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PubMed2004

Early predictors of language in children with and without Down syndrome.

Predictors of productive and receptive language development in 39 children with intellectual disabilities (17 with Down syndrome) and their parents were identified. Children were in the prelinguistic or first stage of productive language acquisition (Brown, 1973). The Down syndrome and non-Down syndrome groups were matched on several variables, including IQ, CA, and vocabulary level. After controlling for initial language level, we attempted to identify unique early predictors of language measured 6 months later. Results indicate that Down syndrome negatively affected language development. Additionally, frequency of optimal parental responding predicted later productive language above and beyond etiology. Finally, canonical vocal communication and commenting predicted later productive language only in children without Down syndrome.

Child↗

PubMed1994

Effects of early manual instruction on the oral-language development of two deaf children.

The speech and language training provided to deaf children at our clinic is done by the Kanazawa Method, which consists of reception and expression training in sign communication and auditory/oral language, as well as written-language training. In our investigation, we analyzed the acquisition of passive and active vocabulary in sign and oral language. The subjects were two children congenitally deaf at the 105 dB level or greater. Recorded-language samples through the age of 54 months were analyzed. Acquisition of sign occurred more quickly than oral-language acquisition. The children's production of active nouns, function words, and "wh-" question words in sign was equivalent to that of hearing peers, and later this proficiency transferred to oral language. These results suggest that early presentation of sign is effective in the acquisition of function words and interrogative sentences, both of which are especially challenging for the Deaf.

Child Development↗

PubMedDate not supplied

Acute lymphoblastic leukaemia: language deficits in children post-treatment.

The language abilities of a group of 22 children (aged between 5 years and 17 years, 9 months) treated for acute lymphoblastic leukaemia (ALL) were investigated and compared with those of a group of non-neurologically impaired, age- and sex-matched controls. The language test battery included an age-appropriate measure from the Test of Language Development (TOLD) series, consisting of either the Test of Adolescent Language (TOAL--2), or the Test of Language Development--Intermediate or --Primary (TOLD--I or --P); the timed subtests of the Clinical Evaluation of Language Function (CELF); the Boston Naming Test; and one of either the Token Test or the Token Test for Children, depending on the age of the subject. As a group, the leukaemia subjects performed significantly worse than the controls on the TOAL--2, TOLD--I, TOLD--P, Token Test, and Boston Naming Test. The need for post-treatment monitoring of the language abilities of children treated for ALL to enable early remediation of areas of deficit is highlighted.

Adolescent↗

PubMed1993

Speech and language outcomes 3 years after neonatal intensive care.

Although major handicap rates have been documented in children who required neonatal intensive care, minor handicap rates, including speech and language problems, have received less attention. This paper reports the first stage of a longitudinal study of 118 children, which investigated the speech and language outcomes at 3 years of age. Differences from the normal population were found for the articulation measure, but not for the language comprehension and expression measures used. A major overall communication problem was determined to exist in 13% of the children. The impact of perinatal, medical and environmental variables was investigated. Variables such as low birthweight, short gestational age and mechanical ventilation, found to be important in other studies, had no significant impact on the speech and language outcomes of this cohort of 3 years old. However, for children who had experienced respiratory distress syndrome, there was an effect on articulation and language expression. Paediatric complications and maternal education level had the largest effects on language comprehension and expression, suggesting they were the persistent variables which most contributed to speech and language outcomes at 3 years of age.

Articulation Disorders↗

PubMed1996

Language of dysfunction in schizophrenia.

Twenty-four medicated schizophrenic subjects participated in a study aimed at assessing language dysfunction in schizophrenia. Two groups of subjects participated: schizophrenic responders and non-responders to treatment with antipsychotic medication. All subjects were tested on The Western Aphasia Battery test (WAB), the Cookie Theft picture descriptions task, and the Wechsler Adult Intelligence Scales--Revised (WAIS-R) block design and picture arrangement subtests. All verbal and non-verbal assessments were compared between groups. The three main findings of this study were: 1. Severe language of dysfunction among schizophrenic patients who do not respond to medication treatment. That is, therapeutic response to medication was the major predictor of the severity of language dysfunction in schizophrenia. 2. A group profile of language dysfunction differed in severity but not in shape between responders and non-responders to treatment with antipsychotic medication. 3. Schizophrenic responders and non-responders to medication treatment did not differ in their performance on a standardised picture description task and failed to reach low-moderate aphasia level. Secondary findings suggest that non-verbal aspects, such as attention and logical sequencing, may be influenced by treatment. This study represents an assessment of schizophrenic language function in relation to known language deficits of neurological patients, lending further support for the role of central nervous system (CNS) dysfunction in schizophrenia, and the importance of assessing language dysfunction as a sensitive gauge to treatment response.

Adolescent↗

PubMed1999

Discourse deficits associated with psychiatric disorders and with language impairments in children.

