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PubMedDate not supplied

Language repair via metalinguistic means.

Children with specific language impairment (SLI) have been shown to be deficient in the use of complex sentences. In an attempt to remediate this area of weakness, two groups of such children (mean ages 9;4 and 10;6) received about 55 half-hour sessions of metalinguistic training spread over 12 months. Results showed that the use of complex sentences increased to at least normal levels in the experimental groups, and were significantly improved, at both the written and oral levels, as compared with SLI control groups, which evidenced little change over the same period. Further analysis of the data revealed the striking finding that those children who had the poorest complex sentence usage tended to benefit the most from metalinguistic training. These results are interpreted as support for the hypothesis that metalinguistic training helps to overcome the presumed neurological deficit of the language disordered child by making linguistic rules conscious, and thereby providing a 'metalinguistic bridge' via which information can bypass the damaged area.

Child↗

PubMed1995

Familial aggregation of phonological disorders: results from a 28-year follow-up.

This investigation is a follow-up to a longitudinal speech and educational outcome study involving approximately 400 normally developing children that was initiated in 1960. From this database, two groups of subjects (now aged 32-34), their spouses, and all of their offspring over the age of 3:0 (years:months) completed a battery of cognitive-linguistic and interview measures. One group (probands) consisted of 24 adults with a documented history of a moderate phonological-language disorder that persisted through at least the end of the first grade. The other group (controls) consisted of 28 adults who were known to have had normal articulation abilities as children. Results of this study demonstrated that, in comparison to the children of controls, the children of the proband subjects performed significantly more poorly on all tests of articulation and expressive language functioning and were significantly more likely to have received articulation treatment. There was, however, no evidence that specific misarticulations or phonological processes traveled within proband families. These results are in agreement with those of most previous family studies that have demonstrated an increased rate of occurrence of speech-language disorders of unknown origin in families including a first-degree relative who is similarly affected.

Achievement↗

PubMed1991

MRI findings in boys with specific language impairment.

Magnetic resonance imaging scans of specifically language-impaired (SLI) boys were examined to determine whether atypical cerebral findings could be documented in children whose primary deficits were in language skills. Clinical examination of the scans failed to reveal any visually obvious lesions or abnormalities. In contrast, measurement of the scans revealed atypical perisylvian asymmetries in most of these subjects. The distribution of perisylvian asymmetries in SLI subjects was significantly different from the distribution in controls (p less than .01). Measurement of other brain regions revealed that extraperisylvian areas were occasionally deviant in individual SLI subjects; but no one region was consistently deviant across the SLI group. Thus, only atypical perisylvian asymmetries were linked to the language disorder. These neuroanatomical findings suggest that a prenatal alteration of brain development underlies specific language impairment.

Brain Damage, Chronic↗

PubMedDate not supplied

Family pedigrees of children with suspected childhood apraxia of speech.

UNLABELLED: Forty-two children (29 boys and 13 girls), ages 3-10 years, were referred from the caseloads of clinical speech-language pathologists for suspected childhood apraxia of speech (CAS). According to results from tests of speech and oral motor skills, 22 children met criteria for CAS, including a severely limited consonant and vowel repertoire, difficulty sequencing syllables, and inconsistent and unusual errors. Family pedigrees for these children were constructed through parent interviews and direct testing of nuclear family members. Familial aggregation for speech-sound and language disorders was demonstrated with 86% reporting at least one nuclear family member affected. Based on parent report, 13 of the 22 children (59%) had at least one affected parent. However, CAS was evident in only two siblings of probands with CAS and two probands with other speech-sound disorders. Based on testing, overall affection rates of speech-sound/language disorders were higher in families of children with CAS than in families of children with other speech-sound disorders. Mothers of children with CAS demonstrated a higher affection rate than mothers of children with other speech-sound disorders. A sex-related threshold model of transmission was also supported with brothers more often affected than sisters for male probands only. If our inclusionary criteria for CAS are valid, these findings support a general verbal trait deficit hypothesis. LEARNING OUTCOMES: (1) As a result of this activity, the participant will understand potential familial risk factors for CAS; (2) will differentiate aggregation for speech-sound and language disorders in families with CAS from families of children who have other speech-sound disorders; (3) will distinguish how familial aggregation differs in families of boys and girls with CAS; (4) will determine how children with CAS differ in severity from those with other speech-sound disorders.

Apraxias↗

PubMed2006

Converging evidences on language impairment in Landau-Kleffner Syndrome revealed by behavioral and brain activity measures: a case study.

