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PubMed1997

Semantic memory impairment does not impact on phonological and orthographic processing in a case of developmental hyperlexia.

Recent evidence from patients with progressive language disorders and dementia has been used to suggest that phonological and orthographic processing depend on intact semantic memory. These claims challenge the traditional view that there are functionally separate modules in the language system. The effect of a severe, but nonprogressive, semantic impairment on phonological and orthographic processing was evaluated in LA, a mentally retarded child with hyperlexia. Knowledge of a word's meaning did not affect LA's word repetition, a measure of phonological processing, or his acquisition and retention of orthographic patterns for writing to dictation low-frequency words with exceptional spellings. These findings support the assertion that both orthographic and phonological whole-word representations can be acquired, stored, and retrieved in the absence of a functional link to semantic memory.

Child↗
PubMed1980

Psychiatric disorders in children with speech and langauge retardation. Factors associated with development.

One hundred children (mean age, 5 to 6 years) who were seen consecutively at a suburban speech and hearing clinic were systematically evaluated for speech and language disorders and psychiatric disorders. Fifty-three were found to have a psychiatric illness. The three groups were compared with the psychiatrically well group to ascertain factors associated with the presence of a psychiatric disorder. Significantly differentiating the ill group were more academic and classroom behavior problems and the presence of both speech and language problems. The two groups were not significantly different in intellectual retardation, hearing impairment, medical factors, nonlanguage development disorders, and a variety of family and demographic factors. Common in both groups were psychiatric illness in parents and first-degree relatives. The data indicate that children with speech and langauge disorders are highly at risk for the development of significant psychiatric problems, which suggests the need for proper screening and multimodal treatment planning.

Adolescent↗
PubMed1998

Timing of social gaze behavior in children with a pervasive developmental disorder.

The aim of the study was to compare social initiatives and gaze behavior in low-functioning children with a pervasive developmental disorder (PDD), high-functioning children with a PDD, children with a language disorder, and normally developing children. Behavior of the children was observed while they watched television and performed a playful task with a parent. Compared to the high-functioning children, the low-functioning children with a PDD showed fewer social initiatives. The high-functioning children with a PDD did not differ from the non-PDD control children in the number of social initiatives and gazes. However, in children with PDD, timing of social gaze proved to be different in that they had lower levels of visual checking before but not after a declarative pointing gesture. Furthermore, they had lower levels of returning gaze.

Attention↗
PubMed2007

Two boys with 47, XXY and autism.

Two children with autism and Klinefelter syndrome (KS) (47, XXY) are presented. Both qualify for the diagnosis of autism based on DSM-IV with severely delayed and disordered language, difficulties with social interaction, and a restricted range of interests and activities. Both also have abnormal EEGs, and one patient has had what appear to be clinical seizures. Trials of antiepileptic medications have not been beneficial in either patient. We report the clinical and EEG findings of each patient, and discuss the implications of this combination of disorders.

Autistic Disorder↗
PubMed1995

Word-finding difficulties, verbal paraphasias, and verbal dyspraxia in ten individuals with fragile X syndrome.

Speech/language disorders are common in the fragile X syndrome. [Howard-Peebles, 1979: Am J Hom Genet 31:214-222; Renier et al., 1983: J Ment Defic Res 27:51-59; Sparks, 1984: Birth Defects and Speech-Language Disorders, pp. 39-43; Hanson et al., 1986: Am J Med Genet 23:195-206]. Verbal paraphasias have been considered a rare feature and word-finding difficulties have seldom been reported. Here we report on ten Brazilian patients who were evaluated for speech/language disturbances and found that word-finding difficulties were present in 50% of the cases, which is a slightly higher frequency than that of clear dyspraxia. We suggest, therefore, that word-finding difficulties and verbal dyspraxia can be a common feature within the spectrum of this syndrome. Additional speech findings are discussed.

Adolescent↗
PubMed2000

Nonword repetition performance in school-age children with and without language impairment.

