Non-word repetition (NWR) is often utilized for the assessment of phonological short-term memory (PSTM) and as a clinical marker for language-related disorders. In this study, associations between children's language competence and their performance in language-specific NWR tasks as well as the relevance of NWR for the prediction of language development were scrutinized. German preschoolers ( N = 1,801) were compared regarding their performance in NWR, German vocabulary, and articulation. For 141 children, results of a school enrolment test were available. Multilingual children performed as well as monolingual German-speaking children in NWR only under the condition of comparable German language skills. NWR performance depended on item length, children's vocabulary and articulation skills and was weakly associated with language-related medical issues. The predictive power of NWR for children's performance in the school enrolment test was minimal. To conclude, chosen German-based NWR tasks did not deliver convincing results as a clinical marker or predictor of language development.

Introduction: Dysphagia is one of the most frequent sequels of the head and neck cancer (HNC). For postoperative HNC patients, several clinical parameters such as wet voice are used in the dysphagia assessment. However, most of these parameters were validated for stroke and geriatric patients. Seven clinical parameters were scrutinized in the current study for HNC patients regarding quality criteria for the prediction of dysphagia. Methods: Seven core clinical parameters (dysglossia, wet voice, abnormal volitional cough, reduced mouth opening, limited tongue motility and strength, gag reflex) and three combinations of such parameters were assessed in 184 postoperative HNC patients. The penetration-aspiration scale and Functional Oral Intake Scale were phi-correlated and cross-tabulated with the clinical parameters for the analysis of their quality criteria. The predictive power of clinical parameters was assessed by three logistic regressions and three classification trees, with dysphagia, aspiration, and limitations of oral intake as dependent variables. Results: All phi-correlations between clinical parameters and both scales were low to nonexistent (rho = 0.002-0.320). Sensitivity, specificity, positive likelihood ratio, and efficiency of clinical parameters and their combinations also yielded unsatisfactory results in the prediction of dysphagia. In regression analyses, wet voice showed a weak but significant influence on the dysphagia, aspiration, and limitations of oral intake. In classification trees, none of the clinical parameters yielded significant results. Conclusion: Neither clinical parameters nor their combinations can predict dysphagia in HNC patients. No factors can be recommended for the clinical use. Water swallow tests should be used clinically because they demonstrated better quality criteria for this population in the previous research.

Eine oropharyngeal bedingte Dysphagie ist häufig Folge einer Kopf-Hals-Tumor-Erkrankung. Sie steigert die Morbidität und Mortalität und beeinflusst damit das onkologische Ergebnis eines Betroffenen. Die moderne onkologische Versorgung von Patienten mit Kopf-Hals-Tumor inkludiert daher ein standardisiertes Dysphagiemanagement. Dabei sind die frühe Identifizierung und Diagnostik einer Schluckstörung zwingend erforderlich. Diese können einem 2‑stufigen Vorgehen folgen: zunächst ein evidenzbasiertes Screening zur Identifizierung von Hochrisikopatienten, danach eine instrumentelle Schluckdiagnostik zur Erschließung der individuellen Pathophysiologie als relevante Basis von Management und Rehabilitation. Die vorliegende Übersichtsarbeit gibt die aktuelle Evidenz zu Screeningverfahren von Schluckstörungen bei Patienten mit Kopf-Hals-Tumor sowie einen Überblick über etablierte und innovative instrumentelle Diagnostikverfahren wieder.

Oropharyngeal dysphagia is often a consequence of head and neck cancer. It increases morbidity and mortality and thus influences the oncological outcome of the affected person. Therefore, modern oncological care of patients with head and neck tumors includes standardized dysphagia management. Early identification and diagnosis of a swallowing disorder are mandatory. The procedures can follow a two-stage approach: first, evidence-based screening to identify high-risk patients; second, instrumental swallowing diagnostic tests to scrutinize the individual pathophysiology as a relevant basis for management and rehabilitation. This review presents the current evidence on screening procedures for swallowing disorders in patients with head and neck cancer as well as an overview of established and innovative instrumental diagnostic methods.