OBJECTIVE: To assess the linguistic abilities of a boy having Landau-Kleffner Syndrome, and relate the focal disturbance of brain activity due to epilepsy to the cognitive and linguistic deficits. METHODS: Several kinds of assessments were carried out, including epileptic source analysis using electronic source localization methods and PET, neuropsychological assessment of cognitive functions, and assessment of speech perception skills (discrimination of phonetic and stress cues) using ERPs. RESULTS: The source of epileptic activity was localized in the left superior temporal lobe. The neuropsychological assessment showed dissociation between verbal and nonverbal functions, and the performance in former was bellow the normal range. ERPs obtained to the processing of phonetic and stress speech cues indicated that the two cues were processed asymmetrically: the mismatch negativity component (MMN) was obtained for the phoneme difference, but not for the stress pattern difference. CONCLUSIONS: Our data converged as it showed that the patient presented a selective impairment of the language system, and the verbal working memory system appeared to be especially defective. It is suggested that the language deficit is at least partly due to the focal disturbance of those neural networks that underlie the functioning of the working memory system. SIGNIFICANCE: LKS is a childhood language disorder that might serve as a model in studying what happens to the language system if, in the course of development, the essential neural circuits are severely disturbed.

Brain Mapping↗

PubMed1992

[Speech production and speech comprehension of dysgrammatic speech of preschool children].

The language comprehension and production abilities of 15 preschool children with developmental language disorders (LD) (4;11 yrs.-7;1 yrs.) and 15 control children (3;8 yrs.-4;7 yrs.) were investigated. For this purpose a test consisting of 135 picture cards was devised. On the production task (plural and comparative forms) the majority of the LD children performed significantly poorer than the control children. The results of the comprehension tests (plural and comparative forms and short sentences) showed marked deficits for the majority of the LD children (11 of 15), especially (but not only) in the identification of single forms. These combined expressive-receptive deficits should be considered in an etiological concept of developmental dysphasia. It is discussed whether these deficits are indicative of far-reaching disorders in the processing of language.

Aphasia, Broca↗

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↗

PubMed1996

Patterns of glial cell activity in fronto-temporal dementia (lobar atrophy).

Fronto-temporal dementia is a clinical syndrome with a number of pathological substrates, including frontal lobe degeneration, Pick's disease, and motor neuron disease with dementia; it also includes patients with a primary progressive language disorder. Twenty-four brains were examined, using immunohistochemistry for glial fibrillary acidic protein (GFAP) and ferritin. Five cases of fronto-temporal dementia with a Pick's disease type of histology showed marked cortical gliosis with striking microglial activity in both grey and white matter. In seven cases of frontal lobe degeneration, there was little gliosis and microglial activity was confined largely to the white matter; two of the seven cases of progressive language disorder showed similar changes to frontal lobe degeneration. Five cases of motor neuron disease with dementia showed both astrocytic and microglial activity within the white matter. We suggest that cases of fronto-temporal dementia due to Pick type histology may result from a process which primarily involves grey matter, whereas cases of frontal lobe degeneration might represent a disorder of white matter.

Astrocytes↗

PubMed1998

The responses of autistic children to the distress of others.

The behavior of preschool children from five groups (developmental language disordered, high-functioning autistic, low-functioning autistic, mentally retarded, and normally developing) were coded in three situations: presentation of a nonsocial orienting stimulus (an unfamiliar noise) and two social situations involving simulated distress on the part of an adult with whom they were playing. Cognitive level was correlated with level of responsiveness to stimuli only for the two retarded groups (mentally retarded and low-functioning autistic). Girls showed more prosocial behavior than boys in both social situations, independent of diagnosis. The language-disordered children showed only mild and subtle social deficits. The low-functioning autistic children showed pronounced deficits in responding in all situations. The mentally retarded and high-functioning autistic children showed good awareness of all situations, but were moderately impaired in their ability to respond prosocially; they rarely initiated prosocial behavior, but did respond to specific prompts. The behavioral feature that marked both autistic groups, in contrast to all other groups, was a lack of social referencing; they did not tend to look toward an adult in the presence of an ambiguous and unfamiliar stimulus. Results are discussed in terms of variability between and among high- and low-functioning autistic children, and implications for the core deficits in autism.

Affect↗

PubMed2000

Child speech and language assessment and measurement.

