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Twin language or phonological disorder?

The acquisition of language in the preschool years by multiple-birth children is often reported to be atypical. Some researchers have claimed that they use 'twin language', i.e. an autonomous language specific to a multiple-birth set. This claim was investigated by describing and comparing the phonological characteristics of the speech of 19 sets of two- to four-year-old multiple-birth children, and by measuring multiple-birth children's understanding of their twins' or triplets' context-free speech. The results indicated that multiple-birth children are prone to phonological disorder and consequently their speech is often unintelligible. Siblings' phonologies evidenced some similarities, although they were not identical. Multiple-birth children were better able to understand their siblings' mispronunciations than were other children of the same age, although that understanding was dependent on how closely the error form resembled the adult form. While these three factors conspire to give the impression that 'twin language' is common, none of these findings provided support for the claim that multiple-birth children use an autonomous language.

Articulation Disorders↗

[Speech disorders in ENT practice].

The most frequent speech and language disorders which ENT doctors are confronted with are generally known to be and presented as: delayed speech and language development, dystalia, dysglossia, rhinolalia, dysarthria, and verbal fluency disorders (stuttering, cluttering). The diagnostic portion in comparison to the therapeutic part is always greater and quite different. The close cooperation with representatives of phoniatrics and pedaudiology, as well as logopedics and other specialities such as neurology, and internal medicine is highly necessary.

Adult↗

A study of intellectual abilities in high-functioning people with autism.

This research extends previous research regarding the intellectual functioning of autistic individuals on standardized measures of intelligence (Wechsler Adult Intelligence Scale-Revised and the Wechsler Intelligence Scale for Children-Revised). In Study I 33 individuals with autism who closely fit the DSM-III criteria were studied. Clear evidence was found that differentiates these individuals' verbal intellectual processes from their visual-motor intellectual abilities. Principal components analysis was used to examine the interrelationship among the various intellectual abilities which such tests of intelligence measure. In Study II the intellectual abilities of a group of autistic 8- to 12-year-olds were compared to age-matched groups of children with receptive developmental language disorder, dysthymic disorder, or oppositional disorder. The intellectual abilities of autistic children were significantly different from the other groups of children.

Adolescent↗

[Audimutitas: An analysis].

There are children who are assumed to have normal hearing and normal intelligence, but who do not speak at all. The phoniatric diagnosis for these children used to be audimutitas. Nowadays these children are not specified any more. They are called language-disturbed and are diagnosed and treated like all other language-disturbed children. An analysis is made of 46 nonspeaking children, aged 1.5-3, who are assumed to understand language in a proper way. The analysis deals with their language (language comprehension, language production and pragmatics) as well as with medical and psychological factors influencing the language disorder. We found no correlations between language comprehension, language production and pragmatics. So, when we know one language aspect, we cannot be sure of the others. We also found various factors contributing to the language problem.

Child, Preschool↗

Language sample collection and analysis: interview compared to freeplay assessment contexts.

Spontaneous language samples elicited during freeplay and interview contexts were compared for 10 children who were specifically language impaired (SLI). Clinician-child videotaped interactions were analyzed for both structural and conversational behaviors. The results indicated that the interview was a reliable and valid assessment context, eliciting the same profile of behaviors as the freeplay context without altering diagnostic classifications. Most behaviors occurred significantly more often during the interview than during the freeplay context, indicating further that interviews are an efficient language sampling alternative for assessment purposes with elementary school-aged children with language disorders.

Child↗

Neologisms and idiosyncratic language in autistic speakers.

Language samples from matched groups of 80 autistic, mentally handicapped, and normally developing children were coded for the presence of neologisms and/or idiosyncratic language use. Cognitive, social, or linguistic factors that might account for these errors were identified and assessed. More autistic subjects used neologisms and idiosyncratic language than age- and language skill-matched control groups. No single factor or combination of factors was responsible for this difference. Across diagnostic groups, similar patterns of error were noted, except that the autistic subjects were more likely to use words inappropriately that had no phonological or semantic similarity to the intended English word. For the autistic groups, the frequency of idiosyncratic language increased with language complexity. In contrast, such errors decreased with language skill in the mentally handicapped group. Theoretical implications for determining the nature and source of the language disorder associated with autism are discussed.

