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PubMed2005

Children and adolescents with chronic cerebellar lesions show no clinically relevant signs of aphasia or neglect.

We studied language and visuospatial functions of 12 children and adolescents who had undergone surgery for cerebellar astrocytoma without subsequent radiation or chemotherapy and compared them with 27 age-, gender-, and education-matched healthy control subjects. To study possible lateralization of the functions of the left and right cerebellar hemispheres, subjects performed several language tasks including a verb-generation task as well as standard neglect and extinction tests. Three-dimensional-MR images confirmed that lesions affected cerebellar hemispheres in all children but one who had a pure vermal lesion. The right cerebellar hemisphere was affected in six, the left hemisphere in four children, and both hemispheres in one child. There were no signs of aphasia in the children or adolescents with cerebellar lesions. Language abilities did not differ between cerebellar patients and control subjects except for small increases in reaction times in verb generation in patients with left-sided lesions. Visuospatial functions were also intact in cerebellar subjects except for minor group differences in neglect tasks. In sum, chronic focal cerebellar lesions acquired in childhood or youth do not result in persistent language disorders or clinically significant signs of spatial neglect or extinction.

Adolescent↗

PubMed1991

Remote cortical dysfunction in aphasic stroke patients.

We studied the effect of deep-seated left hemispheric lesions on cortical blood flow in 18 right-handed aphasic stroke patients. Regional cerebral blood flow was measured at rest and during the performance of a functional naming test using the two-dimensional xenon-133 inhalation method. Compared with 10 controls, at rest the patients showed regional cortical hypoperfusion in the left frontoparietal region. In the controls, activation patterns from the rest to the test condition involved mainly the left hemisphere areas. In the patients, a lack of blood flow change was observed in several areas that were usually hypoperfused at rest. However, in patients with slight verbal expression disorders there were obvious blood flow increases in other brain regions in both hemispheres. Such cortical functional reorganization and the presence of a remote cortical dysfunction could play a role in the pathophysiology of language disorders.

Aged↗

PubMed2000

Effects of a phonologically driven treatment for dyslexia on lactate levels measured by proton MR spectroscopic imaging.

BACKGROUND AND PURPOSE: Dyslexia is a language disorder in which reading ability is compromised because of poor phonologic skills. The purpose of this study was to measure the effect of a phonologically driven treatment for dyslexia on brain lactate response to language stimulation as measured by proton MR spectroscopic imaging. METHODS: Brain lactate metabolism was measured at two different time points (1 year apart) during four different cognitive tasks (three language tasks and one nonlanguage task) in dyslexic participants (n = 8) and in control participants (n = 7) by using a fast MR spectroscopic imaging technique called proton echo-planar spectroscopic imaging (1 cm3 voxel resolution). The age range for both dyslexic and control participants was 10 to 13 years. Between the first and second imaging sessions, the dyslexic boys participated in an instructional intervention, which was a reading/science workshop. RESULTS: Before treatment, the dyslexic boys showed significantly greater lactate elevation compared with a control group in the left anterior quadrant (analysis of variance, P = .05) of the brain during a phonologic task. After treatment, however, brain lactate elevation was not significantly different from that of the control group in the left anterior quadrant during the same phonologic task. Behaviorally, the dyslexic participants improved in the phonologic aspects of reading. CONCLUSION: Instructional intervention that improved phonologic performance in dyslexic boys was associated with changes in brain lactate levels as measured by proton echo-planar spectroscopic imaging.

Brain↗

PubMed1998

Practice parameters for the assessment and treatment of children and adolescents with language and learning disorders. AACAP.

These parameters describe the aims and approach to diagnosis, treatment, and monitoring of children and adolescents with language and learning disorders (LLDs). LLDs are among the most common developmental disorders the clinician is likely to encounter. About 50% of children with an LLD also have a comorbid Axis I psychiatric disorder. The diagnosis of an LLD requires a discrepancy, based on age and intelligence, between potential and achievement. The clinician collaborates with parents and school personnel to clarify the diagnosis, implement appropriate treatment and remediation, and monitor progress. The clinician is instrumental in identifying and treating comorbid conditions, including determining the appropriateness of medication. Long-term prognosis depends on the type and severity of the LLD, the availability of remediation, and the presence of a supportive family and school environment.