This study examined nonword repetition performance in a population-based sample of school-age children. A total of 581 second graders who were participating in a longitudinal, epidemiologic investigation of specific language impairment (SLI) were administered the Nonword Repetition Task (NRT) developed by Dollaghan & Campbell (1998). Performance was examined according to second-grade diagnostic category, presence/absence of language impairment, and treatment status. Results indicated that children with language impairment, as well as those in intervention, exhibited deficient nonword repetition skills compared to normal language controls. Findings also confirmed that the NRT is a culturally nonbiased measure of language processing. Results from likelihood ratio analyses indicated that NRT performance, though not sufficient on its own, may provide a useful index to assist in ruling in or ruling out language disorder.

Child↗
PubMedDate not supplied

Co-morbidity and treatment of attention deficit hyperactivity disorder in Saudi Arabia.

To review the experience of a child psychiatric clinic regarding co-morbidity and treatment characteristics of children with attention deficit hyperactivity disorder (ADHD), a retrospective study was done on patients under 19 years who were attending the clinic and were diagnosed with ADHD. Co-morbidity and treatment characteristics were also studied. ADHD was diagnosed in 25.5% of the patients. Of these, 28.3% had coexistent expressive language disorder and 38.7% coexistent mild mental retardation. A psychostimulant (methylphenidate) was prescribed to 23.6% while antidepressants (primarily imipramine) were prescribed to 35.9%. Behavioural therapy was the most commonly offered psychotherapy. Antidepressants were used more than psychostimulants. Psychotropics had a more beneficial effect than psychotherapy.

Antidepressive Agents, Tricyclic↗
PubMedDate not supplied

The use of relative clauses by children with language impairment.

Recently, there has been increased attention to the development of complex syntax by children with language disorder. An example is the work of Schuele and Nicholls and Schuele and Tolbert who describe the acquisition of relative clauses by a group of children with SLI. The current paper presents data from 66 children with language impairment, aged 6 to 11 years. Their use of relative clauses is examined in two contexts, an elicitation and a narrative task. Data are presented on the omission of obligatory relative markers, postulated by Schuele and Tolbert as a recognizable stage in development by SLI but not typically developing children. Obligatory marker omission was rare in the current data. A more common pattern was use of the "reduced relative", described by Schuele and Tolbert as a developmental step prior to the production of full relative clauses. Possible reasons for the discrepancies are considered.

Chi-Square Distribution↗
PubMed1996

Seven-year follow-up of speech/language impaired and control children: psychiatric outcome.

This study examined the 7-year psychiatric outcome of 202 speech/language (S/L) impaired and control children selected from a community sample at age 5 years. Children with S/L at age 5 years were more likely to be psychiatric cases at age 12.5 years than were normal controls, even if their S/L improved. Controlling for concurrent psychiatric disorder, S/L impairment at age 5 years was still associated with an increased rate of psychiatric disorder at 12.5 years. Psychiatric disorder at age 12.5 years was more likely to co-occur with language disorder than with speech disorder.

Articulation Disorders↗
PubMed1996

Topography of auditory evoked cortical potentials in children with severe language impairment: the N1 component.

Topographic maps of late auditory evoked potentials (AEPs) were obtained in a group of 20 children, aged 9-15 years, with severe language impairment (LI) and an age-matched control (C) group of 20 normal children. The study was focused on differences in the latency, amplitude and topography of the N1 component between the two groups and the potential diagnostic value of these variables. The stimulus was a pure tone at 500 Hz with a duration of 100 msec and a rise and fall time of 20 msec. The intensity was 75 dB HL. Six test sequences of 50 stimuli at an interval of 1.0 sec were presented to the left and right ear separately. The AEPs were recorded and analyzed with the Bio-Logic Brain Atlas III program. In the topographic maps a focus corresponding to N1 (FN1) was seen in 15 subjects after left-ear stimulation and in 17 subjects after right-ear stimulation in the LI group. In the C group FN1 was identified in all 20 subjects after left-ear stimulation and in 19 subjects after right-ear stimulation. The position of FN1 was in front of the interaural line and with a dominance on the side contralateral to the ear stimulated in both groups. Among the subjects with an FN1, 6 in the LI group and 4 in the C group had deviating topography. Non-focal maps were seen in 5 LI subjects and 1 C subject. The latencies of N1 were longer in the LI group and there was no decrease in latency with age. There were no differences in FN1 amplitudes between groups. The prolonged latencies in the LI subjects compared to the C subjects may be explained by a slower processing in central auditory pathways and the lack of decrease in latencies with age in the LI subjects might indicate that the disturbance persists and is not a pure delay of maturation. The diagnostic sensitivity of N1 latency, amplitude and topography, in selecting the LI subjects, was 40% with a specificity of 90%. Statistical mapping of a time epoch of 70-140 msec and corresponding to FN1 in the map showed regions of > or = 3 S.D. in 10 LI and 2 C subjects, which corresponds to a sensitivity of 50% and a specificity of 90%. The variability of results within the LI group may reflect different pathophysiological factors underlying the language impairment. In conclusion, topographic evaluation of auditory long-latency potentials may become a diagnostic tool in speech and language disorders.

