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Young Adults with Developmental Language Disorder.

Young Adults with Developmental Language Disorder.

Young Adults with Developmental Language Disorder.

 

Young Adults With Developmental Language Disorder: A Systematic Review of Education, Employment, and Independent Living Outcomesinstructions:

  1. Read and analyze the article “Young Adults with Developmental Language Disorder: A Systematic Review of Education, Employment, and Independent Living Outcomes” included in the course documents in Blackboard.
  1. Complete a written reflection about the article in the discussion board, including:
    1. a summary including what you learned from the article,
    2. your opinion on the topic discussed and how it is pertinent to your role as a Speech and Language Pathologist.

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bizu University Miami Campus Master’s Program in Speech-Language Pathology PRSP-657 ADVANCED CLINICAL PRACTCIUM II Discussion Board Rubric Student Name: _________________________________________ Description Excellent (3pts) Points Average (2pt) Participation • Makes a reflection and uses thoughtful, reflective, and respectful feedback on two peers comments. • Either makes a reflection or gives feedback on at least one peer’s comments. Content • The student reflected and provided significant ideas relevant to the issue under discussion. This is indicated by correct use of terminology, precise selection of the pieces of information required to make a point, correct and appropriate use of examples/counterexamples, demonstrations of which distinctions are important to make, and explanations that are concise and to the point. Information and knowledge are accurate. The student elaborates on statements with accurate explanations, reasons, or evidence. The student quotes and cites examples. • Ideas are correct but not concise. • Contributions to the group are generally supported by some facts, examples, analogies, statistics, and so forth, but further support is needed to defend ideas/comments. • Quotes are poorly cited. • • • Interaction with peers • • • The student initiates the dialogue with thoughtful and reflective comments and questions. The student acknowledges the statements of others in a way that builds a communicative exchanges between participants. Replies to others’ are related to their statement(s) and indicate that the student understands. • • • The student attends to the discussion but contributes little new knowledge or ideas. The student’s contributions do not draw away from the discussions. The student participates in the group but does little to involve others or encourage others to think critically. No se cumplió (0 pt.) • Did not post a reflection or give feedback to a peer’s comment(s). • The student does not demonstrate understanding of the content. • The student struggles to provide details or support for ideas. • Ideas/comments are difficult to understand. • The student has difficulty understanding concepts and distinguishing between main ideas and supporting details. • Terminology is used incorrectly. • The student does not contribute to the discussion. • The student’s input is limited (i.e. “I agree”). • Discussion does not take into consideration the ideas/comments of the others’ post; there is little attempt at exchanging of ideas. • • Language • • • • • When disagreeing, the student does it respectfully. The nature of the disagreement is stated and an invitation to respond is extended. The student encourages a variety of points of view. The student uses precise vocabulary and syntax. Words and syntax are purposefully chosen to demonstrate a point. The student uses language that demonstrates the understanding of the topic being discussed. The student defines or clearly explains language or concepts that might be unfamiliar to others; the student knows when such explanations might be necessary. The student demonstrate no grammatical or typographical errors. Timeliness Gives feedback on two peers comments by due date/time. Total Score: ________ / 15 pts • The student uses general vocabulary and tends to express ideas wordily. • The student has some grammatical and/or typographical errors. Gives feedback on one peer’s comments by due date/time. • The student makes irrelevant or distracting statements. • Some comments are unconstructive and noncourteous. • The student makes a personal attack; language might suggest bias toward a group member or others. • The student appears unaware of cultural differences in conducting discussions. • Vocabulary selected are vague, abstract, or trite. • The student frequently has grammatical and/or typographical errors. • Ideas appear disproportionately lengthy and are difficult to follow. Does not submit work or feedback on peer’s comments by the due date/time. JSLHR Review Article Young Adults With Developmental Language Disorder: A Systematic Review of Education, Employment, and Independent Living Outcomes Pascale Dubois,a Marie-Catherine St-Pierre,a,b Chantal Desmarais,a,b and Frédéric Guaya Purpose: Research on developmental language disorder (DLD) in adulthood has increased rapidly in recent years. However, to date, there has been no systematic literature review on this topic, thereby limiting the possibility to have a comprehensive overview of publications in this field. Method: Following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we conducted a systematic literature review. A literature search was undertaken in four databases, from 2005 to 2018. We selected articles with original data related to life outcomes of young adults with and without DLD, all aged between 18 and 34 years, in three life areas: education, employment, and independent living. Methodological characteristics of the studies were analyzed. Results: Fifteen articles were selected with longitudinal designs. In every life area, young adults with DLD were compared to their typically developing peers to identify their strengths and weaknesses. The predictive role of language abilities was also examined. Conclusions: Outcomes within each life area are heterogeneous. Nevertheless, similarly to young children and adolescents, young adults with DLD face numerous challenges. Although language abilities partly predict some of these outcomes, much of the variance remains unaccounted for and some outcomes are unrelated to this predictor. This systematic literature review has implications for researchers and practitioners to identify promising avenues for research, interventions, and policy development. Supplemental Material: https://doi.org/10.23641/asha. 13022552 D Ramsden, 2018). Concurrently, poor literacy is also reported in young adults with DLD (Law et al., 2013, 2009; Schoon et al., 2010b), who experience persistent difficulties in reading accuracy and comprehension (Conti-Ramsden et al., 2018; Johnson et al., 2010). Although language difficulties are at the heart of DLD, associated challenges are also reported in other areas of the person’s life. This systematic review focuses on a difficult period for young adults with DLD (Bishop et al., 2016, 2017): the school-to-work transition. Defined as the passage “from the end of schooling to the first decent or satisfactory employment” (International Labour Organization, 2009, evelopmental language disorder1 (DLD) describes individuals who, in the absence of a known biomedical condition, have language difficulties that are severe enough to create lifelong functional impacts (Bishop et al., 2017). Longitudinal research indicates that children with DLD have pervasive long-term language problems in adulthood, affecting morphology (Lee & Tomblin, 2015), syntax (Winstanley, Durkin, et al., 2018), vocabulary (Beitchman et al., 2008), semantics (Winstanley, Durkin, et al., 2018), and pragmatics (Winstanley, Webb, & Contia Université Laval, Québec City, Québec, Canada Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec City, Québec, Canada b Correspondence to Marie-Catherine St-Pierre: marie-catherine.st-pierre@rea.ulaval.ca Editor-in-Chief: Stephen M. Camarata Editor: Mary Alt Received March 23, 2020 Revision received May 26, 2020 Accepted July 30, 2020 https://doi.org/10.1044/2020_JSLHR-20-00127 3786 1 The term developmental language disorder is the nomenclature recently endorsed by an international panel (Bishop et al., 2017) to refer to a language disorder that is not associated with known biomedical etiology. Thus, in this review article, this term will be used to refer to previous terminologies used in the cited studies, such as specific language impairment or language impairment. Disclosure: The authors have declared that no competing interests existed at the time of publication. Journal of Speech, Language, and Hearing Research • Vol. 63 • 3786–3800 • November 2020 • Copyright © 2020 The Authors This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Downloaded from: https://pubs.asha.org Lymarie Ortiz on 12/30/2021, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions p. 12), for young adults with DLD, this transition implies mastering a wide range of abilities in various areas of life (Mazzotti et al., 2016; Test et al., 2009).

