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PubMed1999

The psychological development of children from Belarus exposed in the prenatal period to radiation from the Chernobyl atomic power plant.

This study examined psychological development in 138 children at the age of 6-7 and 10-11 years, who had suffered prenatal radiation exposure at the time of the Chernobyl accident in 1986. These children were compared to a control group of 122 children of the same age from noncontaminated areas of Belarus. The examination included neurological and psychiatric examination, intellectual assessment, and clinical psychological investigation of parents as well as the estimation of thyroid exposure in utero. The exposed group manifested a relative increase in psychological impairment compared with the control group, with increased prevalence in cases of specific developmental speech-language disorders (18.1% vs. 8.2% at 6-7 years; 10.1% vs. 3.3% at 10-11 years) and emotional disorders (20.3% vs. 7.4% at 6-7 years; 18.1 vs. 7.4% at 10-11 years). The mean IQ of the exposed group was lower than that of the control group, and there were more cases of borderline IQ (IQ = 70-79) (15.9% vs. 5.7% at 6-7 years; and 10.1% vs. 3.3% at 10-11 years). The mean value of thyroid doses from 131I 0.4 Gy was estimated for children exposed in utero. No correlation was found between individual thyroid doses and IQ at age 6-7 years or 10-11 years. We notice a positive moderate correlation between IQ of children and the educational level of their parents. There was a moderate correlation between high personal anxiety in parents and emotional disorders in children. We conclude that a significant role in the genesis of borderline intellectual functioning, specific developmental disorders of speech, language and scholastic skills, as well as emotional disorders in the exposed group of children was played by unfavourable social-psychological and social-cultural factors such as a low educational level of parents, the break of microsocial contacts, and adaptational difficulties, which appear following the evacuation and relocation from the contaminated areas.

Anxiety↗
PubMed1985

The pediatrician's approach to the preschool child with language delay.

A systematic approach to the child with suspected language disorder includes screening of expressive language, receptive language, general development, and hearing. Various screening approaches and tools are discussed. Diagnostic categories and associated referral patterns are recommended.

Child, Preschool↗
PubMed1982

Communication development and its disorders: a psycholinguistic perspective.

There is a reciprocal relationship between the study of language disorders and research in normal language development. Recent studies in normal acquisition have led to a model of language development that includes not only linguistic achievements, but the development of social and cognitive abilities that lay the basis for the transition from prelinguistic communication to the use of conventional forms. This model has been applied to the study of developmental disorders of language learning. Such a model allows the more puzzling disorders of language development, such as childhood aphasia and primary autism, to be placed in a framework that predicts language disruption when underlying perceptual, cognitive, or social abilities are lacking. Assessment procedures that can be drawn from the model of language disorders are presented. It is argued that the study of these disabilities is important in the building of theoretical models of intact language processing that specify more precisely the contribution of underlying skills to overall functioning. Questions for future research that serve this reciprocal purpose are discussed.

Autistic Disorder↗
PubMed1997

Relation of lesion location to verbal and nonverbal mood measures in stroke patients.

BACKGROUND AND PURPOSE: The aim of the present study was to evaluate the relation between poststroke depression and lesion location, avoiding previous methodological shortcomings. In particular, we intended to determine whether patients with left frontal lesions showed the highest depression scores. METHODS: Patients in the study, categorized on the basis of lesion location, included 149 stroke patients with lesions located in the anterior, central, or posterior regions of the right or left hemisphere. Verbal and nonverbal mood measures as well as the Hamilton Depression Scale Overall Score were the dependent measures of our investigation. Furthermore, the number of patients who could not be assessed or could be evaluated only with the nonverbal mood measure due to the presence of severe language disorders was recorded. RESULTS: No significant relation was observed between depressed mood and lesion location. Approximately one quarter of the left brain-damaged patients were partially or totally excluded from the study because of severe language disorders. CONCLUSIONS: Our data appeared to show that when methodological pitfalls and selection bias are carefully controlled, left frontal lesions are not a major determinant of poststroke depression.

Adult↗
PubMed2002

Impaired processing of brief, rapidly presented auditory cues in infants with a family history of autoimmune disorder.

