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Children with language disorders: natural history and academic success.

Children with developmental language disorders pose specific and unique problems for educators. This article addresses the continuing academic vulnerability of these children during the school years. We advance the position that their academic vulnerability results from the lifelong need to acquire language, to learn with language, and to apply language knowledge for academic learning and social development. Issues are addressed that relate to persistence of language deficits and learning in school.

Achievement

Who shall be called language disordered? Some reflections and one perspective.

This paper discusses some issues involved in identifying children who have language problems. The perspective taken is that (a) the goal of identification must be clearly distinguished from other goals of assessment; (b) identification of children with language disorders is better based on language performance than on inferences about the language knowledge that underlies this performance; (c) language performance must be sampled in more than one context, including, for purposes of identification, contexts that stress the language system; (d) the standards of expectations for comparing performance and determining differences must be explicit; (e) standards used to determine differences are better based on the performance of chronological-age peers than on the performance of children with similar mental abilities; and (f) children who do not evidence poor language performance but are considered at risk for language-related problems should be distinguished from children who demonstrate poor language skills.

Child

Language disorders in childhood and adolescence: implications for learning and socialization.

Children and adolescents with language disorders encounter disruption in the fluency of social interaction. Because of the chronic nature of language disabilities, problems in academic achievement and success become the hallmark of the disorders during the school years. Since adolescence represents a time of experimentation and definition of the self, individuals with language disorders are at high risk for the development of fragmented and inappropriate perspectives about themselves. Treatment must address, in a functionally coordinated manner, the acquisition of essential linguistic and basic academic skills, the learning of curriculum content, and the development of appropriate perspectives of the self and the environment.

Adolescent

Diurnal rhythms in performance tests of school children with and without language disorders.

Time-of-day related changes on four tests used by speech therapists and four other performance tests, in addition to oral temperature, were documented in 16 school children (7-9 years of age). Six of them had language disorders and were receiving speech therapy. Children were synchronized with diurnal activity from around 0730 to around 2100 and nocturnal rest. For each child, at each test time point (e.g. 0900, 1100, 1530 and 1930) tests were performed three times, with two different speech therapists, in a random order, with only one session per day. Conventional methods (t-tested mean differences; ANOVA; correlation tests) were used for statistical analyses. Among 29 parameters (items) which were analyzed, only nine exhibited time-of-day related changes, mainly in speed to-perform measures. In most detected rhythms best performance occurred either at 1100 or at 1530 with no difference in subgroups except for the fastest performance of the sentence repetition test. With regard to the daily mean M, controls performed better than children with language disorders for the word (syllabic) repetition test (P less than 0.0004) but this was reversed for both computing and colouring skill tests (P less than 0.04 and less than 0.002). A difference related to sex (but not to language disorders) was observed in the Ms of speed in sign reproduction (P less than 0.0000) and sorting cards (P less than 0.01), with boys being faster than girls. In children, as in adults, time-of-day effects should be considered when the quantification of performance is desired.

Body Temperature

[Early management of language disorders].

The audio-language consultations of the Centre d'Audiophonologie of Lyon, France, allow the diagnosis of language delay to be documented in very young children. Based on a five-year clinical study, the authors propose a method of regular follow-up for the child and the parents.

Age Factors

Sanfilippo type D presenting with acquired language disorder but without features of mucopolysaccharidosis.

A 7-year-old girl presented with a language disorder reminiscent of verbal auditory agnosia. Later, she proved to have defective N-acetylglucosamine-6-sulfate sulfatase, the enzyme deficient in Sanfilippo D syndrome. She did not show clinical features of mucopolysaccharidosis. The language disorder had a fluctuating course, which eventually evolved into a progressive dementing encephalopathy.

Agnosia

Toe walking. A marker for language disorders in the developmentally disabled.

Toe walking unassociated with an autistic disorder or cerebral palsy generally has been considered a normal infant gait. The incidence of toe walking in various diagnostic subgroups of 799 developmentally disabled children presenting to a tertiary-level multidisciplinary assessment clinic was reviewed to investigate the authors' clinical impression that toe walking may be a marker for language dysfunction. Toe walking was found to be more frequent in those diagnostic subgroups with more severe language disorders. Toe walking also correlated with lower IQ scores (p less than 0.0001). The sensitivities, specificities, predictive validities and odds ratios all supported the hypothesized association between toe walking and language disorders. Further prospective studies of the neurodevelopmental outcome of children with toe walking are needed to determine whether this behavior can identify children at risk for language disorders.

