SLPNarrative ReviewInternational journal of speech-language pathology2019

Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment.

Ronald B Gillam, James W Montgomery, Julia L Evans and 1 others

PMID 30712388

WHAT IT FOUND

Children with developmental language disorder understood simple subject-object and reversed word-order sentences worse than matched peers.

The model links comprehension to complex working memory, not one single ability. It does not show that training working memory helps.

Key findings

01Children with developmental language disorder had significantly poorer comprehension of both canonical and noncanonical sentences than matched typically-developing peers.

02Children with developmental language disorder performed worse than typically-developing peers on all cognitive measures, with differences described as moderate to moderately-large or large.

03In the best-fitting model, complex working memory mediated the influence of fluid reasoning, controlled attention, and language knowledge in long-term memory on sentence comprehension, and no single cognitive factor alone had a significant direct effect.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The paper summarises a study of children's abilities and a model, but it does not report a new experiment testing whether changing a cognitive skill changes sentence comprehension. The study included children aged 7 to 11, so the findings may not apply to children outside that age range. Most of the cognitive measures used in the study were experimental, and the authors say they would not be appropriate for clinical use. The intervention section describes the SKILL narrative programme and earlier studies, but the authors say a large randomised trial is currently being conducted, so the programme's effects are not established in this paper. The model is based on statistical relationships, and the paper says the working memory training hypothesis can be tested with experimental studies.

Declared interests

The supplied paper lists NIH extramural research support. It does not include an author conflict-of-interest declaration in the text provided.

The easy way to misread this

Do not conclude that training complex working memory will improve sentence comprehension. The paper reports a statistical link between working memory and comprehension, not a tested treatment effect, and it says direct working memory training does not appear to maintain over time or generalise to language.

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The study

Participants
117 children with developmental language disorder and 117 typically-developing children
Certainty of evidence
Low

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Ronald B Gillam, James W Montgomery, Julia L Evans, et al. Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment. International journal of speech-language pathology. 2019.

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