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PubMedDate not supplied

Symbolic play language during sensory integration treatment.

OBJECTIVE: Clinical writings on sensory integration treatment and theory have long professed that play serves as an important means of implementing treatment goals. However, to date, there has been little research that examines this aspect of the intervention. With the use of play language as an indicator for the occurrence of play, this study examined the frequency and characteristics associated with symbolic play language that therapists and children use during sensory integration therapy. This study is part of an ongoing research program designed to examine therapist-child interactions. METHOD: The frequency of symbolic play language observed in 41 videotaped treatment sessions of therapist-child dyads (21 children, 12 therapists) was recorded with the Challenge Coding System. The presence of symbolic play language was recorded if the child or therapist used language that incorporated the child, therapist, equipment, or activity into a symbolic or pretend play theme. The frequency of symbolic play language and percentage of time spent using play language were calculated. Associations among frequency of play language, child age, and behavior during the session (e.g., seeking assistance, cooperation) were also examined. RESULTS: Symbolic play language proved to be a major feature of sensory integration treatment sessions. It also correlated with child age and with some features associated with therapeutic interactions (i.e., child tries hard, child seeks assistance, therapist assists child, therapist modifies activity, therapist structures activity). CONCLUSION: The results suggest that these therapists used play language frequently and that this usage may support children in sensory integrative therapy to successfully accomplish activities.

Child↗

PubMed2001

The intentionality model and language acquisition: engagement, effort, and the essential tension in development.

The purpose of the longitudinal research reported in this Monograph was to examine language acquisition in the second year of life in the context of developments in cognition, affect, and social connectedness. The theoretical focus for the research is on the agency of the child and the importance of the child's intentionality for explaining development, rather than on language as an independent object. The model of development for the research is a Model of Intentionality with two components: the engagement in a world of persons and objects that motivates acquiring a language, and the effort that is required to express and articulate increasingly discrepant and elaborate intentional state representations. The fundamental assumption in the model is that the driving force for acquiring language is in the essential tension between engagement and effort for linguistic, emotional, and physical actions of interpretation and expression. Results of lag sequential analyses are reported to show how different behaviors--words, sentences, emotional expressions, conversational interactions, and constructing thematic relations between objects in play--converged, both in the stream of children's actions in everyday events, in real time, and in developmental time between the emergence of words at about 13 months and the transition to simple sentences at about 2 years of age. Patterns of deviation from baseline rates of the different behaviors show that child emotional expression, child speech, and mother speech clearly influence each other, and the mutual influences between them are different at times of either emergence or achievement in both language and object play. The three conclusions that follow from the results of the research are that (a) expression and interpretation are the acts of performance in which language is learned, which means that performance counts for explaining language acquisition; (b) language is not an independent object but is acquired by a child in relation to other kinds of behaviors and their development; and (c) acquiring language in coordination with other behaviors in acts of expression and interpretation takes work, so that acquiring language is not easy.

Child↗

PubMed2003

[Aphasias for verbal and sign languages are due to lesions of nearly localised but not identical brain regions of the left hemisphere].

OBJECTIVES: To study the characteristics of verbal and sign language aphasia in a patient fluent in both languages, who had had a recent left hemisphere stroke as well as to localise the site responsible for Spanish sign language aphasia. PATIENT AND METHODS: 56 years old male, with risk factors for stroke, who presented an episode of sudden onset aphasia and right hemiplegia that partially recovered in a few hours. The residual deficit of language was explored with a detailed protocol that included comprehension, denomination, oral and phonetic praxis, propositional and automatic spontaneous language, reading and writing tasks. The examination of verbal and sign language was video-recorded. The lesion was localised by magnetic resonance imaging 24 days after the stroke. RESULTS: The patient, whose infarction involved the superior temporal gyrus and sylvian operculum, presented similar abnormalities for comprehension of complex sentences, many phonemic paraphasias and no trouble to repeat single words. Oral language was not fluent, but sign language was quite fluent with a rich vocabulary, but with semantic paraphasias, agrammatism and without self-criticism for his own mistakes. CONCLUSIONS: The pattern of oral and sign language alterations is partially different, more for expressive than perceptive discourse, although both types of aphasias are caused by lesions of the left hemisphere. The regions responsible for these abnormalities of both symbolic languages are localised close to each other, but not in the same place.

