The Relationship Between Executive Function and Language Abilities in Grade School Children By: Jacquelyn Liesen Faculty Mentors: Mrs. Jill Fahy & Dr. Rebecca Throneburg

Executive Functions High-Order Cognitive abilities Cognitive Processes Attentional Control and Shifting Inhibition Working Memory Fundamental Components Goal Selection Planning/Organizing Initiation/Persistence Flexibility/Shifting Self-monitoring/regulation Executive functions are comprised of multiple cognitive abilities, including attentional control and shifting, inhibition, and working memory. They are essential for success in everyday life. In addition to these cognitive processes, executive functions are also comprised of specific components: Goal Selection, Planning/Organizing, Initiation/Persistence, Flexibility/Shifting, Self-monitoring

Development of Executive Functions & Language Longest developmental phase in humans Birth through mid-20s Developmental spurts correspond with frontal lobe maturity Attentional and inhibitory control Rapid development in first few years of life Planning/organization Emerging skills throughout childhood More sophisticated in adolescence Flexibility/shifting Emerges in early school-age Matures in adolescence, early 20s Self-monitoring Not fully developed til late adolescence/early 20s Language Critical period 0-3 Morphology Generally mastered by age five Vocabulary acquisition Shifts from oral exposure to written exposure Proceeds throughout school years, adolescence Syntax Spoken syntax levels off in early school years Written syntax becomes more complex Whereas much is known about typical language development, much less specific knowledge is available about the development of executive functions. Longest developmental phase in humans Developmental spurts tend to correspond with frontal lobe refinement and maturity Rapid development begins in first few years of life Emerging skills throughout childhood Many skills approach maturity in teens Refinement in early to mid 20s Language Language consists of content, form, and use. Semantically, receptive language abilities are typically higher than expressive language abilities. Again, see pattern of development beginning in the first few years of life, and extending into early school years. Complex use, syntax forms... Vocab become more refined in later school years

Literature Review: Relationship Between Language and EFs Few studies in this area Most involve isolated assessment of EF skills in un-naturalistic environments, with minimal language assessment Fewer still have evaluated EF behaviors in naturalistic environments Research has concluded Children with SLI may have a deficit in working memory (Hoffman & Gillam, Marton & Schwartz) Significance between preschooler's narrative language abilities and inhibition, working memory, flexibility, and planning (Trainor) Typically developing adolescents and those with SLI differ in executive functions on the BRIEF (Hughes, Turkstra, and Wulfeck) A few studies have found correlations between isolated executive functions and certain language processes however, most involve isolated assessment of EF skills in un-naturalistic environments, with minimal language assessment. Fewer still have evaluated EF behaviors in naturalistic environments Marton and Schwartz found a significant impairment for children with Specific Language Impairment in working memory Hoffman and Gillam found a significant difference between typically developing children and children with SLI in working memory Trainor did not find significant correlations between PPVT scores and performance on the BRIEF-P, but significant relationships were found between preschooler's narrative language abilities and functional measures of executive control for inhibition, working memory, flexibility, and planning Hughes, Turkstra, and Wulfeck found a significant difference between typically developing adolescents and adolescents with SLI on the BRIEF.

Research Questions What is the relationship between executive functions and receptive language skills in typically developing children ages six and eight years of age? What is the relationship between executive functions and expressive language skills in typically developing children ages six and eight years of age? What is the relationship between executive functions and structure language skills in typically developing children ages six and eight years of age? What is the relationship between executive functions and content language skills in typically developing children ages six and eight years of age?