Adolescent↗

Brief assessment of cognitive impairment in patients with stroke.

The Stroke Unit Mental Status Examination (SUMSE) has been developed to provide a reliable poststroke test of cognitive functioning that may be administered at bedside. SUMSE was designed to assess major cognitive disorders caused by stroke (eg, language disorders, visuoperceptual deficits, and memory disorders) while avoiding, as much as possible, reliance on patients' English language skills and motor movements. SUMSE's reliability and validity were evaluated by administering it to patients on a stroke rehabilitation unit in conjunction with already validated tests. The results indicated that SUMSE has the potential to become a useful tool for the bedside assessment of mental impairment in stroke patients.

Aged↗

Adult crossed aphasia in dextrals revisited.

The clinical study of crossed aphasia in dextrals (CAD) may shed light on the discreteness and modularity of several cognitive functions, such as language, gestures and visual spatial abilities, with respect to hemispheric lateralisation. Since 1975 over 180 cases have been described, employing, however, different criteria of assessment and classification. The purpose of this paper is to review them and to propose a set of diagnostic criteria that may be useful to single out a series of reliable CAD cases on which research can be safely carried out. A detailed analysis of such series is dealt with in terms of a number of characteristics concerning both the language disorder and the associated nonverbal cognitive impairments.

Adult↗

Functional MR imaging of language processing: an overview of easy-to-implement paradigms for patient care and clinical research.

Functional magnetic resonance (MR) imaging is one of the most commonly used functional neuroimaging techniques for studying the cerebral representation of language processing and is increasingly being used for both patient care and clinical research. In patient care, functional MR imaging is primarily used in the preoperative evaluation of (a) the relationship of a lesion to critical language areas and (b) hemispheric dominance. In clinical research, this modality is used to study language disorders due to neurologic disease and is generally aimed at language function recovery. A variety of language paradigms (verbal fluency, passive listening, comprehension) have been developed for the study of language processing and its separate components. All of the tasks are easy to implement, analyze, and perform. Silent gap acquisition is preferable for the imaging of specific language processing components because auditory stimuli are not degraded by imager noise. On the other hand, continuous acquisition allows more data to be acquired in less time, thereby increasing statistical power and decreasing the effects of motion artifacts. Although functional MR imaging cannot yet replace intraoperative electrocortical stimulation in patients undergoing neurosurgery, it may be useful for guiding surgical planning and mapping, thereby reducing the extent and duration of craniotomy.

Biomedical Research↗

[Behavior problems in language-impaired children: therapy evaluation using child behavior checklist].

Speech and language impaired children often show accompanying behavioral and emotional problems, putting an additional burden on their developmental course. In a sample of 57 children with a specific speech and language disorder we evaluated the behavioral changes after therapeutic intervention. The children got intensive treatment for about 15 months. Before the beginning of the treatment, all children were assessed using clinical psychiatric interviews and observations and were diagnosed according to the multiaxial classification scheme. The CBCL was filled in by the same parent before and after the treatment program. The Total Behavior Problem Score was used to assess changes in behavioral problems. The school type as well as the still necessary therapeutic interventions after the completion of the treatment program were used as global measures of psychosocial adaptation. 45 of 57 children had a psychiatric diagnosis on axis 1 of the multiaxial classification scheme. Hyperkinetic disorder, with or without conduct disorders were the most commonly given diagnoses, in addition to emotional disorders and adjustment problems. Before treatment, the children with a psychiatric diagnosis had higher scores on the Total Behavior Problem Score than the children without a psychiatric diagnosis. The children with psychiatric problems showed a significant decrease in the Total Behavior Problem Score of the CBCL. Although the children with a conduct disorder also showed improvement after treatment, their CBCL scores remained high. The stability of their problems was associated with a worse school prognosis and with further institutional care after the end of the treatment.

