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Story grammar ability in children with and without language disorder: story generation, story retelling, and story comprehension.

Twenty language-impaired and unimpaired children ages 9:0 to 11:4 participated in three story tasks. The children generated three original stories, retold two adventure stories, and then answered two sets of comprehension questions after each retelling. Stein and Glenn's (1979) story grammar rules were adapted and used to analyze the narratives. The generated and retold stories produced by the language-disordered children contained fewer complete story episodes, a lower mean number of main and subordinate clauses per complete episode, and a lower frequency of use of story grammar components than those of the control group. The story hierarchies produced by both groups were highly similar, though, in both story generation and story retelling. The groups also did not differ in their understanding of the factual details of the retold stories, but did differ significantly in their comprehension of the relationships linking the critical parts of the stories together. The results are discussed relative to cognitive organizational deficits of language-impaired children.

Attention↗

Phonological correlates of middle-ear involvement in speech-delayed children: a methodological note.

The purpose of this note is to illustrate the potential contribution of phonological analysis to the study of the origins of developmental phonological disorders (delayed speech). Speech samples from two clinical populations of children with delayed speech were inspected. Within each group, children were subdivided on the basis of case records data on their histories of middle-ear involvement. In both clinical samples, children with positive histories of middle-ear involvement had statistically higher frequencies of occurrence of two sound change categories. Several analyses of one of the sound change categories were undertaken to determine whether these errors could be related to current deficits in underlying forms, to phonetic output constraints, or to perceptual-acoustic characteristics of the sounds involved.

Child↗

Estimating familial loading in SLI: a comparison of direct assessment versus parental interview.

PURPOSE: Two approaches commonly used for estimating prevalence of language disorders in families were compared. The 1st involved examining a subset of language items from an investigator-based interview used to record parental information on the language and literacy difficulties in relatives. The 2nd was the direct assessment of ability in immediate family using a battery of standardized verbal ability, language, and literacy assessments. METHOD: Using these 2 methods, the prevalence of language and literacy disorders was investigated in the immediate family (n=271) of 93 children with a history of SLI (mean age 13;11 years). RESULTS: The overall proportion of relatives with reported language or literacy difficulty was similar for both methods (34.5% for reported difficulties compared with 35% on direct assessment). The present study further explored maternal, paternal, and sibling prevalence rates and strength of agreement between parental interview and direct assessment. When a low cutoff score was used, good agreement (of true negatives and true positives) for reading and spelling difficulties and expressive language between the 2 types of case identification method was found. CONCLUSIONS: Parents can be effective identifiers when the impairment is severe (below 2 SDs from the population mean). Poor agreement was observed between report and assessment of receptive language difficulties.

Adolescent↗

A callosal transfer deficit in children with developmental language disorder.

Twenty-two control children (aged 6-12 years) and forty-three children with developmental language disorder (DLD) (aged 7-12 years) received a test of callosal transfer of tactile information. Among the children with dysphasia, 30 had a diagnosis of receptive dysphasia and 13 of expressive dysphasia. Both control children and children with DLD made a significantly larger number of errors in the crossed localization condition (implying callosal transfer of tactile information) versus the uncrossed localization condition. In the crossed localization condition, children with DLD made a significantly larger number of errors than controls, while no differences were found in the two groups of children with DLD. These data suggest that the corpus callosum may be involved in the pathogenesis of DLD.

Aphasia, Broca↗

Comprehension monitoring in language-disordered children: a preliminary investigation of cognitive and linguistic factors.

This study provided a preliminary investigation of the relative influence of cognitive and communicative factors in comprehension monitoring. This question was approached by studying language-disordered (LD) children for whom these abilities are presumably dissociated. Their performance on an ambiguity detection task was compared to that of two groups of control children, one matched for comprehension level and the other for cognitive level. Results revealed that LD children performed similarly to the control children who were matched for level of comprehension. The LD children's performance was examined along a continuum of the relative influence of cognitive and communicative factors, given that neither type of factor alone could sufficiently account for effective comprehension monitoring. It was concluded that communicative factors, both active primary comprehension and social communicative knowledge, had a stronger influence than the cognitive factors in our particular comprehension monitoring task.

Child↗

A diagnostic model and a test to assess word-finding skills in children.

There has been a diagnostic gap in the assessment of word-finding disorders in children. Although research in this area has continued to document strong correlations between word-finding skills and low reading achievement, dyslexia, language disorders, learning disabilities, and stuttering there have been no formal standardised measures for the assessment of word-finding skills in children. The purpose of this paper is to present: (1) a diagnostic model for the assessment of word finding; (2) a literature review that supports this model; (3) a formalised measure, the Test of Word Finding (TWF), which executes this diagnostic model for children. The assessment model includes variation in stimulus context (multiple naming sections); incorporates indices traditionally used to define word-finding problems in adults and children (accuracy, response time, response analysis and secondary characteristics); and provides for a comprehension assessment of naming errors. Components of this model are discussed with respect to stimulus context, target word frequency, nature of the target word and facilitating cues.

