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PubMed1999

[EEG anomalies, sleep modification and developmental dysphasia ].

The relation between severe developmental dysphasia and paroxystical anomalies was analyzed in 52 children, mean age 9 years (group I) suffering from developmental dysphasia, compared to a control group of 20 children, mean age 8 years (group II). The children of both groups were selected excluding cases with a prior history of epilepsy or neurological disease, and all had a cerebral MRI in the normal range. In group I, using the Rapin and Allen classification, we distinguished: 14 children with a syntactic-lexical syndrome and 34 children with a syntactic-phonological syndrome. Two children had verbal agnosia and two others verbal dyspraxia. The analysis of repeated standard EEGs showed: normal recordings in all the group II children and paroxystical anomalies in six of the 52 group I children. Night ambulatory sleep recordings showed such anomalies in 18 of the 34 children with a syntactic-phonologic syndrome and in 6 of the 14 children with a syntactic-lexical syndrome, but in only two of the 20 children of the control group. Paroxysmal abnormalities predominated in light sleep (stages I + II) and slow wave sleep (stages III + IV), but were rare in REM sleep. The abnormalities were diffuse or localized over the left frontotemporal area. Children with developmental dysphasia also showed an inconstant nocturnal sleep pattern with a higher incidence of awakenings during sleep significantly different from our group control. The relations between dysphasias, Landau-Kleffner syndrome, paroxystical anomalies, and sleep disorders are discussed and the results of genetic research concerning such population suffering from language disorders analyzed.

Aphasia↗

PubMed2000

Assessing the executive function abilities of adults with neurogenic communication disorders.

Whereas it is known that executive function abilities are often impaired in clients having neurogenic communication disorders, few assessments of this cognitive domain are available that consider the speech and language deficits of this population. This article provides an overview of current procedures for assessing executive functions including a discussion of team approaches to assessment, a review of currently available neuropsychological and functional tests of executive function abilities, as well as a critique of those assessment procedures. In addition, suggestions are provided for how best to use or modify appropriately current tests of executive functioning for clients having acquired speech and language disorders as a result of brain damage.

Adult↗

PubMed1996

[Crossed aphasia disclosed by central auditory disorder].

A 80-year-old woman, right-handed, suddenly felt the impression to be deaf. Besides, she presented language disorders of aphasic type relating to a sensorial transcortical aphasia. The case meets the diagnostic criteria for crossed aphasia. The magnetic resonance imaging showed a right temporo-parietal infarct. There was no sensorial or peripheral auditive disorder and no auditory agnosia of non verbal modality. During the evolution, the aphasic symptoms diminished partially and the subjective auditory deficit of the left ear continued. The integrated auditory evaluation (neuroacoustic test, study of auditory gnosia, dichotic listening test, evoked cortical auditory potentials) allowed the evidence of the characteristic disturbances of a right hemianacousia: loss of left hear in dichotic audition, decrease of amplitude of evoked right cortical auditory potentials. In the light of theories concerning auditory integration, one can explain this evolution. The initial aphasic comprehension disturbance expresses the alteration of the linguistic treatment of auditory information of the dominant hemisphere, here the right hemisphere. Subsequently, the linguistic disturbance regresses largely, letting persist the change of general auditory treatment. The representation of this general auditory treatment is hemispheric bilateral, the only right hemispheric damage shall result in hemianacousia.

Aged↗

PubMed1985

The need to relate cognitive deficits to specific behavioral referents of schizophrenia.

The implicit rationale for many cognitive studies of schizophrenia hinges on the recognition that verbal communication generated by patients with this disorder is often elusive or difficult to comprehend. This observation has led to the inference that a cognitive dysfunction, which mediates the production of discourse failure, is characteristic of schizophrenia. Unfortunately, most investigators have chosen to examine this type of hypothesis by comparing heterogeneous groups of schizophrenic patients (without regard to whether they exhibit verbal communication impairment) with various control samples; they have not studied the association between cognitive processes and specific schizophrenic symptoms. Data are presented from two studies indicating that such relationships, even when highly plausible, cannot simply be presumed. In both studies, one with adults suffering from schizophrenia and the other with children at risk, a laboratory measure of referential communication failed to be strongly related to language disorder. These data suggest that future investigators should specify the features of schizophrenia that are expected to correlate with their laboratory measures and empirically evaluate these relations.

