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A family aggregation study: the influence of family history and other risk factors on language development.

Substantial evidence continues to accrue for familial transmission of specific language impairment (SLI). The incidence in families with a history of SLI is estimated at approximately 20%-40%, whereas in the general population the estimated incidence is about 4%. Typical aggregation studies compare data on the speech and language status of parents and siblings of individuals with SLI (the probands) to similar data from family members of control individuals with no speech or language disorder history. In the present study, family aggregation of SLI was examined for a unique sample of children who were ascertained before 6 months of age and thus did not have SLI, but were born into a family with a positive history of SLI (FH+). No study to date has examined the pattern of affectance in families of children ascertained at such a young age. In addition, the ratio of boys to girls born into such families was investigated, as previous studies have suggested alterations in the expected gender ratios. Consistent with prior research, SLI was found to aggregate in families; the average affectance rate in FH+ families was 32%, with significantly more boys (41%) reported as having SLI than girls (16%). A comparison of FH+ and control families (FH-) on sociodemographic factors and medical history revealed differences in the overall rate of autoimmune diseases; FH+ families reported a significantly higher incidence (35%) compared to FH- families (9%). Finally, the 3-year language abilities of a subset of 32 children from FH+ families were compared with those of 60 children from FH- families. Children from FH+ families scored significantly lower on standardized measures of language and were more likely to fall below the 16th percentile (28%) than children from FH- families (7%). These results provide converging evidence that children from FH+ families are indeed at greater risk of developing language delay compared to children from control families.

Autoimmune Diseases↗

Early Language Milestone Scale and language screening of young children.

The purpose of this project was to evaluate the use of the Early Language Milestone Scale (ELM) in screening language skills in young children. In this study, 657 children from birth to 36 months of age were evaluated with the ELM. The overall failure rate was 8%. Children who failed the ELM screening were evaluated with the Sequenced Inventory of Communication Development (SICD) that was used as the "gold standard" for diagnosing language disorders. In the 12-month age and younger group, there was poor agreement between the ELM Scale and the SICD. For infants 13 to 24 months of age, there was moderately good agreement between the SICD and a second ELM that was administered 1 to 2 weeks after the initial screening. In the 25- to 36-month age group, there was excellent agreement between the SICD and a rescreen ELM. The agreement between the two instruments indicated that the rescreen ELM correctly classified 79% of the 13- to 24-month-old infants and 89% of the 25- to 36-month-old toddlers.

Child, Preschool↗

Validity of the Sklar Aphasia Scale.

A German version of the Sklar Aphasia Scale (SAS) was administered to groups of fluent aphasics, nonfluent aphasics, and three control groups (brain-damaged patients without aphasia, schizophrenics, and normal subjects). The SAS discriminated fluent and nonfluent aphasics from schizophrenic brain-damaged, and normal control subjects with a high level of confidence; 91.8% of the aphasic and 81.5% of the brain-damaged patients without aphasia were correctly classified. However, the SAS did not discriminate between fluent and nonfluent aphasics. A factor analysis, which also included the subtests of the Token Test and eight other variables, showed the SAS and the Token Test to load mainly on the same general factor, which represents the severity of language disorders or the impairment of those left-hemisphere functions that might be basic to language. Subtests II and IV of the SAS also had loadings on a memory factor, but none of the subtests had variance on the third factor which represented the sensory-motor or fluency/nonfluencey dimension.

Aphasia↗

Memory and language in neurodegenerative diseases.

This article reviews recent studies concerning memory and language disorders in Alzheimer's disease and other neurodegenerative conditions. It shows how different memory and language subcomponents may differentially be impaired in different neurodegenerative diseases and at different stages of the same disease.

Alzheimer Disease↗

Pedigree analysis of children with phonology disorders.

This study examined 87 pedigrees of individuals with histories of preschool phonology disorders. Results confirmed previous reports that speech and language disorders aggregate in families, with a higher incidence of males affected than females. Significantly more family members with dyslexia and learning disabilities, but not stuttering or hearing impairment, were found in pedigrees of individuals with phonology disorders than in pedigrees of nondisabled individuals. Probands with and without additional language problems did not differ in the incidence of affected family members. Nuclear family members demonstrated a higher incidence of disorders than when all family members were considered, with brothers of probands most often affected. Pedigrees of female probands had more affected members in their nuclear families than pedigrees of male probands.

Adolescent↗

Autism by another name? Semantic and pragmatic impairments in children.

The literature on children with language disorders that are characterized by semantic and pragmatic impairments is reviewed and the conclusion is drawn that some of these conditions may stem from the same fundamental cognitive and interpersonal difficulties that are found in early childhood autism. A summary is presented of recent relevant research and theory in the field of autism and suggestions are offered on how these ideas might be applied to children showing semantic and pragmatic difficulties.

Autistic Disorder↗

Historical note: Jules Séglas on language in dementia.

