This study evaluated a newly developed quasi-universal nonword repetition task (Q-U NWRT) as a diagnostic tool for bilingual children with language impairment (LI) who have Dutch as a 2nd language. The Q-U NWRT was designed to be minimally influenced by knowledge of 1 specific language in contrast to a language-specific NWRT with which it was compared.


One hundred twenty monolingual and bilingual children with and without LI participated (30 per group). A mixed-design analysis of variance was used to investigate the effects of LI and bilingualism on the NWRTs. Receiver operating characteristic analyses were conducted to evaluate the instruments' diagnostic value.


Large negative effects of LI were found on both NWRTs, whereas negative effects of bilingualism only occurred on the language-specific NWRT. Both instruments had high clinical accuracy in the monolingual group, but only the Q-U NWRT had high clinical accuracy in the bilingual group.


This study indicates that the Q-U NWRT is a promising diagnostic tool to help identify LI in bilingual children learning Dutch as a 2nd language. The instrument was clinically accurate in both a monolingual and bilingual group of children and seems better able to disentangle LI from language disadvantage than more language-specific measures.


  • Adriaans, F. (2006). PhonotacTools. [Computer program]. Utrecht, the Netherlands: Utrecht Institute of Linguistics OTS, Utrecht University.
  • Bedore, L., & Peña, E. (2008). Assessment of bilingual children for identification of language impairment: Current findings and implications for practice.International Journal of Bilingual Education and Bilingualism, 11, 1–29.
  • Bishop, D. V. M., North, T., & Donlan, C. (1996). Nonword repetition as a behavioural marker for inherited language impairment: Evidence from a twin study.Journal of Child Psychology and Psychiatry and Allied Disciplines, 37, 391–403.
  • Blom, E., de Jong, J., Orgassa, A., Baker, A., & Weerman, F. (2013). Verb inflection in monolingual Dutch and sequential bilingual Turkish–Dutch children with and without SLI.International Journal of Language & Communication Disorders, 48, 1–12.
  • Campbell, T., Dollaghan, C., Needleman, H., & Janosky, J. (1997). Reducing bias in language assessment: Processing-dependent measures.Journal of Speech, Language, and Hearing Research, 40, 519–525.
  • Chiat, S. (2015). Nonword repetition.In S. Armon-Lotem, J. de Jong, & N. Meir (Eds.), Methods for assessing multilingual children: Disentangling bilingualism from language impairment (pp. 125–150). Bristol, England: Multilingual Matters.
  • Coady, J. A., & Evans, J. L. (2008). Uses and interpretations of non-word repetition tasks in children with and without specific language impairments (SLI).International Journal of Language & Communication Disorders, 43, 1–40.
  • Coady, J. A., Evans, J. L., & Kluender, K. R. (2010). The role of phonotactic frequency in nonword repetition by children with specific language impairments.International Journal of Language & Communication Disorders, 45, 494–509.
  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Mahwah, NJ: Erlbaum.
  • Conti-Ramsden, G., Botting, N., & Faragher, B. (2001). Psycholinguistic markers for specific language impairment (SLI).Journal of Child Psychology and Psychiatry, 42, 741–748.
  • COST Action IS0804. (2011). Questionnaire for Parents of Bilingual Children (PaBiQ). Retrieved from http://www.bi-sli.org
  • De Bree, E., Rispens, J., & Gerrits, E. (2007). Non-word repetition in Dutch children with (a risk of) dyslexia and SLI.Clinical Linguistics & Phonetics, 21, 935–944.
  • Dispaldro, M., Leonard, L. B., & Deevy, P. (2013). Real-word and nonword repetition in Italian-speaking children with specific language impairment: A study of diagnostic accuracy.Journal of Speech, Language, and Hearing Research, 56, 323–336.
  • Dollaghan, C., & Campbell, T. F. (1998). Nonword repetition and child language impairment.Journal of Speech, Language, and Hearing Research, 41, 1136–1146.
  • Ellis Weismer, S., Tomblin, J., Zhang, X., Buchwalter, P., Chynoweth, J., & Jones, M. (2000). Nonword repetition performance in school-age children with and without language impairment.Journal of Speech, Language, and Hearing Research, 43, 865–878.
  • Engel, P. M. J., Santos, F. H., & Gathercole, S. E. (2008). Are working memory measures free of socioeconomic influence?.Journal of Speech, Language, and Hearing Research, 51, 1580–1587.
  • Engel de Abreu, P. M. J. (2011). Working memory in multilingual children: Is there a bilingual effect?.Memory, 19, 529–537.
