of the term “Developmental Language Disorder” in the literature Impact of increasing phenotypic heterogeneity Evidence of language/processing differences based on NVIQ

Developmental Language Disorder Study Participant Criteria Richman & Kitchell Hyperlexia as a variant of developmental language disorder, Brain & Language (1981) Tallal, Stark, & Mellits The relationship between auditory temporal analysis and receptive language development: Evidence from studies of developmental language disorder, Neuropsychologica (1985) Broad term for dyslexia & “developmental aphasia” “Developmental dysphasic”; NVIQ 85; receptive AND expressive language deficits; discrepancy criteria

Developmental Language Disorder Study Participant Criteria Preis et al. Corpus callosum size in children with developmental language disorder, Cognitive Brain Research (2000) Meronen et al. Audiovisual speech perception in children with developmental language disorder in degraded listening conditions, JSLHR (2013) Fyfe et al. Mathematical thinking in children with developmental language disorder: The roles of pattern skills and verbal working memory, J Comm Dis (2019) DLD; phonologic-syntactic deficit; NVIQ 85; normal neurological exam DLD; Mean NVIQ=93 (21 DLD had NVIQ >85, 4 had 75-80); Finland schools for severe language disorders DLD: Discuss and use new term but use traditional SLI criteria of NVIQ 85

Important RESEARCH Considerations Rigor and Reproducibility (per NIH) Building on prior literature and making appropriate comparisons Use of the term “Developmental Language Disorder” in the literature Impact of increasing phenotypic heterogeneity Evidence of language/processing differences based on NVIQ -Allowing NVIQ to vary more widely increases the phenotypic heterogeneity of language disorder, which has implications not only for genetic studies but for behavioral studies as well – perhaps with respect to underlying mechanisms, response to intervention and so forth -Norbury+ 2016, J Child Psych Psychiatry – population study provides support for DLD criteria in that no significant differences between children with average range or below-average NVIQ scores in terms of language severity, social, emotional, behavioral problems or educational attainment (only covered first grade) – clinical presentation of language disorder The older Iowa epidemiologic study also included children with SLI and NLI; findings from my own experimental tasks were mixed regarding the role of nonverbal cognition SLI and NLI subgroups performed similarly on verbal processing measures in terms of accuracy, but showed different patterns of correlation with extant language skills on standardized tests and prediction from Grade 2 to Grade 8

Session Format Opening Comments (6 min) 1st Panelist (12 min) 2nd Panelist (12 min) Attendee Participation (50-55 min) Panelists’ closing remarks (5 min)