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Changes in language development among autistic and peer children in segregated and integrated preschool settings.

Five young children with autism enrolled in a segregated class, five other children with autism in an integrated class, and four normally developing peer children in the integrated class were compared for developmental changes in language ability as measured by the Preschool Language Scale before and after training. The results, based on Mann-Whitney U tests, showed that (a) all of the children as a group made better than normative progress in rate of language development, (b) the scores of the autistic children were significantly lower than the peers before and after treatment, and (c) there were no significant differences in changes in language ability between the autistic children in the segregated and integrated classes.

Autistic Disorder↗

A comparison of language characteristics of mentally retarded adults with fragile X syndrome and those with nonspecific mental retardation and autism.

Fragile X syndrome is a recently identified form of mental retardation that is associated with a chromosomal abnormality and inherited in an X-linked manner. Previous studies have suggested that distinctive speech and language characteristics are associated with the syndrome. Twelve adult male residents of an institution for the retarded (aged 23 to 51 years) were compared on a series of speech and language measures to 12 adult males with nonspecific forms of MR who were residents of the same institution and were matched on age and IQ. A second contrast group consisted of similarly matched autistic men. Results revealed that there were no significant differences among the groups' performance, with the exception of increased rates of echolalia in the autistic group. A nonsignificant trend toward poorer performance on expressive measures on the part of the fragile X group was noted. The implications of these findings for further research on the syndrome are discussed.

Adult↗

The effects of two levels of linguistic constraint on echolalia and generative language production in children with autism.

The effects of specific types of adult antecedent utterances (high vs. low constraint) on the verbal behaviors produced by three subjects with autism were examined. Adult utterance types were differentiated in terms of the amount of control the adults exhibited in their verbal interactions with the subjects during a free play setting. Videotaped interactions were analyzed and coded according to a predetermined categorical system. The results of this investigation suggest that the level of linguistic constraint exerted on the child interactants during naturalistic play sessions affected their communicative output. The overall findings suggest that (a) adult high constraint utterances elicited more verbal utterances in general, as well as a majority of the subjects' echolalia; (b) adult low constraint utterances elicited more subject high constraint utterances; and (c) the degree of constraint of adult utterances did not appear to influence the mean lengths of subjects' utterances. The results are discussed in terms of their implications for educational interventions, and suggestions are made for future research concerning the dynamics of echolalia in interactive contexts.

Autistic Disorder↗

Phenotypic profiles of language-impaired children based on genetic/family history.

Although etiological influences in developmental language impairment (dysphasia) are not well defined, a significant increase of family aggregation for the disorder has been reported. We report data from a large cohort of language-impaired (LI) children participating in the San Diego longitudinal study in which we examined whether children with or without positive family histories show different phenotypic profiles. Due to the longitudinal design of the study, questions pertaining to change over time are also addressed. Second, a subgroup of the most impaired children were reevaluated to obtain additional information pertaining to family history and phenotypic outcome. Approximately 70% of the LI children met criteria for inclusion as family history positive, with fathers reporting a history of language or learning problems one and a half to two times as frequently as mothers. LI children with or without a positive family history were not significantly different on language skills or IQ. However, subjects having a positive family history for developmental language/learning problems were significantly lower in socioeconomic status and were rated by parents and teachers as having more attention-related behavior problems than their family history negative counterparts. Similarly, family history positive LI children performed more poorly on standardized academic tests as well as on tests of auditory processing and attention.

Child↗

Increasing speech intelligibility in children with autism.

Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, reliably influence the effectiveness of language teaching interactions for children with autism. However, the effectiveness of this approach has not yet been assessed with respect to improving speech intelligibility. The purpose of this study was to systematically compare two intervention conditions, a Naturalistic approach (which incorporated motivational variables) vs. an Analog (more traditional, structured) approach, with developmentally similar speech sounds equated within and across conditions for each child. Data indicate that although both methods effectively increased correct production of the target sounds under some conditions, functional use of the target sounds in conversation occurred only when the naturalistic procedures were used during intervention. Results are discussed in terms of pivotal variables that may produce improvements in speech sounds during conversational speech.

Articulation Disorders↗

Phonological disorders II: a conceptual framework for management.

A conceptual framework for management of phonological disorders is proposed. The framework includes a 10-element system for describing the structure of management programs and invokes a diagnostic classification system for determining appropriate management content. Data from three serial studies of management structure describe the effectiveness, efficiency, and clinician acceptance of four modes of management: Drill, Drill Play, Structured Play and Play. Review of past, present, and future content of management programs emphasizes the central role of individual differences among persons with phonological disorders.