The necessity of using standardized and norm-referenced tests in assessing speech and language of impaired children has now been recognized. Thus it seems useful to summarize based on the literature principles for founding such testing methods. These include: a) the necessity for a neuropsycholinguistic model that allows the speech-language pathologist to relate the observed linguistic behavior to underlying language processes, b) the knowledge of the psychometric characteristics required for language tests, and c) a discussion of some of the difficulties or controversed points from clinical practice. Among these latter the following are discussed: 1) measurement versus clinical observation, 2) screening versus exhaustive assessment, 3) language linguistic aspects versus pragmatic dimension, 4) formal tasks versus spontaneous language analysis, 5) linguistic versus metalinguistic assessment, 6) "knowledge-dependent" versus "processing-dependent" tests, 7) early detection of at risk children versus diagnosis of developmental language disorders. Diagnosticians are advised to be aware of the principles to respect when assessing child language.

Child↗

PubMed1982

Use of radiotelemetry to obtain expressive language samples.

Expressive language samples were obtained from normal and language-disordered children through standard interview procedures and through wireless radiotelemetry. Comparisons of these samples using Developmental Sentence Scoring (DSS), mean length of utterance (MLU), and inflectional scoring indicated significant differences between the groups of children, and among the interview-telemetry samples. Telemetry samples yielded different overall scores from those obtained with the interview samples, and there were significant differences in the types of language performance within the samples. Reliable telemetry scores across days were obtained. Difficulties in using the equipment are described and the procedures are compared.

Child↗

PubMed2006

Estimating familial loading in SLI: a comparison of direct assessment versus parental interview.

PURPOSE: Two approaches commonly used for estimating prevalence of language disorders in families were compared. The 1st involved examining a subset of language items from an investigator-based interview used to record parental information on the language and literacy difficulties in relatives. The 2nd was the direct assessment of ability in immediate family using a battery of standardized verbal ability, language, and literacy assessments. METHOD: Using these 2 methods, the prevalence of language and literacy disorders was investigated in the immediate family (n=271) of 93 children with a history of SLI (mean age 13;11 years). RESULTS: The overall proportion of relatives with reported language or literacy difficulty was similar for both methods (34.5% for reported difficulties compared with 35% on direct assessment). The present study further explored maternal, paternal, and sibling prevalence rates and strength of agreement between parental interview and direct assessment. When a low cutoff score was used, good agreement (of true negatives and true positives) for reading and spelling difficulties and expressive language between the 2 types of case identification method was found. CONCLUSIONS: Parents can be effective identifiers when the impairment is severe (below 2 SDs from the population mean). Poor agreement was observed between report and assessment of receptive language difficulties.

Adolescent↗

PubMed2006

Making evidence-based decisions about child language intervention in schools.

PURPOSE: The results of recent survey studies suggest that speech-language pathologists base most of their clinical decisions on information they were taught during their graduate programs, their clinical experience, and the opinions of colleagues (T. Wolf & J. Balderson, 2005; R. Zipoli & M. Kennedy, 2005). This is contrary to the principles of evidence-based practice (EBP), in which clinical decisions arise from the integration of scientific evidence, clinician experience, and client needs. Our field's interest in EBP is relatively young. Currently, there are no published committee-derived EBP guidelines for providing language intervention services for children with language disorders. Until national or international organizations publish recommendations from EBP guideline writing panels, clinicians will need to make personal evidence-based decisions with relatively little assistance from outside sources. The purpose of this article is to summarize a seven-step process for making local EBP decisions. METHOD: The authors provide information about a method for forming clinical questions, finding relevant scientific studies, and evaluating those studies that requires relatively little time and few external resources. The authors also provide a system for integrating scientific evidence with their own expertise and training within the context of their employment settings. Finally, an example is provided to show clinicians how to use the evidence-based decision-making process to answer a clinical question about clinical methods for improving grammatical morphology in children with speech-language impairment. CONCLUSION: It is possible for clinicians to make time- and resource-efficient evidence-based decisions that integrate scientific evidence, clinical expertise, and student-parent preferences.

Child↗

PubMed1979

Imitative modeling as a language intervention strategy: the effects of two mediating variables.

Previous research has indicated that language intervention strategies which stress the learning of abstract grammatical rules are more successful than those which emphasize specific stimulus-response associations. Accordingly, this study experimentally compared two such strategies (imitative modeling versus mimicry) to determine their relative effectiveness in teaching language-disordered children rules which they previously lacked. Moreover, two additional variables, reinforcement and whether the modeled examples originated with the clinician or with a separate, third-person model, were examined to determine their influence on the modeling process. The results suggest that modeling strategies were superior to mimicry, thereby replicating the earlier results of Courtright and Courtright (1976). In addition, it was found that neither reinforcement nor third-person models significantly increased the teaching effectiveness of modeling techniques. These results are discussed in terms of their pragmatic implications for practicing speech clinicians.

