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Specific Language Impairment and Early Second Language Acquisition: The Risk of Over- and Underdiagnosis

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Abstract

Child and family risk factors of Specific Language Impairment (SLI), including delayed mastery of early language milestones and family history of language impairment, have been found to affect more SLI children than typically developing (TD) children. However, little to no research has examined whether prevalence differs between monolingual and early second language (eL2) learners. Furthermore, the degree of misdiagnosis in clinical settings is unknown as well as whether monolingual and eL2 children differ in the proportion of over- and underdiagnosis. The present study compared both language groups regarding the prevalence of risk factors and (mis)diagnosis as SLI. The sample included 92 monolingual (69 TD, 23 SLI) and 74 eL2 children (55 TD, 19 SLI), aged 5–8 years, and their parents. Prevalence of child/family risk factors was assessed via parental questionnaire; misdiagnosis was calculated by comparing children’s identification as (non)SLI via a standardized test with their clinical diagnosis. Except for dyslexia/dysgraphia, the rate of child and family risk factors was the same in both language groups, correctly identifying up to half of the SLI children. Correlation analyses between SLI-identification and clinical diagnosis indicated a moderate positive association. The rates of misdiagnosis in monolingual and eL2 children varied, with underdiagnosis being more frequent than overdiagnosis across groups. Moreover, the rate of overdiagnosis was marginally higher for eL2 children than for monolinguals. Summarizing, correct clinical diagnosis as SLI is difficult in both monolinguals and in eL2 learners; a correct diagnosis as unimpaired is especially challenging in eL2 children. Our results suggest that complementing standardized language assessments with parental information helps to reduce the rate of misdiagnosis in both types of learners.

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Notes

  1. Note that throughout this paper the term ‘diagnosis’ is used to refer to the procedure of clinically assessing a child’s language status as SLI or as TD, and is not restricted to the diagnosis of a disorder.

  2. The Project MILA (The role of migration background and language impairment in children’s language achievement; PI: P. Schulz) is part of the Research Centre IDeA. For more information, see Grimm and Schulz (2012) and www.idea-frankfurt.eu. The design of the project is approved by the ethics committee of the German Psychological Association (DGPs).

  3. In the monolingual-SLI group, 15 children scored below T = 40 in two subscales, six in three subscales, one in four subscales and one in six subscales. In the eL2-SLI group, six children scored below T = 40 in two subscales, seven in three subscales, one in four subscales, two in five subscales, two in six subscales, and one child in seven subscales of LiSe-DaZ.

  4. Recall that here diagnosis is not used in the medical sense of diagnosing a disorder, but simply as a result of a diagnostic procedure.

References

  • Armon-Lotem, S. (2010). Instructive bilingualism: can bilingual children with SLI rely on one language in learning a second one? Applied Psycholinguistics, 31(2), 29–36.

    Article  Google Scholar 

  • Armon-Lotem, S. (2012). Specific language impairment in bilingual children. Bilingualism: Language and Cognition, 15(1), 1–4.

    Article  Google Scholar 

  • Bahr, R. (2007). Wer besucht die Förderschule mit dem Förderschwerpunkt Sprache? Analyse eines Einschulungsjahrganges. In U. de Langen-Müller & V. Maihack (Eds.), Früh genug—aber wie? Sprachförderung per Erlass oder Sprachtherapie auf Rezept? Tagungsbericht vom 8. wissenschaftlichen Symposium des Deutschen Bundesverbandes der akademischen Sprachtherapeuten (pp. 34–46). Köln: ProLog.

    Google Scholar 

  • Bishop, D. V. M. (2000). Pragmatic language impairment: A correlate of SLI, a distinct subgroup, or part of the autistic continuum? In D. V. M. Bishop & L. B. Leonard (Eds.), Speech and language impairments in children: Causes, characteristics, intervention, and outcome (pp. 99–113). East Sussex: Psychology Press.

    Google Scholar 

  • Bishop, D. V. M., & Edmundson, A. (1987). Language-impaired 4-year-olds. Distinguishing transient from persistent impairment. Journal of Speech and Hearing Disorders, 52, 156–173.

    Article  Google Scholar 

  • Bishop, D. V., North, T., & Donlan, C. (1995). Genetic basis of specific language impairment: evidence from a twin study. Developmental Medicine and Child Neurology, 37(1), 56–71.