Adolescent↗

PubMed1988

Perinatal risk factors and first-year vocalizations: influence on preschool language and motor performance.

Spontaneous vocalizations of nine children with neonatal risk factors were systematically tape-recorded during the first year of life, as were those of 20 randomly chosen children without such risk factors. All the children were also given a battery of tests measuring language, speech, intelligence and motor function at six years. Cumulated tape-recordings for the periods six to 11 months and six to 14 months showed the infants with risk factors to have a significant reduction in various reduplicated syllables and consonants during the first year compared to those without risk factors. At six years, six of the nine at-risk children had an abnormal language test, as did two of the 20 without neonatal risk factors. Children with abnormal language tests performed significantly more poorly on various motor tasks; they also had had significantly fewer reduplications and consonants during infant vocalizations than the children with normal language tests. Perinatal risk factors may delay the production of prelinguistic sounds, and analysis of vocalizations might help to identify children who are at risk for later language disorders.

Apgar Score↗

PubMed2002

Epilepsy in autism.

There is an increased but variable risk of epilepsy in autism. Three main factors--age, cognitive level, and type of language disorder--account for variability in the reported prevalence of epilepsy. The prevalence is highest in studies that have included adolescents and young adults, individuals with moderate to severe mental retardation and those with motor deficits, and individuals with severe receptive language deficits. The association of autism with clinical or subclinical epilepsy might denote common genetic factors in some cases. Whether subclinical epilepsy has adverse effects on cognition, language, and behaviour is debated, as is the relation of autistic regression with an epileptiform electroencephalogram to Landau-Kleffner syndrome. There is no evidence-based treatment recommendation for individuals with autism, regression, and subclinical epilepsy. Double-blind studies with sufficient power to resolve this issue are urgently needed.

Anticonvulsants↗

PubMed1980

Ideatory apraxia in a left-handed patient with right-sided brain lesion.

A case is described of a left-handed patient with a circumscribed right-sided posterior brain lesion, who presented with a neuro-psychological syndrome of Wernicke's aphasia, ideomotor and ideatory apraxia. The aphasia and ideomotor apraxia cleared within 10 days, while ideatory apraxia persisted. Ideatory apraxia therefore was not dependent on the language disorder, nor was it related to ideomotor apraxia. On the basis of various neuropsychological examinations, the nature of the apraxic movement disorder in this case is discussed. To our knowledge, this is the first case of ideatory apraxia with right-sided brain damage described in the literature. A particular feature of this patient is that obviously language and the motor functions underlying performance in tests for ideomotor apraxia had a bilateral hemispheric representation whereas a unilateral lesion was sufficient to bring about persistent ideatory apraxia.

Aged↗

PubMed2003

The role of dominant premotor cortex in language: a study using intraoperative functional mapping in awake patients.

Although the role of the premotor cortex (PMC) was widely studied in motor function, very few data are currently available about the participation of this structure in language. We report a series of 25 right-handed patients harboring a low-grade glioma near or within the left dominant PMC, operated on under local anesthesia with intraoperative real-time sensorimotor and language mappings using electrical stimulations all along the resection. Language tasks consisted of counting and picture naming (preceded by the reading of a short sentence). Stimulations of the left PMC induced transient speech disturbances in all patients, with disruption of both counting and reading/naming during stimulation of the ventral PMC--due to elicitation of an anarthria--while generating an anomia during stimulation of the dorsal PMC. Moreover, corresponding subcortical pathways generated the same language disorders as at the cortical level when stimulated. Eloquent structures were systematically preserved, allowing the avoidance of definitive postoperative deficit. These findings suggest first that the left dominant PMC seems to play a major role in language and second that this structure could have a well-ordered functional organization, namely with the ventral PMC, which might be involved in planification of articulation, and the dorsal PMC, which might be involved in the naming network.

Adult↗

PubMed2000

Cognitive functions and epileptic activity.

