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PubMed2001

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

OBJECTIVE: To examine the association between early childhood speech and language disorders and young adult psychiatric disorders. METHOD: In a longitudinal community study conducted in the Ottawa-Carleton region of Ontario, Canada, interviewers administered structured psychiatric interviews to age 19 participants who were originally identified as speech-impaired only, language-impaired, or nonimpaired at age 5. The first stage of the study took place in 1982 when participants were 5 years old, and the latest stage of the study took place between 1995 and 1997 when participants had a mean age of 19 years. This report examines the association between early childhood speech/language status and young adult psychiatric outcome. RESULTS: Children with early language impairment had significantly higher rates of anxiety disorder in young adulthood compared with nonimpaired children. The majority of participants with anxiety disorders had a diagnosis of social phobia. Trends were found toward associations between language impairment and overall and antisocial personality disorder rates. Males from the language-impaired group had significantly higher rates of antisocial personality disorder compared with males from the control group. Age of onset and comorbidity did not differ by speech/language status. The majority of participants with a disorder had more than one. CONCLUSIONS: Results support the association between early childhood speech and language functioning and young adult psychiatric disorder over a 14-year period. This association underscores the importance of effective and early interventions.

Adult↗

PubMed1999

Evaluation and management of the child with speech delay.

A delay in speech development may be a symptom of many disorders, including mental retardation, hearing loss, an expressive language disorder, psychosocial deprivation, autism, elective mutism, receptive aphasia and cerebral palsy. Speech delay may be secondary to maturation delay or bilingualism. Being familiar with the factors to look for when taking the history and performing the physical examination allows physicians to make a prompt diagnosis. Timely detection and early intervention may mitigate the emotional, social and cognitive deficits of this disability and improve the outcome.

Age Factors↗

PubMed1976

[Applied phoniatry. I. Retarded language and speech development (author's transl)].

To better understand the assessment of difficulties in verbal communication it is considered to explain language and speech development in relation to motor function. The aetiology, diagnosis, prognosis and treatment of language disorders and their common characteristics are discussed. The otolaryngologist must expect an increase in the number of such cases and should initiate prompt and adequate treatment.

Age Factors↗

PubMed1991

Aphonia due to paramedian thalamo-subthalamic infarction. Remarks on two cases.

We describe two patients in whom CT brain scans imaged paramedian thalamo-subthalamic infarcts in the territory of the thalamo-mesencephalic arteries. Such infarcts give rise to a complex syndrome marked by disturbances of consciousness and of eye movement and neuropsychological disorders, including attentional, memory and, more rarely, language deficits. A loss of voice volume may accompany aphasic disturbances but is exceedingly rare in isolation. In the cases described the aphonia, total but transient, was the only language disorder. The physiopathological mechanisms involved in aphonia are complex and controversial.

Aged↗

PubMed2000

Developmental dyscalculia: prevalence and prognosis.

The prevalence of developmental dyscalculia (DC) in the school population ranges from 3-6 %, a frequency similar to that of developmental dyslexia and ADHD. These studies fulfilled the criteria for an adequate prevalence study, i.e., were population based, using standardized measures to evaluate arithmetic function. Although the variation in prevalence is within a narrow range, the differences are probably due to which definition of dyscalculia was used, the age the diagnosis was made and the instrument chosen to test for DC. The relative predominance of girls with DC may reflect a greater vulnerability to environmental influences alone or in addition to a biological predisposition. DC is not only encountered as a specific learning disability but also in diverse neurological disorders, examples of which include ADHD, developmental language disorder, epilepsy, treated phenylketonuria and Fragile X syndrome. Although the long-term prognosis of DC is as yet unknown, current data indicate that DC is a stable learning disability persisting, at least for the short term, in about half of affected children. The long-term consequences of DC and its impact on education, employment and psychological well-being have yet to be determined.

Adolescent↗

PubMed1985

Aphasia in dementia of the Alzheimer type.