Adult↗

PubMed2001

Profile of referrals for early childhood developmental delay to ambulatory subspecialty clinics.

The objective of this study was to determine the profile and pattern of referral to subspecialty clinics of young children with suspected developmental delay together with the factors prompting their referral. All children under 5 years of age referred to either developmental pediatrics or pediatric neurology clinics at a single tertiary hospital over an 18-month period were prospectively identified. Standardized demographic and referral information were collected at intake, final developmental delay subtype diagnosed was identified, and referring physicians were surveyed regarding factors prompting referral. A total of 224 children met study criteria. There was a marked male preponderance (166/224), especially among those with either cognitive or language delay. Two delay subtypes, global developmental delay and developmental language disorder, accounted for two thirds of the diagnoses made. For slightly more than one third of the children (75/224), the delay subtype diagnosed following specialty evaluation was different from that initially suspected by the referring physician. A mean delay of 15.5 months was observed for the cohort as a whole between initial parental concern and specialty assessment. For referring physicians, the major factor prompting referral was the severity of the observed delay. The most important aspects of the specialty evaluation according to referral sources were the identification of a possible etiology and confirmation of delay. A profile of referrals and the rationale thereof for a cohort of children with suspected developmental delay is presented that, although locale specific, has implications for service provision and training.

Ambulatory Care↗

PubMed1982

Language functioning and speech development of six children receiving tracheotomy in infancy.

Language functioning and speech development were assessed in six preschool boys who had undergone tracheotomy during infancy and had tracheal tubes in place for varying periods of time (from 11 to 44 mo). Results indicated that neonatal tracheotomy did not produce long-term effects on language development. Children with subnormal intelligence showed aberrant language functioning, characteristic of language-disordered children who had not had tracheotomies. Children with average intelligence exhibited grossly normal expressive language and verbal comprehension. All children learned to produce some verbalizations, if only through pops, lip movements, and breath sounds; or through esophageal speech. One child who did not vocalize until his cannula was removed at 21 mo was able to develop age-appropriate expressive language, despite lack of previous opportunity to produce speech sounds.

Child Language↗

PubMed1985

Evidence for sex differences in brain organization in recovery in aphasia.

Ninety-one adult aphasics of both sexes were studied before and after a 3-month period of language therapy. Although no initial sex difference was found in severity of language disorders, females within the global aphasic group showed significantly greater improvement in three tests of language comprehension. It is suggested that more bilateral representation of language functions in the female brain may account for this greater improvement.

Aged↗

PubMed2006

The implications of RTI and EBP for SLPs: commentary on L. M. Justice.

PURPOSE: This commentary responds to Justice's article on response to intervention (RTI) and evidence-based practice (EBP) for reading instruction. The educational changes brought about by RTI and EBP provide an opportunity as well as a challenge for speech-language pathologists (SLPs) to make fundamental changes in service delivery. METHOD: In this article, I discuss how RTI will change who qualifies as reading disabled and who receives special reading instruction. I examine how RTI might change who qualifies and how they qualify for speech-language services. Finally, I consider what can be taken from EPB and RTI to improve speech-language service delivery. CONCLUSION: RTI has the potential to fundamentally change regular education and its interface with special education. If SLP clinicians, researchers, and policymakers recognize the possibilities, RTI could also significantly and positively impact educational speech-language pathology.

Child↗

PubMed1997

Cognitive impairment in Schwartz-Jampel syndrome: a case study.