    Article  Google Scholar 

  • Bishop, D. V. M., Price, T. S., Dale, P. S., & Plomin, R. (2003). Outcomes of early language delay: II. Etiology of transient and persistent language difficulties. Journal of Speech, Language, and Hearing Research, 46, 561–575.

    Article  Google Scholar 

  • Botting, N., Conti-Ramsden, G., & Crutchley, A. (1997). Concordance between teacher/therapist opinion and formal language assessment scores in children with language impairment. European Journal of Disorders of Communication, 32, 317–327.

    Article  Google Scholar 

  • Cattell, R. B., Weiss, R. H., & Osterland, J. (1997). Grundintelligenztest Skala 1 (CFT 1). Göttingen: Hogrefe.

    Google Scholar 

  • Choudhury, N., & Benasich, A. A. (2003). A family aggregation study: the influence of family history and other risk factors on language development. Journal of Speech, Language, and Hearing Research, 46, 261–272.

    Article  Google Scholar 

  • Conti-Ramsden, G. (2008). Heterogenity of specific language impairment in adolescent outcomes. In C. F. Norbury, J. B. Tomblin, & D. V. M. Bishop (Eds.), Understanding developmental language disorders: From theory to practice (pp. 117–130). Hove: Psychological Press.

    Google Scholar 

  • Conti-Ramsden, G., & Durkin, K. (2012). Language development and assessment in the preschool period. Neuropsychology Review, 22, 384–401.

    Article  Google Scholar 

  • Crutchley, A. (1999). Bilingual children with SLI attending language units: getting the bigger picture. Child Language Teaching and Therapy, 15, 201–217.

    Article  Google Scholar 

  • Crutchley, A., Botting, N., & Conti-Ramsden, G. (1997a). Bilingualism and specific language impairment in children attending language units. European Journal of Disorders of Communication, 32, 226–236.

    Article  Google Scholar 

  • Crutchley, A., Conti-Ramsden, G., & Botting, N. (1997b). Bilingual children with specific language impairment and standardized assessments: preliminary findings from a study of children in language units. International Journal of Bilingualism, 1, 117–134.

    Google Scholar 

  • Dale, P. S., Simonoff, E., Bishop, D. V. M., Eley, T. C., Oliver, B., Price, T. S., Purcell, S., Stevenson, J., & Plomin, R. (1998). Genetic influence on language delay in two-year-old children. Nature Neuroscience, 1, 324–328.

    Article  Google Scholar 

  • Dale, P. S., Price, T. S., Bishop, D. V. M., & Plomin, R. (2003). Outcomes of early language delay. I. Predicting persistent and transient language difficulties at 3 and 4 years. Journal of Speech, Language, and Hearing Research, 46, 544–560.

    Article  Google Scholar 

  • De Jong, J., Çavus, N., & Baker, A. (2010). Language impairment in Turkish-Dutch bilingual children. In S. Topbaş & M. Yavas (Eds.), Communication Disorders in Turkish in monolingual and multilingual settings (pp. 288–300). Clevedon: Multilingual Matters.

    Google Scholar 

  • Dockrell, J. E., & Messer, D. J. (2004). Lexical Acquisition in the early school years. In R. A. Berman (Ed.), Language development across childhood and adolescence (pp. 35–52). Amsterdam: John Benjamins Publishing.

    Chapter  Google Scholar 

  • Dollaghan, C. A., & Horner, E. A. (2011). Bilingual language assessment: a meta-analysis of diagnostic accuracy. Journal of Speech, Language, and Hearing Research, 54, 1077–1088.

    Article  Google Scholar 

  • Ellis Weismer, S. (1993). Perceptual and cognitive deficits in children with specific language impairment: Implications for diagnosis and intervention. In H. Grimm & H. Skowronek (Eds.), Language acquisition problems and reading disorders: Aspects of diagnosis and intervention (pp. 75–101). Berlin: de Gruyter.

    Google Scholar 

  • Friedmann, N., & Novogrodsky, R. (2008). Subtypes of SLI: SySLI, PhoSLI, LeSLI and PraSLI. In A. Gavarró & M. J. Freitas (Eds.), Language acquisition and development (pp. 205–217). Newcastle: Cambridge Scholars Press.

    Google Scholar 

  • Genesee, F., Paradis, J., & Crago, M. (2004). Dual language development and disorders: A Handbook on bilingualism and second language learning. Baltimore: Brookes.

    Google Scholar 

  • Grimm, H. (2003). Störungen der Sprachentwicklung. Göttingen: Hogrefe.