Speech and language assessment in 30 patients with dementia of the Alzheimer type and in 70 normal controls revealed that all Alzheimer patients were aphasic. Throughout most of the course, the language disorder resembled transcortical sensory aphasia, and increasing language impairment correlated with increasing severity of dementia. Aphasia was present regardless of age of onset or family history of dementia. Aphasia is an important diagnostic criterion of dementia of the Alzheimer type.

Adult↗

PubMed2000

Insecure and disorganised attachment in children with a pervasive developmental disorder: relationship with social interaction and heart rate.

This study on children with a Pervasive Developmental Disorder (PDD; N = 32), children with developmental language disorder (N = 22), and normally developing children (N = 28) sought to answer questions concerning attachment and autistic behaviour. We could replicate the finding that children with a PDD are able to develop secure attachment relationships to their primary caregiver. Children with PDD who had an insecure attachment showed fewer social initiatives and responses than children with PDD who had a secure attachment, even when the insecurely and securely attached PDD children were matched on chronological and mental age. Children with both a PDD and mental retardation were more often classified as disorganised. Three findings suggested that a disorganised attachment does not merely reflect the presence of "autistic" behaviour: (1) children with PDD did not reveal higher rates of a disorganised attachment than matched comparison children; (2) having a PDD diagnosis and having a disorganised attachment were found to be associated with opposite effects on an ethological measure of level of behavioural organisation; and (3) a disorganised attachment but not a PDD diagnosis was associated with an increase in heart rate during parting with the caregiver and a decrease in heart rate during reunion.

Child↗

PubMed2004

[Peripheral, central and psychic deafness: diagnosis difficulties in case of autism child].

The population ofchildren seen in the Georges Vacola day hospital, opened 20 years, suffer from serious personality disorders and from, hearing deficit. Speech and language disorders were present in every case. However. autism seems to be less prominent. The dtlfficulties in communicate are associated with problems of memory comprehension and hearing deficit. Many of the autistic children have associated deafness. The importance of central and functional deafness is highlighted. Deficits of mechanisms indispensable to the recognition, discrimination, structuralization, memorization of auditory stimuli are discussed. Another study including 500 autistic children showed that 15% of these children aged 11 to 13 years presented with auditory disorders.

Audiometry↗

PubMedDate not supplied

[Developmental disorders in the fourth edition of the American classification: diagnostic and statistical manual of mental disorders (DSM IV -- optional book)].

In 1991 the American Psychiatric Association proposed a draft version of the IV edition of the Diagnostic and Statistical Manual of Mental Disorders--the DSM IV Options Book. Authors of this version wanted to increase clarity of the criteria sets and to provide compatibility with the Tenth Edition of the International Classification of Diseases (ICD - 10). The purpose of this Options Book is to propose some changes in wording, diagnostic divisions and to discuss various options concerning the placement of sections and disorders within the classification. The "Disorders of Infancy, Childhood or Adolescence" section was renamed "Disorders Usually First Evident in Infancy, Childhood or Adolescence" and moved to the front of the classification and also was expended to 11 groups of disorders. Several suggestions have been made about including new diagnostic groupings such as: Rett's Disorder, Eating Disorders and Voice Disorder. The Options Book introduces a superior category for Attention Deficit Disorders (with and without hyperactivity) and for Conduct Disorder/Oppositional Defiant Disorder. Several options are proposed regarding The Anxiety Disorders of Childhood or Adolescence. There is no evidence for a distinction in this category according to the age criterion. One option would be to move these disorders into the adult anxiety section (similarly as in the Mood Disorders and Schizophrenia). In the new version the title "Specific Developmental Disorders" is omitted. The suggestion is to include Phonological Disorder (Articulation Disorders) and Elective Mutism into Speech and Language Disorders section.

Age Factors↗

PubMed1997

[Aphasia in a polyglot: description and neuropsychological course].