Schwartz-Jampel syndrome (SJS) is a rare, hereditary neuromuscular disorder. The prevalence of mental retardation has been estimated at 25%, however, no etiologic cause has been described. Neuropsychologic and speech language evaluations of an 8-year-old boy with SJS showed a developmental language disorder and attention deficit disorder. He performed in the impaired range on linguistic/sequential information processing tests while performing in the average range in visuoperceptual and nonverbal tests of intelligence and memory. These results suggest further investigation of the cognitive and language functioning of patients with SJS.

Child↗

PubMed1997

Hearing, speech, language, and vestibular disorders in the fetal alcohol syndrome: a literature review.

Fetal alcohol syndrome (FAS) is characterized in part by mental impairment, as well as craniofacial and ocular anomalies. These conditions are traditionally associated with childhood hearing disorders, because they all have a common embryonic origin in malformations of the first and second branchial arches, and have similar critical periods of vulnerability to toxic insult. A review of human and animal research indicates that there are four types of hearing disorders associated with FAS. These are: (1) a developmental delay in auditory maturation, (2) sensorineural hearing loss, (3) intermittent conductive hearing loss due to recurrent serous otitis media, and (4) central hearing loss. The auditory and vestibular systems share the same peripheral apparatuses (the inner ear and eighth cranial nerve) and are embryologically and structurally similar. Consequently, vestibular disorders in FAS children might be expected. The evidence for vestibular dysfunction in FAS is ambiguous, however. Like other syndromes associated with craniofacial anomalies, hearing disorders, and mental impairment, FAS is also characterized by a high prevalence of speech and language pathology. Hearing disorders are a form of sensory deprivation. If present during early childhood, they can result in permanent hearing, language, and mental impairment. Early identification and intervention to treat hearing, language, and speech disorders could therefore result in improved outcome for the FAS child. Specific recommendations are made for intervention and future research.

Animals↗

PubMed2005

[Specific remedial therapy in a specialist unit: evaluation of 31 children with severe, specific language or reading disorders over one academic year].

INTRODUCTION: Up to 3 percent of the children in France present severe and specific language and/or reading disorders, despite regular remedial therapies. Few studies have measured the effectiveness of treatment administered in a specialist unit. PATIENTS AND METHOD: The aims of this study, focusing on children diagnosed as dysphasic and/or dyslexic, were: During the academic year 2001-2002, 31 children (18 dyslexic and 13 dysphasic) were attending school in our unit. The teaching program and intensive speech therapy (3 hours/week) were tailored for each child according to his/her specific disorders. Reading, spelling and numeracy developmental skills of each child were evaluated by appropriate tools at the beginning and at the end of the year. Impairment was defined by measuring the gap between the observed and the expected skills, according to each child's age. Using a self-control method, progress achieved by each child throughout the year was calculated with each tool, in each subject, by subtracting the impairments disclosed at the beginning from those disclosed at the end of the year. Progression was classified within three groups according to the progress normally expected over an academic year (i.e. nine months) from children with no disabilities attending school regularly; a progression fewer than three months was considered as no progression. Uni- and multivariate analyses including age (< or= or />9), type of pathology (dysphasia/dyslexia), and intellectual quotient (IQ) as covariates was carried out to search for independent prognosticators. RESULTS: The entire group demonstrated during the year significant progress for reading (p = 0.0001), spelling (p = 0.0001) and numeracy (p = 0.0001). Nineteen children (61 percent) showed more progress in reading than normally expected over nine months. Out of the remaining 12 children, 10 demonstrated more progress in spelling and/or numeracy than normally expected over nine months. All three reading evaluation tools disclosed a progression although one was less efficient (p = 0.05). Multivariate analysis disclosed age< or=9 and dysphasia as independent progress prognosticators. CONCLUSION: Placement in a specialist unit allows children suffering from severe dyslexia and dysphasia to lessen the gap in reading, spelling and numeracy. The two prognosticators disclosed highlight the importance of early diagnosis (i.e. before nine years old) and treatment of specific language and/or reading disorders.

Aphasia↗

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↗

PubMed1998

Attention deficit disorder with developmental coordination disorders.

