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Are oral-motor exercises useful in the treatment of phonological/articulatory disorders?

The utility of oral-motor exercises in the remediation of children's speech acquisition delays continues to be a controversial issue. There are few empirical evaluations of the efficacy of these nonspeech activities in effecting speech changes, although much can be learned from investigations in related fields. The purpose of this article is to review the extant studies of the relation between oral-motor exercises and speech production in children as well as to examine the motor learning literature to gain a broader perspective on the issue. Results of this examination lead to questions about the procedures that are currently applied as well as to suggestions for future development of nonspeech activities in the treatment of children's phonological/articulatory disorders.

Articulation Disorders↗

A novel syndrome involving primary skeletal growth and retardation in siblings.

An identical pattern of malformations was found in two brothers both having microcephaly and severe developmental delay. Additionally, they had hypotelorism, epicanthic folds, and convergent strabismus. There was shortening of either the radius or the tibia and shortening of the first metacarpals. Persistently dorsally flexed fingers and toes were noted, all of which are unusually long. Both boys had a high-pitched voice and were unable to communicate verbally at the age of 4.5 years. They both developed short stature. One brother has anal atresia; the other had a pulmonary artery atresia, VSD, ASD, and an over-riding aorta. This apparently new syndrome is possibly an autosomal, or a X-linked recessive trait.

Anus, Imperforate↗

Effect of otitis media on development: a community-based study.

Otitis media history until age 3 years were recorded for 233 children as part of the surveillance in a Community Program for Promotion of Growth and Development (PROD) conducted in a western neighborhood of Jerusalem. Recurrent otitis media (6 or more episodes) occurred more frequently among children who were of North African or Asian origin, of lower social class and maternal education, and whose duration of breast feeding was less than 26 weeks. Children with recurrent otitis media also failed the 7-month hearing test more frequently than other children. The mean Developmental Quotient score at 2 years and the mean Stanford Binet score at 3 years were statistically significantly lower among children with recurrent otitis media, even after controlling for maternal origin and length of breast feeding. These findings underscore the importance of early identification and early intervention for otitis media.

Child Development↗

The influence of long-term tracheostomy on speech and language development in children.

BACKGROUND: Individuals diagnosed as having primary neurological disorders have a high incidence of abnormal speech and language development. However, results in cohorts where this group are excluded are controversial. With no coexisting neurological impairment, some suggested that tracheostomy has little influence on speech development, whilst others showed a clear pattern of language disability. The aim of this study is to evaluate the influence of tracheostomy on speech and language development. METHOD: Retrospective study using standardised outcome measures. RESULTS: A series of 39 paediatric tracheostomies was studied. In the group where children had neurological disorders, 94% showed no language or delayed language development. In contrast, of the group of children without a neurological impairment, 60.9% had normal speech and language development. The median age at the decannulation in those children with delayed speech was 23 months, whilst in those children with normal speech it was 14.5 months. CONCLUSION: Tracheostomy affects speech and language development in those with and without neurological disorders. Crucial factors affecting speech and language development within the neurologically normal group are age at the tracheostomy, and the duration of the tracheostomy until decannulation. Achieving earliest decannulation improves the chance of a normal speech and language development.

Age Factors↗

Interdisciplinary and prospective studies necessary to increase insight into developmental language disorders.

UNLABELLED: The study of developmental language disorders is discussed from an interdisciplinary perspective. It is argued that retrospective studies have provided valuable information on developmental language disorders that needs to be integrated into a theoretical model capable of capturing the basic mechanisms of language development. CONCLUSION: It is concluded that interdisciplinary and prospective studies and theoretical work are necessary to increase insight into developmental language disorders.

Child↗

The development of morphology and syntax in a pair of DZ twin boys.

Twins provide a natural set-up for the study of some of the basic issues that concern the field of language acquisition and of developmental language disorders and brain pathology, in that they present a unique hereditary and environmental situation within which development takes place. Yet, few studies have detailed the development of formal aspects of language in twins. This paper reports on a prospective, longitudinal study of the acquisition of selected aspects of Hebrew syntax and morphology in a pair of DZ twin boys, aged 3;6-4;0, one of whom had a congenital brain abnormality. MLU levels suggest a marked delay for both children in the onset and progression of language development. However, both the healthy and the brain-injured twin followed a normal developmental course. Data to that effect concern frequency of sentences of various lengths, distribution of sentence types, use of tenses, use of pronouns, correct usage of various syntactic markers, variability of verb types and tokens and the distribution of errors of morphology and morphophonology. It is argued that this case study offers support for claims concerning brain plasticity for language. Furthermore, it is in line with previous studies of normal and brain-injured children which, rather unexpectedly, pointed at the relative ease with which formal, linguistic systems were acquired.

Cerebral Ventricles↗

Measuring phonology in babble and speech.

Procedures for measuring prelinguistic vocalizations and early phonological development are described and illustrated. The prelinguistic measures indicate that production of supraglottal consonants in consonant-vowel syllables is correlated with subsequent speech and language development and that limited use of consonants can serve as a way to identify children who are at risk for speech and language disorders. Three measures of meaningful speech are discussed, two based on accuracy of production, one on error patterns. All three correlate with severity of involvement, but as yet their relationship to speech intelligibility is unclear.

Articulation Disorders↗

[Communication and speech disorders and their relationship with psychic development and mental disorders in 8 year old children from the Lódź area].