Child↗

Frozen phonology thawed: the analysis and remediation of a developmental disorder of real word phonology.

A 5-year-old boy presented with very deviant phonological production, as well as some delay in acquisition of vocabulary for comprehension. Investigations showed that, in contrast to his very limited phonological system in word production and naming, he was able to repeat a variety of non-words with reasonable accuracy using a variety of syllable structures. A period of therapy aimed at improving his phonological segmentation skills resulted in dramatic improvement in real word production to the same level that he showed with non-words. This improvement was specific to the domain of treatment--real word phonology--demonstrating that the effects were a result of the therapy regimen. The reasons for this dissociation between the phonology of real words and non-words are discussed. It is concluded that the child's pattern of performance is incompatible with theories which assume that a single phonological representation is used both for word recognition and for output. His deficit appears to lie in a failure to update the underlying phonological representations used to drive spoken output as his phonological abilities develop--his lexical phonology was 'frozen'.

Child, Preschool↗

Improving the positive predictive value of screening for developmental language disorder.

In a previous study, we reported the results of an early language screening program in which 306 children were screened using a parent-report questionnaire sent through the mail (Klee et al., 1998). A sample of the children screened were given clinical evaluations within a month of screening (n = 64) and again 1 year later (n = 36). Although the screening program correctly identified 91% of 2-year-olds with language delay, it produced a large number of over-referrals. In the present study we examine a revised screening criterion designed to reduce the number of false positives. The revised criterion generated fewer positive screens overall than the original and resulted in improved specificity (96% vs. 87%) and positive predictive value (77% vs. 51%), while maintaining the high sensitivity (91%) and negative predictive value (98%) of the original criterion. We also propose a screening score based on the new criterion, designed to inform the process of deciding which children to bring in for further evaluation.

Child, Preschool↗

The stability of primary language disorder: four years after kindergarten diagnosis.

The rates of change in the language status of children with language impairment unaccompanied by other developmental or sensory disorders (primary language disorder) were studied in a longitudinal sample of 196 children who were followed from kindergarten through 4th grade. Previous studies have shown that children with such language impairments have moderate rates of improvement during this age range. Also, those with the most specific deficits have the greatest likelihood of improvement. Cole and colleagues have hypothesized that such results could be due to the effect of regression to the mean (K. Cole, I. Schwartz, A. Notari, P. Dale, & P. Mills, 1995). This study used a baseline measure of language that was independent of the measure used for diagnosis in order to control for factors leading to regression to the mean. Patterns of change using the kindergarten diagnostic measure were compared to those using the baseline measure. Rates of diagnostic change between kindergarten and subsequent observation intervals showed patterns of change similar to those of past research. Comparisons using the baseline measure revealed no significant change in relative language status across the 4-year time period. The results showed that when the conditions for regression to the mean were controlled, the poor language of children with language impairments was very likely to persist during the primary school years.

Analysis of Variance↗

Velopharyngeal function and dysfunction.

The concepts regarding velopharyngeal function, the production of disordered nasalization, and the management of velopharyngeal dysfunction can be summarized as follows: 1. Although the function of the velopharyngeal mechanism is critical to the control of oral-nasal balance, the configuration and function of the speech articulatory system as a whole will determine the degree of nasalized speech that is produced. 2. Velopharyngeal dysfunction can be related to one or a combination of structural and motor limitations within the velopharyngeal mechanism. 3. There are two perceptual manifestations of velopharyngeal dysfunction. One is acoustic (nasality); the other is aerodynamic (nasal emission). For any given speaker, it is possible to hear both, and it is possible to hear one and not the other. 4. Velopharyngeal dysfunction can be treated in a variety of ways. The method of treatment should be determined by the structural characteristics of the velopharyngeal mechanism and the speech-motor abilities of the patient.

Child↗

Untrained acquisition of /s/ in a phonologically disordered child.

The untrained /s/ productions of a phonologically disordered child were followed over a period of several months as she produced /s/ in imitated words and in spontaneous connected speech. For this child, as has been reported in the literature for children acquiring phonology normally, /s/ occurred earliest in the word-final position, appearing in word-initial position only several weeks later. Two word-medial, or intervocalic, contexts were compared: (a) monomorphemic words in which /s/ is word- and morpheme-medial (e.g., lasso); and (b) bimorphemic words in which /s/ is word-medial but morpheme-final (e.g., missing). In this latter group, a grammatical inflection or morpheme was added to a morpheme that ends with /s/. Correct responses to the intervocalic position where /s/ occurred at a morpheme boundary (i.e., in inflected morphemes) occurred earlier and more frequently than responses to single-morpheme intervocalic position. The variability of the child's productions over time is examined and discussed.

