L'évaluation dynamique comme outil de diagnostic, pronostic et remédiation des troubles du langage / Dynamic assessment as a window to language processing: Improving diagnosis and remediation in children with DLD (2021-2024)

 

Descriptif du projet

Le trouble développemental du langage (TDL) s’applique aux enfants présentant des troubles du langage mais des capacités non-verbales dans la norme. Les recherches ont toutefois identifié des déficits cognitifs dans cette population, notamment des difficultés d’apprentissage, ce qui a conduit à une conceptualisation plus large du TDL. Malgré ce changement de paradigme, le TDL continue d'être diagnostiqué avec des tests langagiers traditionnels, dits statiques, qui ne fournissent pas d'informations sur le potentiel d'apprentissage des enfants dans les domaines langagiers et cognitifs et ne sont pas adaptés aux enfants issus de milieux linguistiques et socio-économiques divers. 

L'évaluation dynamique permet de pallier ces faiblesses en évaluant le potentiel d’apprentissage des enfants indépendamment de leurs connaissances linguistiques actuelles. De nombreuses études ont déjà démontré l’efficacité de ce type d’évaluation pour distinguer les enfants anglophones avec et sans TDL. Notre objectif de recherche est d'étudier le potentiel de l'évaluation dynamique comme : 

1) outil de diagnostic pour distinguer les enfants francophones avec et sans TDL, y compris les enfants bilingues pour lesquels l'évaluation dynamique s'est avérée efficace ;

2) mesure prédictive des performances langagières ultérieures chez les parleurs tardifs, c'est-à-dire les jeunes enfants présentant un retard initial du langage et dont le pronostic linguistique reste incertain ;

3) procédé permettant d’informer les cliniciens et d’améliorer l'intervention langagière, comme l'ont déjà démontré des études de cas menées auprès d'un nombre limité d'enfants. 

 

Cette recherche combine l'expertise des membres de notre équipe de recherche : Dr. Hélène Delage (PI), Dr. Margaret Kehoe et Prof. Marco Hessels . 

Olivia Hadjadj et Mélodie Matrat sont engagées sur le projet en tant que doctorantes.

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Project description

Developmental Language Disorder (DLD) refers to children said to have selective difficulties in language but normal nonverbal capacities (Leonard, 1998). Current research has identified cognitive deficits in this population, however, including difficulties in memory and learning leading to a new conceptualization of DLD as being more than a language disorder (Bishop et al., 2016; Leonard, 2014; Leonard & Weber-Fox, 2012). Despite this changing view, DLD continues to be diagnosed using traditional language tests which do not provide information on children’s potential to learn in linguistic and cognitive domains (Camilleri & Law, 2007) and which are not adapted to children from diverse linguistic and socio-economic backgrounds (Williams & McLeod, 2012). Dynamic assessment counteracts these weaknesses by assessing children’s response to learning and their modifiability in response to mediation, regardless of current language knowledge. Numerous studies have demonstrated its efficacy in distinguishing children with and without DLD (Camilleri & Botting, 2013; Hasson et al., 2013; Peña et al., 2001, 2006, 2014). 

Building on current theoretical approaches to DLD, our research goal is to further investigate the potential of dynamic assessment as a tool for aiding diagnosis, predicting language outcomes and improving intervention. To achieve this goal, we will develop a dynamic assessment battery, which targets different domains of language (phonology, lexical-semantic, morphosyntax, narration), for use with French-speaking children. Dynamic assessment tests have been developed for English-speaking children but there is currently no available procedure for French-speaking children, even though there is a real interest for this approach as indicated by a recent survey we conducted with French-speaking clinicians. We propose three distinct studies to explore the relevance of dynamic assessment in children with DLD: 

1) Study 1 evaluates dynamic assessment as a diagnostic tool for distinguishing children with and without DLD, including bilingual children for whom dynamic assessment has proven to be effective (Camilleri & Law, 2007).

2) Study 2 examines dynamic assessment’s ability to predict long-term language outcomes in late talkers, namely toddlers with late language emergence whose language prognosis remains uncertain (Bishop et al., 2016).

3) Study 3 investigates dynamic assessment’s potential in informing and improving language intervention, as has already been demonstrated in case studies with a limited number of clinicians and children (Hasson et al., 2012). 

Thus, our research has two overriding aims: theoretical and clinical. The first is to contribute to current accounts of DLD, which view it as processing disorder not only in language but in larger domains such as learning, whatever the modality (verbal/nonverbal). We intend to show that dynamic assessment is compatible with the processing theory of DLD as opposed to the alternate view of DLD as a linguistic representational deficit. The latter is to provide speech-language therapists with a new and valid tool to complete their evaluation toolkit. This tool will help them to distinguish “difference from disorder” in monolinguals as in bilinguals, predict language outcomes in young children, and develop more effective intervention strategies.

The proposed multidisciplinary research combines the expertise of the research team members: a background in developmental psycholinguistics and speech and language pathologies (Main investigator: H. Delage), an expertise in phonological disorders and bilingual acquisition (Main project partner: M. Kehoe), as well as an expertise in the dynamic assessment of cognitive functioning (Project partner: Prof. M. Hessels).

Olivia Hadjadj and Mélodie Matrat are engaged on the project as PhD students.

 

Subside FNS/SNF Grant n°10001F_197983