Adolescent↗
PubMed2003

A functional MRI protocol for localizing language comprehension in the human brain.

We describe a functional magnetic resonance imaging (fMRI) protocol to separate activation of areas in the brain associated with language comprehension from sensory areas activated as a result of the presentation of the language stimulus, by comparing cortical activation patterns during the presentation of similar or the same language stimulus via two different sensory modalities (auditory and visual), and identifying the regions of activation that are common to both modalities. The protocol can be implemented on any MR scanner capable of functional imaging, and has proven valuable for the reliable identification of the lateralization and location of language centres in patients being considered for neurosurgical procedures. As well, the method has potential for the study of cortical processing of auditory speech and written language in healthy subjects and in subjects suffering from language disorders.

Acoustic Stimulation↗
PubMed2000

Otitis media, fluctuant hearing loss, and speech-language outcomes: a preliminary structural equation model.

The goals of this study were to estimate the risk for lowered speech-language outcomes associated with early recurrent otitis media with effusion (OME) with and without hearing loss and to develop a preliminary descriptive-explanatory model for the findings. Three statistical approaches were used to assess associations among OME, hearing loss, and speech-language outcomes. Participants were a subsample of 70 children followed prospectively in the Dallas Cooperative Project on Early Hearing and Language Development (Friel-Patti & Finitzo, 1990). Findings indicated that hearing levels at 12-18 months were significantly associated with speech delay and low language outcomes at 3 years of age. The risk for subclinical or clinical speech delay at 3 years of age was 2% for children with less than 20 dB average hearing levels at 12-18 months and 33% for children with greater than 20 dB average hearing levels at 12-18 months. A structural equation model (Jöreskog & Sörbom, 1993) indicated that the significant and substantial effects of hearing levels at 12-18 months on speech status at 3 years were significantly mediated by language status at 3 years. Discussion includes implications of these findings for alternative speech perception models linking early OME and hearing loss to later speech-language disorder.

Child, Preschool↗
PubMed1999

[Applicability of the Child Behavior Checklist in developmentally delayed children].

OBJECTIVES: The Child Behavior Checklist is used to assess behavioral problems in a large unselected sample of children. In the present study we assess the usefulness of the CBCL in the evaluation of the typical behavioral problems usually reported in children with developmental disorders. METHODS: We examined two groups of children which both had language or communication problems. The first group consisted of 34 children with infantile autism, the second group consisted of 34 age-, sex- and IQ-matched children with a specific developmental speech and language disorder. The CBCL was filled out by the parents in both groups as part of the routine diagnostic procedures. RESULTS: Half of the language-impaired children have Total Behavioral Problem scores within the clinical range. Problems are mainly reported on the scales: "Attention Problems", "Social Problems" and "Withdrawn". Two-thirds of the autistic children have deviant scores on the syndrome scales mentioned above. 32 out of 34 autistic children score within the clinical range on the scale "Thought Problems", whereas only one language-impaired child does so. Single item analysis shows a high prevalence of developmental problems (speech problems, enuresis ...) in both groups. CONCLUSION: The CBCL records characteristic behavioral problems in children with developmental disorders. The problematic behaviors are shown on the syndrome scale level as well as on the single item level. Children with developmental disorders and high scores on the "Thought Problems" scale of the CBCL should be evaluated for the presence of a possible pervasive developmental disorder.