AIMS: To analyse the contribution of certain social, familial, prenatal, perinatal, and developmental background factors in the pathogenesis of deficits in attention, motor control, and perception (DAMP). METHODS: A population based case-control study was carried out with 113 children aged 6 years, 62 diagnosed with DAMP and 51 controls without DAMP. The children's health and medical records were studied and their history with regard to background factors was taken at an interview with the mother using a standardised schedule. Familial factors, possible non-optimal factors during pregnancy (including smoking), developmental factors (including early language development), and medical and psychosocial data were scored in accordance with the reduced optimality method. RESULTS: Low socioeconomic class was common in the group with DAMP. Familial language disorder and familial motor clumsiness were found at higher rates in the DAMP group. Neuropathogenic risk factors in utero were also more common in the children with DAMP. Maternal smoking during pregnancy appeared to be an important risk factor. Language problems were present in two thirds of the children with DAMP. Sleep problems and gastrointestinal disorders, but not atopy or otitis media, were significantly more common in the DAMP group. CONCLUSIONS: Prenatal familial and neuropathogenic risk factors contribute to the development of DAMP. Primary prevention, such as improved maternal health care and early detection or treatment, or both, of associated language problems appear to be essential.

Attention Deficit Disorder with Hyperactivity↗

PubMed1991

Autistic children: diagnosis and clinical features.

Autism is one of the behaviorally defined developmental disorders of brain function. It has a variety of genetic and nongenetic etiologies, with etiology being unknown in the majority of children. Boys are more frequently affected than girls. Manifest in the preschool years, autism always affects sociability, communication, and the child's repertoire of activities and interests. Autism encompasses children with a broad range of severities and a variety of other signs of brain dysfunction. These include motor signs, notably stereotypies; abnormal responses to a variety of sensory stimuli; and disorders of affect and attention. A significant proportion of autistic children experience epileptic seizures and have abnormal EEGs. Neuroimaging, preferably magnetic resonance imaging, discloses abnormalities of brain development in a minority of autistic persons. The level of intelligence may range from profound mental deficiency to giftedness. The pattern of cognitive skills is likely to be uneven, typically with better nonverbal than verbal skills. In the preschool years, all autistic children have a developmental language disorder. Verbal expression may range from total lack of language to verbosity with echolalia; comprehension and language use are invariably impaired. While there is no specific pharmacologic agent to mitigate the fundamental disorder, children may benefit from drugs to treat specific symptoms such as attention disorder and seizures. Although autistic behaviors are the consequence of a static disorder of brain function, their character changes with maturation and appropriate intervention. Communication skills and sociability remain deficient but improve in all but the most severely affected children. Outcome is a function of both innate cognitive competence and the effectiveness of early intervention focused on the development of appropriate social skills and meaningful communication. Intelligent autistic adults may be educable, employable, and able to live independently, while more severely handicapped ones require a lifelong protected environment.

Autistic Disorder↗

PubMed1985

Elementary school age children's comprehension of specific idiomatic expressions.

This study explored the ability of elementary school age children to comprehend six idiomatic expressions. Eighty linguistically normal children, 20 from each of four different grade levels (kindergarten, second grade, fourth grade, and sixth grade) participated as subjects. All of the children completed a task designed to probe comprehension of specific idioms. A short story was presented, after which the subjects were required to identify events in the story, which were described using idiomatic phrases. When examined as a group, comprehension of the idioms studied improved with increasing age. However, when examined individually, performance was found to be highly variable from idiom to idiom. These results are discussed with regard to clinical implications in the assessment and management of language-disordered children.

Child↗

PubMed1986

Toward an understanding of developmental language and reading disorders.