We present a case of aphasia due to an ischaemic lesion in the left temporo-occipital region of the brain of a 60 year old right-handed polyglot. Mother tongues: French, Italian, Arabic. Educated at school in English. Languages learnt as an adult: German, Portuguese, Spanish. Language habitually spoken prior to illness: Spanish. His language disorder was of non-fluent type and progressed to an anomic disorder. The non-parallel recovery of languages led to an initial and predominant recovery of English (language at school) followed by French (his first language). This type of non-parallel recovery may be compatible with the inhibition-disinhibition mechanism hypothesis. This would mean that the languages of least recovery are inhibited by raising the threshold of some circuits while still permitting comprehension.

Aphasia↗

PubMed1999

A problem with auditory processing?

Recent studies have found associations between auditory processing deficits and language disorders such as dyslexia; but whether the former cause the latter, or simply co-occur with them, is still an open question.

Adult↗

PubMed2000

Working memory: a foundation for executive abilities and higher-order cognitive skills.

This paper presents a discussion of working memory and the relationship between working memory and executive abilities. An overview of three prominent models of working memory is provided with experimental support for each. The importance of assessing working memory in individuals with brain damage and related language disorders is discussed, as well as limitations of the currently available assessment tools. Lastly, future directions for the development of both theory and assessment tools are offered.

Brain↗

PubMed1989

[Dysphatic development: clinical importance and neurological background].

The timely treatment of children with developmental dysphasia is important in the prevention of subsequent learning and behaviour disorders. The pathophysiology of developmental dysphasia is complex and depends on age. In the preverbal and early verbal phase the severity of the clinical picture is determined by accompanying motor function pathology (simple motor function, dysarthria, general and oral dyspraxia) and by receptive pathology (hearing, and auditory perception). In the verbal period linguistic problems become more prominent (syntax, morphology, semantics and verbal memory), these problems might be accompanied by oral motor symptoms. The different developmental language syndromes become more apparent with time. After kindergarten age the oral motor and perceptual problems diminish, but the language disorders, that influence communication and scholastic learning, remain. In a small number of children without oral motor, perceptual and memory problems, there exists a 'bare or nuclear syndrome', a so called 'pure dysphasia', without other neurological signs. In these children there is perhaps a genetically determined developmental disorder on a restricted neuronal level (no brain damage!). In more than half of the patients this syndrome is accompanied by other neurological signs, predominantly pointing to the left cerebral hemisphere. Furthermore there can be signs from the right cerebral hemisphere, the corpus callosum and from the afferent fibers systems for auditory perception. The nature and causes of these disorders are extremely variable, so that one cannot speak of the neural substrate or the pathogenesis. The diagnosis and the treatment can optimally only be performed by an experienced team, the expertise of which has to penetrate into the school education system.

Aphasia↗

PubMed1988

Prediction of fine motor skills of children having language and speech disorders.

Relationships between the fine motor skills and linguistic abilities of 37 developmentally delayed children, ages 5 to 9 yr., were studied using a battery of expressive and receptive language tests, a measure of fine motor performance, a dichotic listening test, and individual intelligence tests. While IQs and MAs were not related to fine motor skills, both expressive and receptive language test scores showed moderate to moderately high correlations, the highest single relationship being the Test for the Auditory Comprehension of Language. In concert with CAs, a dichotic right-ear test score, the Auditory Comprehension Test, predicted fine motor-skill indices substantially; R = .80. Strong relationships appear between linguistic and fine motor skills in an age group not previously investigated and at higher levels than reported in studies of infants and very young children. Dichotic results were abnormal in a majority of the children.

Child↗

PubMed1984

Type of reading disability related to cleft type and neuropsychological patterns.

Two groups of cleft palate subtypes (cleft lip and palate and cleft palate only) with reading disability, matched for intelligence, age, sex, and reading level, were compared on reading and neuropsychological test variables. Subjects included 14 males and 10 females of each cleft type ranging in age from 8 to 13. Results showed a significant difference between groups on most language measures and differences in reading comprehension and type of reading errors. Results suggest that children with cleft palate only constitute a language-disorder group with more severe reading disabilities. Children with cleft lip and palate are more likely to have verbal expressive deficits and milder reading problems, possibly related to peripheral speech mechanisms.