Autistic Disorder

Story grammar ability in children with and without language disorder: story generation, story retelling, and story comprehension.

Twenty language-impaired and unimpaired children ages 9:0 to 11:4 participated in three story tasks. The children generated three original stories, retold two adventure stories, and then answered two sets of comprehension questions after each retelling. Stein and Glenn's (1979) story grammar rules were adapted and used to analyze the narratives. The generated and retold stories produced by the language-disordered children contained fewer complete story episodes, a lower mean number of main and subordinate clauses per complete episode, and a lower frequency of use of story grammar components than those of the control group. The story hierarchies produced by both groups were highly similar, though, in both story generation and story retelling. The groups also did not differ in their understanding of the factual details of the retold stories, but did differ significantly in their comprehension of the relationships linking the critical parts of the stories together. The results are discussed relative to cognitive organizational deficits of language-impaired children.

Attention

Comparative analysis of parent-child interactions with language-disordered and linguistically normal children.

Audio-recordings were made in the home environment of 20 parent-child dyads. Each parent and child participated in a 15-min structured and a 15-min free-play period of interaction. Language samples were analyzed in three areas: frequency components, sentence types, and pragmatic discourse features. Significant differences were found between the linguistic interactions of parents with a language-disordered child and parents with a linguistically normal child in all areas studied. Few differences were found between mothers and fathers within each group. The conclusion is drawn that language-disordered children may live in a different type of linguistic environment which could function to maintain the underlying language problem.

Child, Preschool

[The role of speech therapists on speech language disordered children].

As psychological and physiological development and circumstances vary considerably, the problems of speech and language in children are further complicated. The speech therapists (ST) who have been concerned with these children and their families are requested eagerly to reconsider and control their own communicative attitude. Furthermore, STs have to improve clinical technique that is appropriate to each child. In this report, the author shows the outline of the speech and language problems of children, and discusses the merit and demerit of speech therapy itself. The clinical approach for motor speech disturbance and sensory language disorder is also described.

Child

An investigation of the comprehension and production of requests in normal and language-disordered children.

The ability to comprehend and produce requests was investigated in a group of 15 3-5-yr old normally developing children and 15 5-7-yr-old language-disordered children. The requests were examined under two conditions: 1) during observations in a naturalistic setting; 2) while participating in an experimental task. An important developmental shift in the ability to accurately discriminate between polite and less-polite requests occurred between the ages of 3 and 4 yr for the normals and 5 and 6 yr for the language-disordered children. There appears to be preliminary support for the hypothesis of an underlying pragmatic deficit influencing the communicative performance of some children in this population, accounting for differential abilities in producing, comprehending, and modifying requesting strategies to fit a given communicative situation.

Age Factors

Genetic influences on learning disabilities and speech and language disorders.

This paper is a comprehensive review of known examples of genetically influenced learning disabilities (LDs) and speech and language disorders (SLDs). The review is divided between 2 broad classes of studies: (a) those which begin with an LD or SLD phenotype that appears to be familial and attempt to learn more about the specifics of genetic transmission, if any; and (b) those which begin with a group of individuals, all of whom share a given documented genetic risk factor, to see if it leads to a specific LD or SLD. Included in the first category are familial dyslexia, stuttering, and other speech and language disorders. In the second category are included sex chromosome anomalies, treated PKU, and minor autosomal anomalies. Issues of definition, variability, and developmental changes in the cognitive phenotype are discussed throughout. The implications of this work for our understanding of cognitive development and its bases in brain development and genetics are also discussed.

Adolescent

Brainstem auditory evoked potentials in receptive developmental language disorder.