AIM: The aim of the study was to analyze the occurrence of communication and speech disorders among 8-year-old children in Lódź. The comorbidity of these disorders with mental and somatic disorders was also analysed. We have also studied the correlation between the level of language development and the level of psychic development, and the existence and character of mental disorders. METHOD: The study comprised 7881 children from Lódź, born in 1991. The design of the study was two-stage. Stage I consisted of a screening test, using the Questionnaire of Child-Environment Communication Development, which was sent to the parents of all children. On this basis a group of 58 children with communication disorders was identified, which were further evaluated in the stage II of the study. Stage II consisted of a psychiatric examination, Screening Logopedic Test acc.to Tarkowski, Child Developmental Questionnaire acc. to Rabe-Jabłońska and Gmitrowicz, somatic state evaluation and analysis of the available documentation. RESULTS: In 0.81% of the children communication disorders were found. Speech disorders were present in all cases: in 2/3rds expressive language disorders or mixed receptive-expressive language disorders, in the remaining cases phonological disorders. Estimated frequency of occurrence of specific disorders in the studied population was as follows: specific developmental language disorders 2.9/1000, acquired aphasia with epilepsy 4/10000, autistic disorder 6.4/10000. Over one third of children with a verbal communication disorder suffered also from various neurological and developmental disorders; most of the children showed abnormal mental development (f = 0.86) and mental disorders (f = 0.66). CONCLUSIONS: Poor language development correlated statistically significantly with mental retardation, pervasive developmental disorder and behaviour disorders, caused by brain damage or brain dysfunction. Children with a communication disorder who demonstrated normal language development suffered from social maladaptation or ADHD statistically significantly more frequently.

Attention Deficit Disorder with Hyperactivity↗

Phonological intervention techniques for syllable and word structure development.

This article has two purposes: to outline aspects of nonlinear phonological theory that refer to syllable, word, and phrase structure, and to provide some examples of phonological intervention techniques for development of these structures. A variety of restricted child productions of syllable, word, and phrase structures are described in nonlinear terms. Intervention targets are defined for each of the restrictions, and both general and specific interventions are suggested, the majority of which have been clinically evaluated. Clinicians are encouraged to try various alternatives to discover which techniques that facilitate syllable- and word-building strategies are most productive for an individual child. Rationales, purposes, activities, and procedures are presented to assist the clinician in developing appropriate and individualized intervention strategies.

Articulation Disorders↗

Following the child's lead: mothers' interactions with children with autism.

This study examined the extent to which mothers of preschool children with autism use language that is related to the child's focus of attention. Fourteen mother-child dyads involving preschool children with autism participated in this study, along with 14 matched dyads involving typically developing preschool children. Both groups were observed during 15 minutes of free play. Results revealed that the mothers of children with autism directed verbalizations to something within the child's focus of attention as frequently as the mothers of typically developing children. Thus, children with autism had as many opportunities to benefit from verbal input related to their focus of attention as did typically developing children. However, mothers of children with autism directed verbalizations to something not within the child's focus of attention more frequently than mothers of typically developing children. This nonrelated input may have reflected the mothers' attempts to adapt to their children's difficulties in attention and interaction.

Attention↗

Communication options for children with hearing loss.

This article examines the communication options that are available for use within families of infants and young children who are hard-of-hearing or deaf. The need for language development, regardless of the specific communication mode, is stressed. The demands of the current environment of early identification and intervention often put families in a position of needing to decide among communication methods before they are fully knowledgeable and/or emotionally ready. Specific communication options are delineated and considered within a continuum of spoken and visual language. Available research related to early acquisition of language by infants and young children who are hard-of-hearing and deaf is reviewed; outcomes, when available, are presented for specific methods from reports of older children. Factors that influence families' decisions regarding the selection of a communication option are highlighted in the context of the existing literature. An ongoing evaluative process that respects the choices of families is advocated; a context in which change(s) in communication mode through childhood is viewed as a positive circumstance. The ultimate goal in the selection of any communication approach is to ensure that infants and young children who are hard of hearing or deaf and their families are language proficient and fluent communicators.

Child↗

Exploring the contribution of the cerebral hemispheres to language comprehension deficits in adults with developmental language disorder.

A divided visual field, priming paradigm was used to observe how adults who have a history of developmental language disorder (DLD) access lexically ambiguous words. The results show that sustained semantic access to subordinate word meanings (such as BANK-RIVER), which is seen in control subjects, is disrupted in the right cerebral hemisphere for this special population of readers. In the left hemisphere, only the most dominant meaning of the ambiguous word shows sustained priming in both controls and DLD participants. Therefore, for the DLD readers the subordinate meanings of words are not primed in either hemisphere and, thus, may not be available during online processing and integration of discourse. This right hemisphere lexical access deficit might contribute to the language comprehension difficulties exhibited by adult readers with a history of DLD.

Adult↗

Autism by another name? Semantic and pragmatic impairments in children.

The literature on children with language disorders that are characterized by semantic and pragmatic impairments is reviewed and the conclusion is drawn that some of these conditions may stem from the same fundamental cognitive and interpersonal difficulties that are found in early childhood autism. A summary is presented of recent relevant research and theory in the field of autism and suggestions are offered on how these ideas might be applied to children showing semantic and pragmatic difficulties.

Autistic Disorder↗