Child Language↗

Language and Williams syndrome: how intact is "intact"?

It has been claimed that Williams syndrome (WS), a rare neurodevelopmental disorder, is characterized by serious cognitive deficits alongside intact language. The syndrome is often used as a prime example of the modularity of an innate faculty for morphosyntactic rules. We challenge this claim and hypothesize that morphosyntax, although surprisingly good given WS level of mental retardation, is by no means intact. We make an initial test of this hypothesis through an analysis of the receptive language of a group of English-speaking WS individuals on a standardized morphosyntactic test. We then present an experimental study of expressive language that examines grammatical gender assignment in French-speaking WS patients. Despite a Verbal Mental Age selected to be higher than the chronological age of the young control group, these people with WS continue even in adulthood to show clear-cut deficits in their production of an aspect of morphosyntax that normal children acquire effortlessly very early. The results of the 2 studies, one focusing on receptive language and the other on expressive language, challenge the notion that comprehension and use of morphosyntactic rules in WS individuals are intact. The Within-domain dissociations regarding the use of grammatical gender assignment across several sentence clements and their difficulties in understanding embedded sentences-two quintessentially linguistic skills-suggest that we must rethink the notion of spared, modular, language capacities in Williams syndrome. We conclude that WS language follows a different path to normal acquisition and may turn out to be more like second language learning.

Adolescent↗

Otitis media and developmental disability. Epidemiologic considerations.

Review of the literature indicates that: a) otitis media is a common disorder with risk being highest in the pre- and early school years, b) no marked differences in sex distribution of incidence exist, c) frequent recurrences are the hallmark of this disease, and d) mild hearing deficit lasting for months is not uncommon. A retrospective study in a defined population is suggested as an initial effort to investigate the proposed associations between developmental disability and hearing loss, developmental disability and history of otitis media, and finally, hearing loss and history of otitis media. Such an approach, however, a) could not determine the absolute risk of developmental disability in children with otitis media, and b) would underestimate the frequency of otitis media, since occult otitis media would not be thus identified. The determination of an accurate incidence of otitis media and of the absolute risk of developmental disability in children with otitis media calls for a prospective study. Such an investigation is likely to be justified only as a part of a collaborative study designed to measure multiple outcomes from a limited number of antecedents.

Adolescent↗

Individual differences in anatomy predict reading and oral language impairments in children.

Developmental dyslexia (DD) and specific language impairment (SLI) are disorders of language that differ in diagnostic criteria and outcome. DD is defined by isolated reading deficits. SLI is defined by poor receptive and expressive oral language skills. Reading deficits, although prevalent, are not necessary for the diagnosis of SLI. An enduring question is whether these two disorders are qualitatively different or simply differ quantitatively along a dimension of severity. Here we address this problem by examining neuroanatomical correlates of reading and language in children with learning disabilities. We asked whether a quantitative anatomical risk index derived from previous work could predict behavioural profiles in a heterogeneous sample of 14 boys and 8 girls (11-16 years of age) with reading and language impairments. The results confirmed our predictions that (i) children with relatively smaller and symmetrical brain structures (negative risk indices) would have the severe comprehension impairments typical of SLI; (ii) children with larger, asymmetrical brain structures (positive risk indices) would have poor word reading in the presence of relatively preserved comprehension, a profile typical of DD; and (iii) the best performance would be seen in children with anatomical risk indices near zero (normal anatomy). Also, in confirmation of previous work, rapid automatic naming was not predicted by the anatomical risk index, but by anatomical measures derived from the frontal lobes. These results highlight the key significance of comprehension deficits in distinguishing DD from SLI. Reading impaired children with and without comprehension deficits appear to occupy neuroanatomical domains on the opposite sides of normal.

Adolescent↗

Speech and language therapy interventions for children with primary speech and language delay or disorder.