It has been hypothesized that receptive developmental language disorder (RDLD) may be explained by an auditory processing deficit. The neuroanatomical locus of this deficit is unknown. Brainstem auditory evoked potentials (BAEPs) reflect the functioning of the auditory nerve and auditory brainstem pathways to high-frequency acoustical stimulation in humans and reflect the first stages of auditory processing. These were studied in 12 subjects with RDLD (four females and eight males, ages 12 to 19) and twelve control subjects (three females and nine males, ages 14 to 24). Click intensity and rate of stimulation were varied. The BAEPs for the RDLD group were comparable to the control group as well as to hospital norms across intensity levels and stimulation rates. The evidence obtained suggests that a disorder in the neurophysiological systems underlying the BAEPs and reflecting initial stages of auditory processing is not essential for RDLD.

Adolescent

Speech arrest in partial seizures: evidence of an associated language disorder.

Recurrent episodes of speech arrest were observed in a man as the primary manifestation of a partial seizure disorder. To determine whether speech arrest was associated with a language disorder, the Syntactic Comprehension test was administered during and after speech arrest. This test does not depend upon speech production, but evaluates ability to comprehend sentences in which meaning depends on syntactic relationships. Using this test, we were able to show that speech arrest was associated with a language disturbance.

Adult

The diagnosis of language disorders in bilingual children: surface-oriented and pragmatic criteria.

Certain pragmatic criteria were compared with traditionally employed surface-oriented criteria for the diagnosis of language disorders in bilingual children. Subjects were 10 Spanish/English bilingual children between 6 and 8 years of age who had been referred by bilingual classroom teachers for a special education evaluation. Spontaneous language samples were obtained from each child in both languages. The samples were transcribed and then examined for normalcy according to surface-oriented criteria and pragmatic criteria. The surface elements examined in both languages included morphological and syntactic structures. The pragmatic criteria included nonfluencies, revisions, delays, specificity of referential terms, abrupt topic shifts, inappropriate responses, and the need for multiple repetition of prompts. As expected, it was possible to demonstrate that the two sets of criteria identified different subgroups as language disordered. To test the accuracy of the disparate diagnoses, academic achievement was tested both before and after an average of 7 months of mainstreaming in essentially monolingual English classroom settings. Teacher ratings of English language development and socialization were also examined before and after the 7-month period. Results revealed that the pragmatic criteria were superior predictors of both achievement and teacher ratings. Traditional diagnostic criteria appear to need supplementation by pragmatic criteria.

Achievement

Pragmatic impairments in adults with childhood diagnoses of autism or developmental receptive language disorder.

Audiotaped conversational samples from adults diagnosed as having autistic disorders (n = 15) or developmental receptive language disorders (n = 17) in childhood were transcribed and analyzed using methods based on those of Bishop and Adams (1989). Subjects with autism showed substantially greater pragmatic impairment not explicable by generalized impairment of verbal skills. This was mainly due to autistic subjects' greater difficulty in forming context-relevant communicative intentions; in contrast, pragmatic impairments arising from failures in translating intentions into spoken utterances (i.e., impairments at the level of execution) did not distinguish between the groups. In both diagnostic groups, impairment in forming appropriate communicative intentions was closely related to more generalized impairment of reciprocal social behavior.

Adolescent

Nonverbal indicants of comprehension monitoring in language-disordered children.

This study investigated normal and language-disordered (LD) children's patterns of nonverbal behavior in response to messages varying in degree of ambiguity. Each LD child was matched to two normally developing children: one for comprehension level (LM) and the other for chronological age (CM). All children participated in a videotaped ambiguity detection task. Nonverbal behaviors that were produced between the time the message was completed and the examiner's acknowledgment of the response were scored for type of behavior exhibited including eye contact, hand behavior, body movement, and smile. Results demonstrated that all subjects increased their nonverbal behavior (e.g. eye contact) from unambiguous to ambiguous message conditions, suggesting awareness of the differences in these message types at a rudimentary level. Most often nonverbal indication was the only signal of ambiguity detection exhibited by the LD children and their LM peers. Only the CM children concurrently indicated awareness through more direct means (i.e., verbalization and pointing to all possible referents) in a consistent and accurate manner. The finding that LD children did differentiate inadequate from adequate messages in a rudimentary manner suggests that clinicians might promote the intentionality of these preintentional nonverbal behaviors as a possible intervention strategy.

Child