Using Finiteness as a Clinical Marker to Identify Language Impairment Intervention rates for children with language impairments vary widely across reports. Unfortunately, many language tests focus on areas of language that are not problematic for children with language impairments (LI). Over twenty years of research supports limitations in finiteness as a clinical marker of LI. However, speech language pathologists (SLPs) ... Article
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Article  |   November 01, 2014
Using Finiteness as a Clinical Marker to Identify Language Impairment
Author Affiliations & Notes
  • Andrea C. Ash
    Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, UT
  • Sean M. Redmond
    Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, UT
  • Financial Disclosure: Andrea C. Ash is a research assistant professor at the University of Utah. Sean M. Redmond is a professor at the University of Utah.
    Financial Disclosure: Andrea C. Ash is a research assistant professor at the University of Utah. Sean M. Redmond is a professor at the University of Utah.×
  • Nonfinancial Disclosure: Andrea C. Ash has previously published in the subject area. Sean M. Redmond has previously published in the subject area.
    Nonfinancial Disclosure: Andrea C. Ash has previously published in the subject area. Sean M. Redmond has previously published in the subject area.×
Article Information
Language Disorders / Articles
Article   |   November 01, 2014
Using Finiteness as a Clinical Marker to Identify Language Impairment
SIG 1 Perspectives on Language Learning and Education, November 2014, Vol. 21, 148-158. doi:10.1044/lle21.4.148
SIG 1 Perspectives on Language Learning and Education, November 2014, Vol. 21, 148-158. doi:10.1044/lle21.4.148

Intervention rates for children with language impairments vary widely across reports. Unfortunately, many language tests focus on areas of language that are not problematic for children with language impairments (LI). Over twenty years of research supports limitations in finiteness as a clinical marker of LI. However, speech language pathologists (SLPs) have been reluctant to include assessments of finiteness in clinical decisions for young school-age children. This article addresses the operational definition of finiteness which may have created a barrier to its clinical use. We recommend that SLPs include the Test of Early Grammatical Impairment as a primary measure of finiteness for identifying language impairment in children between 3 and 8 years of age because of its clinical flexibility and high levels of sensitivity and specificity.