Most German states assess German language skills of children of the late kindergarten age in large-scale language screening programs. In the state of Hesse, language test “Kindersprachscreening” (“Language screening for children”, KiSS) was developed for this purpose. Its target group are kindergarten children aged four- to four-and-a-half years. In the present study, changes in the psychometric characteristics of KiSS – level of difficulty, item-total correlations, internal consistency – and possible explanations for these changes were scrutinized. For this purpose, seven KiSS samples were re-analysed retrospectively: five from KiSS validation studies and two from the Hessian language screening program. Psychometric characteristics of KiSS improved for the monolingual German-speaking children in the language screening program in comparison with KiSS validation studies. Fluctuations in the item-total correlations and internal consistency were linked to changes in the difficulty level of KiSS tasks. In the data of bi-/multilingual children, no fluctuations of psychometric characteristics were detected. Some findings point at a selection bias – an unexpectedly high proportion of children needing language therapies – in the samples of KiSS validation studies and of the language screening program. This bias can result in incorrect KiSS cut-off values, if these are updated on the basis of data from the language screening program.

Purpose Oropharyngeal dysphagia represents one of the most frequent postsurgical complications in head-and-neck cancer (HNC) patients, either as aspiration or as limitations of oral intake. At the moment, no dysphagia screening is available for this target population. This study aimed at the development of a water swallow test FraMaDySc that should reliably identify aspiration, limitations of oral intake and, first and foremost, relevant oropharyngeal dysphagia (ROD).

Purpose Children"s language competence is associated with or influenced by a number of factors that can be called sociolinguistic or sociodemographic. Among other things, children cannot avoid being influenced by contact persons from their neighborhood. This study aimed to analyze associations between children"s German language competence and characteristics of the districts where they attended daycare centers.

Purpose An examination of clinical predictors (or parameters) is often used for the first evaluation of the swallowing function of head-and-neck (HNC) patients after surgery. This study aimed to scrutinize such clinical predictors regarding their predictive power for the aspiration, limitations of oral intake, and, as their derivate, a relevant oropharyngeal dysphagia (ROD). Following predictors were chosen: dysglossia, wet voice, volitional cough, mouth opening, tongue motility, tongue strength, gag reflex.

Non-word repetition tasks are widely used to assess phonological short-term memory (PSTM). Results of previous research on the performance of monolingual and bilingual children in PSTM tasks are inconclusive. Although in some studies bilinguals did outperform monolinguals in the repetition of non-words, most studies reported comparatively weak results of bilingual children, especially when they were tested in their L2. In this study, four-year-old monolingual and bilingual children acquiring German (N = 1,441) were tested with both German-based (GBNW) and quasi-universal non-words (QUNW). It was hypothesized that bilinguals would outperform monolinguals both in (a) GBNW under the condition of comparable German language skills and (b) QUNW without any preconditions because QUNW do not presuppose a good command of German. Bilinguals yielded significantly lower results in GBNW, but not in QUNW. After the exclusion of children with limited German language skills from both groups, bilinguals outperformed monolinguals in both tasks, especially in QUNW. It can be assumed that bilingualism puts higher demands on PSTM than monolingualism and thus contributes to its faster development. Unnecessary medical examinations and therapies that are sometimes prescribed to bilinguals due to a poor performance in German-based PSTM tasks can be avoided if QUNW are used instead of language-specific items.

The intensity of the language contact belongs to numerous sociodemographic variables that influence the language competence of preschool children. This study aimed to examine associations between 16 variables related to the language contact and German language competence of multilingual children. Four-year-old kindergarten children (N = 824) were examined with the language test “Kindersprachscreening” (KiSS.2; Holler-Zittlau/Euler/Neumann 2011). Correlations between children’s and their parents’ age of contact to German and children’s language competence were weak to moderate. The same is valid for the use of German at home. Weak German language skills of children speaking Turkish and Arabic were associated with their limited contact to German both in the family and beyond. Their German language competence depended predominantly on how often German was used at home. All other children acquired German predominantly in day care facilities. Therefore, their German language skills did not depend much on the language input in the family. To sum up, intensive language contact was, at best, moderately associated with age-appropriate German language skills. Significant differences in the command of the German language among largest ethnic or linguistic subgroups could be traced back to sociodemographic differences in the children’s and their families’ characteristics. Active use of German at home was more important for those immigrant subgroups that do not attend any day care facilities before kindergarten age.

Bilingual children with a limited command of the second language (L2) often yield unsatisfactory results in L2-based non-word repetition tasks (NWRT) for the assessment of working memory. In this study, monolinguals (MO) and bilinguals (BI) of preschool age acquiring German were compared in regard to their performance on German-based NWRT to choose test items that do not put BI at a disadvantage. Four-year-old children ( N = 876) were tested with the German language screenings Sprachscreening für das Vorschulalter (SSV) and Kindersprachscreening (KiSS), including 38 non-words. BI scored significantly lower in NWRT than MO due to a limited command of German as well as a limited language input (e.g., length of kindergarten attendance). After the statistical deletion of children who did not speak German age-appropriately, BI outperformed MO on the SSV, without significant differences on the KiSS. Performance on NWRT depended on the children’s command of the German vocabulary and phonotactics. Several relatively “culture-fair” NWRT items were identified.

