Preserved phonological but impaired semantic processing in Williams syndrome: Evidence from a word association judgment task.

Williams syndrome (WS) is a genetic neurodevelopmental disorder affecting intellectual, cognitive, and language development. We re-examined the phonological-semantic imbalance hypothesis by probing phonological and semantic processing abilities within the same task context, in 19 children with WS and 57 typically developing (TD) children. Participants saw pictures pairs, heard their names, and indicated whether the words were related; the words, if related, shared either phonological or semantic features. Using a generalized linear mixed model, results showed that WS children exhibited a stronger preference for phonological associations over semantic associations, compared to TD children, after controlling for general verbal or non-verbal abilities. Both groups showed similar sensitivity to phonological relations, but WS children showed reduced sensitivity to semantic ones. This pattern suggests that WS individuals have a less developed or an atypical semantic network, emphasizing the need for language intervention to focus on semantic levels of processing.