Child↗

PubMed2004

Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United kingdom does not support a causal association.

OBJECTIVE: After concerns about the possible toxicity of thimerosal-containing vaccines in the United States, this study was designed to investigate whether there is a relationship between the amount of thimerosal that an infant receives via diphtheria-tetanus-whole-cell pertussis (DTP) or diphtheria-tetanus (DT) vaccination at a young age and subsequent neurodevelopmental disorders. METHODS: A retrospective cohort study was performed using 109 863 children who were born from 1988 to 1997 and were registered in general practices in the United Kingdom that contributed to a research database. The disorders investigated were general developmental disorders, language or speech delay, tics, attention-deficit disorder, autism, unspecified developmental delays, behavior problems, encopresis, and enuresis. Exposure was defined according to the number of DTP/DT doses received by 3 and 4 months of age and also the cumulative age-specific DTP/DT exposure by 6 months. Each DTP/DT dose of vaccine contains 50 microg of thimerosal (25 microg of ethyl mercury). Hazard ratios (HRs) for the disorders were calculated per dose of DTP/DT vaccine or per unit of cumulative DTP/DT exposure. RESULTS: Only in 1 analysis for tics was there some evidence of a higher risk with increasing doses (Cox's HR: 1.50 per dose at 4 months; 95% confidence interval [CI]: 1.02-2.20). Statistically significant negative associations with increasing doses at 4 months were found for general developmental disorders (HR: 0.87; 95% CI: 0.81-0.93), unspecified developmental delay (HR: 0.80; 95% CI: 0.69-0.92), and attention-deficit disorder (HR: 0.79; 95% CI: 0.64-0.98). For the other disorders, there was no evidence of an association with thimerosal exposure. CONCLUSIONS: With the possible exception of tics, there was no evidence that thimerosal exposure via DTP/DT vaccines causes neurodevelopmental disorders.

Attention Deficit Disorder with Hyperactivity↗

PubMed1981

Hemispheric asymmetries and early infantile autism.

The observation that language disorders constitute a major symptom of early infantile autism has led some researchers to speculate that the autistic syndrome may be a result of brain damage to the left hemisphere. Such speculation has fostered a number of studies in which attempts have been made to link autism with ostensibly positive signs of left hemisphere damage, such as left-handedness and preferences for "right hemisphere" functional and cognitive activities. In the present review, contributions to this area are systematically reviewed. Studies attempting to demonstrate that an unusually high incidence of left-handedness occurs in autistic samples are examined. Functional and morphological studies examining patterns of asymmetry in autistic samples are reviewed. It is shown that most studies on handedness fail to account adequately for the role that age of subjects may play in the manifestation of left-handedness. A simple cause-and-effect model of abnormal cerebral asymmetry and autism is rejected in favor of a more integrative yet parsimonious model that specifically attempts to explain the language disorder common to autism.

Adolescent↗

PubMed1992

Computer-based reading and spelling practice for children with learning disabilities.

To examine the effects of computer-based reading and spelling practice on the development of reading and spelling skills, a pretest-training-posttest experiment was conducted in The Netherlands. Eleven girls and 17 boys with written language disorders (on the average, 9 years, 7 months old and performing 2 grades below age expectancy) practiced hard-to-read words under three conditions: reading from the computer screen, copying from the screen, and writing from memory after presentation on the screen. For all words, whole-word sound was available on call during practice. To assess learning effects, both a dictation and a read-aloud task were administered in which nonpracticed control words were also presented. During training, the computer kept record of several aspects of the pupils' learning behavior. It was found that copying words from the screen resulted in significantly fewer spelling errors on the posttest than writing words from memory, and that both forms of spelling practice led to fewer spelling errors than only reading words during practice. All three forms of practice improved to the same degree both the accuracy and fluency of reading the practiced words aloud. The way in which spelling and reading practice, in combination with speech feedback, support the development of phonological skills in children with written language disorders is highlighted in the discussion.

Child↗

PubMed1982

A program for achieving generalization of grammatical rules to spontaneous discourse.

Four language-disordered children were presented with a 4-step program designed to achieve generalization of target grammatical rules to spontaneous discourse. A multiple baseline design was used to compare trained and untrained rule usage. During each step of the program, the clinician arranged for the child's own intentions to evoke the target rule. Progression through the program entailed systematically increasing the number of nontarget events the child needed to convey, and decreasing the frequency with which the clinician modelled the target. Trained target rules increased in frequency while untrained rules did not. When therapy was then initiated on the untrained rules, they also increased in frequency while the first rules continued to be produced at mastery level.

Child↗