Adolescent↗

Clinical evaluation of language and thought disorders in patients with schizophrenic and affective psychoses.

56 patients with RDC diagnoses of schizophrenia (n = 40) and mania (n = 16) were interviewed with a structured interviewing procedure. The evaluation was performed by 2 raters who were blind for diagnosis. Two instruments were used for evaluation concerning thought and language disorders: the 'Scale for Assessment of Thought, Language and Communication' developed by Andreasen and the 'Endogenomorphic Schizophrenic Axial Syndrome' by Berner with its emphasis on thought disorders. The interrater reliability for both instruments was found to be good to acceptable for the essential items. A comparison of the frequency of thought disorders according to the two different instruments showed an occurrence of derailment and incoherence of the Andreasen scale in both diagnostic groups, while thought disorders of the schizophrenic axial syndrome were represented only in the group of schizophrenics. This is because in contrast to the Andreasen scale, the presence of pressure of speech is considered as an exclusion criterion for the schizophrenic axial syndrome. Thus, thought disorders according to the schizophrenic axial syndrome are seen to possess diagnostic significance.

Bipolar Disorder↗

[Aphasia in children].

The acquired aphasia in children is a rarely seen speech and language disorders. Disturbances develop after the child has already achieved the capacity for language comprehension and verbal expression. Brain trauma is most often the cause. The clinical picture of the disorder varies over different age groups and, in contrast to adults, shows no consistent typology. In most of the cases there exists a disturbance of speech production; problems with writing and comprehension are seen less often (although comprehension of language is primarily affected in the Landau-Kleffner syndrome). Only once and a while logorrhoea and jargon can be diagnosed. Besides the speech and language disorders cognitive, motor und emotional problems may appear. Therefore, several diagnostic levels have to be considered (e.g. clinical neurology, neuropsychology, psychophysiology, psychopathology). Course and prognosis of the acquired aphasia in childhood (30% longterm difficulties) depend on several factors like etiology and extension of the lesion, the development of the functional hemispheric dominance for language and the initial recovery velocity after the symptoms appeared. The plasticity of the child's brain is a source for compensating mechanisms which might be triggered by three aspects of therapeutic activities which should be used synchronously: speech and language training, principles of psychotherapy and social medicine and treatment of additional disorders.

Adolescent↗

[Cerebrovascular disease: language acquisition in preschool children].

We describe ten children, aging 5 years and 1 month until 5 years and 11 months, when the phonoaudiological assessment was conducted. They are divided according to cerebrovascular disease, in CVD group (CVD-G) and control group (cG). Children were seen and CVD was confirmed in the acute phase at UNICAMP hospital. Audiologic assessment, protocol for Infant language assessment, and Peabody picture vocabulary test were used in the evaluations. The qualitative analysis of the subjects from a phonoaudiological and neurological point of view has shown the recovery of acquired language disorder (ALD) with no influence whatsoever in the development of 2 subjects and subtle language and/or learning process alterations for 3 subjects. The cases study has revealed that all aspects of language development in preschool children should be analyzed in an individual, quantitative, and qualitative basis to lead to conclusive findings.

Acute Disease↗

Anticipatory imagery ability in normal and language-disabled children.

The literature on cognitive functioning of language-disabled children suggests that they exhibit specific disabilities in nonlinguistic as well as linguistic domains. These disabilities have been hypothesized to be related to deficits in cognitive representational ability. Anticipatory imagery and spatial representation have been reported as two nonlinguistic representational areas in which language-disordered children are deficient. The present study compared normal and language-disabled children on spatial representation tasks involving anticipatory imagery. Five spatial tasks were administered to two groups of 7 1/2-9 1/2-year-old children matched on sex, age, native language, and racial background. One group included 18 language-disabled children and the other group 18 children with normal language development. The language-disabled were less accurate than the normal children on all tasks which involved anticipation or prediction of mental rotations, movements, or other transformations. The results of this study suggest difficulty with dynamic cognitive representation in the linguistic and nonlinguistic deficits demonstrated by language-disabled children.