Ideally, all children with language impairments (LI) would be identified early and receive intervention from a speech-language pathologist (SLP) in a timely manner, with priority given to children with the most severe difficulties. However, this is not always the case with reported intervention rates for children with confirmed LI varying from 9% (Zhang & Tomblin, 2000) to 50% (Beitchman, Wilson, Brownlie, Walters, & Lancee, 1996). The under-identification of young children with LI is problematic because reports suggest that language deficiencies remain generally stable through adolescence (Rice, Hoffman, & Wexler, 2009; Tomblin & Nippold, 2014). Additionally, early language problems have been linked to numerous negative outcomes that continue into adulthood, including poor reading skills, lower levels of educational attainment, and higher rates of socioemotional/behavioral problems (Conti-Ramsden, Durkin, Simkin, & Knox, 2009; Law, Rush, Schoon, & Parsons, 2009).
Several factors appear to influence whether children are identified with language difficulties. Classroom behavior problems and children's sex represent two issues unrelated to language performance which nonetheless can influence referral practices (Tomblin, 2008). An additional problem lies in the tests commonly selected to identify language impairment. Many of the standardized language measures used by SLPs cannot be counted on to accurately identify LI (Betz, Eickhoff, & Sullivan, 2013; Spaulding, Plante, & Farinella, 2006).
We propose that SLPs working with young elementary students (K–2nd grade) consider using limited proficiency with finiteness as a clinical marker of LI. Kamhi (2014)  reflected that traditional language assessments have focused on Brown's 14 grammatical morphemes, while at least 20 years of research confirm that children with LI experience difficulty with only a subset of Brown's morphemes that involve finiteness. In this paper, we will cover how to identify finiteness within sentences and why limited proficiency with finiteness represents an effective clinical marker for LI.
What is “Finiteness”?
The assessment and treatment of finiteness in young elementary students aligns with the principals of evidence-based practice. However, “finiteness” may be a somewhat confusing term. Finiteness is a property of main clauses in most languages and is marked on verbs (Rice & Wexler, 1996). Crystal (1995)  defined finiteness as a contrast based upon whether the verb is “limited” in some way. Based upon this categorization, there are two types of verbs: finite and nonfinite (or infinitive) forms. Finite forms are verbs which have limitations placed upon them in regard to number, tense, person, or mood (Crystal, 1995). A fundamental feature of the contrast is that finite/nonfinite forms are determined by their position within the clause. It is important to recognize that verbs by themselves do not carry finiteness status. For example, the verb walk outside of a clause is neither a finite or nonfinite form. However, “she walks home” is a finite form marked for finiteness with the third person singular present tense –s inflection. The position of the verb in the clause is more important than the structural form of the word. Position is so important that it also determines whether the form is a verb at all. For example, the word walks isn't inherently a verbal form and can appear in English sentences as a noun simply by sticking it in the sentence's subject or object position (e.g., “she likes long walks”).
The notion of syntactic limitations in finite forms is demonstrated by the contrast between “she walks” and “I walk”. In the example “she walks”, finiteness is represented with tense marking and the addition of the –s morpheme on “walk”. However, in a similar example “I walk”, there is not an overt marker of finiteness, yet the verb “walk” is still a finite form. The –s form is limited to the present (tense) and to the third person singular subject (person and number). In English, it is ungrammatical to add the third person singular –s morphological marker to a verb that contains any other number or person in the subject position. For example, it is ungrammatical to produce *we walks because the subject and the verb are not in agreement based upon number and person, *I walks because the subject and verb do not agree based upon person, and *the girls walks because the subject and verb do not agree based upon number. All finite verbs carry these types of syntactic requirements, although they may not be overtly realized in the morphology.
English is a relatively morphologically impoverished language containing only two overt morphosyntactic markers for finiteness: third person singular present tense –s and past tense –ed. Finiteness is also covertly demonstrated by irregular past tense forms, copula forms of BE, and auxiliary forms of BE, DO, and HAVE. In clauses containing auxiliary verbs, there is a main verb in addition to the auxiliary verb. In these clauses, finiteness for tense and agreement are marked on the auxiliary form and not the main verb. In the example “the dog walks were going to be fun”, provided in Table 1, tense marking appears on the BE verb “were” but not on the verb “going”. Modal auxiliaries (e.g., can, could, would, etc.) function similarly, however finiteness on a modal auxiliary form is covert and not marked on the surface form of the modal. In the example, “you might go walking tomorrow morning” provided in Table 1, “might” is the finite form, while “go” and “walking” are nonfinite.
Table 1 Finite Verb Forms.
Finite Verb Forms.×
Subject (Noun or Noun Phrase) Predicate (Verb or Verb Phrase) Finiteness Form Nonfinite Form
I walk First person singular present tense --
I walked First person singular past –ed --