The purpose of the current study was to examine whether types of discourse deficits were associated differentially with psychiatric disorders (PD) and with language impairments (LI) in children. Discourse analyses examining the occurrence of different types of discourse deficits in language structure, information structure, and flow of information were performed on the spoken narratives of 111 children aged 7 to 12 years who comprised 4 groups: (1) psychiatrically referred children with LI (PD + LI), (2) psychiatrically referred children with normally developing language (PD), (3) nonreferred children with language impairments (LI), and (4) nonreferred children with normally developing language (controls). Discourse deficits in language and information structure characterized children with LI, whereas disruptions in the flow of discourse characterized children with PD. Children with the comorbid condition exhibited deficits associated with both LI and PD; in addition, they displayed distinct deficits related to pronominal reference and causal cohesion. The findings provide a preliminary understanding of the associations among language, discourse, and psychopathology in children.

Affective Symptoms↗

PubMed2003

[Confusing stories, not always confusion! Language disorders and dementia].

Sometimes confusing stories may have unexpected causes. A confused patient is not necessarily delirious or demented. We present three patients in which diagnosis was difficult. Their confusion appeared to be caused only partially by memory impairment. Dementia often presents with memory impairment, but sometimes a language disorder is more prominent. Ten percent of the dementias show language disturbances as the first sign. Language disturbances may exist for a long time, even before the onset of the memory impairment. The language disorder causes difficulty in proper judgment of memory. Logopedic examination is necessary to diagnose the language disorder. Neuropsychological testing should take the language disorder into account. Diagnostic accuracy is important. Distinguishing dementia from a language disorder has implications for the judgment of the patient's (dis)abilities and management.

Aged↗

PubMedDate not supplied

[Specific developmental language disorder: a theoretical approach to its diagnosis, aetiology and clinical symptoms].

AIM: This article presents an updated review about the definition, diagnostic criteria, classifications, etiology and the evolution of the specific language impairment (SLI). DEVELOPMENT: The specific language impairment is characterized by a developmental language delay and an impaired language, that persist over time and it is not explained by sensorial, motor and mental disabilities, neither by psycopathological disorders, socio-emotional deprivation, nor brain injury. The diagnosis is based on exclusional criteria. Some researchers propose different classifications considering the children performance in language comprehension and language production. Genetical linkage to the FOXP2 gen in the SPCH1 region of the chromosome 7 and to the chromosomes 13, 16 y 19 has been reported. The neuroimage studies have shown alterations in the volume and perfusion of some brain structures related to language. The manifestations of SLI may change during the development of the children and may disturb the self-esteem, the academic performance and the social abilities. CONCLUSIONS: The variability in the linguistic and cognitive performance, and the variety in the etiological findings in children with SLI, don't allow to settle the affected population as an homogeneous group. Different theoretical positions have emerged as a consequence of this condition.

Cognition↗

PubMed1991

A minority perspective in the diagnosis of child language disorders.

The effective diagnosis and treatment of persons from diverse minority language backgrounds has become an important issue in the field of speech and language pathology. Yet, many SLPs have had little or no formal training in minority language, there is a paucity of normative data on language acquisition in minority groups, and there are few standardized speech and language tests appropriate for these groups. We described a diagnostic process that addresses these problems. The diagnostic protocol we have proposed for a child from a Black English-speaking background characterizes many of the major issues in treating minority children. In summary, we proposed four assessment strategies: gathering referral source data; making direct observations; using standardized tests of non-speech and language behavior (cognition, perception, motor, etc.); and eliciting language samples and probes.

Black or African American↗

PubMed1984

Gestural communication in deaf children: the effects and noneffects of parental input on early language development.

We previously reported that deaf children of hearing parents can develop a gestural communication system with some of the observed properties of early child language. In the present study, this phenomenon of gesture creation was replicated in four deaf children aged 1-4 to 3-1 at the time of the first interview. Each child, despite his atypical language-learning conditions (in particular his lack of usable conventional linguistic input, either oral or manual), developed a gesture system comparable in semantic content and structure (specifically, constructional ordering of elements, differential probabilities of production of elements, and recursive concatenation of semantic relations) to the gestural systems of the six deaf children of hearing parents in our original study and comparable as well to the spoken and sign systems of children acquiring conventional languages under typical learning conditions. This phenomenon suggests that the human child has strong biases to communicate in language-like ways. Nevertheless, it is possible that the deaf child's hearing parents, and not the child himself, were responsible for the emergence of the child's structured (yet idiosyncratic) gesture system. To investigate this possibility, we considered three possible parental influences on the child's sentence structures. First, we entertained the hypothesis that the children's sign sentences were merely imitations (perhaps even uncomprehending imitations) of a hearing adult's immediately preceding gestures. Second, we considered the possibility that the regularities underlying the deaf children's structured sign sentences were induced from their hearing parents' gestures taken in toto. Finally, we considered the possibility that the deaf children's sign sentences had been shaped by their parents' responses to those sentences. We found no evidence to support any of these hypotheses. The data reported in this series of studies confirm that deaf children lacking a conventional linguistic input can develop a gestural communication system that shows some of the structural regularities characteristic of early child language. The results suggest that communication with a number of language-like properties can develop in a markedly atypical language-learning environment, even without a tutor's modeling or shaping the structural aspects of the communication. The data are consistent with the hypothesis that the deaf child himself plays a seminal role in the emergence of the structural aspects of these communication systems.