Aphasia, Broca↗

PubMed2003

In the right words: addressing language and culture in providing health care.

As part of its continuing mission to serve trustees, executives, and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a group of experts from philanthropy, research, health care practice, and policy on April 4, 2003, to discuss the roles of language and culture in providing effective health care. During this Issue Dialogue, In the Right Words: Addressing Language and Culture in Providing Health Care, health grantmakers and experts from policy and practice participated in an open exchange of ideas and perspectives on language access and heard from fellow grantmakers who are funding innovative programs in this area. Together they explored ways to effectively support comprehensive language services, including the use of interpreters and translation of written materials. This Issue Brief synthesizes key points from the day's discussion with a background paper previously prepared for Issue Dialogue participants. It focuses on the challenges and opportunities involved with ensuring language access for the growing number of people who require it. Sections include: recent immigration trends and demographic changes; the effect of language barriers on health outcomes and health care processes; laws and policies regarding the provision of language services to patients, including an overview of public financing mechanisms; strategies for improving language access, including enhancing access in delivery settings, promoting advocacy and policy change, improving interpreter training, and advancing research; and roles for foundations in supporting improved language access, including examples of current activities. The Issue Dialogue focused mainly on activities and programs that ensure linguistic access to health care for all patients. Although language and culture are clearly inseparable, a full exploration of the field of cultural competence and initiatives that promote its application to the health care setting are beyond the scope of this Issue Brief. The day's discussion did, however, raise provocative issues of culture that are reflected throughout this report.

Civil Rights↗

PubMed2004

Narrative discourse in bilingual children: language and task effects.

PURPOSE: This study investigated the effect of language on Spanish-English bilingual children's production of narrative samples elicited in two ways. METHOD: Twelve bilingual (Spanish-English-speaking) children ranging in age from 4;0 (years;months) to 6;11 who were fluent speakers of English as a second language produced two narratives--one elicited by using a wordless picture book and another by using a static picture. The children produced stories for each task in each language, for a total of four stories. For the book task, the story complexities were compared across both languages. Stories were scored for complexity of story grammar and the inclusion of specific narrative elements. Both stories in each language were further analyzed for productivity (total words, number of C-units, and mean length of C-unit). The grammaticality (proportion of grammatically acceptable C-units) and the proportion of utterances influenced by the nontarget language was compared across each language and story task. RESULTS: Children produced narratives of equal complexity for the book task regardless of language. However, children used more attempts and initiating events in Spanish, while producing more consequences in English. The picture task yielded mixed results, and these were not compared quantitatively. There were differences in the two task conditions with respect to the children's use of Spanish-influenced English and English-influenced Spanish. Although children were equally productive in both languages, they used proportionally more Spanish-influenced utterances in the book task. CLINICAL IMPLICATIONS: The results demonstrate the importance of considering the test language when eliciting narratives from bilingual children and the type of the narrative task for eliciting a productive and complex narrative.

Child↗

PubMed2005

Language outcomes subsequent to treatment of brainstem tumour in childhood.

While the occurrence and management of brainstem tumours in children would not traditionally indicate potential direct structural impact on classical language centres, recent theories have implicated some involvement of the brainstem in a functional language and cognitive neural loop between the cerebellum and the cerebral hemispheres. Thus, the present paper explored the impact of treatment for brainstem tumour on the general and high-level language abilities of six children treated for brainstem tumour, in addition to phonological awareness skills. Group analysis revealed that children treated for brainstem tumour demonstrated intact language and phonological awareness abilities in comparison to an age- and gender-matched control group. Individual analysis revealed only one of six children treated for brainstem tumour revealed evidence of language disturbances, with an additional child demonstrating an isolated mildly reduced score on one phonological awareness task. Language deficits identified in a child treated with a combination of both radiotherapy and chemotherapy were noted in the high-level language area of lexical generation. Findings highlighted that no overt language disturbances were evident in children treated for brainstem tumour. However, further analysis into higher-level language skills in the present study indicated that both general and high-level language abilities require long-term monitoring in this population.

