Prevention of communication disorders: a position statement.
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The purpose of this study was to explore the relationship between functioning of the vestibular system, measured by duration of postrotatory mystagmus, and specific communiccation disorders (articulation, speech and language, and language). A total of 190 children participated in the study, 173 of which were included in the final data analysis. The findings revealed a depressed mean duration of postrotatory nystagmus in all categories of communication disorders when compared to the control group. In addition, the language group had a sig;ificantly lower mean duration of postrotatory nystagmus when compared to the articulation and speech and language groups. Although the test measure did discriminate between groups, it did not discriminate well between children within groups.
Twelve hundred four preschool children were administered the Miller Assessment for Preschoolers (MAP), a screening test for children aged 2.5 to 5.5 years designed to identify children at risk for learning problems. Scores on the Verbal Index of the MAP were analyzed for each of six age groups by sex and race, using six 2-way ANOVA's. Results indicated that boys and girls in all six age groups were equally identified as being at risk for communication disorders. In three of six age groups, black children had a greater likelihood of being identified at risk than white children. Results are discussed in terms of cultural and gender bias and compared with other language screening tests.
This paper presents and explains an early clinical discussion of the case of a young nobleman who had developed a severe speech impediment associated with anxiety. The discussion was written by the famous Italian physician Hieronymus Mercurialis, in consultation with the renowned surgeon Gaspar Tagliacozzi, probably in the late 1580s. The case had first come to the attention of Dr. Pio Enea Caprili, who wrote to Mercurialis for an opinion. It has not heretofore been cited in the modern literature on communication disorders. The document is placed in its intellectual context and modern analogues are cited. Mercurialis' discussion belongs to a highly developed tradition of language study in medicine and natural philosophy that goes back to ancient Greece and deserves to be better known. A brief survey of late 16th century literature on voice and speech is provided in an appendix.
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Traumatic brain injuries (TBI) may result in a broad array of cognitive-communicative impairments. Cognitive-communicative impairments are the result of deficits in linguistic and nonlinguistic cognitive functions. The speech-language pathologist functions as a member of the multidisciplinary team of professionals that collaboratively assess and treat individuals with TBI. The role of the speech-language pathologist includes assessment of all aspects of communication, as well as the communicative implications of cognitive deficits, and swallowing; treatment planning and programming, as determined by the individual's stage of recovery; client and family training/counseling; and interdisciplinary consultation. The effectiveness of speech and language intervention for specific cognitive deficits (e.g., attention, memory, executive functions) as well as general issues of social-skills training and early intervention are illustrated by scientific and clinical evidence from group-treatment and single-subject studies as well as case studies.
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Many children and adolescents with psychiatric disorders exhibit severely compromised language and social communication systems. The nature and scope of their deficits make a multidisciplinary team approach essential to management in which improved functional and socially appropriate communication is a primary goal. For this reason SLPs generally play a key role in the intervention process and share responsibilities for the planning, coordination, and implementation of instructional-educational goals.
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Often, children with language disorders exhibit other more subtle delays or deviance in social, communicative, and cognitive development. By focusing on these three areas, the clinician can understand the developmental context in which the language delay manifests. This approach includes the following: gathering information, psychological and communicative examinations, psychiatric examination, and medical evaluation.
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A retrospective study investigated the incidence and types of communication problems in 115 patients referred for swallowing difficulties. Each patient had a bedside swallowing evaluation completed as well as a screening of communication abilities. A formal speech-language evaluation was done when warranted and possible. Of the 115 patients, 93 had suspected swallowing problems based on the bedside evaluation done by the speech-language pathologist. Videofluoroscopy was performed on 85 of these patients. A significant positive correlation was found between communication impairments and both suspected and videofluoroscopically confirmed dysphagia. Cognitive problems were the most frequent communication impairment with dysarthria being second. Neurological diseases were the most common medical diagnoses in patients with swallowing difficulties. The case is presented for the speech-language pathologist to be the primary diagnostician and manager of both communication and oral-pharyngeal swallowing disorders whether they co-occur or not.
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