Executive function behaviours in children with specific language impairment (SLI)

Background: There is growing evidence that linguistic and non-linguistic factors may contribute to the problems associated with specific language impairment (SLI). One factor that has been implicated is executive functioning (EF). Most studies investigating EF in children with SLI use performance based tasks. Significant group differences in children with SLI are reported on the following components of EF: inhibition, working memory, planning and fluency, although not on the 'shifting' component. Correlations between performance based measurements of EF and ratings of everyday EF behaviours are often low. It is possible that standardised tests are not sufficiently sensitive to the multidimensional nature of EF. Therefore it is suggested that information on EF should be collected in different contexts and from different sources using behavioural ratings, like the Behaviour Rating Inventory of Executive Function (BRIEF) for children. Methods and procedures: A clinical sample of 237 school aged children, aged 5-12 years, (157 boys, 80 girls) with SLI participated in this study. Behavioural and cognitive measures of EF were administered: the BRIEF-questionnaire, assessing everyday EF behaviour in a home and school setting and two EF tasks: Digit span (WISC-III-NL) and Creature Counting (TEA-Ch). Outcomes and results: Compared to the normative sample the prevalence of EF problems in school in children with SLI is much higher than in the normal population. Teachers reported significantly more problems on almost all EF domains (i.e. Inhibition, Shifting, Emotional control, Initiate, Working memory, Plan/organise, and Monitor), except organisation of materials. Working memory and Initiate are the most impaired, since more than one third of the children had scores in the clinical range on these scales. Compared to the normative sample parents scored significantly more working memory problems. MANOVA-analyses showed developmental and gender differences on EF behaviour in school. Overall, older children had less problems in EF behaviours than younger children and boys showed more problems than girls. Like others we found low correlations between behavioural and cognitive measures (r=0.20). Conclusions: School aged children with SLI show substantial impairments in everyday EF behaviour in a classroom setting. Almost one third of the children scored in the clinical range on the Metacognition Index. Our findings replicate low correlations between performance based and behavioural based measures on EF. These findings indicate the importance of expanding EF assessment with behavioural measures in clinical practice for children with SLI