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PubMed2005

Epidemiological study of child & adolescent psychiatric disorders in urban & rural areas of Bangalore, India.

BACKGROUND & OBJECTIVE: There are limited data on child mental health needs in our country. Therefore, an epidemiological study to determine the prevalence rates of child and adolescent psychiatric disorders was initiated as a two-centre (Bangalore and Lucknow) study by the Indian Council of Medical Research. It also aimed to study the psychosocial correlates of the psychiatric disorders. We present here the findings of Bangalore Centre. METHODS: In Bangalore, 2064 children aged 0-16 yr, were selected by stratified random sampling from urban middle-class, urban slum and rural areas. The screening stage was followed by a detailed evaluation stage. The ICD-10 DCR criteria were used to reach a penta-axial diagnosis. RESULTS: The results indicated a prevalence rate of 12.5 per cent among children aged 0-16 yr. There were no significant differences among prevalence rates in urban middle class, slum and rural areas. The psychiatric morbidity among 0-3 yr old children was 13.8 per cent with the most common diagnoses being breath holding spells, pica, behaviour disorder NOS, expressive language disorder and mental retardation. The prevalence rate in the 4-16 yr old children was 12.0 per cent. Enuresis, specific phobia, hyperkinetic disorders, stuttering and oppositional defiant disorder were the most frequent diagnoses. When impairment associated with the disorder was assessed, significant disability was found in 5.3 per cent of the 4-16 yr group. Assessment of felt treatment needs indicated that only 37.5 per cent of the families perceived that their children had any problem. Physical abuse and parental mental disorder were significantly associated with psychiatric disorders. INTERPRETATION & CONCLUSION: Prevalence rates of psychiatric morbidity in 0-16 yr old children in India were found to be lower than Western figures. Middle class urban areas had highest and urban slum areas had lowest prevalence rates. The implications for clinical training, practice and policy initiatives are discussed.

Adolescent↗
PubMed1989

Infantile autism and developmental receptive dysphasia: a comparative follow-up into middle childhood.

An interim follow-up study of a group of "higher functioning" boys with infantile autism and control group of boys with severe (receptive) developmental language disorder (or dysphasia) is reported. The boys were compared both initially and at follow-up for overall functioning in the areas of language, peer relationships, stereotyped behaviors, and disruptive public behaviors, as well as for the presence of a number of specific symptoms. In some respects, the behaviors that differentiated the groups initially did so also at follow-up, although there were important differences. Very few of the autistic boys had good language skills at follow-up, whereas nearly half of the dysphasic group were communicating well, a difference that is striking in view of the initial general similarity between the groups in terms of poor language functioning. However, some of the dysphasic children had developed greater difficulties in peer relationships. The implications for concepts of the nature of the deficit in severe receptive developmental language disorders are considered.

Autistic Disorder↗
PubMed2004

Children on the borderlands of autism: differential characteristics in social, imaginative, communicative and repetitive behaviour domains.

A sample of 37 children aged 4-7 years who all showed some autistic features was investigated. Children with a primary diagnosis of autism were compared with those diagnosed with a language disorder, on behaviours within four domains; social behaviour, imaginative activities, repetitive behaviour and communication. The aim was to identify potentially differentiating features of the two groups using observational ratings and questionnaire measures provided by parents and teachers. Information on participants' intelligence and language skills was also collected. The children with autism showed greater deficits in joint attention, functional play and pragmatic language, and engaged in more repetitive behaviours, than the language disordered children. However, the groups did not differ significantly on formally assessed language skills. A cluster analysis produced three groups of children varying in level of functioning and parent-rated behaviours. The results are informative for clinicians dealing with the challenge of differential diagnosis.

Attention↗
PubMed1997

Tutorial: an introduction to syntax.

This paper is intended as an introduction to syntax. Borrowing from Chomsky's Government & Binding and Principles & Parameters frameworks (Chomsky, 1986, 1992, 1995), various aspects of syntactic theory are described. These include lexical, functional, and phrasal categories and how they are put together into clauses and sentences, how words are represented in the mental lexicon, how lexical properties project to the syntax, and how noun phrases are assigned structural and semantic information. Additionally, how sentences that are not canonically ordered are derived and represented, how and to what do pronouns refer, and the principles that connect all these theoretical notions to form knowledge of language are described. The paper concludes with a summary of work in normal and disordered language, including treatment of language disorders, that has exploited aspects of the syntactic theory described in this paper.