BACKGROUND: It is thought that approximately 6% of children have speech and language difficulties of which the majority will not have any other significant developmental difficulties. Whilst most children's difficulties resolve, children whose difficulties persist into primary school may have long-term problems concerning literacy, socialisation, behaviour and school attainment. OBJECTIVES: To examine the effectiveness of speech and language interventions for children with primary speech and language delay/disorder. SEARCH STRATEGY: The following databases were searched: The Cochrane Controlled Trials Register (Cochrane Library, CENTRAL: 2002/3), CINAHL (1982 - July 2002), EMBASE (1980 - Sept Week 4 2002), ERIC (1965 - 2002), MEDLINE (1966 - Sept Week 3 2002), PsycINFO (1872 - 2002/10 Week 2), The National Research Register (2002/3). In addition to this references were taken from reviews of the literature and reference lists from articles. SELECTION CRITERIA: The review considered randomised controlled trials of speech and language therapy interventions for children or adolescents with primary speech and language delay/disorder. DATA COLLECTION AND ANALYSIS: Titles and abstracts were identified and assessed for relevance, before the full text version was obtained of all potentially relevant articles. The data were categorised depending on the nature of the control group and considered in terms of the effects of intervention on expressive and receptive phonology, syntax and vocabulary. The outcomes used in the analysis were dependent on the focus of the study with only the primary effects of therapy being considered in this review. MAIN RESULTS: The results of twenty-five studies were used in the meta-analysis. The results suggest that speech and language therapy is effective for children with phonological (SMD=0.44, 95%CI: 0.01,0.86) or vocabulary difficulties (SMD=0.89, 95%CI: 0.21,1.56), but that there is less evidence that interventions are effective for children with receptive difficulties (SMD=-0.04, 95%CI: -0.64,0.56). Mixed findings were found concerning the effectiveness of expressive syntax interventions (n=233; SMD=1.02, 95%CI: 0.04-2.01). No significant differences were shown between clinician administered intervention and intervention implemented by trained parents, and studies did not show a difference between the effects of group and individual interventions (SMD=0.01, 95%CI: -0.26,1.17). The use of normal language peers in therapy was shown to have a positive effect on therapy outcome (SMD=2.29, 95%CI: 1.11,3.48). REVIEWER'S CONCLUSIONS: The review shows that overall there is a positive effect of speech and language therapy interventions for children with expressive phonological and expressive vocabulary difficulties. The evidence for expressive syntax difficulties is more mixed, and there is a need for further research to investigate intervention for receptive language difficulties. There is a large degree of heterogeneity in the results, and the sources of this need to be investigated.

Adolescent↗

Family with three apparently balanced t(3;15) (p27;q22) translocation carriers. Association with deficits in language acquisition and mental retardation: a possible example of position effect in man.

A father, son, and daughter had a (3;15) (p27;q22) simple reciprocal translocation. No abnormality in the G-banding pattern was noted. The girl was most severely affected; she had an abnormal phenotype, noticeable delay in receptive and expressive language development, bilateral hearing impairment, and definite mental retardation. The boy had a moderate delay in receptive language skills, had moderate hearing impairment in one ear, and showed mild mental retardation. The father has low-set ears, some deficits in receptive language skills, is illiterate, and was found to be borderline mentally retarded. The mother and younger child do not have the translocation and are normal in terms of phenotype, intellect, and verbal skills. The accumulating evidence suggests that balanced translocations are associated with an increased frequency of intellectual deficit and congenital anomalies, and the cytogenetic mechanism may be that of position effect.

Adult↗

Cerebral asymmetry and verbal intellectual deficits.

In a group of 53 children and young adults with learning disability, reversed cerebral asymmetry as measured by CT scan correlated highly with the prevalence, and to some extent with the degree, of verbal intellectual deficit as measured by age-appropriate Weschler Intelligence Scales. A history of delayed speech also correlated with reversed asymmetry but was not associated with a greater degree of verbal intellectual deficit among the reversed-asymmetry cases.

Adolescent↗

Theoretical influences on research on language development and intervention in individuals with mental retardation.

In this article, we consider the theoretical debates and frameworks that have shaped research on language development and intervention in persons with mental retardation over the past four decades. Our starting point is the nativist theory, which has been espoused most forcefully by Chomsky. We also consider more recent alternatives to the nativist approach, including the social-interactionist and emergentist approaches, which have been developed largely within the field of child language research. We also consider the implications for language development and intervention of the genetic syndrome-based approach to behavioral research advocated by Dykens and others. We briefly review the impact and status of the debates spurred by the nativist approach in research on the course of language development in individuals with mental retardation. In addition, we characterize some of the achievements in language intervention that have been made possible by the debates spurred by nativism and the various alternatives to it. The evidence we consider provides support for all three alternatives to the nativist approach. Moreover, successful interventions appear to embody elements of several of these approaches as well as other theoretical approaches (e.g., behaviorism). We conclude that language intervention must be theoretically eclectic in its approach, with different strategies appropriate for teaching different features of language, at different points in development, and for children displaying different characteristics or learning histories.

Child↗