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Concomitant speech and language disorders in stuttering children: a critique of the literature.

This article presents a critical review of the literature concerning concomitant speech and language disorders in stuttering children. Studies published since the 1920s that examined language onset and disorders of articulation, syntax and morphology, semantics, and word finding are analyzed. Collectively, the studies present a mixed impression of stutterers, not only because of methodological variations, but also because of the tremendous variability that exists among children who stutter. Although the evidence is not convincing that stutterers as a group are more likely than nonstutterers to have deficits in any of these areas, it is clear that some stutterers do have concomitant speech and language problems that may bear some relationship to their stuttering. The message from this body of research is that individual differences among stuttering children should not be ignored during clinical or research activities.

Articulation Disorders

The contribution of perceptual learning to performance on the repetition task.

The hypothesis that the Repetition Task partially reflects the listener's level of perceptual learning was tested in this study. Specifically, it was predicted from data on auditory temporal processing that performance on the Repetition Task would improve with experience. Ten kindergarten children with no known communication problems were given 10 sets of the Repetition Task over a span of 5 days. Analysis of the data revealed a significant difference in performance across interstimulus intervals (ISI) and also over the training period. Performance improved as a function of increments in ISI and number of days of training. The data reflected a significant training effect, thereby supporting the experimental hypothesis. These results suggest the possibility that differences between dysphasic and normal children on the Repetition Task may result from differences in perceptual learning.

Auditory Perceptual Disorders

Homonymy and the voiced-voiceless distinction in the speech of children with specific language impairment.

Two studies are reported in which homonymy in the speech of children with specific language impairment (SLI) was examined. In the first study, the degree of homonymy reflected in the speech of 14 SLI children was found to resemble that seen in the speech of a group of language-matched children with normal language (NL). Within each group there was considerable variation in the degree of homonymy observed. An examination of the sound changes that contributed to the children's use of homonymy suggested that homonyms arising from prevocalic voicing were more frequent in the speech of the NL children. The second study represented a more systematic examination of prevocalic voicing differences between NL and SLI children. Minimal pairs differing only in the voicing feature of the initial consonant were produced by four SLI and four language-matched NL children. The SLI children showed greater ability to distinguish the minimal pairs by means of a voiced-voiceless initial consonant contrast, as measured by voice onset time as well as by phonetic transcription. The linguistic and neuromotor factors contributing to the findings are discussed.

Articulation Disorders

Hearing, speech, and language in survivors of severe perinatal asphyxia.

Hearing, speech, and language were studied in 26 children who survived severe perinatal asphyxia. The results of hearing tests showed that most children had a favourable outcome. Only 1 child had sensorineural deafness. Hearing loss in 6 others was due to middle-ear disease which resolved after treatment, and on retesting was found to be normal. The study also showed that neither gentamicin treatment nor incubator noise seemed to affect hearing. The results of speech and language assessment were less encouraging and about one-third of the children without serious mental or physical handicap had deficits in speech and language. It is suggested that the quality of life in such children could be improved if these deficits were detected early and adequately treated.

Asphyxia Neonatorum

Psychological and speech studies in Rubinstein-Taybi syndrome.

Forty individuals with Rubinstein-Taybi syndrome were tested using an extensive test battery to obtain more insight about their intelligence level, social competency, temperament, and behavior as well as articulation and receptive and expressive language level. Examination of individuals in the Netherlands who have this rare syndrome has been extensive, allowing some generalizations to be made. The intelligence level of affected individuals is usually low, although some persons have much higher scores than do others. The tested individuals were remarkably consistent in their social competency, temperament, and behavior. They were able to make good use of their limited verbal abilities. Comparable studies of other groups of persons with a specific syndrome are needed to determine whether the present findings are specific for Rubinstein-Taybi syndrome or may be found among persons with other syndromes.

Adolescent

Very-low-birthweight children and speech and language development.

Very low birthweight (VLBW) is often considered to be a risk factor for speech and language disorders, yet data are equivocal. The present study compared speech and language comprehension and production between 249 very-low-birthweight (VLBW: less than 1.5 kg) and 363 normal-birthweight 8-year-olds, randomly sampled in a geographic area. Mean performance for the entire group of VLBW children and for the group when 24 VLBW children with major neurologic abnormalities were excluded, was significantly lower than for controls on the majority of speech and language measures. Further analyses addressed the clinical significance of these statistically significant differences. Test scores were converted to standard scores and grouped according to standard deviation intervals, thus portraying each child's performance in terms of the magnitude of discrepancy from each test's mean. When the 24 children with major neurological abnormalities were excluded, no significant differences between the VLBW and control children were observed. Using discrepancy between WISC-R performance IQ and language to define specific language impairment (SLI), a higher percentage of control than VLBW children were identified as having SLI. Neonatal risk factors did not differentiate between VLBW children with or without SLI. A higher proportion of VLBW than control children did present subnormal language associated with IQ less than 85, hearing deficits, and/or major neurological impairments. Thus, SLI is not more common among VLBW than control children. Language deficits accompanied by more general developmental problems, however, are more frequent.

Chi-Square Distribution

[Retarded development of speech and language because minimal cerebral dysfunction (author's transl)].

Retarded development of speech and language may represent a facultative symptom of minimal cerebral dysfunction. The current neurologic and psychologic or psychiatric considerations in children are reviewed, and follow the author's experiences in speech and language. The treatment for this in patients with minimal brain dysfunction is based on four principles: a) Consultation with patients; b) exercise proceedings in patients involved; c) psychological or pedigogical methods; d) drug therapy. The prognosis for effective therapy in these patients is considered to be quite good.

Attention Deficit Disorder with Hyperactivity

Otitis media and language performance in a cohort of Apache Indian children.

Language performance was evaluated in 167 healthy Apache Indian children aged 6 to 8 years, who had contrasting histories of otitis media and who had been followed since birth. All children received pneumatic otoscopy, tympanometry, pure tone audiometry, and a battery of language measures. Groups were similar with respect to age, sex, school experience, family income, housing, primary language spoken, and nonverbal intelligence. No statistically or clinically significant differences in language performance were observed between groups of children with frequent episodes of otitis media and those from the same cohort with infrequent otitis. While frequent otitis media was associated with abnormalities on tympanometry and otoscopy, bilateral hearing loss (greater than 25 dB) was observed in only 1% of the children.

Acoustic Impedance Tests