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A model for collaborative service delivery for students with language-learning disorders in the public schools. Committee on Language Learning Disorders American Speech-Language-Hearing Association.

Collaborative service delivery can augment traditional methods for serving students with language-learning disorders in the public schools. In collaborative service delivery, the speech-language pathologist is an integral member of a transdisciplinary team consisting of educators, parents, and the student. Team members collaborate to formulate a single educational program for each student. The team devises all treatment goals, assessment methods, intervention procedures, and documentation systems to enhance the student's academic and social functioning in the school environment. All team members are aware of the student's entire curriculum, and team members typically share responsibility for specific educational goals. Most special services, as well as regular instruction, take place within the classroom. Administrative support is crucial to the implementation of collaborative service delivery. Effective collaboration requires that team members be allotted time to meet outside of their classroom duties. In addition, cooperation among team members is essential. Potential team members must be willing to pool their expertise and abandon notions of professional "turf." The implementation of collaborative service delivery may require some adjustment in the way speech-language pathologists and other educators perceive their roles in public school settings. However, this service delivery model holds great promise for providing services to maximize the functional potential of students with language-learning disorders.

American Speech-Language-Hearing Association↗

Cognitive neuropsychology and its application to children.

Cognitive neuropsychology has been used successfully in the analysis of adult neuropsychological disorders in both verbal and nonverbal domains. When applied to children, it aims to construct models on the basis of functional lesions manifest within developing systems and provides a theoretical framework within which patterns of intact and deficient skills can be charted over time. These patterns constrain possible underlying models. In highlighting potential individual differences in the acquisition of skills and indicating intact skills within subjects, cognitive neuropsychology may also enable a precise description of the locus of difficulty and potential circumventory routes for remediation around it. The theoretical assumptions of cognitive neuropsychology and issues relevant to its methodology are discussed, including the terminology and principles of modularity, the significance of individual differences and the use of case studies, the dynamics of developing systems, current views on plasticity, and distinctions between developmental and acquired disorders. The application of cognitive neuropsychology to children is discussed in relation to three cognitive areas: face recognition disorders, language disorders and arithmetical disorders. These illustrate the similarities that there are between many developmental cognitive neuropsychological disorders and those seen in adults following brain injury. Models derived from studies of adults are helpful in enabling understanding of both face recognition disorders and arithmetical disorders in childhood. Within language systems, a variety of different types of disorder are evident, which not only relate to receptive and productive difficulties but differentially affect the core components of the language system. All of the disorders discussed illustrate the limitations of functional plasticity in development. In each case, there is not a generalised deficit resulting from degradation of capabilities independent of task requirements. Rather, there are focal and selective disorders which affect subcomponents of cognitive systems. In some cases, genetic factors may constrain compensatory mechanisms.

Adolescent↗

[Disordered speech and language development as a pedagogic problem. Reaction of parents to child speech problems].

Since children live with their parents and meet other children, we looked into the possible effects of language disorders in children on their interactions with the social surroundings. Language disorders are woven into the fabric of communication between parents and child and are not attributes of the child alone. Language-disturbed children are not more difficult in their behavior than normal-speaking children at the same age. However, the parental emotions about the language problem lead to the perception of more difficult behavior. Parents of language-disturbed children try to stimulate the language development of their child. In this they get disappointed by the reactions of the child and become less stimulating. It seems as if in the interactions between parents and child, the child partly creates his own--negative--surroundings.

Child, Preschool↗

Auditory middle latency responses in children: effects of age and diagnostic category.

The nature of auditory middle latency responses (MLRs) in children has been the subject of considerable debate. In order to study MLRs as a function of age, MLRs were obtained in 217 subjects ranging in age from 6 days to 20 years, all with normal auditory brain-stem responses (ABRs). Subjects were classified into several diagnostic categories: normal; communicative disorders (language delay, learning disability); mentally retarded, multiply handicapped; and post-meningitic. Age effects, the effects of diagnostic category, and possible differences in MLRs of males vs. females and right vs. left ears were examined. The detectability of both Na and Pa was found to increase significantly as a function of age. Detection of these MLR components became similar to adult values (approaching 100% detectability) at approximately 10 years of age. No significant differences were found among diagnostic categories. There were also no significant differences in the detectability of MLRs in males as compared to females, and there were no right vs. left ear differences. The strong age effect which appears to exist in the MLR influences their clinical use. When responses are present, they may be useful indicators of hearing sensitivity, but the absence of MLRs in children cannot be taken as an indication of hearing loss. Similarly, absent or abnormal MLRs cannot be interpreted as a manifestation of auditory pathway dysfunction, since there appears to be little difference in MLRs in normal subjects and MLRs in patients with a wide range of neurologic, cognitive, and speech and language disorders.

Adolescent↗

Motor difficulties in children with developmental disorders of speech and language.