  • Engel de Abreu, P. M. J., Baldassi, M., Puglisi, M. L., & Befi-Lopes, D. M. (2013). Cross-linguistic and cross-cultural effects on verbal working memory and vocabulary: Testing language minority children with an immigrant background.Journal of Speech, Language, and Hearing Research, 56, 630–642.
  • Gathercole, S. E. (1995). Is non-word repetition a test of phonological memory or long-term knowledge? It all depends on the non-words.Memory & Cognition, 23, 83–94.
  • Gathercole, S. E. (2006). Nonword repetition and word learning: The nature of the relationship.Applied Psycholinguistics, 27, 513–543.
  • Gathercole, S. E., & Baddeley, A. D. (1989). Evaluation of the role of phonological STM in the development of vocabulary in children: A longitudinal study.Journal of Memory and Language, 28, 200–213.
  • Gathercole, S. E., & Baddeley, A. D. (1990). Phonological memory deficits in language disordered children: Is there a causal connection?.Journal of Memory and Language, 29, 336–360.
  • Graf-Estes, K., Evans, J. L., & Else-Quest, N. M. (2007). Differences in the nonword repetition performance of children with and without specific language impairment: A meta-analysis.Journal of Speech, Language, and Hearing Research, 50, 177–195.
  • Gray, S. (2003). Diagnostic accuracy and test-retest reliability of nonword repetition and digit span tasks administered to preschool children with specific language impairment.Journal of Communication Disorders, 36, 129–151.
  • Grimm, A., & Schulz, P. (2014). Specific language impairment and early second language acquisition: The risk of over- and underdiagnosis.Child Indicators Research, 7, 821–841.
  • Grüter, T. (2005). Comprehension and production of French object clitics by child second language learners and children with specific language impairment.Applied Psycholinguistics, 26, 363–392.
  • Gutiérrez-Clellen, V. F. (1996). Language diversity: Implications for assessment.In K. N. Cole, P. S. Dale, & D. J. Thal (Eds.), Assessment of communication and language (pp. 29–56). Baltimore, MD: Brookes.
  • Gutiérrez-Clellen, V. F., & Simon-Cereijido, G. (2010). Using nonword repetition tasks for the identification of language impairment in Spanish-English-speaking children: Does the language of assessment matter?.Learning Disabilities Research & Practice, 25, 48–58.
  • Håkansson, G. (2001). Tense morphology and verb-second in Swedish L1 children, L2 children and children with SLI.Bilingualism: Language and Cognition, 4, 85–99.
  • Håkansson, G., & Nettelbladt, U. (1996). Similarities between SLI and L2 children. Evidence from the acquisition of Swedish word order.In J. Gilbert & C. Johnson (Eds.), Children's Language (pp. 135–151). Mahwah, NJ: Erlbaum.
  • Hoff, E., Core, C., Place, S., Rumiche, R., Señor, M., & Parra, M. (2012). Dual language exposure and early bilingual development.Journal of Child Language, 39, 1–27.
  • IBM Corp. (2013). SPSS Statistics for Windows (Version 22.0) [Computer software]. Armonk, NY: IBM Corp.
  • Kalnak, N., Peyrard-Janvid, M., Forssberg, H., & Sahlén, B. (2014). Nonword repetition: A clinical marker for specific language impairment in Swedish associated with parents' language-related problems.PLoS ONE, 9, e89544.
  • Kohnert, K. (2010). Bilingual children with primary language impairment: Issues, evidence and implication for clinical actions.Journal of Communication Disorders, 43, 456–473.
  • Kohnert, K., & Bates, E. (2002). Balancing bilinguals. II: Lexical comprehension and cognitive processing in children learning Spanish and English.Journal of Speech, Language, and Hearing Research, 45, 347–359.
  • Kohnert, K., Windsor, J., & Yim, D. (2006). Do language-based processing tasks separate children with primary language impairment from typical bilinguals?.Journal of Learning Disabilities Research & Practice, 21, 19–29.
  • Kort, W., Schittekatte, M., & Compaan, E. L. (2008). CELF-4-NL: Clinical Evaluation of Language Fundamentals. Amsterdam, the Netherlands: Pearson Assessment and Information.
  • Messer, M. H., Leseman, P. P. M., Boom, J., & Mayo, A. Y. (2010). Phonotactic probability effect in nonword recall and its relationship with vocabulary in monolingual and bilingual preschoolers.Journal of Experimental Child Psychology, 105, 306–323.
  • Munson, B., Kurtz, B. A., & Windsor, J. (2005). The influence of vocabulary size, phonotactic probability, and wordlikeness on nonword repetitions of children with and without language impairments.Journal of Speech, Language, and Hearing Research, 48, 1033–1047.