Child, Preschool↗

PubMed1983

Developmental milestones: sign language acquisition and motor development.

The sign language and motor development of 11 young children of deaf parents were studied across a 16-month period. The subjects showed accelerated early language development producing, on the average, their first recognizable sign at 8.5 months, their tenth sign at 13.2 months, and their first sign combination at 17.0 months. In contrast, children learning to speak typically do not attain the equivalent spoken language milestones until 2-3 months later. The structure and content of the subjects' 50-sign vocabularies closely resembled those for children at the same stage in previously published studies of spoken language acquisition. The pattern of synchrony between motor and language development previously reported by investigators of children learning to speak was found not to apply to the population of the present study: most of the subjects learning to sign did not slow down in their rate of language acquisition after achieving a new motor milestone, but rather continued to show a gradual increase in the size of their sign language vocabularies.

Child Development↗

PubMed1995

The nature of outcomes assessment in speech-language pathology.

In this article, the clinician/researcher dichotomy as it exists for speech-language pathology will be presented, followed by a discussion of the concept of clinical significance. Several clinical effectiveness studies will be discussed, with an emphasis on descriptive follow-up studies--one of the most prevalent types of clinical effectiveness studies used by speech-language pathologists. The American Speech-Language-Hearing Association's (ASHA) task force on treatment outcomes and cost effectiveness, developed to generate an efficacy database for speech-language pathologists, will be discussed. In addition, implications for the education of speech-language pathologists with respect to outcomes will be discussed, including areas such as course content, clinical practicums, future research needs, and continuing education. Finally, future needs in the area of outcomes assessment in speech-language pathology will be presented, particularly the need for improved measurements, follow-up studies, and further initiatives by the American Speech-Language-Hearing Association.

American Speech-Language-Hearing Association↗

PubMed1994

Word skills of children normal and impaired in communication skills and measures of language and speech development.

Results from two related investigations are reported, one using 60 normal language learners, ages 3-5 and one using 34 children with communication disorders, ages 5.4-8.5. Tasks involving the sequential recall of words from five categories (nouns, verbs, adjectives, adverbs, and prepositions) were given to the subjects in each investigation, thus providing an opportunity to compare group performances. A hierarchy of recall strengths of words from different categories and the organizational pattern of scores was determined for each group. Each group's word category scores were used as independent variables in regression analyses to predict scores from a battery of language tests and a test of phonology. The results were anticipated to be capable of contributing to descriptions of children's mental dictionaries, have implications for word category differences in normal and impaired language learners, and clinical relevance. Comparisons of the word recall accuracy of skills of children from each group revealed that the younger normal Ss had word scores equal to the older language and speech impaired children. However, the hierarchy of word category strengths and the patterns of organization within each group's mental dictionary were essentially the same in both groups. Word category scores predicted language and speech scores in both investigations, but the prediction was stronger in the children having impaired language or speech.

Child↗

PubMed2006

Response time in 14-year-olds with language impairment.

PURPOSE: To determine whether children with language impairment were slower than typically developing peers at age 14, and whether slowing, if present, was similar across task domains; whether differences in response time (RT) across domains were the same for children with specific language impairment (SLI) and nonspecific language impairment (NLI); and whether RT performance at age 9 predicted performance at age 14. METHOD: Fourteen-year-old children with SLI (n = 20), NLI (n = 15), and typical development (NLD; n = 31) were administered several linguistic and nonlinguistic speeded tasks. The children had received the same tasks at age 9. RT performance was examined. RESULTS: Both the SLI and the NLI groups were significantly slower than the NLD group in motor, nonverbal cognitive, and language task domains, and there was no significant difference among domains. Individual analyses showed that most, but not all, children with SLI and NLI were slower than the NLD group mean. Slowing at age 9 and age 14 were moderately correlated. CONCLUSIONS: The results suggest that slow RT is a persistent characteristic of many children with language impairment; however, the nature of the relationship between RT and language performance requires further investigation.

Adolescent↗

PubMed1985

Word, syllable, and sound awareness in language-disordered children.