Child↗

Communication issues in Attention-deficit Hyperactivity Disorder.

Children with Attention-deficit Hyperactivity Disorder (ADHD) evidence a variety of pragmatic deficits and are particularly at risk for other speech and language disorders. Speech and language pathologists in educational settings have the special expertise needed for interpretation and treatment of communication issues associated with ADHD. They should contribute more directly to the multi-modality treatment team in creating management programs for these children.

Attention Deficit Disorder with Hyperactivity↗

Auditory dysfunction in stroke.

The auditory and vestibular systems share the same end organ and cranial nerve, yet vestibular signs and symptoms are common with stroke, whereas hearing disturbances are much less frequent. Several reasons would appear to account for this striking dissimilarity. One is that the auditory pathway is less ubiquitous than the vestibular pathways. The likelihood that a stroke involves the auditory pathway is, therefore, less on this basis alone. A second difference, to our knowledge not previously reported, is that the auditory pathway is often spared by the most common strokes. This is because major parts of the auditory pathway, such as the cochlear nucleus, inferior colliculus and medial geniculate body, have multiple sources of blood supply. A third well-recognized factor is the redundancy of the central auditory system and its strong bilateral representation above the level of the cochlear nuclei. Consequently, rostral to the cochlear nuclei gross deficits in hearing, such as those measured by standard pure-tone audiometry and speech discrimination, only occur if lesions are bilateral. Furthermore, widespread bilateral lesions of the auditory system typically render the patient unable to respond or are incompatible with life. In contrast, language disorders are more frequent because language is usually unilaterally represented in the cortex. Certainly, cerebral stroke often includes the auditory system, resulting in various types of auditory disorders, but most hemispherical lesions produce subtle hearing dysfunctions that can only be detected with sophisticated psychoacoustic and electrophysiological testing. The purpose of this review is to provide an overview of the auditory system and its blood supply and to review how auditory processing can be affected by stroke. Psychoacoustic and electrophysiological test procedures for identifying lesions in the central auditory system are described. The literature of hearing disorders due to stroke is reviewed and illustrative cases are presented.

Audiometry, Pure-Tone↗

Thirty years of research on developmental neurolinguistics.

A body of medically important work has accumulated in the field of developmental neurolinguistics in the 30 years since Lenneberg set forth a research agenda for that field, consisting of the following: (1) the physiologic specialization or endowment for speech; (2) the genetic origin or natural history of vocalization and speech; (3) the nature of prelinguistic behavior, making possible the detection of any environmental (social) influences; (4) the development of motor-speech organization from birth; and (5) the limiting effects of deficient intelligence, hearing, and environmental stimulation. Subsequent study of these questions has established a genetic, neuroanatomic, and functional basis for such outwardly disparate disorders as dyslexia, stuttering, autism, and delayed language. Studies of emergent motor behavior suggest that babbling may index a state of neural maturation favoring expression of spoken languages. Based on studies of the congenitally deaf, mentally retarded, and other clinical populations it is now considered possible to detect early warning signs of developmental language disorders during the first year of life based on analyses of vocal turn-taking, gesturing, and utterance complexity.

Adolescent↗

[Diagnosis of children with specific language impairment using a developmental scale].

Specific language impairment (SLI) should have an early diagnosis, since it can interfere with social and school adaptation of the child. The aim of this study was to verify the performance of children with SLI in comparison with normal children using the Behavior Developmental Scale of Gesell and Amatruda. Twenty-five SLI children, 3 to 6 years of age, were evaluated. This group was compared to 50 normal children of the same age. Children of control group showed better performance in all aspects of the scale. The medium value of the studied group was borderline in adaptative and social aspects, and was slightly below the medium in the language aspect. We conclude that language disorder may impair the assessment of other areas of development. Nevertheless, this scale may be useful in the evaluation of children with SLI.

Case-Control Studies↗