The dog walks Third person singular –s --
The dog doesn't want to walk Irregular third person singular present tense DO auxiliary walk
The dog walks are my favorite Third person plural present tense BE copula --
The dog walks were going to be fun Third person plural past tense BE auxiliary going, be
That dog has walked all day Irregular third person singular present tense HAVE auxiliary walked
Table 1 Finite Verb Forms.
Finite Verb Forms.×
Subject (Noun or Noun Phrase) Predicate (Verb or Verb Phrase) Finiteness Form Nonfinite Form
I walk First person singular present tense --
I walked First person singular past –ed --
The dog walks Third person singular –s --
The dog doesn't want to walk Irregular third person singular present tense DO auxiliary walk
The dog walks are my favorite Third person plural present tense BE copula --
The dog walks were going to be fun Third person plural past tense BE auxiliary going, be
That dog has walked all day Irregular third person singular present tense HAVE auxiliary walked
×
The lack of an overt marker can make it difficult sometimes to determine whether the form is finite or nonfinite. However, because finiteness is based upon the position of the verb in the clause, the only cue needed to determine finiteness is the position of the verb in relation to the subject. The finite verb is always next to the subject. Examples in Table 1 demonstrate a contrast between past and present tense which result in differing covert and overt finiteness. The example, “the dog walks are my favorite”, demonstrates the importance of looking at the placement of morphemes within the clause structure as opposed to looking at its surface form. The subject noun phrase “the dog walks” contains a plural –s marker on the noun “walk”, which could be mistaken for a marking of third person singular present tense –s if the structure of the sentence was not properly analyzed. Many of the examples in Table 1 contain additional nonfinite verb forms. The verb forms “to walk”, “going” and, “to be”, which are not directly next to the subject, are all nonfinite verbs. Although “walked” in the final example in Table 1 may appear to be a past tense –ed form, it is a past participle and is nonfinite. When looking for finite forms that are marked with past tense –ed, it is important to examine the position of the word within the clause to differentiate the past –ed form from the adjectival or past participle forms.
In English, auxiliary and copula forms are necessary for the formation of questions. In adult-like grammatical production of questions, finiteness moves to the left of the subject, such that the auxiliary or copula form is inverted. Table 2 demonstrates how the position for finiteness has been moved to the front of the subject. Notice that in the wh-questions, the inverted auxiliary/copula form still remains next to the subject, despite the addition of a wh-form.
Table 2 Question Forms with Auxiliary/Copula Inversion.
Question Forms with Auxiliary/Copula Inversion.×
Sentence Question: Auxiliary inversion
You are excited about the walk Image Not Available
She is walking Image Not Available
They walked Image Not Available
She walks to the store Image Not Available
You are excited about the walk. Image Not Available
Table 2 Question Forms with Auxiliary/Copula Inversion.
Question Forms with Auxiliary/Copula Inversion.×
Sentence Question: Auxiliary inversion
You are excited about the walk Image Not Available
She is walking Image Not Available
They walked Image Not Available
She walks to the store Image Not Available
You are excited about the walk. Image Not Available
×
In summary, finite forms in English include verbs marked (overtly or covertly) for tense and for agreement with the subject. Finite verb forms are always directly next to the subject— either to the right or left of the subject depending upon clause type. Although not all finite forms include an overt marker on the verb, all verbs next to the subject are finite. Because English speaking children with LI have been shown to have inordinate difficulties with this aspect of grammar, limited proficiency with finiteness represents a good candidate for a clinical marker.
What is a “Clinical Marker”?
The term clinical marker has been used to describe characteristics that can reliably differentiate between children affected with LI from those who are developing typical language (Rice & Wexler, 1996). Rice (2003)  proposed that clinical markers for LI should display a markedly skewed distribution, such that typically developing children will perform well at near-adult-like levels and children with LI will have lower levels of accuracy. Rather than thinking of LI as low performance manifested on the tail end of a normal bell-shaped curve as in Figure 1, a clinical marker for LI would have a bimodal distribution as shown in Figure 2, reflecting the separation of children who have language impairment from those who don't (Rice, 2003). Many omnibus language tests are designed around the bell-shaped model of LI where the separation between impaired performance and intact language skills is gradual. In contrast, a clinical marker distribution will show a clear separation between impaired and normal performance. While there may be some overlap between affected and unaffected individuals, ideally, it should be minimal. A clinical marker should only involve key aspects of language and poor performance does not entail that all aspects of language are compromised. Using clinical markers to identify LI avoids the problem of using arbitrary cutoff scores on standardized language testing (Is there any real reason to believe that language impairments indexed to standard scores of 87, 85, or 79 are qualitatively different?) while maintaining high levels of diagnostic accuracy.
Figure 1

