Accentuate the Negative: Grammatical Errors During Narrative Production as a Clinical Marker of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders Purpose The purpose of this study was to examine (a) whether increased grammatical error rates during a standardized narrative task are a more clinically useful marker of central nervous system abnormality in Fetal Alcohol Spectrum Disorders (FASD) than common measures of productivity or grammatical complexity and (b) whether combining the ... Research Article
Research Article  |   December 20, 2017
Accentuate the Negative: Grammatical Errors During Narrative Production as a Clinical Marker of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders
 
Author Affiliations & Notes
  • John C. Thorne
    Department of Speech and Hearing Sciences, University of Washington, Seattle
  • Disclosure: The author has declared that no competing interests existed at the time of publication.
    Disclosure: The author has declared that no competing interests existed at the time of publication. ×
  • Correspondence to John C. Thorne: jct6@uw.edu
  • Editor-in-Chief: Sean Redmond
    Editor-in-Chief: Sean Redmond×
  • Editor: Margaret Kjelgaard
    Editor: Margaret Kjelgaard×
Article Information
Special Populations / Genetic & Congenital Disorders / Language / Research Articles
Research Article   |   December 20, 2017
Accentuate the Negative: Grammatical Errors During Narrative Production as a Clinical Marker of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders
Journal of Speech, Language, and Hearing Research, December 2017, Vol. 60, 3523-3537. doi:10.1044/2017_JSLHR-L-17-0128
History: Received April 10, 2017 , Revised July 7, 2017 , Accepted August 3, 2017
 
Journal of Speech, Language, and Hearing Research, December 2017, Vol. 60, 3523-3537. doi:10.1044/2017_JSLHR-L-17-0128
History: Received April 10, 2017; Revised July 7, 2017; Accepted August 3, 2017

Purpose The purpose of this study was to examine (a) whether increased grammatical error rates during a standardized narrative task are a more clinically useful marker of central nervous system abnormality in Fetal Alcohol Spectrum Disorders (FASD) than common measures of productivity or grammatical complexity and (b) whether combining the rate of grammatical errors with the rate of cohesive referencing errors can improve utility of a standardized narrative assessment task for FASD diagnosis.

Method The method used was retrospective analysis of narrative and clinical data from 138 children (aged 7–12 years; 69 with FASD, 69 typically developing). Narrative analysis was conducted blind to diagnosis. Measures of grammatical error, productivity and complexity, and cohesion were used independently and in combination to predict whether a story was told by a child with an FASD diagnosis.

Results Elevated grammatical error rates were more common in children with FASD, and this difference facilitated a more accurate prediction of FASD status than measures of productivity and grammatical complexity and, when combined with an accounting of cohesive referencing errors, significantly improved sensitivity to FASD over standard practice.

Conclusion Grammatical error rates during a narrative are a viable behavioral marker of the kinds of central nervous system abnormality associated with prenatal alcohol exposure, having significant potential to contribute to the FASD diagnostic process.

Acknowledgments
We thank Truman Coggins, Susan J. Astley, Lesley B. Olswang, Heather Carmichael Olson, Amy Pace, and everyone at the Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network (WA Department of Social and Health Services, WA State Contract #1165-28549, S. Astley, PI) and the University of Washington Child Language Lab for their support in completion of this research. I am particularly in debt to Sara Jerger for her tireless and meticulous work to prepare transcripts for analysis, as well as her detailed error analysis.
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