Studies have shown that individuals with language disorders, such as developmental dyslexia and specific language impairment, exhibit impairments in the processing of brief, successive, or rapidly changing auditory information. It is also the case that a higher rate of autoimmune disorders have been identified in those with language-based learning disorders and, conversely, that individuals with autoimmune disorders show a higher incidence of language-related disorders. The rapid auditory processing (RAP) deficits described for older individuals with language impairments may also be used as a behavioral marker to identify infants at higher risk for language delays. Thus, we were interested in examining RAP abilities in a subset of infants with a positive family history of autoimmune disorders. Eleven infants from our ongoing prospective longitudinal studies were identified based on parental response to a question about the presence of a family history of autoimmune disease and compared to 11 matched controls. The RAP threshold of each infant was assessed at 6 and 9 months of age using a conditioned head-turn procedure (using tone pairs with brief interstimulus intervals) and an auditory-visual habituation-recognition memory task using computer-generated consonant-vowel syllables (/ba/ vs. /da/). A visual habituation-recognition memory task that did not require processing of brief temporal cues was also administered. Group differences emerged on the infant RAP tasks, and on language outcome measures at 12 and 16 months of age. Infants from families with a history of autoimmune disorder had significantly higher (i.e., poorer) RAP thresholds and lower language scores than did control infants, whereas visual discrimination scores did not differ between family history infants and controls. Moreover, when brief auditory cues were necessary for the discrimination of /ba/ vs. /da/, infants with a family history of autoimmune disorder performed significantly more poorly than did controls. These findings lend support to the hypothesis that a similar mechanism, perhaps a neural-immune interaction, may underlie the observed co-occurrence of autoimmune disorders and learning impairments.

Acoustic Stimulation↗
PubMed1989

Familial concentration of developmental language impairment.

A questionnaire concerning the history of treatment of developmental language disorder was used to evaluate the prevalence of these problems within the immediate family members of second-grade children with and without language impairment. The data obtained from these families revealed strong evidence that such language problems are not randomly distributed across families but rather tend to concentrate within families. Although all family members of the language-impaired second graders demonstrated substantially increased odds for language impairment over those who came from families with normal second graders, a considerable range of increased odds for language impairment existed among the family members. Specifically, brothers and to a lesser degree sisters had a higher familial association with language impairment than did the parents. These results suggest that the factors that contribute to developmental language disorders are at least in part associated with the family unit.

Adult↗
PubMed2001

Aphemia: an isolated disorder of articulation.

Aphemia is a disorder with prominent speech abnormality. Since its description by Broca, there has been debate regarding the neuropsychological disorganization underlying aphemia: is aphemia an articulatory disorder or a language disorder? We describe a patient with markedly impaired articulation, but preserved receptive and written language function and buccal-facial coordination. The location of his stroke was in the left precentral gyrus, undercutting a small area of motor and premotor cortex. This case suggests that aphemia can occur as an isolated articulation deficit without language involvement or more widespread bulbar apraxia, and may be a severe form of apraxia of speech.

Aphasia, Broca↗
PubMed1987

[What are specific performance weaknesses?].

The term "specific developmental disorder" means localized deficits in very different functions contrasting fit in the general otherwise normal performance level of a child. These disorders are mostly looked upon in a developmental context and differentiated from acquired neuropsychological syndromes (e.g. aphasia, apraxia). The most important clinically relevant disorders are: the specific reading disability, the specific dyscalculia, other specific learning disabilities, the specific developmental language disorder, the specific retardation in the motor development, and multiple developmental retardations. In a population of all patients treated in institutions for children and adolescents, 30% show specific developmental disorders with a predominance of boys. There is no correlation between dyslexia and social class but it does exist for specific developmental language disorder and motor retardation. As to the etiology of specific developmental disorders, genetic factors, congenital or acquired cerebral dysfunctions, maturation or developmental retardation and cognitive variables are discussed. The multifactor-approach seems to be the best way of understanding specific developmental disorders, which are difficult to prove.

Child↗
PubMed2002

Dissociated crossed aphasia: a challenging language representation disorder.

A monolingual strongly right-handed woman developed a left hemiparesis and severe motor aphasia following a right middle cerebral artery infraction, whereas comprehension was entirely intact. She had a history of a transient cerebrovascular event characterized by right hemiparesis and fluent sensory aphasia. This case suggests a transhemispheric pattern of language organization in which the Broca area resides in the right hemisphere, whereas the Wernicke area is in the left.

Aged↗
PubMed1989

The effect of pictured visual cues on elicited sentence imitation.