Humans↗
PubMed1989

The relationship of play behavior to cognitive ability in developmentally disabled preschoolers.

The relationship of play behavior to cognitive functioning in preschool developmentally disabled children was studied by comparing performance on Lowe and Costello's Symbolic Play Test (SPT) with that on the Bayley Scales and Stanford-Binet Scale. Subjects were 247 children referred for evaluation to a hospital-based child development clinic. Subjects were classified as mildly retarded, moderately retarded, atypical, borderline, and language disordered. Correlations between the Bayley/Binet and SPT for the whole sample were significant and in the low to moderate range. Correlations between cognitive and play measures for each clinical group were in the low to moderate range, except for atypical children where the correlations were negligible. The retarded and borderline groups achieved similar mental ages on the Bayley/Binet and SPT, but the language-disordered and atypical groups demonstrated marked differences in their Bayley/Binet and SPT functioning. Implications for using the SPT in clinical practice were discussed.

Child Development Disorders, Pervasive↗
PubMed1991

MRI findings in the parents and siblings of specifically language-impaired boys.

Four families that include a specifically language-impaired (SLI) boy were studied to test the hypothesis that developmental language disorders are biologically transmittable. A majority of the parents of the SLI boys had experienced communication difficulty (i.e., difficulty with speech, language, or academic skills) as children. Evidence of communication difficulty was paired on an individual basis with neuroanatomical data obtained through quantitative analysis of magnetic resonance imaging scans. Atypical perisylvian asymmetries were documented in a majority of the parents and were frequently associated with a history of communication difficulty. Atypical perisylvian asymmetries and disordered language skills were also documented for siblings of SLI boys. These findings suggest that atypical perisylvian asymmetries reflect a transmittable, biological factor that places some families at risk for language impairment.

Adult↗
PubMed1989

Language growth in children with expressive language delay.

Developmental expressive language disorder is a frequently occurring condition in children, characterized by severe delay in the development of expressive language compared with receptive language and cognitive skills. Opinions differ regarding whether expressive language delay is a disorder worthy of active intervention or an indication of normal variation in the onset of expressive language. The purpose of this research was to follow for 5 months 26 2-year-old children in whom expressive language disorder had been carefully diagnosed to discover the rate of improvement and its predictors. Improvement was variable, with approximately one third of the children showing no improvement, one third showing mild improvement, and one third in the normal range at posttest. Nearly two thirds of the variance in improvement could be accounted for by three child variables measured by the pretest: parentally reported vocabulary size, parentally reported problems with having regular meals, and observed frequency of quiet activity not requiring the parent's management. A screening procedure involving only one of those variables, reported vocabulary size, was 81% accurate in identifying children's improvement status. The implications of these results for the management of children with expressive language disorder are discussed.

Child Behavior Disorders↗
PubMed2002

Sinistrality in subtypes of schizophrenia.

UNLABELLED: Sinistrality, characterized by an excess of non-right-handedness, has been reported in schizophrenic patients, but the findings are controversial. AIM: As sinistrality could be linked to a failure of hemisphere specialization in schizophrenia that would translate into language disorders, sinistrality was found out in disorganized and positive schizophrenic patients characterized by language disorders. METHODS: Seventy-three schizophrenic patients (DSM IV) and 81 controls were evaluated with the Edinburgh Handedness Inventory (EHI). Patients were evaluated and classified into five subtypes (deficit, positive, disorganized, mixed and residual) with the Positive and Negative Syndrome Scale and the Schedule for the Deficit Syndrome. RESULTS: Disorganized patients had a significantly more severe sinistrality in comparison to the deficit, residual and mixed subtypes and controls. A negative correlation was found between the disorganization and the EHI scores (r = - 0.34; P < 0.01). A significantly more severe sinistrality was also observed in the positive subtype in comparison to controls, but there was no correlation between hallucinatory and EHI scores (r = 0.06). CONCLUSION: The findings provided further evidence that the defects in the normal process of lateralization observed in schizophrenia affects primarily disorganized patients.

Adult↗
PubMedDate not supplied

Research priorities in language and learning.