Response to Intervention Subjects   First Grade Third Grade Total 14 13 Mean Age 80 months 104 months Age Range 75-86 months 99-107 months Speech Disorder 1 3 Language Disorder Response to Intervention 5 - reading 2 - reading 2 - math 27 total participants All within regular education classroom 14 First grade Mean age 80 months One had a speech disorder and 5 were receiving RTI for reading 13 Third grade Mean age 104 months Three had a speech disorder and one had a language disorder in syntax. Two were receiving RTI for reading and two for math. Attending a school in Central Illinois in a regular education classroom

Assessment Measures: Language Peabody Picture Vocabulary Test-4 Receptive language Clinical Evaluation of Language Fundamentals-4 Language skills Core Language Score Expressive Language Index Receptive Language Index Language Content Index Language Structure Index Working Memory Index We used the PPVT, the CELF, and the Behavioral Rating Inventory of Executive Function – Parent. The PPVT examines a child’s receptive language ability. The CELF assessed language skills. Nine subtests were administered: Concepts and Following Directions, Word Structure, Recalling Sentences, Formulated Sentences, Word Classes, Sentence Structure, Expressive Vocabulary, Number Repetition, and Familiar Sequences. Performance on individual subtests generated a Core Language Score, an Expressive Language Index, and a Receptive Language Index. In addition, subtest scores were further transformed into a Language Content Index, a Language Structure Index, and a Working Memory Index.

Assessment Measures: Executive Functions Behavioral Rating Inventory of Executive Functions – Parent Form Parents’ rating of executive function ability in naturalistic environment Initiate Working Memory Plan/Organize Organization of Materials Monitor Inhibit Control Shift Control Emotional Control Global Executive Composite T-scores of 65 and above indicate clinical significance/area of concern The Parent Rating form from the BRIEF was used to capture parents’ observations of EF behaviors in children’s daily environments. Indices on the BRIEF include: The BRIEF measured eight subdomains of executive functions: Initiate, Working Memory, Plan/Organize, Organization of Materials, Monitor, Inhibit Control, Shift Control, and Emotional Control. An overall Global Executive Composite is given from two sub-indexes. The Behavioral Regulation Index is composed of the inhibit control, shift control, and emotional control sub-domains. The Metacognition Index consists of the initiate, working memory, plan/organize, organization of materials, and monitor domains. High scores on the BRIEF signify advanced executive dysfunction.

(Behavior Regulation Index) BRIEF MI (Metacognition Index) Results Means and Standard Deviations of BRIEF BRIEF GEC BRIEF BRI (Behavior Regulation Index) BRIEF MI (Metacognition Index) First Grade: Groups Mean Standard Deviation 52 12 11 Third Grade: 14 15 53 Overall: 13 All within normal range Above 65 = impairment Standard scores represented as T-scores with mean of 50 and a SD of +/-15. T-scores c>65 are considered clinically significant (higher score = more impairment)

Results Means and Standard Deviations of CELF CELF Core Lang. CELF Receptive Lang. CELF Express. Lang. CELF Lang. Content CELF Lang. Structure CELF Working Memory First Grade: Groups Mean Standard Dev. 104 11 106 9 105 13 103 15 Third Grade: 107 110 12 108 14 111 109 10 99 Overall: 101 All means between 99-111 which is within normal range Mean=100. Typical performance = +/- SD of 15

Results Means and Standard Deviations of PPVT Standard Score First Grade: Groups Mean Standard Deviation 104 12 Third Grade: 121 22 Overall: 112 19 The First Grade mean is within the normal range and the third grade mean is 1 SD above the mean Mean=100. Typical performance = +/- SD of 15

Relationship between PPVT and BRIEF Parent BRIEF GEC BRIEF BRI (Behavior Regulation Index) BRIEF MI (Metacognition Index) PPVT -.317 -.298 -.371 Insignificant correlation between PPVT & BRIEF No significant correlations