    Google Scholar 

  • Grimm, A., & Schulz, P. (2012). Das Sprachverstehen bei frühen Zweitsprachlernern: Erste Ergebnisse der kombinierten Längs- und Querschnittstudie MILA. In B. Ahrenholz (Ed.), Einblicke in die Zweitspracherwerbsforschung und ihre methodischen Verfahren. Reihe DaZ-Forschung. Deutsch als Zweitsprache, Mehrsprachigkeit und Migration (pp. 195–218). Berlin: De Gruyter.

  • Håkansson, G., Salameh, E., & Nettelbladt, U. (2003). Measuring language development in bilinugual children: Swedish-Arabic children with and without language impairment. Linguistics, 41, 255–288.

    Article  Google Scholar 

  • Horwitz, S. M., Irwin, J. R., Briggs-Gowan, M., Bosson Heenan, J. M., Mendoza, J., & Carter, A. (2003). Language delay in a community cohort of young children. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 932–940.

    Article  Google Scholar 

  • Hyltenstam, K. (1992). Non-native features of near-native speakers. On ultimate attainment of childhood L2 learners. In R. J. Harris (Ed.), Cognitive processing in bilinguals (= Advances in Psychology 83) (pp. 351–368). Amsterdam: Benjamins.

    Chapter  Google Scholar 

  • Kayser, H. (1995). Bilingual speech-language pathology: An Hispanic focus. San Diego: Singular.

    Google Scholar 

  • Leonard, L. (1998). Children with specific language impairment. Cambridge: MIT Press.

    Google Scholar 

  • Lyytinen, H., Ahonen, T., Eklund, K., Guttorm, T. K., Laakso, M.-L., Leinonen, S., Leppänen, P. H., Lyytinen, P., Poikkdeus, A.-M., Puolakanaho, A., Richardson, U., & Viholainen, H. (2001). Developmental pathways of children with and without familial risk for dyslexia during the first years of life. Developmental Neuropsychology, 20, 535–554.

    Article  Google Scholar 

  • Marinis, T., & Özge, D. (2010). Measuring the language abilities of Turkish-English bilingual children using TELD-3. In S. Topbaş & M. Yavas (Eds.), Communication disorders in Turkish, Communication disorders across languages (pp. 303–314). Clevedon: Multilingual Matters.

    Google Scholar 

  • Meisel, J. (2009). Second language acquisition in early childhood. Zeitschrift für Sprachwissenschaft, 28, 5–34.

    Google Scholar 

  • Melchers, P., & Preuß, U. (2003). Kaufman-assessment battery for children: K-ABC. Amsterdam: Swets & Zeitlinger.

    Google Scholar 

  • Montrul, S. (2008). Incomplete acquisition in bilingualism. Re-examining the age factor. [Series on Studies in Bilingualism]. Amsterdam: John Benjamins.

    Book  Google Scholar 

  • Paradis, J. (2005). Grammatical morphology in children learning English as a second language: implications of similarities with Specific Language Impairment. Language, Speech and Hearing Services in the Schools, 36, 172–187.

    Article  Google Scholar 

  • Paradis, J. (2007). Bilingual children with specific language impairment: theoretical and applied issues. Applied Psycholinguistics, 28, 512–564.

    Article  Google Scholar 

  • Paradis, J. (2008). Tense as a clinical marker in English L2 acquisition with language delay/impairment. In E. Gavruseva & B. Haznedar (Eds.), Current trends in child second language acquisition: A generative perspective (pp. 337–356). Amsterdam: John Benjamins.

    Chapter  Google Scholar 

  • Paradis, J. (2010). The interface between bilingual development and specific language impairment. Keynote article for special issue with peer commentaries. Applied Psycholinguistics, 31, 3–28.

    Google Scholar 

  • Paradis, J., Crago, M., Genesee, F., & Rice, M. (2003). French-English bilingual children with SLI: how do they compare with their monolingual peers? Journal of Speech, Language, and Hearing Research, 46, 113–127.

    Article  Google Scholar 

  • Paradis, J., Emmerzael, K., & Sorenson Duncan, T. (2010). Assessment of English language learners: using parent report on first language development. Journal of Communication Disorders, 43, 474–497.

    Article  Google Scholar 

  • Penner, Z., Schulz, P., & Wymann, K. (2003). Learning the meaning of verbs: what distinguishes language impaired from normally developing children? Linguistics, 41(2), 289–319.