Oropharyngeal dysphagia is one of the most common postoperative consequences in head and neck cancer patients. Above all, these patients often suffer from aspiration and limitations of oral intake. However, no reliable dysphagia screening is available for this target group. This study aimed to develop and validate a screening, FraMaDySc, based on a water swallow test (WST) for the identification of postsurgical patients with a risk of aspiration, limitations of oral intake, and, as their derivate, a relevant oropharyngeal dysphagia in general (OD) that constituted the main reference standard. A total of 184 postsurgical head and neck cancer patients were tested with a WST. The patients were, on average, 62 years old and predominantly male (71

Background. In recent years, limited phonological short-term memory has become a widely recognized clinical marker for language(-related) impairments both for monolingual and bilingual children. Usually, it is assessed by the repetition of nonwords, sentences, and digit spans. However, in the case of bilingual children, its assessment has been shown to be inaccurate due to the influence of bilinguals’ first language phonotactics and their limited command of the second language. Methods. Monolingual (n = 712) and bilingual (n = 1,004) German preschoolers (age 4;0–4;11 years) were compared with each other with respect to their German language skills and performance in German-based and “quasi-universal” nonword repetition tasks (that is, items following the phonotactic rules of German vs. many world languages). Associations of both kinds of nonword repetition tasks with children’s language impairments were quantified. Results. German language skills of the bilinguals were weaker than those of the monolinguals. Whereas the bilinguals scored significantly lower than the monolinguals in German-based nonwords, there were no considerable differences between these subgroups in quasi-universal items. Poor performance in tasks employing both German-based and quasi-universal nonwords was significantly associated with language impairments. In contrast to quasi-universal nonwords, weak performance in German-based items was more strongly associated with limited German language skills than with language impairments. Conclusions. Because nonword repetition tasks were designed to identify children with language impairments, and not those with a weak command of German, quasi-universal nonwords appear to be more appropriate for language tests than language-specific items.

Background: In the German state of Hesse, the language competence of children in German is assessed in (mostly) 6-year-old children during the school enrolment examination. In several regions, it is also assessed in 4-year-olds by means of a large-scale language screening program; however, no representative data on German language skills are available for 5-year-old children. Objective: The current study aimed to quantify German language skills both in monolingual and multilingual 5-year-olds and to analyze sociodemographic variables associated with the need for additional educational or medical assistance in acquiring German. Material and methods: In this prospective cross-sectional study, a total of 908 kindergarten children aged 5;0-5;11 years (52% male, 48% female; 29% monolingual Germans, 71% multilinguals) were tested with the validated language test "Kindersprachscreening" (KiSS.2). KiSS.2 includes subtests on speech comprehension, vocabulary, grammar, articulation, and working memory. Sociodemographic characteristics of children and their families were assessed by KiSS.2-based questionnaires for parents and kindergarten teachers. Descriptive statistics were calculated for children's German language skills according to KiSS.2 and for children's participation in language courses and therapies. By means of classification trees, factors associated with children's need for additional educational or medical assistance in acquiring German were analyzed, with a focus on variables related both to the quality and quantity of the language contact. Results: About one fifth of monolingual German children and more than three quarters of multilinguals were in need of additional educational and/or medical assistance in acquiring German. The difference can be attributed to a much larger proportion of children with educational needs among multilinguals because the percentage of children in need of medical assistance did not differ significantly between these two subgroups. Almost all children who did not speak German at home or who began to acquire it only at the age of 4 years or later did not speak German age-appropriately. Children speaking Turkish and Arabic demonstrated significantly weaker German language skills than other multilinguals. The need for additional educational assistance in acquiring German was most strongly associated with the quantity of the German language input beyond day care centers. Children's medical needs showed the strongest associations (among language contact variables) with not speaking out when playing with other children. Most children with educational needs did not attend German language courses and most children with medical needs did not undergo language therapies. Conclusion: Since more than one half of Hessian preschool children have an immigrant background, it was assumed that most Hessian children do not speak German age-appropriately shortly before school enrolment. This was confirmed for the sample of the current study (57% of fail results in KiSS.2). Some findings indicate that multilinguals are underrepresented both in German language courses and in therapies in comparison with monolinguals. German language skills are clearly associated with the quality and quantity of the language input. For children with minimal language input in German, no sociodemographic variables were identified that would improve their German language competence. This shows that in order to speed up the acquisition of German there is no other way than to optimize the quality and quantity of the language input.