In his book Des troubles du language chez les aliénés (1892) Séglas applied the model of language processing of his teacher, Charcot, to analyze the language disorders of various groups of mentally ill, including patients considered to suffer from dementia. Among the language phenomena he described from dementia are logorrhea, neologisms, embolalia, near-mutism, angophrasia, automatic speech, alexia, and agraphia. Séglas must be credited for his early descriptions of how language behaviors cluster in various psychiatric and dementing diseases.

Dementia↗

Electrophysiologic assessment of auditory pathways in high risk infants.

This study evaluated auditory processing in a group of 59 infants at risk for subsequent hearing and language disorders due to low birthweight and/or perinatal asphyxia. Auditory system integrity was evaluated electrophysiologically by recording the auditory brainstem response (ABR), middle latency response (MLR) and the cortical auditory evoked potential (CAEP). 63% of the babies had normal peripheral function or slight unilateral impairment; 84% had normal brainstem auditory system function; 82% showed normal MLRs; and 81% showed normal CAEPs. Fifty-three percent of the babies were normal on all tests and only 3% were deviant on all tests. The remaining infants showed diverse patterns of peripheral, brainstem and cortical abnormalities.

Auditory Cortex↗

Language in benign childhood epilepsy with centro-temporal spikes abbreviated form: rolandic epilepsy and language.

Although Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS) has a good prognosis, a few studies have suggested the existence of language disorders relating to the interictal dysfunction of perisylvian language areas. In this study, we focused on language assessment in 16 children aged 6-15 currently affected by BECTS or in remission. An important proportion of children showed moderate or more severe language impairment. The most affected domains were expressive grammar and literacy skills. We found linguistic deficits during the course of epilepsy but also persistent deficits in children in remission, suggesting possible long-term effects. Our results support the hypothesis that BECTS may be associated with impairment to language and suggest the possibility of a direct link between epileptic activity and language development, and the existence of long-term consequences.

Adolescent↗

[Genetic studies in communication disorders].

OBJECTIVES: To review current literature on population, cytogenetic and molecular studies of specific language disorders (SLD) and pervasive developmental disorders (PDD). DEVELOPMENT: Clinical concordance studies in twins and in vertical familial groups suggest polygenic multifactorial modes of inheritance, but in some families an autosomal dominant model may be present. The data favour not a modular, but rather a molar model of the relationship between genes and neural abilities for communicative behaviors. Several extensive genome screenings have demonstrated linkage to specific markers on 7q for SLD, and on 7q and 2q for PDD. The strong evidence of linkage on 7q for both disorders has led to the hypothesis that this region contains several separate quantitative trait loci (QTL) related to different communicative abilities. Mutations in different QTL would facilitate the different disabilities and stereotyped behaviors associated with the phenotypic spectrum of PDD. There are other candidate regions for QTLs but the linkage is weaker and there is little agreement between studies; due, in part, to over extensive inclusion criteria and small sizes of familial groups. CONCLUSIONS: To enhance linkage research in further molecular genetic studies, clinicians must refine behavioral target traits when selecting familial groups and enlarge the size of familial groups by including non handicapped members with related behavioral traits. At present, a chromosome region in 7q shows the strongest evidence for communication related QTL, but other QTL need to be identified elsewhere in the genome in order to explain the genetic contribution to the large spectrum of language and autistic disorders.

Autistic Disorder↗

Age of onset and outcome in 'acquired aphasia with convulsive disorder' (Landau-Kleffner syndrome).

The relationship between age at onset of language disorder and eventual outcome was examined in 45 cases of Landau-Kleffner syndrome reported in the literature, all of whom had been followed up to at least 12 years of age. A strong relationship was found, which is opposite to that for childhood aphasia after structural lesions of the left hemisphere; i.e. in Landau-Kleffner syndrome, the older the child at onset the better the prognosis for language.

Age Factors↗

The use of two language tests to identify pragmatic language problems in children with autism spectrum disorders.

PURPOSE: Pragmatic language disorders (PLDs) are difficult to diagnose in a cost-effective manner, and there are few assessment tools that yield quantitative data. This investigation was designed to determine whether two formal assessment tools would differentiate PLDs in children with autism spectrum disorders (ASDs) from controls matched on verbal IQ and language fundamentals. METHOD: Thirty-four matched participants were given the Test of Pragmatic Language (TOPL; D. Phelps-Terasaki & T. Phelps-Gunn, 1992) and the Strong Narrative Assessment Procedure (SNAP; C. J. Strong, 1998). RESULTS: Participants with ASDs had significantly poorer scores than controls on the TOPL. On the SNAP, the children with ASDs performed similarly to controls on syntax, cohesion, story grammar, and completeness of episodes. The controls performed significantly better only on the ability to answer inferential questions. CLINICAL IMPLICATIONS: The TOPL was effective in differentiating PLDs in children with ASDs when performance was compared tomatched controls. The SNAP did not clearly differentiatelanguage problems in these two groups. Research is needed to develop formal assessment tools that target the unique language disabilities of high-functioning individuals with ASDs.