Adolescent↗

PubMed2005

[The related factors influencing development of language understanding and expression of early-children].

OBJECTIVE: To assess the level of language understanding and expression of healthy children aged from 8 to 16 months in urban Beijing and to investigate the children's physical and psychological development conditions and social and economic status of children's family as to identifying the related factors to children's language development and providing a basis for instructing parents child-rearing and promoting early children language development. METHODS: A quantitative Cross-sectional Study was made. The parents or care givers of 636 healthy young children, randomly stratified and selected in two districts in Beijing were interviewed. T-test was used to compare the scores of language understanding and expression between boys and girls in the same age. Single and multiple factors analysis were used so as to find out the related factors. RESULTS: For boys, the average scores of language were respectively 115.0 for 8 months, 243.0 for 12 months and 410.6 for 16 months; for girls the average scores were respectively 109.9 for 8 months, 286.4 for 12 months and 456.2 for 16 months. The average score of language understanding of boys was higher than that of girls only in the 11 month group. The average scores of language expression of girls were higher than those of boys in 11, 12, 14, 15 month groups. Multiple factors analysis showed that parent-child book reading, parent-child tape listening, higher education level of grandmothers, children' extroversion personality, child being able to speak one word and children's age were positively related to the children' language score. CONCLUSION: Providing rich language environment should be helpful to early children's language development.

China↗

PubMed1986

Sensitivity of the Denver Developmental Screening Test in speech and language screening.

A retrospective study was undertaken to determine whether the Denver Developmental Screening Test (DDST) language sector is a sensitive screen of speech and language development. Seventy-one children between 18 and 66 months of age with suspected developmental problems were referred to screening clinics conducted by a child evaluation team. Each child was screened using the DDST (revised) and another screening measure of speech and language development. Statistically significant differences were found between the DDST language sector and the speech-language screening in identification of expressive language and articulation problems. No significant difference was found with receptive language. The DDST failed to identify more than one half of the children with expressive language and/or articulation problems. These results demonstrate that the DDST may fail to identify children with speech and language impairment. Professionals involved in developmental screening need to be advised of alternative speech and language screening measures.

Child↗

PubMed2006

Clinical neurophysiology of language: the MEG approach.

Clinical evaluation of language function and basic neuroscience research into the neurophysiology of language are tied together. Whole-head MEG systems readily facilitate detailed spatiotemporal characterization of language processes. A fair amount of information is available about the cortical sequence of word perception and comprehension in the auditory and visual domain, which can be applied for clinical use. Language production remains, at present, somewhat less well charted. In clinical practice, the most obvious needs are noninvasive evaluation of the language-dominant hemisphere and mapping of areas involved in language performance to assist surgery. Multiple experimental designs and analysis approaches have been proposed for estimation of language lateralization. Some of them have been compared with the invasive Wada test and need to be tested further. Development of approaches for more comprehensive pre-surgical characterization of language cortex should build on basic neuroscience research, making use of parametric designs that allow functional mapping. Studies of the neural basis of developmental and acquired language disorders, such as dyslexia, stuttering, and aphasia can currently be regarded more as clinical or basic neuroscience research rather than as clinical routine. Such investigations may eventually provide tools for development of individually targeted training procedures and their objective evaluation.

Brain↗

PubMed2005

Language sampling for kindergarten children with and without SLI: mean length of utterance, IPSYN, and NDW.