The present investigation evaluated language-disordered children's metalinguistic awareness of words, syllables, and sounds. Subjects were 15 language-disordered children matched for mental age to 15 normally developing children and for language age to another 15 normally developing children. In the first task, children were asked to divide sentences, bisyllabic words, and monosyllabic words into smaller units. In the second task, children were asked several questions designed to assess their word awareness. The language-disordered children performed significantly poorer than both groups of normally developing children in dividing sentences and words. The language-disordered children also did not show the same level of responses to the word-awareness questions as the normally developing children. These findings indicate that language-disordered children's metalinguistic deficit is not limited to difficulty making grammatical judgments. Importantly, these disordered children's lack of word, syllable, and sound awareness places them significantly at risk for future academic difficulties, in particular, learning how to read.

Awareness↗

PubMed1993

Grammatical morpheme acquisition in 4-year-olds with normal, impaired, and late-developing language.

The production of the grammatical morphemes studied by Brown and his colleagues was examined in free speech samples from a cohort of 4-year-olds with a history of slow expressive language development (SELD) and a control group of normal speakers. Results suggest that children with SELD acquire morphemes in an order very similar to that shown in previous acquisition research. Children who were slow to begin talking at age 2 and who continued to evidence delayed expressive language development by age 4 showed mastery of the four earliest acquired grammatical morphemes, as would be expected, based on their MLUs, which fell at Early Stage IV. Four-year-olds with normal language histories produced all but one of the grammatical morphemes with more than 90% accuracy, as would be expected based on their late Stage V MLUs. Children who were slow to acquire expressive language as toddlers, but who "caught up" in terms of sentence length by age 4 did not differ in MLU from their peers with normal language histories. However, they had acquired fewer of the grammatical morphemes. The implications of these findings for understanding the phenomenon of slow expressive language development are discussed.

Child Language↗

PubMed2000

Factors affecting language development in West African children: a pilot study using a qualitative methodology.

Data on referral patterns to pre-school facilities for speech- and language-delayed children suggest that West African children are over represented relative to other ethnic/language groups. This study was set up as a pilot to explore some of the issues which distinguish this group of children and their families. A qualitative methodology was adopted to access the views of a small group of parents (nine) and professionals with direct experience of these services (three). Between them the parents had a total of 11 children who had received speech and language therapy services. Extensive in-depth interviews were transcribed and coded. The families are predominantly well educated with high expectations for their children. Their beliefs about child development in general and language development often differed from those of the professionals interviewed. For example, parents saw little direct link between very early language stimulation and subsequent school performance. West African parents also perceived that they had different (higher) expectations of behaviour than other families. It was generally accepted by all parties that the West African community experiences a high degree of stress resulting from a combination of interacting factors, namely pressures relating to employment, to immigration status, to matters financial and to expectations from family back in their own country. It is unclear exactly how these impact on the development of the child but there is an awareness that there may be a negative effect of such stress and that children's speech and language development may be one aspect of development that is affected. As a result of this pilot study a number of mechanisms relating to the relationship between environment factors and language development are proposed and suggestions are made regarding service provision for this community.

Africa↗

PubMed1996

Longitudinal study of FM system use in nonacademic settings: effects on language development.

OBJECTIVE: The overall objective of the present study was to assess the efficacy of FM system use in the home setting for a group of preschool children with mild-to-severe sensorineural hearing loss. Changes in language acquisition were monitored and compared with similar measures from a group of children who used hearing aids. Secondarily, the perceived benefits and practical problems associated with FM system use across a variety of nonacademic situations were documented. DESIGN: Ten children with mild-to-severe sensorineural hearing loss participated in a 2-yr longitudinal study investigating the efficacy of FM system use in the home setting. The subjects were divided into two groups: one group was instructed to use FM systems at home as often as possible while the other used only their personal hearing aids. Changes in language acquisition were monitored in both groups. Subjective benefit and the practical problems associated with use of FM systems outside of traditional academic environments were monitored via daily use logs, a weekly observation inventory, and a situational listening profile. RESULTS: The majority of children in both groups improved in all measures of language development over the study interval. Although there were relatively large individual differences in performance for some measures, no statistically significant differences between the FM and hearing aid users were found. However, some children in the FM group made unusually large gains in some aspects of language development over the study interval. In addition, both parents and children reported benefits of FM system use in specific listening situations. Throughout the 2-yr study, a number of practical problems associated with FM system use outside the classroom were identified. CONCLUSIONS: Formal language measures did not yield significant differences between the FM and HA groups, but some subjects had rates of language acquisition which suggested that FM system use may be beneficial in selected cases. In addition, subjective reports of FM system benefit suggest that appropriate use of the device may facilitate effective communication in a variety of listening situations. Although recent advances in FM system design may minimize some of the factors that reportedly restricted consistent FM use in this study, the complexities associated with the modes of operation and problems with FM interference remain issues that require consistent audiologic monitoring of FM system use in nonacademic environments.

Audiometry, Pure-Tone↗