In this review, we focus on three significant areas outlined by the Individuals with Disabilities Education Act (2004), namely, education, employment, and independent living. While these three outcome categories have guided large-scale studies related to postschool success of youth with disabilities, such as the National Longitudinal Transition Study-2 (NLTS2; Newman et al., 2011), none of them offers a thorough portrait of outcomes experienced by students with DLD. Establishing such a comprehensive picture is crucial to guiding speech-language pathology practice, future research, and transition policy development. For example, based on the NLTS2 study, the National Technical Assistance Center on Transition developed a self-assessment tool for schools wishing to analyze their proficiency regarding their transition services, in which they inventoried a list of predictors of postschool success that schools must address (National Technical Assistance Center on Transition, 2019).

Research on young adults with DLD has also started identifying postschool success predictors, including oral and written language abilities that are at the core of this disorder (e.g., Conti-Ramsden et al., 2018; Johnson et al., 2010). In addition, speech-language pathologists (SLPs) have long focused on developing these language skills to enhance the daily life of students with DLD. Nevertheless, no study has reviewed whether these language skills effectively predict the young adulthood outcomes of this population. Moreover, if there is a relationship between language abilities and adulthood characteristics, it would be important to determine whether it is direct or indirect (e.g., mediation effect) in order to better explain the postschool outcomes of this population. Consequently, a more detailed understanding of the predictive role of language would be the first step in developing transition policies that are tailored to the needs of students with DLD. The purpose of this review article is twofold. First, we present a systematic literature review on the outcomes of young adults with DLD in education, employment, and independent living. Second, we examine the predictive role of language abilities for each of these life areas. Method From the original search, after the removal of duplicate entries, she identified 1,507 articles. Study Selection The principal author read and screened the 1,507 abstracts according to the following inclusion criteria:

1. Original data are presented (i.e., studies that only discussed results previously published in other studies were excluded). 2. An outcome is measured in one of the three life areas (i.e., education, employment, or independent living). 3. A longitudinal design, with a control or comparison group, is used. The rationale for including only studies with longitudinal designs was the following. In addition to the fact that longitudinal designs are more rigorous than cross-sectional ones, it allows a more uniform comparison of studies and presentation of the results. 4. Participants are young adults (i.e., aged between 18 and 34 years). 5. The inclusion criteria of each study are detailed. 6. Participants with DLD have problems in at least one dimension of language (Bishop et al., 2017).