Bell Curve: Normal Distribution.

 Bell Curve: Normal Distribution.
Figure 1

Bell Curve: Normal Distribution.

×
Figure 2

Clinical Marker Distribution: Bimodal Distribution.

 Clinical Marker Distribution: Bimodal Distribution.
Figure 2

Clinical Marker Distribution: Bimodal Distribution.

×
There is strong evidence supporting the premise that problems with finiteness are a key aspect of language impairment in children between 3 and 8 years. Figure 3 presents data from studies spanning 15 years that have found significant group differences. The studies included in Figure 3 compared groups of children with LI and performance IQ in the normal range to age-matched typically developing (TD) control groups across different finite forms (i.e., third person singular –s, past tense –ed, etc). Investigators also provided group means and standard deviations which permitted calculation of z-scores. Z-scores were calculated with the following formula: Display Formula
z=LIgroupmeanControlgroupmeanControlgroupstandarddeviation
Most of the studies in Figure 3 involved multiple finiteness measures. The z-scores provided in Figure 3 represent average z-scores across different measures.
Figure 3

Z-scores from Finiteness Measures on Children with LI.

 Z-scores from Finiteness Measures on Children with LI.
Figure 3

Z-scores from Finiteness Measures on Children with LI.

×
Figure 3 summarizes the preponderance of evidence implicating weaknesses in finiteness as feature of pediatric LI, with twelve of the studies reporting performances in children with LI at least -1.25 to -1.5 SD below the mean, a conventional clinical cutoff. The median z-score across reports was much lower, -4.59 SD, which would yield a standard score of 31 and indicate “profound” deficits. The bimodal distribution accounts for the large number of studies that are essentially “off the chart” when compared to a normative expectations.
Sensitivity and Specificity
While it is evident that children with LI consistently perform poorer than age matched peers on finiteness, a clinical marker also needs to accurately identify children with the disorder. The ideal clinical marker has appropriate levels of sensitivity (i.e., correctly identifying children with LI as having LI) and specificity (i.e., correctly identifying children who are typically developing as typical). Plante and Vance (1994)  recommended that standardized language tests meet an 80% criterion for levels of sensitivity and specificity. Table 3 provides an overview of studies that examined sensitivity and specificity levels of finiteness in young children, providing strong evidence that finiteness meets this criteria. The data in Table 3 were collected from either spontaneous language samples or linguistic production tasks targeting finiteness. Generally, sensitivity and specificity levels remain high across various methods of measurement, with the highest levels of sensitivity and specificity coming from reports providing multiple measures of finiteness, indicating that in clinical applications a composite of finiteness may be preferable. Finite production tasks may lose some diagnostic power in children under 3 years and in later elementary school ages (10 years; Conti-Ramsden, Botting, & Faragher, 2001; Hadley & Short, 2005).
Table 3 Sensitivity and Specificity Levels across Studies.
Sensitivity and Specificity Levels across Studies.×
Citation Age (years) Sensitivity Specificity
Hadley & Short (2005)  2-3 73.25 87.25
Bedore & Leonard (1998)  3-5 94.73 94.73
Gladfelter & Leonard (2013)  4-5 96.16 92.82
Conti-Ramsden (2003)  5 71 91
Redmond, Thompson & Goldstein (2011)  7-8 84 95
Conti-Ramsden, Botting, & Faragher (2001)  10 68.5 89.5
Table 3 Sensitivity and Specificity Levels across Studies.
Sensitivity and Specificity Levels across Studies.×
Citation Age (years) Sensitivity Specificity
Hadley & Short (2005)  2-3 73.25 87.25
Bedore & Leonard (1998)  3-5 94.73 94.73
Gladfelter & Leonard (2013)  4-5 96.16 92.82
Conti-Ramsden (2003)  5 71 91
