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The prolonged central transmission time (CTT) in ABR examinations in children with the delayed speech was described in 1992. Now after 4 years the examinations were repeated. The children with actually good speech revealed normalization of CTT, but in children with dyslalia and dyslexia this interpeak latencies were once again prolonged.
The MacArthur Communicative Development Inventory, a parent-report measure of vocabulary and syntax, was administered to 103 children (M = 23 months) who had participated in a study of temporal resolution when they were 6 months (n = 55) or 12 months (n = 48) of age. Children who performed above the median on the temporal resolution task in infancy were subsequently reported to have larger productive vocabularies, greater numbers of irregular word forms, and longer and more complex sentences than those who had performed below the median. Whether these findings reflect specific links between temporal resolution and language or whether they reflect general developmental factors remains to be determined.
A boy with severe quadriplegia who neither recognized nor uttered speech sounds acquired language. Until the age of 6 years he was considered to be of severely subnormal intelligence. At age 6 years 9 months he was introduced to a manual sign system. Subsequently he was able to read, write, converse, and produce imaginative stories. Attention and memory were unimpaired and affective and social responsiveness developed appropriately. The case history demonstrates the selective effects of brain lesions that, despite extensive damage, may spare functional systems necessary for cognitive and linguistic development. It highlights the difficulty in diagnosing and evaluating the intellectual and affective potential of a multihandicapped child without functional hearing or speech and emphasizes the importance of sign language as a communication channel and prerequisite for the acquisition of reading and writing skills.
The course of development of a 5-year-old boy with a serious developmental retardation and massive behaviour problems who spoke only a few words is documented and described with psychometric tests and spontaneous language samples up to the age of 8-9. Inspite of this developmental retardation and poor care, the child reached until then an average to above-average intelligence in nonverbal functions. The symptoms were reduced only to a specific language impairment. At the age of 11, this disorder as well had practically disappeared. Such a course of development after the age of 5 is not common, whereas a specific language impairment normally remains a deficit. Possible causes for this favourable development are discussed.
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The accuracy of a risk index based on reproductive and demographic factors to predict subsequent development was tested with 51 full-term and 53 preterm (birth weight less than 1,501 grams) infants. Stanford-Binet IQ and Reynell Language Expression and Comprehension at 3 years were significantly predicted by this risk index. Socioeconomic status, birth order, and, for the preterm group, severity of illness in the perinatal period were the most significant predictors of developmental outcome. The Home Observation for Measurement of the Environment (HOME) scores were significantly correlated, independently of SES and developmental level, with the 3-year Reynell and Stanford-Binet scores for the preterm, but not the full-term, group. Children who were classified as being at risk at 12 months but who had scores in the normal range at 3 years came from families with significantly higher scores on the HOME scale. Children not detected as being at risk in infancy but whose development was delayed at 3 years came from families with lower scores on the HOME scale. The combination system of perinatal, reproductive, and environmental variables allows the detection of infants at risk for subsequent developmental problems.
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OBJECTIVE: The primary purpose of this study was to examine the relationship between age of enrollment in intervention and language outcomes at 5 years of age in a group of deaf and hard-of-hearing children. METHOD: Vocabulary skills at 5 years of age were examined in a group of 112 children with hearing loss who were enrolled at various ages in a comprehensive intervention program. Verbal reasoning skills were explored in a subgroup of 80 of these children. Participants were evaluated using the Peabody Picture Vocabulary Test and a criterion-referenced measure, the Preschool Language Assessment Instrument, administered individually by professionals skilled in assessing children with hearing loss. A rating scale was developed to characterize the level of family involvement in the intervention program for children in the study. RESULTS: A statistically significant negative correlation was found between age of enrollment and language outcomes at 5 years of age. Children who were enrolled earliest (eg, by 11 months of age) demonstrated significantly better vocabulary and verbal reasoning skills at 5 years of age than did later-enrolled children. Regardless of degree of hearing loss, early-enrolled children achieved scores on these measures that approximated those of their hearing peers. In an attempt to understand the relationships among performance and factors, such as age of enrollment, family involvement, degree of hearing loss, and nonverbal intelligence, multiple regression models were applied to the data. The analyses revealed that only 2 of these factors explained a significant amount of the variance in language scores obtained at 5 years of age: family involvement and age of enrollment. Surprisingly, family involvement explained the most variance after controlling for the influence of the other factors (r =.615; F change = 58.70), underscoring the importance of this variable. Age of enrollment also contributed significantly to explained variance after accounting for the other variables in the regression (r = -.452; F change = 19.24). Importantly, there were interactions between the factors of family involvement and age of enrollment that influenced outcomes. Early enrollment was of benefit to children across all levels of family involvement. However, the most successful children in this study were those with high levels of family involvement who were enrolled early in intervention services. Late-identified children whose families were described as limited or average in involvement scored >2 standard deviations below their hearing peers at 5 years of age. Even in the best of circumstances (eg, early enrollment paired with high levels of family involvement), the children in this study scored within the low average range in abstract verbal reasoning compared with hearing peers, reflecting qualitative language differences in these groups of children. CONCLUSIONS: Consistent with the findings of Yoshinaga-Itano et al,(1) significantly better language scores were associated with early enrollment in intervention. High levels of family involvement correlated with positive language outcomes, and, conversely, limited family involvement was associated with significant child language delays at 5 years of age, especially when enrollment in intervention was late. The results suggest that success is achieved when early identification is paired with early interventions that actively involve families.
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