Ow the mean) were considered to have a language disorder. Many children EXEL-2880 solubility identified by this criterion had not been identified by caregivers or professionals as having language difficulties. Nevertheless, a follow-up in adolescence confirmed that children identified this way often had persistent problems [60]. 14. When using standardized tests, a staged approach to language assessment is efficient, with an initial age-appropriate instrument that taxes a range of receptive and expressive skills (e.g. tests involving narrative retelling and/or sentence repetition), to give an indication of the nature and severity of impairment, followed by more specific assessments as necessary. Supplementary comment: There are many components to language, but it is seldom feasible to evaluate all of them in an initial assessment, even if suitable instruments are available. An initial assessment should suggest hypotheses about factors that lead to language impairment, which can then be assessed with more specific measures. Evaluation of component skills can be conducted alongside intervention and be informed by response to intervention. N.B. Pragmatic difficulties, which are difficult to assess using traditional assessments, are specifically considered in item 19, below. 15. There is no distinctive language profile associated with social disadvantage. Supplementary comment: Language development will be influenced by social and linguistic environment as well as by biological differences between children (e.g. due to genetic and prenatal influences). Attempts have been made to distinguish between social and other causes of language difficulties using the child’s profile of language skills. Some panel members noted that an uneven, ‘spiky’ profile of skills is sometimes equated with language disorder, whereas a more even pattern corresponds to language delay, which is assumed to be due to inadequate language experience. However, there is no supporting evidence for this approach. A second view is that social and non-social factors are associated with order JNJ-54781532 different types of language difficulty. There is some research showing that measures of learned knowledge, e.g., vocabulary, are more sensitive to social disadvantage than measures that reflect language processing, such as nonword repetition [61,62]. However, these trends do not provide an adequate basis for categorising individual children as having social vs. non-social causes of language difficulties. In practice, it is over-simplistic to treat these as alternative explanations for language difficulties, as both social and non-social risk factors often co-occur and may interact [63].PLOS ONE | DOI:10.1371/journal.pone.0158753 July 8,12 /Identifying Language Impairments in Children16. Aspects of language impairment that are relatively uninfluenced by social and cultural background are nonword repetition, sentence repetition, and production of grammatical inflections marking verb tense. Some studies have found these to give good agreement with clinical diagnosis of language impairment, at least for children whose main difficulties are with language form, rather than content or use. Supplementary comments: A body of work on ‘markers’ for language impairment has identified these particular aspects of language as promising for identifying children with language difficulties [64,65,66,67]. Both nonword repetition and aspects of grammatical inflection production have been shown to have strong genetic influence, and also.Ow the mean) were considered to have a language disorder. Many children identified by this criterion had not been identified by caregivers or professionals as having language difficulties. Nevertheless, a follow-up in adolescence confirmed that children identified this way often had persistent problems [60]. 14. When using standardized tests, a staged approach to language assessment is efficient, with an initial age-appropriate instrument that taxes a range of receptive and expressive skills (e.g. tests involving narrative retelling and/or sentence repetition), to give an indication of the nature and severity of impairment, followed by more specific assessments as necessary. Supplementary comment: There are many components to language, but it is seldom feasible to evaluate all of them in an initial assessment, even if suitable instruments are available. An initial assessment should suggest hypotheses about factors that lead to language impairment, which can then be assessed with more specific measures. Evaluation of component skills can be conducted alongside intervention and be informed by response to intervention. N.B. Pragmatic difficulties, which are difficult to assess using traditional assessments, are specifically considered in item 19, below. 15. There is no distinctive language profile associated with social disadvantage. Supplementary comment: Language development will be influenced by social and linguistic environment as well as by biological differences between children (e.g. due to genetic and prenatal influences). Attempts have been made to distinguish between social and other causes of language difficulties using the child’s profile of language skills. Some panel members noted that an uneven, ‘spiky’ profile of skills is sometimes equated with language disorder, whereas a more even pattern corresponds to language delay, which is assumed to be due to inadequate language experience. However, there is no supporting evidence for this approach. A second view is that social and non-social factors are associated with different types of language difficulty. There is some research showing that measures of learned knowledge, e.g., vocabulary, are more sensitive to social disadvantage than measures that reflect language processing, such as nonword repetition [61,62]. However, these trends do not provide an adequate basis for categorising individual children as having social vs. non-social causes of language difficulties. In practice, it is over-simplistic to treat these as alternative explanations for language difficulties, as both social and non-social risk factors often co-occur and may interact [63].PLOS ONE | DOI:10.1371/journal.pone.0158753 July 8,12 /Identifying Language Impairments in Children16. Aspects of language impairment that are relatively uninfluenced by social and cultural background are nonword repetition, sentence repetition, and production of grammatical inflections marking verb tense. Some studies have found these to give good agreement with clinical diagnosis of language impairment, at least for children whose main difficulties are with language form, rather than content or use. Supplementary comments: A body of work on ‘markers’ for language impairment has identified these particular aspects of language as promising for identifying children with language difficulties [64,65,66,67]. Both nonword repetition and aspects of grammatical inflection production have been shown to have strong genetic influence, and also.