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A follow-up study of children with articulation and language disorders.

Thirty-six subjects, 18 language-impaired and 18 articulation-impaired children, were followed up with respect to communication skills and educational performance 13 to 20 years after their initial contact with the Speech and Hearing Clinic. According to their parents, nine language-impaired subjects continued to exhibit communication problems as adults, compared to only one of the articulation-impaired subjects. Standardized educational testing conducted while the subjects were in elementary and secondary schools indicated that the language-impaired group consistently achieved at a lower level than the articulation-impaired group, particularly in reading. Differences between the groups were also exhibited in the types of postsecondary education attempted by the subjects. Clinical, educational, and research implications of these results are discussed.

Achievement↗

Language disorder--James: a case history.

When James was born he seemed the perfect baby. But gradually Venetia Young became concerned about his slow development. Despite repeated reassurance from health professionals, including her health visitor, she persisted in seeking medical opinion and finally learned that James had a language disorder. Here she describes his early years, the warning signs of his language problem and her battle against the experts' disbelief.

Attitude of Health Personnel↗

Corpus callosum size in children with developmental language disorder.

Using high-resolution in-vivo magnetic resonance morphometry of the midsagittal area of the corpus callosum (CC) and four callosal subareas in 21 children with developmental language disorder (DLD) of the phonologic-syntactic type we found no significant anatomical differences in comparison to an age- and gender-matched normal control group. There was also no significant between-group difference when the approximately 7% smaller forebrain volume among children with DLD was accounted for by relating CC measures to forebrain volume. Only a tendency towards a larger anterior and middle CC in relation to forebrain volume was found in DLD children. In our DLD children we found the same relationship between CC midsagittal size and forebrain volume as recently reported for normal adults, namely, that the CC area increases to the two-third power of forebrain volume.

Child↗

Technology applications in intervention for preschool-age children with language disorders.

Preschool-age children are capable of using computers and benefiting from developmentally appropriate software. Computer technology has been used successfully in therapy for young children with speech and language disorders; however, the clinician is a crucial factor in such success. Clinicians choose communication goals and appropriate software, plan precomputer activities, provide appropriate models and opportunities during the computer activity, and provide postcomputer activities that ensure the generalization of new skills. In this article, we discuss and illustrate the characteristics of developmentally appropriate computer-based activities and the role of clinicians in planning and implementing these activities for young children.

Child↗

A treatable language disorder: pharmacological treatment of pervasive developmental disorder.

Results of treatment of four patients are described. All of the patients had pervasive developmental disorder (PDD), a tic disorder, and a characteristic pattern of speech and language impairment. The patients were treated with haloperidol for their tic disorders, and concomitant with the reduction of the frequency and severity of tics was marked improvement in language. The patients averaged 3 months of language gain for each week of speech therapy directly after the initiation of haloperidol treatment for tics. Progress in speech and language therapy was extremely slow during the years prior to treatment with haloperidol. To the authors' knowledge, no language disorder has been described in the literature which shows such a predictable and marked response to pharmacological treatment. The authors hypothesize that tic disorders in individuals with PDD may be a marker for a more positive response to dopamine antagonists like haloperidol.

Child↗

Treatment research in speech, language and swallowing: lessons from child language disorders.

Three major types of treatment research methodologies are described. Studies on child language intervention are reviewed as examples of trends and methodological issues characterizing treatment research in speech, language, and swallowing within the last 2-3 decades. Principles are drawn from that literature and suggestions for future directions are discussed with particular attention to recent efforts to support clinical trials and treatment outcomes research.

Child Language↗

A minority perspective in the diagnosis of child language disorders.

The effective diagnosis and treatment of persons from diverse minority language backgrounds has become an important issue in the field of speech and language pathology. Yet, many SLPs have had little or no formal training in minority language, there is a paucity of normative data on language acquisition in minority groups, and there are few standardized speech and language tests appropriate for these groups. We described a diagnostic process that addresses these problems. The diagnostic protocol we have proposed for a child from a Black English-speaking background characterizes many of the major issues in treating minority children. In summary, we proposed four assessment strategies: gathering referral source data; making direct observations; using standardized tests of non-speech and language behavior (cognition, perception, motor, etc.); and eliciting language samples and probes.

Black or African American↗

FOXP2 expression during brain development coincides with adult sites of pathology in a severe speech and language disorder.

Disruption of FOXP2, a gene encoding a forkhead-domain transcription factor, causes a severe developmental disorder of verbal communication, involving profound articulation deficits, accompanied by linguistic and grammatical impairments. Investigation of the neural basis of this disorder has been limited previously to neuroimaging of affected children and adults. The discovery of the gene responsible, FOXP2, offers a unique opportunity to explore the relevant neural mechanisms from a molecular perspective. In the present study, we have determined the detailed spatial and temporal expression pattern of FOXP2 mRNA in the developing brain of mouse and human. We find expression in several structures including the cortical plate, basal ganglia, thalamus, inferior olives and cerebellum. These data support a role for FOXP2 in the development of corticostriatal and olivocerebellar circuits involved in motor control. We find intriguing concordance between regions of early expression and later sites of pathology suggested by neuroimaging. Moreover, the homologous pattern of FOXP2/Foxp2 expression in human and mouse argues for a role for this gene in development of motor-related circuits throughout mammalian species. Overall, this study provides support for the hypothesis that impairments in sequencing of movement and procedural learning might be central to the FOXP2-related speech and language disorder.

