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[Children with a presumably isolated speech-language disorder often have medical or cognitive problems as well].

OBJECTIVE: To assess the language problems of children who otherwise appear to develop normally. DESIGN: A clinical inventory. SETTING: University Hospital Groningen. METHOD: The children (n = 319) were examined according to a standard protocol consisting of: ENT examination, audiologic examination, paedogogic observation and logopaedic examination. Further psychological examination was carried out when needed according to the paedagogic observation. RESULTS: 25 per cent of the children had isolated language problems. For these children logopaedic therapy was indicated. In 75 per cent, a clear associated medical factor, or a retarded cognitive and (or) motor development, was found. Forty per cent of these children received medical treatment and 35 per cent specific paedagogic guidance. In some cases additional logopaedic therapy was given. CONCLUSION: It appears advisable to give children with language problems logopaedic therapy only after a diagnostic examination has been carried out according to a standard protocol as described.

Child↗

Language disorders in young children: when is speech therapy recommended?

OBJECTIVE: Analysis of treatment recommendation given by speech therapists. Evaluation of the language abilities in the examined children and re-examination of those abilities after 12 months. MATERIALS AND METHODS: Thirty-four children, aged between 2.0 and 5.3 years, referred to speech therapists by their General Practitioners because of possible language problems were included in a prospective study. The number of children receiving speech therapy and the number of speech therapy sessions received during 1 year, and the therapy effect on three quantitative language measures were compiled. RESULTS: In 97% of the children referred to a speech therapist, speech therapy was recommended. Most of these children showed average to above-average language scores on standardised tests for sentence development (61%) and language comprehension (79%). In addition, for most children spontaneous speech, as screened by the Groningen Diagnostic Speech Norms, was age-adequate (76%). The children's problems consisted of pronunciation difficulties or periods of stammering. After 12 months for 50% of these children speech therapy was still continued which means that the articulation problems still were present. The mean number of speech therapy sessions was 26.7. The language scores on the three language tests remained relatively stable over the 12-month interval. CONCLUSIONS: In young children pronunciation difficulties often lead to the recommendation for speech therapy. For a large number of children therapy takes more than a year, indicating that speech therapy cannot influence these problems to a great extent. In addition language scores remained relatively stable. Therefore, language problems and especially articulation problems in young children should be reconsidered regarding maturation and normal variations in speech motor development. A 'watchful waiting' approach should be taken more often.

Child Language↗

Kinematic differentiation of prosodic categories in normal and disordered language development.

Prosody is complex and hierarchically organized but is realized as rhythmic movement sequences. Thus, observations of the development of rhythmic aspects of movement can provide insight into links between motor and language processes, specifically whether prosodic distinctions (e.g., feet and prosodic words) are instantiated in rhythmic movement output. This experiment examined 4-7-year-old children's (both normally developing and specifically language impaired) and adults' productions of prosodic sequences that were controlled for phonetic content but differed in morphosyntactic structure (i.e., content vs. function words). Primary analyses included kinematic measures of rhythmic structure (i.e., amplitude and duration of movements in weak vs. strong syllables) across content and function contexts. Findings showed that at the level of articulatory movement, adults produced distinct rhythmic categories across content and function word contexts, whereas children did not. Children with specific language impairment differed from normally developing peers only in their ability to produce well-organized and stable rhythmic movements, not in the differentiation of prosodic categories.

Adult↗