  • Oller, D. K., & Pearson, B. Z. (2002). Assessing the effects of bilingualism: A background.In D. K. Oller & R. E. Eilers (Eds.), Language and Literacy in Bilingual Children (pp. 3–21). Clevedon, England: Multilingual Matters.
  • Orgassa, A., & Weerman, F. (2008). Dutch gender in specific language impairment and second language acquisition.Second Language Research, 24, 333–364.
  • Paradis, J. (2005). Grammatical morphology in children learning English as a second language: Implications of similarities with specific language impairment.Language, Speech, and Hearing Services in Schools, 36, 172–187.
  • Paradis, J. (2010). The interface between bilingual development and specific language impairment.Applied Psycholinguistics, 31, 3–28.
  • Paradis, J. (2011). Individual differences in child English second language acquisition: Comparing child-internal and child-external factors.Linguistic Approaches to Bilingualism, 1, 213–237.
  • Paradis, J., Emmerzael, K., & Sorenson Duncan, T. (2010). Assessment of English language learners: Using parent report on first language development.Journal of Communication Disorders, 43, 474–497.
  • Plante, E., & Vance, R. (1994). Selection of preschool language tests: A data-based approach.Language, Speech, and Hearing Services in Schools, 25, 15–24.
  • Restrepo, M. A., & Silverman, S. (2001). Validity of the Spanish Preschool Language Scale-3 for use with bilingual children.American Journal of Speech-Language Pathology, 10, 382–393.
  • Rispens, J., & Baker, A. (2012). Nonword repetition: The relative contributions of phonological short-term memory and phonological representations in children with language and reading impairment.Journal of Speech, Language, and Hearing Research, 55, 683–694.
  • Salameh, E. K., Nettelbladt, U., Håkansson, G., & Gullberg, B. (2002). Language impairment in Swedish bilingual children: A comparison between bilingual and monolingual children.Acta Paediatrica, 9, 229–234.
  • Scheele, A. F., Leseman, P. P. M., & Mayo, A. Y. (2010). The home language environment of monolingual and bilingual children and their language proficiency.Applied Psycholinguistics, 31, 117–140.
  • Schlichting, L. (2005). Peabody Picture Vocabulary Test-III-NL. Dutch version. Amsterdam, the Netherlands: Harcourt Assessment.
  • Schlichting, J. E. P. T., & Lutje Spelberg, H. C. (2010a). Schlichting Test voor Taalbegrip: Handleiding [Schlichting Test for Language Comprehension: Manual]. Houten, the Netherlands: Bohn, Stafleu, Van Loghum.
  • Schlichting, J.E.P.T., & Lutje Spelberg, H. C. (2010b). Schlichting Test voor Taalproductie-II: Handleiding [Schlichting Test for Language Production: Manual]. Houten, the Netherlands: Bohn, Stafleu, Van Loghum.
  • Sharp, K. M., & Gathercole, V. C. M. (2013). Can a novel word repetition task be a language neutral assessment tool? Evidence from Welsh–English bilingual children.Child Language Teaching and Therapy, 29, 77–89.
  • Stichting Siméa. (2014). Indicatiecriteria: auditief en/of communicatief beperkte leerlingen [Criteria for diagnosis: Auditorily and/or communicatively impaired students]. Retrieved from http://www.simea.nl/dossiers/passend-onderwijs/brochures-po/14-simea-brochure-indicatiecriteria-digitaal.pdf
  • Smeets, E., Driessen, G., Elfering, S., & Hovius, M. (2010). Allochtone leerlingen en speciale onderwijsvoorzieningen [Immigrant students and special education]. Nijmegen, the Netherlands: ITS.
  • Summers, C., Bohman, T. M., Gillam, R. B., Peña, E. D., & Bedore, L. M. (2010). Bilingual performance on nonword repetition in Spanish and English.International Journal of Language & Communication Disorders, 45, 480–493.
  • Tape, T. (2008). Interpreting diagnostic tests. Retrieved from http://gim.unmc.edu/dxtests/Default.htm
  • Thordardottir, E., & Brandeker, M. (2013). The effect of bilingual exposure versus language impairment on nonword repetition and sentence imitation scores.Journal of Communication Disorders, 46, 1–16.
  • Thordardottir, E., Rothenberg, A., Rivard, M.-E., & Naves, R. (2006). Bilingual assessment: Can overall proficiency be estimated from separate measurement of two languages?.Journal of Multilingual Communication Disorders, 4, 1–21.
  • Tomblin, J. B., Records, N. L., & Zhang, X. (1996). A system for the diagnosis of specific language impairment in kindergarten children.Journal of Speech and Hearing Research, 39, 1284–1294.
  • Verhoeven, L., & Vermeer, A. (2001). Taaltoets Alle Kinderen (TAK). Arnhem, the Netherlands: Cito.
  • Wechsler, D., & Naglieri, J. A. (2008). Wechsler Nonverbal Scale of Ability. Purchased from http://www.pearsonclinical.nl/wnv-nl-wechsler-non-verbal

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