UNLABELLED: Language sample analysis measures have long been promoted as exhibiting greater ecological validity than formal testing in the assessment of language disorder in children. In practice, their use is often restricted to preschool children, owing to lack of normative information, as well as criticisms of the validity of commonly used measures for the language of older children. This study compared scores of kindergarten children (mean age 6 years) with and without specific language impairment (SLI) on three commonly used language sample analysis measures: mean length of utterance in morphemes (MLU-m), the index of productive syntax (IPSyn), and number of different words (NDWs). Mean scores of the children with SLI were significantly lower for all three measures, though not for all subtests of the IPSyn. A number of individual differences were observed; notably, several children with SLI scored as well as those without. The problems and promise of language sampling for children beyond the preschool years are discussed in light of these results. LEARNING OUTCOMES: (1) Readers will gain an understanding of strengths and weaknesses of language sample measures in assessing kindergarten children with language impairment. (2) The reader will become aware of the utility of MLU in differentiating between young school age children with and without language impairment.

Child↗

PubMedDate not supplied

Four-year language outcomes of children exposed to cocaine in utero.

A large cohort of children exposed to cocaine in utero (n=189) were followed prospectively from birth to 4 years of age and compared to nonexposed children (n=185) on the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P), a measure of receptive and expressive language abilities. Children exposed to cocaine in utero performed more poorly on the expressive and total language measures than nonexposed children after controlling for confounding variables, including prenatal exposure to alcohol, marijuana, and tobacco, as well as medical and sociodemographic variables. Children exposed to cocaine had more mild receptive language delays than nonexposed children and were less likely to have higher expressive abilities. Also, maternal factors such as language ability, performance IQ, race, and education correlated with child language abilities. Prenatal cigarette and marijuana exposure were related to deficits in specific language skills. Children placed in adoptive or foster care who were cocaine exposed demonstrated superior language skills compared to children exposed to cocaine who remained in biological relative or mother's care. These findings support a cocaine-specific effect on language skills in early childhood that may be modified with an enriched environment.

Analysis of Variance↗

PubMed2003

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↗

PubMed1998

Predicting variation in the timing of language milestones in the second year: an events history approach.

In a longitudinal investigation of 40 child-mother dyads, we examined prediction from three indexes of children's own language: (1) vocal imitations, (2) first spontaneous words in production, and (3) receptive language starting at 0;9, and their mothers' verbal responsiveness at 0;9 and 1;1, to the developmental onset of three significant language milestones of the second year: (1) 50 words in productive language, (2) combinatorial speech, and (3) the use of language to express a memory. In these analyses, we utilized EVENTS HISTORY ANALYSIS, a statistical technique well suited to questions concerning when in development certain events begin and the extent to which predictors influence the timing of those events. The timing of children's first words in production, the timing of their achievement of 50 words in receptive language, and maternal responsiveness at 1;1 each contributed uniquely to variation in the timing of the three language milestones. When child and mother factors were considered together, the onset of the three language milestones differed by as much as 0;5 months for children in the lower and upper 10th percentiles of the predictor variables. The present findings contribute to generating and testing specific models about child and mother factors thought to explain variation in key aspects of children's second-year language development.

Adult↗

PubMed1990

Who shall be called language disordered? Some reflections and one perspective.

This paper discusses some issues involved in identifying children who have language problems. The perspective taken is that (a) the goal of identification must be clearly distinguished from other goals of assessment; (b) identification of children with language disorders is better based on language performance than on inferences about the language knowledge that underlies this performance; (c) language performance must be sampled in more than one context, including, for purposes of identification, contexts that stress the language system; (d) the standards of expectations for comparing performance and determining differences must be explicit; (e) standards used to determine differences are better based on the performance of chronological-age peers than on the performance of children with similar mental abilities; and (f) children who do not evidence poor language performance but are considered at risk for language-related problems should be distinguished from children who demonstrate poor language skills.

Child↗

PubMed2002

Language dysfunction in epileptic conditions.