Child↗

Arithmetic skills in kindergarten children with developmental language disorders.

Although arithmetic is not a language-based skill, a specific learning disability in arithmetic--dyscalculia--is commonly seen in children with developmental language disorders (DLD). The object of this study was to assess whether kindergarten children with DLD have impaired arithmetic skills and, if so, to correlate the pattern of dysfunction with language syndromes. Forty-two children with DLD attending mainstream kindergartens, and their matched controls, underwent an arithmetic battery, neurological examination, intelligence quotient (IQ) test (WPPSI/WISC-R) and language assessment (CELF-R).* Attention deficit hyperactivity disorder (ADHD) was diagnosed by psychological assessment and behaviour questionnaires. Results showed that children with DLD were similar to controls on performance IQ (104.2+/-12.1 and 109.4+/-12.7 respectively, p = NS), but inferior on both the CELF-R expressive (74.8+/-9.3 vs 95.2+/-15.1, p < 0.01) and receptive (77.5+/-10.0 vs 87.8+/-12.3, p < 0.01) language scores. Their performance on the arithmetic battery was also significantly poorer: 61.2+/-17.7 vs 77.4+/-13.7, p < 0.01. Low scores in reasoning principles and arithmetic operations were associated with both receptive and expressive language impairment, while poor performance on counting principles was primarily associated with expressive deficits. Mild motor signs and ADHD were more frequent in children with DLD (p < 0.01 and < 0.05, respectively). We concluded that the arithmetic impairment in children with DLD is pervasive, affecting a broad spectrum of skills. Whereas impairment of most arithmetic skills is associated with global language disturbances, counting correlates primarily with expressive language deficits. Anticipatory guidance by physicians will better prepare parents and educators for the multiple challenges facing children with DLD.

Attention Deficit Disorder with Hyperactivity↗

Pragmatic comprehension in secondary school-aged students with specific developmental language disorder.

This study explores the hypothesis that there may be particular difficulties for secondary school students with specific developmental language disorder (SDLD) in understanding contextual, pragmatic meaning. Sixty-four SDLD students aged 11+ to 14+ years are compared with chronological-age-matched and language-age-matched non-impaired students. New procedures are used to examine comprehension of two types of ambiguity where the context determines speaker intention: inconsistent messages of emotion and multiple meanings in context. These types of ambiguity are evident in a range of communicative intent, e.g. sarcasm, idiomatic expression, deceit and humour. Preliminary study into adolescent language suggests that at this age there is a growing expectation for students to understand these kinds of communication, both in the classroom and socially. The study finds that the SDLD students were less able than both comparison groups to use context to understand implied meanings. Non-impaired children were also more able to rule out literal interpretations when they did not know the non-literal meaning. These findings were statistically significant. The implications for research and practice are discussed, including those of diagnostic assessment, in the light of the literature survey revealing that many currently available do not assess pragmatic meaning comprehension. There is a challenge to the view that disorders in the semantic and pragmatic domains necessarily co-occur, as suggested by the diagnostic category semantic-pragmatic disorder.

Adolescent↗

Follow-up of children attending infant language units: outcomes at 11 years of age.

A large cohort of 242 children who had been attending infants language units at 7 years of age was followed up when the children were in their final year of primary school. Two hundred (83%) of the children were reassessed at 11 years of age on a wide battery of language and literacy measures, on a test of non-verbal ability, an autism checklist and a communication checklist. In total, 89% of children still scored < 1 SD from the mean on at least one test of language and the majority (63%) scored poorly on three or more assessments demonstrating widespread difficulties. Compared with non-verbal abilities at 7 years of age, a large proportion of the cohort also performed poorly on performance IQ subtests (28%). A further 10 children scored highly on a checklist for autistic spectrum disorder. Thus, only 115 (58%) children could be said to meet criteria for specific language impairment. A small group of 16 children appeared to have entirely resolved their difficulties. These outcomes and their implications for education and long-term impact of the disorder are discussed.

Autistic Disorder↗

Hearing, language, speech, vestibular, and dentofacial disorders in fetal alcohol syndrome.