More precisely, the initial language profile of the participants with DLD during childhood had to reveal language problems in at least one of the following dimensions: phonology, syntax, word finding and semantics, pragmatic/language use, discourse, and verbal learning and memory. After the initial screening, 1,366 articles were excluded because they did not respect at least one of the inclusion criteria. The remaining 141 articles were fully read and assessed for eligibility by the principal author. Of these, 126 articles were excluded (four did not have a longitudinal design with a control/comparison group, 27 did not present an expected outcome, 55 included participants who were not all aged between 18 and 34 years, 37 were not specifically related to DLD, and three did not present original data), leaving 15 articles that met all inclusion criteria. The second and last authors reviewed the articles for which the principal author needed confirmation regarding criteria. Any disagreement was resolved by discussion (see Figure 1 for a synthesis of the search strategy and Supplemental Materials S2 and S3 for the list of included and excluded articles). Study Design We used the PRISMA guidelines (PRISMA-P; Moher et al., 2015) to report the results. We consulted PubMed, PsycInfo, EBSCO, and Embase from 2005 up to 2018, and we kept active alerts until January 2019 to add recent articles. The principal author carried out the literature search by using the following combination of key words with their synonyms: developmental language disorder, young adults, and school-to-work transition (see the Appendix for the exhaustive list of terms). The first author added additional references cited in the selected articles, and she searched the websites of all first authors to include relevant articles.

Characteristics and Risk of Bias in Included Studies The principal author reported the following characteristics for each article: age and estimated birth year of the participants, number of participants, attrition and its specifications, inclusion and exclusion criteria for the DLD group, origin of the sample, and the terminology used in the original study to identify young adults with DLD. Based on these characteristics, she estimated the risk of bias in the interpretation of the study’s results, according to the following criteria (Wells et al., 2018): birth year of the participants (bias present if the participants were born before Dubois et al.: Young Adults With DLD Downloaded from: https://pubs.asha.org Lymarie Ortiz on 12/30/2021, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions 3787 Figure 1. Process of article identification for inclusion in the review. DLD = developmental language disorder. 1980 due to the difference between the social context in which participants evolved in their childhood and the actual social context; Conti-Ramsden & Durkin, 2012), inclusion criteria to identify young adults with DLD (bias present if participants could be included in the DLD group with a vocabulary test only due to their low accuracy regarding identification of DLD in childhood; Gray et al., 1999), and number of participants at each wave for longitudinal studies (bias present if the attrition was over 20% [Yew & O’Kearney, 2013] due to the possible difference in the reported outcomes if more participants had remained in the study). The presence of these biases was considered throughout the completion of this review to support the interpretation of the divergent results, as well as the description of the limitations and implications in the discussion. The methodological quality was also assessed by the first author and an expert in methodology using the Kmet et al. (2004) checklist for quantitative studies. This tool includes 14 criteria evaluating the internal validity of a study (i.e., research questions/objectives, methods, results, and 3788 conclusions). Three of them were not applicable because studies selected are longitudinal (i.e., interventional and random allocation, interventional and blinding of investigators, interventional and blinding of subjects). Based on the description of the criteria offered in the scoring manual, both raters independently attributed a score to each criterion, ranging between 0 and 2 (no, partial, yes). They afterward discussed their evaluation for two criteria (4 and 9) where their ratings were mostly different (initial Po = .61 and κ = −.07).