The motor hand function of 16 children, aged between 4 and 7 years, with developmental speech and language disorders, was compared with that of 16 control children. The children with developmental speech and language disorders were significantly slower than controls on three out of four motor tasks. They were also more likely than controls to have mixed hand preference although this results was not significant. Children with developmental speech and language disorders should be assessed to ensure that motor deficits are diagnosed and that appropriate support is given.

Brain Damage, Chronic↗

Working memory impairments in children with attention-deficit hyperactivity disorder with and without comorbid language learning disorders.

Our objectives were to examine whether children with attention-deficit hyperactivity disorder (ADHD) are impaired on one or more components of working memory (WM) independent of comorbid language learning disorders, and whether WM impairments are more strongly related to symptoms of inattention than to symptoms of hyperactivity-impulsivity. Four groups of children participated: ADHD (n = 62); ADHD+RD/LI (n = 32); RD/LI (n = 15); and a typically developing comparison group (n = 34). Four simple and brief measures of WM were used that varied in modality (auditory-verbal; visual-spatial) and processing demands (temporary storage versus manipulation of information). Children with ADHD without comorbid language learning disorders exhibited deficits in visual-spatial storage and verbal and visual-spatial central executive (C.E.) functions that were independent of comorbid psychiatric disorders. Children with language learning disorders, regardless of comorbidity with ADHD, exhibited impairments in both verbal and spatial storage as well as C.E. domains of WM. Symptoms of inattention, but not symptoms of hyperactivity/impulsivity, predicted performance on verbal and visual-spatial C.E. measures independent of age, verbal cognitive ability, and reading and language performance. Findings are consistent with data implicating neuropsychological impairments in ADHD. The dimensional results are also consistent with prior research demonstrating the neuropsychological impairments are more strongly associated with the inattention symptom dimension than with the hyperactive-impulsive dimension.

Attention Deficit Disorder with Hyperactivity↗

[Cognitive profiles of borderline intelligence. The boundaries of mental retardation].

Few studies have been conducted on children and teenagers with borderline intelligence (BI) as a collective that shares this condition. In this paper we discuss the concept of intelligence and analyse the different cognitive profiles with which BI can be expressed. We also evaluate how aspects linked to a 'g' factor of intelligence and those linked to executive functions are involved. Among the former, how fast information is processed may play a significant role and would be related to a homogeneous BI profile. On the other hand, executive deficits would lead to BI with the passing of the years and would be linked to selective deficiencies that are related to learning disorders, language disorders and attention deficit hyperactivity disorder. We highlight the need to individualise each case in order to determine the most suitable educational needs.

Child↗

Linguistic processing and performance in articulation-disordered subgroups of language-impaired children.

The linguistic and dichotic listening performances of three groups of nine children were studied. The groups were divided as follows: (1) Language-disordered children whose articulatory errors were primarily omissions; (2) language-disordered children whose articulatory errors were primarily substitutions; (3) communicatively normal children. All subjects participated in articulation testing, imitative language tests, analysis of a spontaneous language sample, and a dichotic word task. The articulatory omission group differed significantly from the substitution group on the imitative language test but not on the developmental sentence analysis. All groups demonstrated a right ear advantage, suggesting left hemispheric processing of the dichotic stimuli. The results of the present study and prior research are discussed in terms of possible sources of variability.

Child↗

Co-occurring disorders in children who stutter.

UNLABELLED: This study used a mail survey to determine the (a) percentage of children who stutter with co-occurring non-speech disorders, speech disorders, and language disorders, and (b) frequency, length of sessions, and type of treatment services provided for children who stutter with co-occurring disorders. Respondents from a nationwide sample included 1184 speech-language pathologists (SLPs). Of the 2628 children who stuttered, 62.8% had other co-occurring speech disorders, language disorders, or non-speech-language disorders. Articulation disorders (33.5%) and phonology disorders (12.7%) were the most frequently reported co-occurring speech disorders. Only 34.3% of the children who stuttered had co-occurring non-speech-language disorders. Of those children with co-occurring non-speech-language disorders, learning disabilities (15.2%), literacy disorders (8.2%), and attention deficit disorders (ADD) (5.9%) were the most frequently reported. Chi-square analyses revealed that males were more likely to exhibit co-occurring speech disorders than females, especially articulation and phonology. Co-occurring non-speech-language disorders were also significantly higher in males than females. Treatment decisions by SLPs are also discussed. LEARNING OUTCOMES: As a result of this activity, the participant should: (1) have a better understanding of the co-occurring speech disorders, language disorders, and non-speech disorders in children who stutter; (2) identify the speech disorders, language disorders, and non-speech disorders with the highest frequency of occurrence in children who stutter; and (3) be aware of the subgroups of children with co-occurring disorders and their potential impact on assessment and treatment.

Child↗

[Value of the Heidelberg Language Development Test in diagnosis of children with language development disorders].