The primary purpose of this study was to compare the ability of language-impaired and reading-impaired children to process (i.e., encode and retrieve) phonological information. Four measures of phonological awareness and several measures of word and sentence repetition abilities were used to evaluate phonological processing skills. Two additional measures assessed children's awareness of lexical and morphological information. Subjects were 12 language-impaired (LI), 12 reading-impaired (RI), and 12 normal children between the ages of 6 and 8 years. The findings supported previous claims that children with reading impairments have difficulty processing phonological information. To our surprise, however, the LI children performed significantly worse than the RI children on only three measures, all involving word and sentence repetition. These findings raise questions about the distinctiveness of school-age children with a history of language impairment and poor readers with no history of language impairment.

Child↗

PubMed1996

[A longitudinal study of three-year-old children with delayed development of language].

UNLABELLED: From January 1982 to December 1986, 113 three-year-old children (100 boys and 13 girls) visited the department of pediatrics, Asahikawa Medical College, because of delayed development of language (their expressive language age less than two-year-old). Of these children, 102 children (90%) have visited until they graduated from junior high school for the evaluation of intelligence quotient (IQ), diagnosis, the type of attended school and complications. The mean follow-up period was 10.8 years. The 113 children ware classified as 32 cases of developmental language disorder (DLD), 38 of autistic disorder (Au), 39 of mental retardation (MR), and 4 of deafness based on the results of clinical examination (DSM-III-R), ABR and WPPSI/WISC-R. The purpose of this study is to compare the assessment of language development at the age 3 with the prognosis for intelligence, academic achievement and behavioral adjustment. At the age of three, we divided them into three groups using the Enjoji shiki hattatsu kensa-hyo. Group A including 31 children (29 boys and 2 girls) means delayed development in verbal expression only. Group B including 23 children (17 boys and 6 girls) means delayed development in verbal expression and comprehension. Group C including 59 children (54 boys and 5 girls) means delayed development not only in verbal expression and comprehension but also in communication skills. RESULTS: ABR: Four (2 boys and 2 girls) of 113 children did not show any significant waves on ABR at aged 3, and were also diagnosed as deafness by another audiometry. Comparison between the assessment of verbal expression at aged 3 and full scale IQ (FSIQ): FSIQs in 77% of group A were more than 70, while FSIQs in 79% of groups B and C were 70 or below. The assessment of verbal comprehension at aged 3 was significantly related with FSIQ (x2 = 23.88, p < 0.01). Classification of disorders and type of schools according to the assessment at aged 3: [Group A] Thirty one children were classified as 25 cases of DLD and 6 of MR. Before a graduation from junior high school, 20 children attended regular classes and 8 attended special classes for MR. [Group B] Twenty three children were classified as 4 cases of DLD, 10 of MR, 5 of Au and 4 of deafness. Before a graduation from junior high school, 4 children attended regular classes, 8 attended special classes for MR, 6 attended special schools for MR and 4 attended schools for deafness. [Group C] Fifty nine children were classified as 3 cases of DLD, 23 of MR and 33 of Au. Before graduating from junior high school, 10 children attended regular classes, 18 attended special classes for MR, 19 attended special schools for MR and 2 entered educational facilities. CONCLUSION: 1. Poor mental outcome could be predicted by delayed development of both expressive and comprehensive language, particularly associated with dysfunction of communication skills at the age of three. 2. ABR is a useful method for detecting of hearing loss in non-cooperative young children with delayed development of language.

Attention Deficit Disorder with Hyperactivity↗

PubMed1998

The Thai version of the German Aachen Aphasia Test (AAT): description of the test and performance in normal subjects.

The Aachen Aphasia Test (AAT), originally developed as a test for aphasia language disorders in Germany, consists of six spontaneous speech rating scales and five subtests: Token Test, Repetition, Written Language, Confronting Naming and Comprehension. The study aimed to describe the linguistic properties of the AAT Thai version and to investigate the test performances of the normal subjects. In this study some problems of linguistic changes in the construction of the Thai version were discussed. The results revealed that the normal subjects' performances on the test were independent of age, sex and education level. Therefore, the Thai version of AAT is applicable to the differential diagnosis of the communicative abilities of Thai aphasic patients.

Adult↗