In one experiment language-normal 6 1/2-year-old and 4 1/2-year-old children (N = 68) were asked to imitate sentences with or without pictured visual cues. In a second experiment groups of language-disordered children (N = 43) also 4 1/2 and 6 1/2 years of age were asked to imitate sentences with and without pictured visual cues. In both experiments there was no significant difference in the syntactical and grammatical quality of elicited imitations between conditions. Older children performed better than young children in both experiments. It was concluded that pictured visual cues do not affect the syntactical and grammatical quality of language-normal and language-disordered children's elicited sentence imitations.

Child↗
PubMed2003

Language impairment in dementia: impact on symptoms and care needs in residential homes.

BACKGROUND: Impairment of language skills affects the level of functioning of an individual, interferes with effective communication and can result in development of disruptive behaviour. Social skills and capacity for self care may be compromised. Few studies have evaluated the impact of language problems on symptoms and socialization in people with dementia in care environments. METHOD: 315 elderly residents with dementia (29% living in nursing homes, 71% in social care facilities) were assessed using standardized psychiatric schedules including the Sheffield Screening Test for Acquired Language Disorders and Neuropsychiatric Inventory. Dementia Care Mapping was undertaken at random in at least 50% of residents in each facility. RESULTS: Expressive language impairment was associated with the presence of delusions even when severity of dementia was controlled for (p=0.02) and showed a tendency of association with depression (p=0.06). Receptive language difficulties were strongly associated with presence of Aberrant Motor Behaviour, even controlling for severity of dementia (p=0.04). Decreased participation in social activities was correlated with both expressive (p=0.048) and receptive aspects of language (p<0.01) but social withdrawal was only correlated with receptive language difficulties (p=0.01). CONCLUSION: Language disorders are associated with both behavioural and psychological symptoms of dementia even when severity of dementia is controlled for. Patients' needs in communication skills should be addressed earlier to help them maintain social interactions and reduce the impact on behavioural problems and patients' quality of life.

Aged↗
PubMed2026

Novel Proactive Speech-Language Intervention Is More Effective Than Usual Care: Randomized Controlled Trial of Babble Boot Camp for Infants With Classic Galactosemia.

PURPOSE: Speech and language disorders cannot be diagnosed and treated until children are approximately 2-4 years old. To investigate whether these disorders can be prevented, we developed and trialed Babble Boot Camp (BBC), the first proactive sustained intervention starting with precursor skills including cooing and babbling. METHOD: Participants were two randomly assigned groups of 22 infants with classic galactosemia, a metabolic disease with known risks for severe speech and language disorders. One group started BBC at under 6 months of age, and the other started at 15 months of age, both completing BBC at 24 months of age. Coached by a speech-language pathologist in weekly telehealth sessions, caregivers implemented BBC activities and routines daily at home. A typical control group and a group of children with classic galactosemia who received usual care participated as well. All children completed standardized assessments of speech and language at postintervention. RESULTS: Assessment scores showed that BBC was more effective than usual care for both intervention groups. Greatest benefits were seen in the group that started at or before 6 months of age, with a proportion of clinically concerning scores equal to that in the typically developing peers. No effects of sex, genotype, or milk consumption were evident in the outcomes. CONCLUSIONS: Findings motivate a paradigm shift from deficit-based to proactive approaches for infants with classic galactosemia. BBC is extensible to many other disorders, with trials currently underway for infants with Down syndrome and infants born preterm.

Humans↗
PubMed1993

The Fluharty Preschool Speech and Language Screening Test: a population-based validation study using sample-independent decision rules.

Two cohorts of 4- and 5-year-old children (N = 700) were screened with the Fluharty Preschool Speech and Language Screening Test. Two stratified samples (n = 51 cohort 1; n = 147 cohort 2), based on speech/language screening results, were administered criterion tests for articulation (AAPS-R or Templin-Darley) and language (TOLD or TALC-R). Clinical validation indices for combined speech or language outcome in the two cohorts were as follows: sensitivity, .43 and .31 respectively; specificity, .82 and .93; predictive value, .43 and .54; overreferral, 14% and 5%; underreferral, 14% in both cohorts, and percent agreement, 72% and 80%. The measure of sensitivities for language outcomes was lower than the above, whereas sensitivities for articulation was higher. These results suggest that the Fluharty is too insensitive to be relied on for screening programs aimed at identifying preschool children with language disorders, although it appears to have promise for the identification of children with articulation impairments.