Adolescent↗

PubMed2005

The language of dissociation.

Three case studies of inner-city elementary school children illustrate the connection between speech-language disorders and dissociative disorders in children who have known or suspected trauma histories. The role of speech language pathologists in identifying and responding to dissociative symptoms in children is explored. Lack of adequate training concerning the impact of trauma and scarce literature on the communication profiles of dissociative children contributes and greatly impacts the diagnosis, referral, and treatment of these children. The case studies demonstrate how unusual speech and language symptoms and awareness of dissociative features may aid in identifying trauma-related problems and instituting effective treatment. Grounding techniques and specific language interventions can assist children in acquiring the vocabulary needed for communicating both their daily experiences and traumatic histories. The nature of the relationship between dissociation and communication disorders is explored, and the importance of future research, interdisciplinary collaboration, and trauma training in the speech-language curriculum is emphasized.

Child↗

PubMed2003

Nothing to say, something to sing: primary progressive dynamic aphasia.

We describe a 76-year-old man (ADY) with dynamic aphasia in the setting of a degenerative frontal lobe dementia: primary progressive dynamic aphasia. He displayed a striking paucity of propositional speech despite intact speech production, and preserved singing and prosody. Vocal expression in the verbal and musical domains was investigated in a series of neuropsychological experiments based on novel language and musical tasks that were designed to establish the nature and specificity of the verbal output deficit. The features of the language disorder indicated that the speech output pathway was disrupted at the early stage of generation of a new pre-verbal message. In contrast, tests of musical output demonstrated that the generation of new musical ideas was unimpaired. The domain-specificity of dynamic aphasia may result from the disruption of specific cognitive processes necessary for the creation of verbal messages, as well as selective damage of brain regions involved in language production.

Aged↗

PubMed1996

Training wh-question production in agrammatic aphasia: analysis of argument and adjunct movement.

The present research utilized aspects of the Principles and Parameters Approach (P&PA; Chomsky, 1991, 1993) in linguistic theory as well as findings from the psycholinguistic literature as a basis for examining sentence production in aphasic individuals. We examined the production of particular wh-movement constructions--wh-questions requiring movement of an argument noun phrase (i.e., who and what questions) and those which require adjunct movement (i.e., when and where questions). Using a single-subject experimental treatment paradigm, subjects were sequentially trained to produce these wh-questions and, throughout training, generalization to untrained wh-questions relying on similar wh-movement processes was tested. As well, the influence of training on aspects of narrative and conversational discourse was examined. Seven agrammatic aphasic subjects who evinced difficulty producing (and comprehending) "complex" sentences (e.g., passives, object relative clauses, wh-questions)--sentences that involve movement of noun phrases (NPs) out of their canonical positions, leaving behind a "trace" of that movement or "gap"--participated in the study. Subjects were trained to produce wh-questions by taking them through a series of steps emphasizing the lexical and syntactic properties (e.g., thematic role assignment, movement processes, and proper selection of wh-morpheme) of declarative sentence counterparts of target sentences. Results revealed improved sentence production abilities in all subjects under study in both constrained sentence production and, importantly, in discourse tasks. The argument/adjunct distinction was observed in the sentence production recovery patterns noted in six of the seven subjects. Three of the subjects evinced correct argument movement across trained and untrained question structures when wh-questions relying on argument movement were trained; similarly, for these subjects, training structures relying of adjunct movement resulted in improved adjunct movement. Three of the remaining four subjects who required additional treatment to alleviate their wh-morpheme selection deficits, too showed covariance between argument and adjunct movement structures with each type of movement emerging across structures in temporal sequence. We discuss these data in terms of the operations necessary to produce wh-questions, the importance of considering linguistic and psycholinguistic data when designing treatment programs for language disordered patients, and the contribution that detailed recovery data can make both to understanding the nature of sentence production deficits and to issues regarding normal sentence production.

Adult↗