Relationship between BRIEF &CELF Sig at the * = .05 ** = .01 level BRIEF GEC (Composite) BRIEF BRI (Behavior Regulation Index: Inhibit Control, Shift Control, & Emotional Control) BRIEF MI (Metacognition Index: Initiate, Working Memory, Plan/Organize, Organization of Materials, & Monitor) CELF Core -.460* -.428* -.443* CELF Receptive -.369 -.264 (Shift-.258, Inhibit -.221, Emotional Control -.312) -.400* (Initiate-.418*, Working Memory-.332, Plan/Organize-.288, Monitor -.332, Materials-.110) CELF Expressive -.495** (Shift-.606**, Inhibit-.372, Emotional Control-.312) -.489** (Plan/Organize-.579**, Monitor-.490**, Initiate-.436*, Working Memory-.399, Materials-.135) CELF Content -.282 -.249 (Shift-.323, Inhibit-.195, Emotional Control-.269) -.300 (Plan/Organize-.238, Monitor-.244, Initiate-.281, Working Memory-.196, Materials-.061) CELF Structure -.404* -.348 (Shift-.518**, Inhibit-.328, Emotional Control--.269) -.405* (Plan/Organize-.508**, Monitor-.439*, Initiate-.414*, Working Memory-.333, Materials-.135) Significant correlation between CELF & BRIEF CELF Expressive Language & all 3 BRIEF EF indices. CELF Core Language & all 3 BRIEF EF indices. The strongest relationships were between: BRIEF Shift & CELF Expressive Language BRIEF Plan/Organize & CELF Expressive Language BRIEF Monitor & CELF Expressive Language BRIEF Initiate & CELF Expressive Language

Clinical Implications Suggests that expressive communication skills engage not only semantics & syntax, but also EFs. Expressive language skills are particularly related to planning and organizing, shifting, monitoring, and initiating Indicate children with weak expressive language skills may also have weak executive function skills. Successful use of compensatory strategies is dependent upon the presence of intact executive functions Speech-language pathologists should assess children’s executive functions in addition to language Avoid assuming that intact executive function skills are available to compensate for weak language skills Within the field of speech-language pathology, components of language are a primary focus for communication and academic performance. The results of the current study suggest that expressive communication skills engage not only semantics and syntax, but also executive functions—particularly shifting, planning, organization, and monitoring. Results of the current study indicate children with weak expressive language skills may also have weak executive function skills. Successful use of compensatory strategies is dependent upon the presence of intact executive functions which serve to monitor, regulate, organize, and initiate the use of said strategies. Speech-language pathologists should assess children’s executive functions in addition to language in order to identify more specific profiles and gain insight into communication breakdowns within the child’s home and academic environments. Development of accommodations or compensatory strategies for children with language impairments should take into consideration the degree of executive functioning available to each child. Lastly, speech-language pathologists should avoid assuming that intact executive function skills are available to compensate for weak language skills

Limitations Small sample with similar demographics. Executive function behaviors are based on parent report only, without use of direct measures. Did not assess language in naturalistic environments A limitation of this research study includes a small sample with similar demographics. All of the children attended the same public elementary school in central Illinois. Although executive functions are measured in an ecologically valid manner, they are also based on parent report instead of direct measures. A more robust study would include both types of evaluation. In addition, language measurements we chose used highly structured isolated tasks, rather than also including more environmentally natural, spontaneous assessments.

Future research Similar research to validate findings Subtypes of children with specific language impairment (semantic, syntactic) Treatment of executive functions for children with language impairments The nature of the relationship between executive functions and language should be further evaluated. This study found significant relationships between executive functions and language. Specifically, expressive language and language structure are related to shifting, initiating, planning and organizing, and monitoring. More research is needed to validate the current research on typical grade school children with larger sample sizes and differing demographics. The present study only researched Caucasian first and third graders within central Illinois. Future research should determine if the results can be applied to the general population in differing ages. Also, research on the relationship between executive functions and language in children with different types of specific language impairments (semantic and syntactic) is needed. The results indicate that executive functions and language are correlated; therefore children with language impairments may also have executive function deficits. Various language disorders should be researched to determine if this correlation is present. Future research should investigate treatment of executive functions for children with language impairments (children with and without concomitant executive function deficits). A variety of treatment settings should be studied including early intervention, within the classroom, and with SLPs outside the classroom. Potential changes within the treatment settings and the functional impact on academic performance should also be researched.  

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