The paper reviews recent work in the area of linguistics applied to abnormal language development, specifically in the area of grammar. Particular attention is paid to the notion of linguistic profiling as a procedure for assessment and remediation, using information from normal language development research as a guide. It is suggested that in addition to the potential benefit of the continuing advance in knowledge of normal language acquisition for studies of language disorders, the study of the language of mothers to children could prove of considerable value to the speech and language pathologist.

Child↗
PubMed1999

Issues in augmentative and alternative communication in child psychiatry.

This article provided an introduction to AAC systems for children and adolescents with severe spoken-language disorders. Over the last decade, significant advances have been made in assessment and intervention approaches. For children with severe spoken communication disabilities, the AAC assessment is an ongoing process that includes information about the child's communication development, the child's environments, and the child's physical abilities. Children with severe disabilities who use AAC systems can demonstrate communication achievements far beyond traditional expectations. Recommended assessment and intervention practices are continuing to develop and the future is certainly optimistic for children with severe spoken-language disorders who may use AAC to communicate.

Adolescent↗
PubMed1997

Three-dimensional cortical morphometry of the planum temporale in childhood-onset schizophrenia.

OBJECTIVE: Anomalous planum temporale asymmetry has been linked to both schizophrenia and dyslexia. The authors examined the planum temporale of adolescents with childhood-onset schizophrenia who had a high rate of prepsychotic language disorders. METHOD: Planum temporale area and asymmetry were measured in 16 right-handed adolescent patients with schizophrenia who had experienced onset of psychosis by age 12. The same measures were made in 16 healthy adolescents matched for age, sex, and handedness. RESULTS: No differences between the healthy adolescents and those with schizophrenia in planum temporale area or asymmetry were observed. Prepsychotic language disorder predicted abnormal planum temporale asymmetry in the adolescents with schizophrenia. CONCLUSIONS: These findings do not support anomalous planum temporale asymmetry as a basis for psychopathology in childhood-onset schizophrenia.

Adolescent↗
PubMedDate not supplied

Written discourse and acquired brain impairment: evaluation of structural and semantic features of personal letters from a Systemic Functional Linguistic perspective.

This qualitative study investigated written discourse in the form of personal letters written by ten people with aphasia following stroke and ten people with cognitive-language disorder as a consequence of traumatic brain injury, and compared their performance with 15 non brain-damaged writers. Personal letters perform the dual function of providing information and maintaining social relationships. Using the Systemic Functional Linguistics framework for investigation, letters were examined in terms of their dual functions, and at two different strata of language--generic structure and semantic organisation. A small quantum of research suggests that the dissociation between different strata of language (i.e., macro and micro linguistic abilities), identified in the spoken discourse of people with aphasia and people with cognitive-language disorder is mirrored in written discourse. Aphasic writers largely maintain coherent text structure while writers with cognitive-language impairment demonstrate problems with global text coherence and the episodic structure of texts. Results of the generic structure analysis did not support the hypothesis. However, the semantic Move analysis revealed how diminished linguistic resources, most evident in the letters written by the subjects with aphasia, impacted upon the semantic diversity of the text, as well as the interpersonal function of the personal letter. Variable performance as a feature pathology and normality is highlighted and clinical implications discussed.

Adolescent↗
PubMed1999

A normed study of face recognition in autism and related disorders.

Although the interpretation of studies of face recognition in older children, adolescents, and adults with autism is complicated by the fact that participating samples and adopted methodologies vary significantly, there is nevertheless strong evidence indicating processing peculiarities even when task performance is not deficient. Much less is known about face recognition abilities in younger children with autism. This study employed a well-normed task of face recognition to measure this ability in 102 young children with autism, pervasive developmental disorder not otherwise specified (PDDNOS), and non-PDD disorders (mental retardation and language disorders) matched on chronological age and nonverbal mental age, and in a subsample of 51 children divided equally in the same three groups matched on chronological age and verbal mental age. There were pronounced deficits of face recognition in the autistic group relative to the other nonverbally matched and verbally matched groups. Performance on two comparison tasks did not reveal significant differences when verbal ability was adequately controlled. We concluded that young children with autism have face recognition deficits that cannot be attributed to overall cognitive abilities or task demands. In contrast to controls, there was a lower correlation between performance on face recognition and nonverbal intelligence, suggesting that in autism face recognition is less correlated with general cognitive capacity. Contrary to our expectation, children with PDDNOS did not show face recognition deficits.