Redmond, Thompson & Goldstein (2011)  7-8 84 95
Conti-Ramsden, Botting, & Faragher (2001)  10 68.5 89.5
×
It is not surprising that production of finite forms in simple production tasks lose sensitivity after age 10 (Conti-Ramsden et al., 2001). Growth trajectories of children with LI demonstrate that most children with language problems will eventually catch up to age matched peers in production tasks involving simple sentences by fourth grade (Rice, Tomblin, Hoffman, Richman, & Marquis, 2004). Thus, the best time to target finiteness in simple sentences is from 3 to 8 years. However, if finiteness represents a durable index of language impairment, then language difficulties in this area should persist in some form in other contexts throughout the lifespan. Studies addressing the longitudinal development of finiteness in children with LI have found that finiteness continues to be problematic in complex sentences, writing samples, and during grammaticality judgment tasks for adolescents and adults with LI (Poll, Betz, & Miller, 2010; Rice, Hoffman, & Wexler, 2009).
Methods for Evaluating Finiteness
There are multiple methods for eliciting productions of finite forms that can be used to reliably identify children with LI. Language sample analysis (LSA) provides SLPs with a naturalistic representation of children's linguistic proficiencies and has been demonstrated to be a robust diagnostic tool (Gladfelter & Leonard, 2013; Rice, Redmond, & Hoffman, 2006). However, LSA can be problematic if key finite forms are not produced at sufficient rates for analysis. Bedore & Leonard (1998)  created a finite verb composite (pooled performance across regular past –ed, regular third person singular present –s, and copula and auxiliary BE forms) that circumvents this issue. Unfortunately, the length of language sample needed to sufficiently capture finiteness for diagnostic purposes remains unknown. Bedore and Leonard (1998)  included language samples with a mean of 861 utterances, which is impractical in most settings. Heilmann, Nockerts, and Miller (2010)  examined the reliability of shorter language sample lengths, finding that in general, 3-minute samples were similar to 1- and 7-minutes samples on measures of productivity, lexical diversity, and utterance length. However, they also reported that the reliability of shorter samples for the number of errors and omissions were at “undesirable” levels. This is problematic because errors and omissions represent precisely the type of diagnostic information needed most by SLPs. Alternatively, we propose that SLPs use the Rice Wexler Test of Early Grammatical Impairment (TEGI: Rice & Wexler, 2001) as their measure of finiteness because it avoids some of the limitations inherent in LSA.
The TEGI examines children's ability to produce targeted finiteness structures and includes a Third Person Singular Probe (3S), a Past Tense Probe (PT), a Be/Do Probe, and a Grammaticality Judgment Probe. The TEGI yields two composite scores; the Screening Test (3S and PT probes) score and an Elicited Grammar Composite (3S, PT, Be/Do probes) score. The items on the TEGI set up brief scenarios that elicit obligatory contexts for finite forms. Scoring is based upon opportunities produced regardless of the specific lexical forms the child produces (e.g., replacing jumped with splashed would be ok). Table 4 provides examples of responses that are scorable and unscorable, while Table 5 represents the most common prompts we have used when children have provided an off target response. Anecdotally, over the course of administering the TEGI to hundreds of children, we have found that these prompts will usually elicit a scorable response.
Table 4 Past Tense Probe Scorable and Unscorable Responses.
Past Tense Probe Scorable and Unscorable Responses.×
Scorable Responses Unscorable Responses
Painted, she painted Paint, painting, Paints
Painteded, she painteded She is painting, She was painting
She paint She's done
Other marked verb (i.e., colored, built) She will/could/might/did paint