Adolescent↗

Language in right-handers with right-hemisphere lesions: a preliminary study including anatomical, genetic, and social factors.

A comprehensive test battery was devised to study the effects of right hemisphere lesions on the speech and language of "nonaphasic" dextrals. Data were thus obtained for 62 subjects, 20 of them neurologically healthy and 42 with a focal right hemisphere lesion resulting from a cerebro-vascular accident. A preliminary global analysis of these data is reported. Anomalies were observed in 33 brain-damaged subjects. Although discreet in all cases, these anomalies were shown to have various degrees of severity. Given the population submitted to this study, the subject most likely to show such anomalies was defined, genetically, as a right-handed adult with a family history of ambidextrality or left-handedness and, socially, as one with a relatively limited education. The implications of these findings are discussed together with the problem of the anatomo-clinical correlations of language disorders resulting from right hemisphere lesions in "nonaphasic" dextrals.

Aged↗

Language dysfunction in schizophrenia.

Similarities between language disorders in aphasia and formal thought disorder in schizophrenia are explored in 24 schizophrenic, 5 manic and 5 depressed psychiatric in-patients, and 28 normal controls. Eight sub-tests from the Boston Diagnostic Aphasia Examination, a picture naming test and the Token test were administered. Schizophrenics with formal thought disorder showed significant abnormalities compared to all other groups, particularly on the Token Test and the repetition of phrases test. These deficits are suggestive of language comprehension and repetition dysfunctions in a substantial minority of rigorously defined schizophrenics.

Adult↗

Thought disorder in schizophrenia is associated with both executive dysfunction and circumscribed impairments in semantic function.

BACKGROUND: Formal thought disorder (FTD) has long been regarded as a key sign of schizophrenia but little is known about its origins or aetiology. One suggestion is that it is directly related to disordered language functioning; a second is that it is a reflection of poor neurocognitive functioning. A current model posits that it is related to a combination of executive dysfunction and impaired semantic processing. METHOD: To examine these alternative ideas, a heterogeneous group of 30 patients, all carrying a diagnosis of schizophrenia, and 18 non-patient controls completed a series of neurocognitive and psycholinguistic tests, and a clinical review that, inter alia, permitted assessment of thought disorder (TD) using the Thought, Language and Communication Scale (TLC). RESULTS: Patients generally performed at a lower level on most components of the test battery, but there was little evidence of a relationship between TD and syntactic psycholinguistic function. However, schizophrenic patients manifesting higher levels of TD performed at a lower level on tests sensitive to executive dysfunction and semantic impairments. CONCLUSIONS: The origins of TD seem more closely linked to deficits in executive functioning and semantic processing than to impairments in other language functions or general cognition.

Adolescent↗

Delusions and mood disorders in patients with chronic aphasia.

Sixty-one inpatients manifesting chronic aphasic syndromes were reviewed. Most aphasic patients with behavioral abnormalities sufficiently severe to require hospitalization had posterior hemispheric lesions and fluent disorders. Thirty-eight (62%) had fluent aphasia, eight (13%) had nonfluent aphasia, and 15 (25%) had anomic, global, or transcortical aphasic syndromes. Delusions were more common among patients with fluent aphasias (58%), whereas depression was the most common psychiatric disorder among patients with anterior lesions (63%). Elation occurred in 12 patients, 11 with posterior lesions and 1 with a nonlocalizing syndrome. Neuropsychiatric disturbances in patients with chronic aphasia syndromes correlate with the type of language disorder and with the location of the associated lesion.

Adult↗

Prevalence and type of psychiatric disorder and developmental disorders in three speech and language groups.

Six hundred children with communication disorders presenting to a community clinic were evaluated for psychiatric and developmental disorders. The 600 children fell into three subgroups: those with "pure speech disorders," those with "speech and language disorders," and those with "pure language disorders." The two subgroups with language involvement had higher rates of both psychiatric and developmental disorders than the children with pure speech involvement. Those children with language involvement also had a different pattern of psychiatric diagnoses than the children with pure speech disorders. Possible etiological factors and clinical significance of these findings are discussed.

Child↗

Elicited imitation in language assessment: a tool for formulating and evaluating treatment programs.

Four different clinical populations were administered an elicited imitation task before and after therapy to determine the usefulness of elicited imitation procedures for formulating and evaluating language treatment programs. Children's imitations were analyzed according to the numbers and patterns of omission errors, substitution errors, and correct responses. Results indicated that (1) patterns of responding could be identified; (2) specific patterns were associated with different clinical populations; (3) performance on pretherapy measures could be efficiently analyzed and utilized for formulating language treatment programs; and (4) changes in posttherapy performance could be readily evaluated using this procedure. The data suggest that the elicited imitation procedures can be effectively used to increase the precision of the evaluation and clinical programming of children with language disorders.

Adolescent↗