Articulation Disorders↗
PubMed1999

Autism spectrum disorders at 20 and 42 months of age: stability of clinical and ADI-R diagnosis.

The association between, and stability of, clinical diagnosis and diagnosis derived from the Autism Diagnostic Interview-Revised (ADI-R; Lord, Rutter, & Le Couteur, 1994) was examined in a sample of prospectively identified children with childhood autism and other pervasive developmental disorders assessed at the age of 20 months and 42 months. Clinical diagnosis of autism was stable, with all children diagnosed with childhood autism at age 20 months receiving a diagnosis of childhood autism or a related pervasive developmental disorder (PDD) at age 42 months. Clinical diagnosis of childhood autism was also reasonably sensitive, with all children who went on to receive a clinical diagnosis of childhood autism at 42 months being identified as having autism or PDD at 20 months. However, clinical diagnosis for PDD and Asperger's syndrome lacked sensitivity at 20 months, with several children who subsequently received these diagnoses at 42 months receiving diagnoses of language disorder or general developmental delay, as well as in two cases being considered clinically normal, at the earlier timepoint. The ADI-R was found to have good specificity but poor sensitivity at detecting childhood autism at 20 months; however, the stability of diagnosis from 20 to 42 months was good. In addition, the ADI-R at age 20 months was not sensitive to the detection of related PDDs or Asperger's syndrome. The continuity and discontinuity between behavioural abnormalities identified at both timepoints in the three domains of impairment in autism was examined, both in children who met final clinical criteria for an autistic spectrum disorder, and for children with language disorder who did not, as well as for a small sample of typically developing children.

Autistic Disorder↗
PubMed1992

Familial transmission of speech and language impairment: a preliminary investigation.

The familial transmission of speech and language disorders was investigated using a community sample of five year old children with speech and/or language impairment and a control group with normal language skills. The results indicated a significantly higher prevalence rate of language-related problems in families of speech and language impaired children than in normal language controls. Girls with speech/language impairments had more affected relatives than boys, suggesting that girls with this type of family history are at a greater risk of developing speech or language related problems. The pattern of transmission of speech and language disorders was also compared with published reports of the family histories of stuttering and reading disabilities, and with reports of cognitive and linguistic deficits among families of autistic individuals. The findings are discussed in relation to the theory of an underlying neurolinguistic diathesis common to these various disabilities.

Child of Impaired Parents↗
PubMedDate not supplied

The word length effect in children with language impairment.

UNLABELLED: Two types of serial word recall tasks (full verbal recall and probed recall) were administered to 11 children with language impairment and 22 language-normal children matched for productive language or chronological age. The methods were designed to take into account age-related differences in the use of subvocal rehearsal, as measured by the word length effect. The word length effect was significant for all three groups in full recall, but not in probed recall, supporting the hypothesis that children with language impairment demonstrate limited capacity for processing verbal output. Discussion focuses on the importance of considering developmental factors in measuring short-term memory effects in children with language impairment. LEARNING OUTCOMES: As a result of this activity, the participant will be able to describe the phonological loop hypothesis and discuss the interactions between working memory and language performance in children with language disorders.

Child↗
PubMed2004

[Early recognition of speech and speech-associated disorders after acute stroke].

In the course of increasing demands in acute stroke care in stroke units, criteria for efficient speech diagnosis, which can be applied in the first hours of acute stroke are necessary. In this study we investigated early recognition of speech and speech-associated disorders in acute stroke, and compared the neurologists' clinical diagnoses at admission with the results of a test battery (KAP--Kurze Aphasieprüfung). 90 of 104 consecutively recruited patients could be tested within the first three days. 53.8% (n = 49/N = 91) of the patients presented with language disorders in the clinical neurological examination at admission compared to 63.7% (n = 58/N = 91) that were found to have language disorders according to KAP. Syndrome classification in the group of aphasias showed a frequent occurrence of global aphasia, unclassified aphasia, anomic aphasia and agraphia. Speech apraxia and alexia were always accompanied by aphasia. A large amount of patients are affected by a variety of speech disorders. This study could show that a portion of these disorders could not be diagnosed in the acute situation without using a standardized test battery. Therefore clinical examination should be supplemented by standardized tests in routine diagnosis of speech disorders in acute stroke units in order to treat every patient adequately as soon as possible.

Acute Disease↗