Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. e1541-e1549 (doi:10.1542/peds.2005-2761)
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ARTICLE

The Clinical Spectrum of Developmental Language Impairment in School-Aged Children: Language, Cognitive, and Motor Findings

Richard I. Webster, MBBS, MSc, FRACPa,b, Caroline Erdos, MScc, Karen Evans, MScc, Annette Majnemer, PhD, OTa,d,e, Eva Kehayia, PhDe, Elin Thordardottir, PhDc, Alan Evans, PhDf and Michael I. Shevell, MD, CM, FRCPCa,d

a Department of Neurology/Neurosurgery
c School of Communications Sciences and Disorders
d Department of Pediatrics
e School of Physical and Occupational Therapy
f McConnell Brain Imaging Centre, McGill University, Montreal, Quebec, Canada
b Department of Neurology and Children's Hospital Education Research Institute, Children's Hospital at Westmead, Westmead, New South Wales, Australia

OBJECTIVE. Our goal was to evaluate detailed school-age language, nonverbal cognitive, and motor development in children with developmental language impairment compared with age-matched controls.

METHODS. Children with developmental language impairment or normal language development (controls) aged 7 to 13 years were recruited. Children underwent language assessment (Clinical Evaluation of Language Fundamentals-4, Peabody Picture Vocabulary-3, Goldman-Fristoe Test of Articulation-2), nonverbal cognitive assessment (Wechsler Intelligence Scale for Children-IV), and motor assessment (Movement Assessment Battery for Children). Exclusion criteria were nonverbal IQ below the 5th percentile or an acquired language, hearing, autistic spectrum, or neurologic disorder.

RESULTS. Eleven children with developmental language impairment (7:4 boys/girls; mean age: 10.1 ± 0.8 years) and 12 controls (5:7 boys/girls; mean age: 9.5 ± 1.8 years) were recruited. Children with developmental language impairment showed lower mean scores on language (Clinical Evaluation of Language Fundamentals-4—developmental language impairment: 79.7 ± 16.5; controls: 109.2 ± 9.6; Goldman-Fristoe Test of Articulation-2—developmental language impairment: 94.1 ± 10.6; controls: 104.0 ± 2.8; Peabody Picture Vocabulary-3—developmental language impairment: 90.5 ± 13.8; controls: 100.1 ± 11.6), cognitive (Wechsler Intelligence Scale for Children-IV—developmental language impairment: 99.5 ± 15.5; controls: 113.5 ± 11.9), and motor measures (Movement Assessment Battery for Children percentile—developmental language impairment: 12.7 ± 16.7; controls: 66.1 ± 30.6) and greater discrepancies between cognitive and language scores (Wechsler Intelligence Scale for Children-IV/Clinical Evaluation of Language Fundamentals-4—developmental language impairment: 17.8 ± 17.8; controls: 1.2 ± 12.7). Motor impairment was more common in children with developmental language impairment (70%) than controls (8%).

CONCLUSIONS. Developmental language impairment is characterized by a broad spectrum of developmental impairments. Children identified on the basis of language impairment show significant motor comorbidity. Motor assessment should form part of the evaluation and follow-up of children with developmental language impairment.

Key Words: cognitive development • language disorders • developmental delay • motor development • language development

Abbreviations: SLI—specific language impairment • DLI—developmental language impairment • CELF-4—Clinical Evaluation of Language Fundamentals-4 • PPVT-3—Peabody Picture Vocabulary Test, 3rd Edition • GFTA-2—Goldman-Fristoe Test of Articulation-2 • WISC-IV—Wechsler Intelligence Scale for Children, 4th Edition • PRI—Perceptual Reasoning Index • M-ABC—Movement Assessment Battery for Children

Accepted May 30, 2006.


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