Adolescent↗
PubMed2006

Neuropsychiatric and neurodevelopmental outcome of children at age 6 and 7 years who screened positive for language problems at 30 months.

We present a prospective study at school age of neuropsychiatric and neurodevelopmental outcome of language delay suspected at child health screening around 30 months of age. In a community sample, 25 children (21 males, 4 females) screening positive and 80 children (38 males, 42 females) screening negative for speech and language problems at age 30 months were examined in detail for language disorders at age 6 years. The screen-positive children were then followed for another year and underwent in-depth neuropsychiatric examination by assessors blind to the results of previous testing. Detailed follow-up results at age 7 years were available for 21 children. Thirteen of these 21 children (62%) had a major neuropsychiatric diagnosis (autism, atypical autism, Asperger's syndrome, attention-deficit-hyperactivity disorder [ADHD]), or combinations of these. Two further children (10%) had borderline IQ with no other major diagnosis. We conclude that children in the general population who screen positive for speech and language problems before age 3 years appear to be at very high risk of autism spectrum disorders or ADHD, or both, at 7 years of age. Remaining language problems at age 6 years strongly predict the presence of neuropsychiatric or neurodevelopmental disorders at age 7 years.

Age Factors↗
PubMed2004

Evaluation of the child with cerebral palsy.

Cerebral palsy (CP) is a common problem, occurring in about 2 to 2.5 per 1000 live births. The diagnosis of CP is based upon a history of abnormal motor development that is not progressive coupled with an examination (e.g. hypertonicity, increased reflexes, clonus) "placing" the lesion in the brain. In order to establish that a brain abnormality exists in children with CP that may, in turn, suggest an etiology and prognosis, neuroimaging is recommended with magnetic resonance imaging preferred to computed tomography. Metabolic and genetic studies should be obtained if there are atypical features in the history or on the examination. Detection of a brain malformation in a child with CP might suggest an underlying genetic or metabolic etiology. As cerebral infarction is high in children with hemiplegic CP, diagnostic testing for coagulation disorders should be considered. However, there is insufficient evidence at present to be precise as to what studies should be ordered. An electroencephalogram is not recommended unless there are features suggestive of epilepsy or a specific epileptic syndrome. As children with CP may have associated deficits of mental retardation, ophthalmologic and hearing impairments, speech and language disorders and oral-motor dysfunction, screening for these conditions should be part of the initial assessment.

Adolescent↗
PubMed2001

Incorporating language phenotypes strengthens evidence of linkage to autism.

We investigated the effect of incorporating information about proband and parental structural language phenotypes into linkage analyses in the two regions for which we found the highest signals in our first-stage affected sibling pair genome screen: chromosomes 13q and 7q. We were particularly interested in following up on our chromosome 7q finding in light of two prior reports of linkage of this region to developmental language disorder, since one of the diagnostic criteria for autism is absent or abnormal language development. We hypothesized that if the language phenotype were genetically relevant to linkage at the chromosome 7q locus, then incorporating parents phenotypes would increase the signal at that locus, and most of the signal would originate from the subset of families in which both probands had severe language delay. The results support these hypotheses. The linkage signals we obtained on chromosome 7q as well as at least one signal on chromosome 13q are mainly attributable to the subgroup of families in which both probands had language delay. This became apparent only when the parents' history of language-related difficulties was also incorporated into the analyses. Although based on our data, we were not able to distinguish between epistasis or heterogeneity models, we tentatively concluded that there may be more than one autism susceptibility locus related to language development.

Autistic Disorder↗
PubMed1976

Progressive dialytic encephalopathy.

A subacutely progressive dialytic encephalopathy lasting for three to 15 months in 11 patients who had been on haemodialysis for 14 to 36 months was characterized by dementia, language disorder, myoclonic jerks, behavioural disturbance, distinctive EEG abnormalities, and normal or nonspecific neuropathological findings.

Adult↗