Gave, She gave, She give, She gived, Gaved, She gaved She paints, She put paint on, Give
Table 4 Past Tense Probe Scorable and Unscorable Responses.
Past Tense Probe Scorable and Unscorable Responses.×
Scorable Responses Unscorable Responses
Painted, she painted Paint, painting, Paints
Painteded, she painteded She is painting, She was painting
She paint She's done
Other marked verb (i.e., colored, built) She will/could/might/did paint
Gave, She gave, She give, She gived, Gaved, She gaved She paints, She put paint on, Give
×
Table 5 Prompt for Off Target Past Tense Probe Responses.
Prompt for Off Target Past Tense Probe Responses.×
Child's response Prompt
She is skating/She was skating. Tell me what she did with the skates.
Tell me what she did on the ice.
He rakes. Tell me what he did to the leaves.
He put them in a pile. Tell me what he did with the rake.
He's done eating the cookies. What did he do to the cookies?
Skate. Tell me what she did. She… (cloze task)
Table 5 Prompt for Off Target Past Tense Probe Responses.
Prompt for Off Target Past Tense Probe Responses.×
Child's response Prompt
She is skating/She was skating. Tell me what she did with the skates.
Tell me what she did on the ice.
He rakes. Tell me what he did to the leaves.
He put them in a pile. Tell me what he did with the rake.
He's done eating the cookies. What did he do to the cookies?
Skate. Tell me what she did. She… (cloze task)
×
The percent correct use scores that are generated on each subtest of the TEGI are compared to manual provided cutoffs which track expected growth on these verbal forms from 3;0 to 8;11 years. The criterion cutoff represents the score associated with the optimal balance between sensitivity and specificity for that particular age range. For example, on the Third Person Singular Probe for children aged 3;00–3;05, the criterion cutoff is 51%, which is associated with a sensitivity level of .74 and a specificity level of .80. The sensitivity level of .74 indicates that 74% of three-year olds with known language impairments performed below 51% correct use. Similarly, the specificity level indicates that 80% of typically developing children scored above 51% correct use. Thus, children who score below the criterion score on the TEGI would be expected to have a LI rather than typical language skills.
SLPs using the TEGI may use a different criterion score than what has been preselected by the TEGI authors. A more liberal or conservative cutoff score may be used by adjusting the sensitivity and specificity level as needed and identifying the corresponding raw score available in Appendix B of the TEGI manual. For example, the suggested cutoff score on the Screening Test (i.e., sensitivity = .80, specificity = .86) for children aged 5;0–5;5 is 78%. However, if a clinician needed a cutoff that was more sensitive (i.e., contained fewer “misses”), they could increase the cutoff score to 86, which would provide a higher sensitivity level of .90 but a lower specificity level of .76 (i.e., more “false alarms”). Similarly, the criterion score can also be lowered. The TEGI is the only language test that provides SLPs with this level of flexibility.
The TEGI manual does not provide users with standard scores for the various subtests or composites. We recommend calculating a standard score based upon group means and standard deviations provided by Rice and Wexler (2001)  when these are needed for eligibility decisions. Using the observed raw score, a z-score is calculated (i.e., [raw score-group mean]/group SD) which can then be converted to a standard score (i.e., [z-score*15]+100). It may be worthwhile to calculate a standard score in order to compare the child's grammatical abilities to their abilities in other areas (e.g., vocabulary). For example, if a child aged 6;11 scored 79 on the Elicited Grammar Composite, they would be below the criterion score of 81, with a sensitivity level of .76 and specificity level of 1.00. Based upon the mean and standard deviation provided by Rice and Wexler (2001)  in Table 4.17 (p. 74), the z-score would be calculated as follows: Display Formula