    Article  Google Scholar 

  • Pennington, B. F. (1991). Diagnosing learning disorders: A neuropsychological framework. New York: Guilford Press.

    Google Scholar 

  • Pennington, B. F., Van Orden, G. C., Smith, S. D., Green, P. A., & Haith, M. M. (1990). Phonological processing skills and deficits in adult dyslexics. Child Development, 61, 1753–1778.

    Article  Google Scholar 

  • Plomin, R., & Dale, P. S. (2000). Genetics and early language development: A UK study of twins. In D. V. M. Bishop & B. E. Leonard (Eds.), Speech and language impairments in children: Causes, characteristics, intervention, and outcome (pp. 35–51). Hove: Psychology Press.

    Google Scholar 

  • Prathanee, B., Thinkhamrop, B., & Dechongkit, S. (2007). Factors associated with Specific Language Impairment and later language development during early life: a literature review. Clinical Pediatrics, 46(1), 22–29.

    Article  Google Scholar 

  • Rescorla, L. (1989). The language development survey. A screening tool for delayed language in toddlers. Journal of Speech and Hearing Disorders, 54, 587–599.

    Article  Google Scholar 

  • Rescorla, L., & Schwartz, E. (1990). Outcomes of toddlers with expressive language delay. Applied Psycholinguistics, 11, 393–407.

    Article  Google Scholar 

  • Restrepo, M. A. (1998). Identifiers of predominantly Spanish-Speaking children with language impairment. Journal of Speech, Language, and Hearing Research, 41, 1398–1411.

    Article  Google Scholar 

  • Restrepo, M. A., & Gutierrez-Clellen, V. F. (2004). Grammatical impairments in Spanish/English-speaking children. In B. Goldstein (Ed.), Bilingual language development and disorders in Spanish-English speakers (pp. 213–134). Baltimore: Paul H. Brookes.

    Google Scholar 

  • Roeper, T. (2012). Minimalism and bilingualism. How and why bilingualism could benefit children with SLI. Bilingualism: Language and Cognition, 15(1), 88–101.

    Article  Google Scholar 

  • Rothweiler, M., Chilla, S., & Clahsen, H. (2012). Subject-verb agreement in specific language impairment: a study of monolingual and bilingual German-speaking children. Bilingualism: Language and Cognition, 15(1), 39–57.

    Article  Google Scholar 

  • Salameh, E.-K., Nettelbladt, U., Håkansson, G., & Gullberg, B. (2002). Language impairment in Swedish bilingual children. A comparison between bilingual and monolingual children. Acta Paediatrica, 9, 229–234.

    Article  Google Scholar 

  • Salameh, E.-K., Håkansson, G., & Nettelbladt, U. (2004). Developmental perspectives on bilingual Swedish-Arabic children with and without language impairment: a longitudinal study. International Journal of Language & Communication Disorders, 39(1), 65–91.

    Article  Google Scholar 

  • Scarborough, H. S. (1990). Index of productive syntax. Applied Psycholinguistics, 11, 1–22.

    Article  Google Scholar 

  • Schulz, P. (2007). Frühdiagnostik: Frühindikatoren und Verfahren zur Früherkennung von Risikokindern. In H. Schöler & A. Welling (Eds.), Sonderpädagogik der Sprache. = J. Borchert & H. Goetze (Eds.). Handbuch der Sonderpädagogik. Band 1 (pp. 688–704). Göttingen: Hogrefe.

  • Schulz, P. (2010). Some notes on semantics and SLI. In A. Castro, J. Costa, M. Lobo, & F. Pratas (Eds.), Language acquisition and development. Proceedings of GALA 2009 (pp. 391–406). Cambridge: Cambridge Scholars Press.

  • Schulz, P. (2013). Wer versteht wann was? Sprachverstehen im frühen Zweitspracherwerb des Deutschen am Beispiel der w-Fragen. In A. Deppermann (Ed.), Das Deutsch der Migranten. Jahrbuch 2012 des Instituts für deutsche Sprache Mannheim (pp. 313–337). Berlin: de Gruyter.

  • Schulz, P., & Roeper, T. (2011). Acquisition of exhaustivity in wh-questions: a semantic dimension of SLI? Lingua, 121(3), 383–407.

  • Schulz, P., & Tracy, R. (2011). Linguistische Sprachstandserhebung—Deutsch als Zweitsprache (LiSe-DaZ). Göttingen: Hogrefe.