Diagnosis of developmental speech and language disorders in accordance with the ICD-10 is to be based on the psychometric assessment of speech and language performance. In the present study the clinical validity of the Heidelberger Sprachentwicklungstest (HSET) for diagnosing expressive language disorders was assessed by comparing HSET subtest results for 92 children aged 4 to 10 years who had various speech and language disorders with the children's scores on another language test, a cognitive test and clinical findings. The HSET scores differed considerably from the clinical ratings of the severity of the language disturbance. The correlations between the HSET scores and the score on the other language test was also low. Although the correlations of the HSET scores with the performance IQ was low, the correlations with the verbal IQ were high. The implications of these findings for the use of the HSET in diagnosing children with language impairments are discussed.

Child↗

Clinical characteristics of children referred to a child development center for evaluation of speech, language, and communication disorders.

Speech, language, and communication disorders are prominent reasons for referrals to a child development center. From 1984 to 1988, 1,090 preschool children were referred to our child development center, which serves the Tel Aviv metropolitan area. Of all referrals, 432 (41%) were primarily due to speech, language, and communication problems. After exclusion of those with IQ < 50 and those with non-language-related disabilities, 323 children remained. The children were classified into different subtypes of developmental language disorders and autistic spectrum disorders. The main developmental language disorder subtypes were combined expressive-receptive (49%) and expressive (44%). Central processing deficits were less common, occurring in 20 (7%) of the children. Parents of children with developmental language disorders had educational levels similar to those of parents of children referred to the child development center for other causes. However, parents of children with infantile autism had higher educational levels than parents of children with developmental language disorder or parents of children referred for other causes (P < .001). Our results reflect the distribution of language and related problems in an unselected population of preschool children referred to a child development center.

Autistic Disorder↗

[Verbal and nonverbal intelligence in children with language development disorders].

Difficulties in language acquisition seem to be serious, if there are additional problems like intellectual and/or emotional/social impairment, which are often reported [10]. These additional problems and the definition of specific language impairment as a developmental disorder, restricted to language acquisition seem to be contradictory [17]. Aim of that study is to look for specific language impaired children with similar cognitive abilities and though to investigate, if there are children without additional cognitive problems considering the definition of specific language impairment. 93 children, between 4;0 and 6;6 years old, were diagnostized as specific language impaired (ICD-10) and were assessed by the "Hannover Wechsler Intelligenztest für das Vorschulalter (HAWIVA)" [6] (german version of WPPSI). Cluster analysis showed, that 1/3 of the specific language impaired children presented no additional cognitive problems and 2/3 of them showed cognitive problems regarding nonverbal and verbal intelligence indeed. These additional cognitive problems indicate that there may be a more basic cognitive defect underlying specific language impairment [15]--at least for a group of specific language impaired children. Furthermore the nonverbal and verbal intellectual difficulties emphasize to general developmental support of specific language impaired children for optimal improvement in language acquisition.

Child↗

[Early diagnosis of language development disorders in children].

In a prospective study, we examined whether it is possible to diagnose language disorders in children in their second and third years. Twenty patients aged 17-35 months (average 26 months) were examined from August 2002 to June 2004. Language development was tested on the basis of a questionnaire for parents (ELFRA-1 or ELFRA-2) and on a detailed language assessment. After 3-8 months, the children's language was examined again by the same speech pathologist. In 12 children, in whom we had suspected a language disorder, the diagnosis was confirmed. Eight patients showed age-appropriate language development, which was confirmed in six patients at follow-up. In two cases, the follow-up revealed a language disorder. On the basis of a parent questionnaire and examination by a speech therapist, language disorders can be diagnosed in the second and third years of life. However, control assessments are necessary in order to reveal language development disturbances beginning at later ages.

Child, Preschool↗

[ICD-10 diagnosis of specific speech and language development disorders].

Diagnostics of developmental speech- and language disorders is based primarily on the criteria severity of involvement and pattern. Regarding phonological disorders single word articulation tests are widely used because of efficiency considerations. However they are insufficient for ICD-10 diagnostics, because severity of involvement and pattern are influenced from the fact that children are spontaneously talking or giving single word responses. "Percentage of Consonants Correct (PCC)" and "Percentage of Consonants Correct for early, middle and late consonants" are described as an articulation competence metric, whereas "Natural Process Analysis" is proposed to describe the pattern of the disorder. Three case studies are used to outline the methods. Data show that "Percentage of Consonants Correct" is a good metric to index severity of involvement and "Natural Process Analysis" is a prerequisite to describe the pattern of the disorder.

Articulation Disorders↗

[Early auditory evoked potentials in children with language development disorders].

One of the prerequisites for normal language development is a highly sensitive auditory perception. An auditory perception deficit is therefore likely to affect the normal course of language acquisition. To test this hypothesis, we studied the BAEPs in 25 preschool boys with an expressive developmental language disorder and 12 boys with a history of stuttering. These children had no hearing disorders. Comparisons with the control group (49 neurologically healthy male subjects with normal hearing) revealed a statistically significant delay of waves III, IV and V in the language impaired subjects, whereas no significant differences were detected in the group of stutterers. Our findings suggest that a delayed or altered conduction of acoustic stimuli is important to the pathogenesis of developmental language disorders.

Adolescent↗