Adult↗
PubMed2004

The effects of ageing and Alzheimer's disease on semantic and gender priming.

Normal ageing as well as age-associated pathological conditions, such as Alzheimer's disease, are associated with modifications of language processing. In particular, an impaired performance in semantic tasks, associated with relatively spared syntactic processing, has been suggested to be the hallmark of the language disorder of Alzheimer's disease. The present experiment tests semantic and syntactic aspects of language processing at the same time, using an on-line paradigm, in patients with Alzheimer's disease, compared with elderly and young controls. Normal ageing was associated with a profile of performance, which was slowed but qualitatively comparable with that of young controls. Both gender agreement and congruent sentential semantics resulted in facilitation relative to baseline in young and elderly controls, with no significant interference effects of incongruent grammatical and semantic information. In contrast, Alzheimer's disease patients presented both facilitation and interference effects. These findings suggest that interference effects are amplified by dementia, and may result from defective inhibitory processes due to Alzheimer's disease pathology.

Adult↗
PubMed2005

Hemispheric specialization for language in children with different types of specific language impairment.

The aim of the study was to investigate whether children with Specific Language Impairment (SLI) show reduced left hemisphere specialization for language and, if so, whether it is associated with a deficit in phonological encoding and a specific type of SLI (Mixed Receptive-Expressive, Expressive, Phonological). We adopted two dichotic listening paradigms, which differed in the phonological similarity of the presented words (Fused and Non-Fused dichotic words tests), as well as a phonological working memory test. Participants included 34 pre-school and school age children affected by SLI. On the dichotic tests, as a group the children with SLI showed a reduced pattern of left hemisphere specialization for language compared to age-matched normal children, with significant differences only in the Fused condition. However, the pattern of hemispheric specialization varied depending on the type of SLI, with reduced left hemisphere specialization in the Expressive type and, to a lesser extent, in the Phonological type of SLI, but not in the Receptive-Expressive type. The three subgroups also differed in phonological processing abilities and the incidence of a positive family history for language disorders: the Receptive-Expressive group performed worse on the working memory and dichotic tests and the Expressive and Phonological groups presented high frequency for familial language disorder. These results suggest that different subtypes of SLI are not different manifestations of the same underlying disorder, but represent pathological conditions that have distinct markers both at the behavioral and neurofunctional level.

Child↗
PubMed2006

Schneider's first rank symptoms and continuous performance disturbance as indices of dysconnectivity of left- and right-hemispheric components of language in schizophrenia.

BACKGROUND: Here we investigate pathophysiological dimensions (language disturbance, negative symptoms, lateralisation and the continuous performance test) in relation to ICD-10 and DSM-IV concepts of diagnosis. METHODS: A total of 32 consecutive psychotic patients with at least one Schneider's first rank symptom (SFRS), 15 depressed patients without SFRS and 17 normal volunteers were assessed with the Clinical Language Disorder Rating Scale (CLANG), SFRS, "pure defect" Huber's basic symptoms (HBS), handedness (Annett's pegboard task), and the A-X Continuous Performance Test (AX-CPT). RESULTS: CLANG total score (an index of severity of language disorder) was correlated with the severity of SFRS, a higher leftward shift of handedness, and poorer performance on AX-CPT. Receiver operating characteristic (ROC) analysis showed that only CLANG and AX-CPT variables had adequate predictive validity in separating cases of ICD-10 schizophrenia from other diagnoses. The logistic regression model predicting the presence of ICD-10 schizophrenia was statistically significant using CLANG and AX-CPT variables, but not SFRS or other variables. HBS did not correlate with other variables and did not predict ICD-10 diagnosis. CONCLUSIONS: A cross-sectional diagnosis based on language disturbance and CPT performance yields a diagnostic construct largely overlapping with the ICD-10 definition of schizophrenia. We suggest that Schneider's first rank symptoms (that play a large role in the DSM-IV concept) can be considered an index of left hemisphere dysconnectivity for language whereas CPT dysfunction reflects dysconnectivity of the right hemisphere for those remoter ("spatial") associations that are closer to Bleuler's core defect and to the chronicity implicit in the ICD definition. Thus the dimensions of language disturbance in psychosis can be traced to specific cortico-cortical dysconnectivities.

Adult↗