The final between-raters agreement was sufficient (Po = .75 and κ = .36; McHugh, 2012), and the scores of both raters were thus combined in a single score. All studies are above the cutoff point of 55% (see Table 1 for the percentage attributed to each study), indicating moderate (55%–79%) to strong (80%–100%) quality. Data Extraction The principal author read the articles to extract relevant information and summarized it by life area: education, Journal of Speech, Language, and Hearing Research • Vol. 63 • 3786–3800 • November 2020 Downloaded from: https://pubs.asha.org Lymarie Ortiz on 12/30/2021, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions Table 1. Characteristics of included studies and risk of bias. Risk of bias Study Quality (Kmet et al., 2004) Participants at follow-up (n in DLD/ comparison group) The Manchester Language Study (Great Britain) Botting, Durkin, Strong 81/87 et al. (2016) 86% Botting, Toseeb, Strong 84/66 et al. (2016) 84% Conti-Ramsden Strong 50/50 & Durkin (2012) 89% Attrition in DLD group (%) Age (years. months) 24 65.3 24 79.3 84/88 65 Conti-Ramsden et al. (2018) Durkin et al. (2016) Strong 86% Strong 86% 84/88 65 84/88 65 Durkin et al. (2017) Strong 93% Strong 84% Strong 91% 84/88 65 84/64 65 84/88 65 84/88 65 68/123 + 35 speech disorder– only group 75/132 33 31 27 24.7 Dubois et al.: Young Adults With DLD Winstanley, Webb, Strong & Conti-Ramsden 89% (2018) The Ottawa Language Study (Canada) Beitchman et al. Moderate (2014) 77% Johnson et al. (2010) Strong 91% Around 1980 7-year-olds attending language units in England for at least half of the school week Language characteristics of children in most language units: • language disorder identified as primary problem (with possible minor associated physical, emotional, or behavioral difficulties) • language difficulties present in any other language(s) spoken when English is a second language Around 1976– 1978 At age of 5 years (kindergarten), DLD as one or more of the following:

• < 1 SD on Test of Language Development (TOLD) Spoken Language Quotient • < 2 SDs on any TOLD language subscale • < 15th percentile on Content and Sequence subtests of Goldman–Fristoe–Woodcock Auditory Memory Tests • < 1 SD on Peabody Picture Vocabulary Testd 19.9 (DLD group)/ 19.3 (comparison group) 24.44 (DLD group)/ 24.09 (comparison group) 24 Strong 89% Winstanley, Durkin, et al. (2018) DLD group inclusion criteria at initial phasea,b ✓ 66.5 Conti-Ramsden et al. (2016) Toseeb et al. (2017) Year of birtha Attrition in DLD group Born > 20% < 1980 24.4 (DLD group)/ 24.1 (comparison group) 24 Vocabulary only for inclusion in DLD group ? 24 24.4 (DLD group)/ 24.1 (comparison group) 24.4 (DLD group)/ 24.1 (comparison group) ✓ ✓ ✓c 3789 (table continues) Downloaded from: https://pubs.asha.org Lymarie Ortiz on 12/30/2021, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions 3790 Journal of Speech, Language, and Hearing Research • Vol. 63 • 3786–3800 • November 2020 Table 1. (Continued). Risk of bias Participants at follow-up (n in DLD/ comparison group) Attrition in DLD group (%) 406/8,726 Not available 34 Not available for DLD group (14.8 in total sample) Family Study of Speech and Language Disorders (United States) Lewis et al. (2016) Strong 31/39 + 28 Not available 84% with speech sound disorders only (SSD) 34 Study Quality (Kmet et al., 2004) British Cohort Study (Great Britain) Law et al. (2009) Strong 86% Schoon et al. Strong (2010a) 91% Age (years. months) Year of birtha DLD group inclusion criteria at initial phasea,b Attrition in DLD group Born > 20% < 1980 ? 861/6,080 1970 At age of 5 years, DLD as: < 2 SDs on English Picture Vocabulary Test (EPVT; Law et al., 2009) or < 1 SD on EPVT (Schoon et al., 2010a) In the 1980s and 1990s In early childhood (4–6 years old), DLD as: prior to speech therapy, ˂ 1 SD on two or more subtests of the Clinical Evaluation of Language Fundamentals Preschool or Test of Language Development– Primary: Third Edition ✓ Vocabulary only for inclusion in DLD group ✓ ? 22.2 (DLD group)/ 22.3 (comparison group)/22.5 (SSD only) Note. DLD = developmental language disorder; ✓ = presence of bias; ? = insufficient information reported to conclude if bias is present. a The information presented in these columns is the same for all the studies related to one cohort. bCriteria related to language only are presented. cThirteen percent of the sample was included based on a vocabulary test only (see footnote d for details). dChildren diagnosed based on multiple criteria (56%), TOLD Spoken Language Quotient (23%) or Subtest (1%), Goldman–Fristoe–Woodcock Auditory Memory Tests (7%), and Peabody Picture Vocabulary Test (13%). Downloaded from: https://pubs.asha.org Lymarie Ortiz on 12/30/2021, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions employment, and independent living. To the extent that all of the studies reviewed are correlational, no causal relation could be inferred. Readers should therefore interpret the word “outcomes” with caution. Results A total of 15 articles met all inclusion criteria. A careful examination of the 15 articles revealed that samples were reused to test different hypotheses and that, in total, only four independent samples were used, for a total of 1,051 participants with DLD: 84 participants in the Manchester Language Study (Botting, Durkin, et al., 2016; Botting, Toseeb, et al., 2016; Conti-Ramsden & Durkin, 2012; Conti-Ramsden et al., 2016, 2018; Durkin et al., 2017, 2016; Toseeb et al., 2017; Winstanley, Durkin, et al., 2018; Winstanley, Webb, & Conti-Ramsden, 2018), 75 participants in the Ottawa Language Study (Beitchman et al., 2014; Johnson et al., 2010),