z‐score:79(raw score)94(normal group mean)6(normal group standard deviation)=2.5
Standard score conversion:Display Formula
standard score:(2.5[z‐score)*15)+100=62.5
Standard scores can assist SLPs interpretation of a child's grammatical performance relative to the more familiar normal distribution. However, it is important to remember that the sensitivity and specificity cutoffs are the preferred method for identifying children with LI when using the TEGI because this index aligns better with evidence-based clinical practice.
Betz and colleagues (2013)  found that the TEGI is rarely used by SLPs, which is unfortunate because it is one of the only measures available focusing on the crucial area of finiteness that provides users with detailed information on sensitivity and specificity. The TEGI is downloadable free of cost (http://www2.ku.edu/~cldp/MabelRice/screener_pack/), although the manipulatives for the Be/Do probe will need to be gathered by the clinician.
Why Care about Finiteness?
We have demonstrated that finiteness can be viewed as a clinical maker for identifying LI in children from 3 to 8 years of age. The use of finiteness as a diagnostic measure should not be limited to children who are otherwise unimpaired. It has also been shown to be an effective index for children with developmental disorders such as Down syndrome, autism, hearing impairment, and fragile X syndrome (Rice, Warren, & Betz, 2005). Finiteness is also capable of differential diagnosis, separating cases of LI from attention deficit hyperactivity disorder (ADHD) with 90% accuracy (Redmond, Thompson, & Goldstein, 2011).
Producing grammatically correct sentences is not a luxury, and yet finiteness can be overlooked as an area for language intervention because it may not be viewed as an important part of “functional communication”. We would like to challenge this notion. Finiteness is a crucial element in many communicative acts, such as adult-like question formation and the discussion of past events. Children with LI may be able to “get their message across” to others without proficiency, but at what cost? Research has shown that children with LI can be expected to struggle academically in the areas of reading, writing, and mathematics, and may fall increasingly behind academically as a result of their impairment (Harrison, McLeod, Berthelsen, & Walker, 2009; Morgan, Farkas, & Wu, 2011).
Numerous studies have demonstrated that risk for severe negative social consequences is associated with LI. For example, children with LI are at greater risk than their typical peers for being bullied by their peers (Knox & Conti-Ramsden, 2003; Redmond, 2011). LI has also been linked to higher rates of other forms of victimization, such as neglect, physical abuse, sexual assault, and emotional maltreatment (Brownlie, Jabbar, Beitchman, Vida, & Atkinson, 2007). The relative risk for this type of mistreatment is higher in children with LI than in children with learning disabilities, mental retardation, hearing impairment, visual impairment, or autism (Sullivan & Knutson, 2000). As professionals charged with serving children with LI, we have an ethical obligation to identify and provide timely services for children with language difficulties to offset some of these negative consequences.
If as a profession we choose to invoke “functional communication” as our criteria for service eligibility, we must recognize that an unintended consequence will be that children with comorbid conditions will be given priority over children with primary LIs, regardless of the severity of their LI. Instead, we believe that we should aim for the ideal, where all children with LI are identified early and receive appropriate language intervention in a timely manner. The inclusion of finiteness as a clinical marker for LI and as a target in intervention has the potential to bring us closer to that goal.
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Figure 1