Adult↗

Dyslexia: a developmental language disorder.

The acquisition of literacy in an alphabetic script such as English makes heavy demands on linguistic skills. The relation between spoken and written language however, is far from straightforward. This article reviews the research that suggests that phonological processing skills are crucial in the translation of symbols to sounds, and the development of rapid and automatic decoding skills. It examines research that indicates that children whose phonological processing skills are compromised in some way, are at-risk of experiencing difficulties in the acquisition of literacy; it supports the suggestion that dyslexia can be viewed as lying on the continuum of developmental language disorders. It goes on to relate theory to practice and discusses the responsibilities of health care professionals in relation to the early identification of dyslexia, and makes suggestions regarding intervention. In particular, it looks at the responsibilities of speech and language therapy services in the care and management of children with dyslexia.

Child↗

Judgments of grammaticality by normal and language-disordered children.

Fifteen linguistically normal children and 15 linguistically deviant children were presented with three types of agrammatical sentences. The subjects were asked to judge the sentences as right or wrong and to change the sentences judged as wrong, rendering them correct. The three types of agrammatical sentences represented rule violations of syntactic agreement (Type A), lexical restrictions (Type B), and word order (Type C). The two groups of children were compared in terms of the number of sentences of each type that were agrammatical. Those productions which represented the child's correction of agrammatical sentences were subjected to descriptive analyses (percentages) with specific reference to the number of attempted changes and the number of those changes which demonstrated corrections of the specific deviation from well formedness. Results indicated that the two groups of subjects were significantly different in their ability to recognize grammatical errors in sentence Types A and C, but did not differ in their ability to recognize errors in sentence Type B. The descriptive comparison of the groups' verbal corrections reflected this trend, in that the language-disordered subjects made corrections specific to the error on more of the Type B sentences (for example, "The dog writes the food.") than on Types A (for example, "She will pick some flowers last week.") or C (for example, "Get and come your dinner."1.) Linguistically normal children accurately corrected 90.7% of the sentences judges as agrammatical; this percentage did not vary more than 1% across sentence types.

Child↗

Evidence from imaging on the relationship between brain structure and developmental language disorders.

This article discusses findings using various imaging techniques regarding the neurological underpinnings of developmental language and learning disorders. Evidence from magnetic resonance imaging, functional magnetic resonance imaging, single photon emission spectroscopy, and positron emission tomography implicates the left perisylvian regions in the processing of phonemes and auditory information, as had been predicted from lesion data and from neurobiological theory. The areas of the planum temporale and angular gyrus have been found to be compromised in children and adults with dyslexia or language impairment. Emerging evidence suggests that these differences are also present in members of families with a history of developmental language disorders, which provides support for a transmittable, biological factor involved in such disorders. Dynamic imaging procedures are beginning to provide an understanding of the relationship between structure and function in normal and abnormal language acquisition.

Adult↗

Typical pattern of the Kaufman-Assessment Battery in children with developmental language disorder.

In this study we used the Kaufman-Assessment Battery for children (K-ABC), which assumes a dichotomy of sequential versus simultaneous processing of intelligence, in order to describe the typical pattern of processing in 25 children with normal nonverbal intelligence and developmental language disorder (DLD) of the phonologic-syntactic subtype, a mixed receptive-expressive DLD with grammatical and phonologic deficits. The results of the K-ABC showed a significant deficit in auditory sequential processing, whereas simultaneous processing was normally performed.

Child Language↗

Elucidation of a cryptic interstitial 7q31.3 deletion in a patient with a language disorder and mild mental retardation by array-CGH.

We report on a 14-year-old boy who presented with bilateral cleft lip and palate, hearing loss, a language processing disorder, and mild mental retardation (MR). G-banded chromosome analysis of the patient and his family revealed he carried an apparently balanced de novo complex translocation involving chromosomes 5, 6, and 7. Chromosomal comparative genomic hybridization (CGH) was performed to investigate the possibility of any genomic imbalance as a result of the complex rearrangement. No abnormality was detected at any of the translocation breakpoint regions (5p13.2, 6p24, 7q21.1, and 7q21.3), nor was there any other imbalance which fell inside our significance level of 0.8-1.2. Array-CGH analysis was initiated to perform a higher resolution search for gains and losses, and revealed a deletion of two adjacent clones, CTB-133K23 and RP11-112P4, mapping to 7q31.3, which are 4.4 Mb apart. Fluorescence in situ hybridization (FISH) using these two clones confirmed the deletion. 7q31 has frequently been implicated in the search for genes involved in speech and language disorders. The specific 7q31.3 region deleted in our patient has significant overlap with some such areas of the genome. These findings are, therefore, of value in identifying genes involved in the speech and language phenotypes. This study has shown the importance of array-CGH in investigating patients who have clinical features suggestive of a chromosome abnormality, but with apparently balanced chromosome rearrangements. It has demonstrated that the array-CGH technique provides a much greater insight into submicroscopic chromosome imbalances than conventional cytogenetic techniques.

Abnormalities, Multiple↗