861 participants in the British Cohort Study (Law et al., 2009; Schoon et al., 2010a), and 31 participants in the Family Study of Speech and Language Disorders (Lewis et al., 2016). Study Characteristics and Risk of Bias The results of the 15 articles were described with respect to their methodological characteristics (see Table 1 for the main study characteristics and Supplemental Material S1 for additional information regarding the origin of each sample). The terms DLD group and comparison group will be used throughout this review, even if they do not correspond to those used in each study. Indeed, we identified six terms referring to participants with DLD: specific language impairment (Conti-Ramsden & Durkin, 2012; Law et al., 2009), nonspecific language impairment (Law et al., 2009), language impairment (Botting, Durkin, et al., 2016; Botting, Toseeb, et al., 2016; Conti-Ramsden et al., 2016; Durkin et al., 2017, 2016; Johnson et al., 2010; Lewis et al., 2016; Toseeb et al., 2017), developmental language disorder (Conti-Ramsden et al., 2018; Winstanley, Durkin, et al., 2018; Winstanley, Webb, & Conti-Ramsden, 2018), language disorder (Beitchman et al., 2014), and poor receptive language skills (Schoon et al., 2010a). Concerning the risk of bias, the three criteria were evaluated for each cohort, as detailed in Table 1. The following sections will present the results for each life area: education, employment, and independent living. Education Six studies, stemming from the results of the four cohorts, reported on the area of education. Young adults with DLD were generally engaged in post–secondary education in similar proportion to their peers (see Table 2 for engagement with education rates for DLD and comparison groups; Conti-Ramsden & Durkin, 2012; Conti-Ramsden et al., 2018; Johnson et al., 2010). In the Manchester Language Study, following the end of compulsory education at age of 16 years, all participants with DLD had obtained some qualification by age of 24 years, and nearly half of them had achieved a level of qualification (academic or vocational) sufficient for advanced study or training. Another important element to consider was the services and support received during their studies. More young adults with DLD reported receiving institutional support (e.g., extra time, help) than their peers (Conti-Ramsden et al., 2018). However, there were no differences between groups for noninstitutional support, such as family and friends, or for their level of satisfaction regarding the support they received.

Less desirable outcomes were identified regarding academic achievement. First, differences were reported when examining the age at which participants with DLD left the education system, showing that they were at risk of dropping out of school prematurely. Indeed, in the Manchester Language Study, the mean age at which young adults with DLD left school was 18.7 years versus 19.7 years for the comparison group (Conti-Ramsden et al., 2018). In the British Cohort Study, 61.5% of them were re ported to have left education by age of 16 years versus 44.5% in the comparison group (Schoon et al., 2010a). Young Adults with Developmental Language Disorder.

Second, although young adults with DLD reported having completed a wide range of achievements, with some having no qualification and others obtaining a master’s degree, they remained less successful than their peers in terms of grades, level of qualification (Conti-Ramsden & Durkin, 2012; ContiRamsden et al., 2018), level of education (Johnson et al., 2010), and number of examinations passed and qualifications acquired (Conti-Ramsden & Durkin, 2012). Indeed, young adults with DLD tended to obtain vocational qualifications; a smaller proportion of them reported having completed high school and undergraduate university education (see Table 2 for program completion rates for DLD and comparison groups;

Conti-Ramsden et al., 2018; Johnson et al., 2010). Only one study reported similar educational attainment for the DLD group and their siblings (Lewis et al., 2016). This discrepancy could be related to the methods used, which may have reduced the group differences. First, the authors dichotomized the educational attainment variable, without giving any details on how they dichotomized it, instead of using the specific achievement level of the participants as the other studies did. Second, this study was the only one to compare young adults with DLD to their siblings, who shared a similar family environment and had access to similar resources. As for the predictive role of language, it appeared that language and literacy skills may contribute to explaining the academic achievement of young adults with DLD.

Young Adults with Developmental Language Disorder.

Young Adults with Developmental Language Disorder.