Epilepsy may disrupt brain functions necessary for language development by its associated intellectual disabilities or directly as a consequence of the seizure disorder. Additionally, in recent years, there has been increasing recognition of the association of epileptiform electroencephalogram (EEG) abnormalities with language disorders and autism spectrum disorders. Any process that impairs language function has long-term consequences for academic, social, and occupational adjustments in children and adolescents with epilepsy. Furthermore, impairments in specific language abilities can impact memory and learning abilities. This article reviews interictal language function in children and adults with epilepsy; epilepsy surgery and language outcome; and language disorders associated with abnormal EEGs. The relationship between epilepsy and language function is complicated as the neuroanatomic circuits common to both overlap. We demonstrate how magnetoencephalography (MEG) offers the ability to analyze the relationship of language, EEG abnormalities, and epilepsy.

Adolescent↗

PubMed1999

Language sample analysis in the 21st century.

Time requirements inherent in transcription and analysis of spontaneous language samples represent a significant barrier to the regular use of language sample analysis in clinical settings. Taking advantage of the options provided by new large, fast, and affordable personal microcomputers, two language analysis programs, the Systematic Analysis of Language Transcripts and The Child Language Data Exchange System have been developed to provide automated analysis of a wide range of language indices, as well as tools designed to reduce and simplify the time-intensive process of transcribing and analyzing children's language samples from both typical and clinical populations. In this article we provide a historical context for the development of these language analysis programs and a brief introduction to the transcription editors and language sample databases for both systems. In addition, a case study highlighting the interactive use of both analysis systems is provided.

Child↗

PubMedDate not supplied

[Occurrence of child abuse: knowledge and possibility of action of speech-language pathologists].

BACKGROUND: This work presents the results of an epidemiological survey about the professional experience of Speech-Language Pathologists and Audiologists of Rio de Janeiro (Brazil) with children and adolescents who are victims of domestic violence. AIM: To understand the occurrence of child abuse and neglect of children and adolescents treated by speech-language pathologists, characterizing the victims according to: most affected age group, gender, form of violence, aggressor, most frequent speech-language complaint, how the abuse was identified and follow-up. METHOD: 500 self-administered mail surveys were sent to a random sample of professional living in Rio de Janeiro. The survey forms were identified only by numbers to assure anonymity. RESULTS: 224 completed surveys were mailed back. 54 respondents indicated exposure to at least one incident of abuse. The majority of victims were children, the main abuser was the mother, and physical violence was the most frequent form of abuse. The main speech disorder was late language development. In most cases, the victim himself told the therapist about the abuse--through verbal expression or other means of expression such as drawings, story telling, dramatizing or playing. As the majority of the victims abandoned speech-language therapy, it was not possible to follow-up the cases. CONCLUSION: Due to the importance if this issue and the limited Brazilian literature about Speech-Language and Hearing Sciences and child abuse, it is paramount to invest in the training of speech-language pathologists. It is the duty of speech-language pathologists to expose this complex problem and to give voice to children who are victims of violence, understanding that behind a speech-language complaint there might be a cry for help.

Adolescent↗

PubMed1986

First stage of language acquisition through two modalities in deaf and hearing children.

We consider the earliest stages of language acquisition in both vocal and gestural modalities. The basic hypothesis is that there is a kind of equipotentiality between the two modalities and that the choice between the two depends on the linguistic input to which the child is exposed. We set forth the results of studies conducted in deaf and hearing children who acquire as native language the sign language used by deaf persons (gestural modality) and discuss the data on language acquisition in hearing and deaf children exposed to the American Sign Language (ASL) and in deaf children exposed to the Italian Sign Language (LIS). We go on to present the results of work in deaf children exposed to a bimodal Italian input. Against the background of studies in hearing children exposed to spoken Italian only we discuss the role of the gestural modality in the language acquisition of these children from the holophrastic to the diphrastic period. The comparison of sign language acquisition and spoken language acquisition will enable us to assess which aspects may be considered universal and which modality-related.

Adolescent↗