Bell Curve: Normal Distribution.

 Bell Curve: Normal Distribution.
Figure 1

Bell Curve: Normal Distribution.

×
Figure 2

Clinical Marker Distribution: Bimodal Distribution.

 Clinical Marker Distribution: Bimodal Distribution.
Figure 2

Clinical Marker Distribution: Bimodal Distribution.

×
Figure 3

Z-scores from Finiteness Measures on Children with LI.

 Z-scores from Finiteness Measures on Children with LI.
Figure 3

Z-scores from Finiteness Measures on Children with LI.

×
Table 1 Finite Verb Forms.
Finite Verb Forms.×
Subject (Noun or Noun Phrase) Predicate (Verb or Verb Phrase) Finiteness Form Nonfinite Form
I walk First person singular present tense --
I walked First person singular past –ed --
The dog walks Third person singular –s --
The dog doesn't want to walk Irregular third person singular present tense DO auxiliary walk
The dog walks are my favorite Third person plural present tense BE copula --
The dog walks were going to be fun Third person plural past tense BE auxiliary going, be
That dog has walked all day Irregular third person singular present tense HAVE auxiliary walked
Table 1 Finite Verb Forms.
Finite Verb Forms.×
Subject (Noun or Noun Phrase) Predicate (Verb or Verb Phrase) Finiteness Form Nonfinite Form
I walk First person singular present tense --
I walked First person singular past –ed --
The dog walks Third person singular –s --
The dog doesn't want to walk Irregular third person singular present tense DO auxiliary walk
The dog walks are my favorite Third person plural present tense BE copula --
The dog walks were going to be fun Third person plural past tense BE auxiliary going, be
That dog has walked all day Irregular third person singular present tense HAVE auxiliary walked
×
Table 2 Question Forms with Auxiliary/Copula Inversion.
Question Forms with Auxiliary/Copula Inversion.×
Sentence Question: Auxiliary inversion
You are excited about the walk Image Not Available
She is walking Image Not Available
They walked Image Not Available
She walks to the store Image Not Available
You are excited about the walk. Image Not Available
Table 2 Question Forms with Auxiliary/Copula Inversion.
Question Forms with Auxiliary/Copula Inversion.×
Sentence Question: Auxiliary inversion
You are excited about the walk Image Not Available
She is walking Image Not Available
They walked Image Not Available
She walks to the store Image Not Available
You are excited about the walk. Image Not Available
×
Table 3 Sensitivity and Specificity Levels across Studies.
Sensitivity and Specificity Levels across Studies.×
Citation Age (years) Sensitivity Specificity
Hadley & Short (2005)  2-3 73.25 87.25
Bedore & Leonard (1998)  3-5 94.73 94.73
Gladfelter & Leonard (2013)  4-5 96.16 92.82
Conti-Ramsden (2003)  5 71 91
Redmond, Thompson & Goldstein (2011)  7-8 84 95
Conti-Ramsden, Botting, & Faragher (2001)  10 68.5 89.5
Table 3 Sensitivity and Specificity Levels across Studies.
Sensitivity and Specificity Levels across Studies.×
Citation Age (years) Sensitivity Specificity
Hadley & Short (2005)  2-3 73.25 87.25
Bedore & Leonard (1998)  3-5 94.73 94.73
Gladfelter & Leonard (2013)  4-5 96.16 92.82
Conti-Ramsden (2003)  5 71 91
Redmond, Thompson & Goldstein (2011)  7-8 84 95
Conti-Ramsden, Botting, & Faragher (2001)  10 68.5 89.5
×
Table 4 Past Tense Probe Scorable and Unscorable Responses.
Past Tense Probe Scorable and Unscorable Responses.×
Scorable Responses Unscorable Responses
Painted, she painted Paint, painting, Paints
Painteded, she painteded She is painting, She was painting
She paint She's done
Other marked verb (i.e., colored, built) She will/could/might/did paint
Gave, She gave, She give, She gived, Gaved, She gaved She paints, She put paint on, Give
Table 4 Past Tense Probe Scorable and Unscorable Responses.
Past Tense Probe Scorable and Unscorable Responses.×
Scorable Responses Unscorable Responses
Painted, she painted Paint, painting, Paints
Painteded, she painteded She is painting, She was painting
She paint She's done
Other marked verb (i.e., colored, built) She will/could/might/did paint
Gave, She gave, She give, She gived, Gaved, She gaved She paints, She put paint on, Give
×
Table 5 Prompt for Off Target Past Tense Probe Responses.
Prompt for Off Target Past Tense Probe Responses.×
Child's response Prompt
She is skating/She was skating. Tell me what she did with the skates.
Tell me what she did on the ice.
He rakes. Tell me what he did to the leaves.
He put them in a pile. Tell me what he did with the rake.
He's done eating the cookies. What did he do to the cookies?
Skate. Tell me what she did. She… (cloze task)
Table 5 Prompt for Off Target Past Tense Probe Responses.
Prompt for Off Target Past Tense Probe Responses.×
Child's response Prompt
She is skating/She was skating. Tell me what she did with the skates.
Tell me what she did on the ice.
He rakes. Tell me what he did to the leaves.
He put them in a pile. Tell me what he did with the rake.
He's done eating the cookies. What did he do to the cookies?
Skate. Tell me what she did. She… (cloze task)
×
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