  • Schulz, P., Tracy, R., & Wenzel, R. (2008). Linguistische Sprachstandserhebung—Deutsch als Zweitsprache (LiSe-DaZ): Theoretische Grundlagen und erste Ergebnisse. In B. Ahrenholz (Ed.), Zweitspracherwerb. Diagnosen, Verläufe, Voraussetzungen (pp. 17–42). Fillibach: Freiburg im Breisgau.

  • Schwartz, B. D. (2004). Why child L2 acquisition? In J. van Kampen & S. Baauw (Eds.), Proceedings of generative approaches of language acquisition (pp. 47–66). Utrecht: LOT.

    Google Scholar 

  • Schwartz, B. D. (2009). Unraveling inflection in child L2 development. Language, Interaction and Acquisition, 1(1), 63–88.

    Google Scholar 

  • Spitz, R. V., Tallal, P., Flax, J., & Benasich, A. A. (1997). Look who’s talking: a prospective study of familial transmission of language impairments. Journal of Speech and Hearing Research, 40, 990–1001.

    Article  Google Scholar 

  • Tallal, P., Ross, R., & Curtiss, S. (1989). Familial aggregation in specific language impairment. Journal of Speech and Hearing Disorders, 54, 167–173.

    Article  Google Scholar 

  • Thal, D., Reilly, J., Seibert, L., Jeffries, R., & Fenson, J. (2004). Language development in children at risk for language impairment: cross-population comparisons. Brain and Language, 88, 167–179.

    Article  Google Scholar 

  • Tomblin, J. B., Records, N. L., Buckwalter, P. R., Zhang, X., Smith, E., & O’Brien, M. (1997). Prevalence of specific language impairment in kindergarten children. Journal of Speech, Language, and Hearing Research, 40, 1245–1260.

    Article  Google Scholar 

  • Unsworth, S. (2005). Child L2, adult L2, child L1: Differences and similarities. A study on the acquisition of direct object scrambling in Dutch. PhD thesis, Utrecht University.

  • Unsworth, S. (2008). Age and input in the acquisition of grammatical gender in Dutch. Second Language Research, 24, 365–395.

    Article  Google Scholar 

  • van der Lely, H. K. J. (2005). Domain-specific cognitive systems: insight from grammatical specific language impairment. Trends in Cognitive Sciences, 9(2), 53–59.

    Article  Google Scholar 

  • Voet Cornelli, B., Geist, B., Grimm, A., & Schulz, P. (2012). Praktiken der Sprachstandserhebung bei mehrsprachigen Kindern—erste Erkenntnisse aus dem Projekt cammino. In S. Jeuk & J. Schäfer (Eds.), Deutsch als Zweitsprache in Kindertageseinrichtungen und Schulen: Aneignung, Förderung, Unterricht. Beiträge aus dem 7. Workshop Kinder mit Migrationshintergrund (pp. 43–74). Fillibach: Freiburg im Breisgau.

  • Yağmur, K., & Nap-Kolhoff, E. (2010). Aspects of acquisition and disorders in Turkish-Dutch bilingual children. In S. Topbaş & M. Yavaş (Eds.), Communication disorders in Turkish in monolingual and multilingual settings (pp. 269–288). Clevedon: Multilingual Matters.

    Google Scholar 

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Acknowledgments

The research presented here is part of the project MILA and was carried out at the Research Center IDEA, funded by the LOEWE program for excellency from the State of Hesse. We thank Magda Wojtecka and Rabea Schwarze for their help with data collection and analysis, and Judith Dirk and Wolfgang Woerner for statistical support. We also acknowledge the help of the research assistants. We are grateful to the children, their parents and the teachers in kindergartens and in special needs centers for their participation in the study. We thank the two anonymous reviewers for their helpful comments on previous versions of the paper.

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  1. University of Frankfurt and Research Centre IDeA, Frankfurt, Germany

    Angela Grimm & Petra Schulz

  2. FB 10, Institute of Psycholinguistics and Didactics of German, University of Frankfurt/Main, P.O. Box 22, 60629, Frankfurt, Germany

    Angela Grimm & Petra Schulz

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Grimm, A., Schulz, P. Specific Language Impairment and Early Second Language Acquisition: The Risk of Over- and Underdiagnosis. Child Ind Res 7, 821–841 (2014). https://doi.org/10.1007/s12187-013-9230-6

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