Fetal alcohol syndrome (FAS) is characterized by congenital anomalies traditionally associated with hearing disorders. The present study sought to (a) evaluate possible central hearing loss; (b) verify and extend previous observations on sensorineural and conductive hearing losses; (c) evaluate possible vestibular disorders; (d) examine the relationships between hearing, speech, language, vestibular, and dentofacial disorders in FAS patients; and (e) evaluate the influence of patient age, race, and gender on the expression of these morbidities. A biracial group of 22 FAS patients (aged 3 to 26 years) were evaluated by standard hearing, speech, language, and vestibular tests. Dentofacial and other malformations were also assessed. Of the 22 FAS patients, 17 (77%) had intermittent conductive hearing loss due to recurrent serous otitis media that persisted from early childhood into adulthood, whereas 6 (27%) had sensorineural hearing loss in addition to the conductive hearing loss. Among the 12 patients tested for central hearing function, all (100%) were significantly impaired. Among the patients tested for speech and language ability, 18 of 20 (90%) had speech pathology, 16 of 21 (76%) had expressive language deficits, and 18 of 22 (82%) had receptive language deficits. Hearing, speech, and language deficits were not influenced by age, race, or gender. On the vestibular tests, all performed within normal limits with the possible exception of one child (n = 6). High incidences of dentofacial, temporomandibular joint, ocular, cardiac, and skeletal disorders were observed. Race and gender tended to influence dental malocclusion class. Two subjects exhibited autistic tendencies. In conclusion, new and important findings included a high prevalence of sensorineural, conductive, and central hearing deficits, the persistence of otitis proneness into adulthood, the existence of temporomandibular joint disorders, and the possible influence of gender or race on dental malocclusions. Such disorders can contribute to the learning, behavioral, and emotional difficulties seen in FAS patients and warrant early, aggressive intervention.

Adolescent↗

Theoretical perspectives on language and communication problems in mental retardation and developmental disabilities.

We argue that researchers interested in language and communication problems in mental retardation or any other developmental disorder should view such problems as emerging within the broader context of the behavioral profile, or phenotype, associated with a particular genetic condition. This will require understanding the direct and indirect effects of genes on the development of language and communication and thereby an understanding of the complex relations that exist between language and other dimensions of psychological and behavioral functioning as well as an understanding of the environments in which the developing person acts and is acted upon. We believe that the dominant model for understanding language and communication problems--the nativist approach, which emphasizes the child's innate capacity for acquiring language and characterizes language as consisting of a set of context-free deterministic rules that operate on abstract representations--is inconsistent with an emphasis on indirect genetic effects. We review recent evidence that undermines the nativist approach--evidence concerning the initial state of the language-learning child, the role of environmental input, the competence-performance distinction, and modularity. In place of nativism, we argue for Emergentism, which is a model in which language is seen to emerge from the interaction between the child's biological abilities to map statistical properties of the language input into a distributed representation and the characteristics of the language learning environment and for the purpose of engaging in real-time, meaningful language use.

Child↗

Expressive language development of children exposed to cocaine prenatally: literature review and report of a prospective cohort study.

It was hypothesized that prenatal exposure to cocaine and other substances would be related to delayed expressive language development. Speech and language data were available for 458 6-year olds (204 were exposed to cocaine). No significant univariate or multivariate differences by cocaine exposure group were observed. Classification and regression tree modeling was then used to identify language variable composites predictive of cocaine exposure status. Meaningful cut points for two language measures were identified and validated. Children with a type token ratio of less than 0.42 and with fewer than 97 word types were classified into a low language group. Low language children (n = 57) were more likely to be cocaine exposed (63.1%), with cocaine-exposed children 2.4 times more likely to be in the low language group compared with control children after adjustment for covariates. Prenatal cigarette, but not alcohol exposure, was also significantly related to expressive language delays.

Child↗

Hearing and language development in high risk and normal infants.

In the present study a group of 147 infants who are at risk for a loss are contrasted with 49 normal infants on an audiological screening battery, which is used to assess auditory and language variables. A descriptive comparison between expected and actual performance levels was made for both groups in regards to their respective receptive and expressive language, auditory localization, and speech detection threshold scores. In general the normal infants were found to perform at or above the expected performance level, whereas the high risk infants seemed to perform at or slightly below expectation. The interrelationships of these language and auditory variables along with age and birth weight were also calculated separately for each group. The direction and significance of these intercorrelations were the same for both groups with the exception of the birth weight correlations. These findings and their implications are discussed.

Attention↗