Epilepsy, and its treatment, can affect the development and use of language in a number of different ways. The seizures may be a symptom of a lesion in areas of the brain essential for language function, and the complications of both the seizures and of the drugs can interfere with learning. However, the purpose of this review is to consider the role of epileptic activity as demonstrated by electrical discharges in the electroencephalogram (EEG), whether these are accompanied by overt seizures or not, on cerebral function especially that of language. The Landau-Kleffner, the continuous spike-waves during sleep, and the benign epilepsy of childhood with Rolandic spikes syndromes are considered; as well as the evidence of epileptic discharges affecting language development. If there are doubts that a patient is suffering from epilepsy the diagnosis may be difficult; and anyone involved in the treatment of language disorders should keep this possibility in mind. Particularly during childhood an EEG, awake and asleep, should be an important part of the assessment of both developmental and acquired dysphasia. The control of overt fits may be relatively easy, but drugs are not so effective in controlling the epileptic activity in the EEG. The treatment of such discharges used to be discouraged, but the evidence is now strongly in favour of employing both medical and surgical treatment. The results in restoring language function are sometimes dramatic.

Adolescent↗

PubMed2006

The Spanish language version of the Eating Disorder Examination Questionnaire: comparison with the Spanish language version of the eating disorder examination and test-retest reliability.

This study compared the Spanish language questionnaire (S-EDE-Q) and interview (S-EDE) versions of the Eating Disorder Examination and examined the short-term test-retest reliability of the questionnaire version. Seventy-seven monolingual Spanish-speaking Latina women recruited from the community completed the S-EDE-Q and were then administered the S-EDE by fully bilingual doctoral-level research clinicians. The same assessment was repeated after approximately one week (5-14 days). The S-EDE-Q and the S-EDE were significantly correlated on frequencies of binge eating and all four subscales. Mean differences in the frequency of binge eating and the Restraint subscale were not significant, but scores on the Eating Concern, Weight Concern, and Shape Concern subscales differed significantly, with the S-EDE-Q yielding higher scores. Test-retest reliability for the S-EDE-Q was modest for binge eating but was excellent for the subscales (Spearman rho ranged 0.71-0.81), albeit somewhat variable for the individual items. Overall, the acceptable convergence between the S-EDE-Q and the S-EDE for many features of eating disorders and the good short-term test-retest findings provide preliminary support for the use of the S-EDE-Q. These findings, derived using a non-clinical sample of monolingual Spanish-speaking Latina women, require replication and extension. Evaluation with a clinical sample is necessary to further establish the reliability of the S-EDE-Q with an eating disordered group.

Adult↗

PubMed2004

Cortical activation and synchronization during sentence comprehension in high-functioning autism: evidence of underconnectivity.

The brain activation of a group of high-functioning autistic participants was measured using functional MRI during sentence comprehension and the results compared with those of a Verbal IQ-matched control group. The groups differed in the distribution of activation in two of the key language areas. The autism group produced reliably more activation than the control group in Wernicke's (left laterosuperior temporal) area and reliably less activation than the control group in Broca's (left inferior frontal gyrus) area. Furthermore, the functional connectivity, i.e. the degree of synchronization or correlation of the time series of the activation, between the various participating cortical areas was consistently lower for the autistic than the control participants. These findings suggest that the neural basis of disordered language in autism entails a lower degree of information integration and synchronization across the large-scale cortical network for language processing. The article presents a theoretical account of the findings, related to neurobiological foundations of underconnectivity in autism.

Autistic Disorder↗

PubMed1993

The speech-language pathologist's role in an interdisciplinary approach to learning-disabled children.

Individual and environmental factors or characteristics influence disabled learners, particularly in reference to language disorders. An interaction of various fields is needed to minimize the impact of learning disabilities on a child's education and subsequent ability to communicate successfully. Various components of communication are affected by the inability to decode and encode language. Language areas most greatly influenced by learning disabilities are discussed.

Auditory Perception↗

PubMed1992

[A study of infant and child health care "follow up clinic"].

Health screening examinations of children. The 1st. health screening forms a major part of the public health services in community health, but it still encounters many problems. In the present study, the health screening programs and the infant and child health care follow-up clinic (2nd health screening) conducted by the Yoshikawa health center in Saitama-pref., as well as by each city and town, were investigated and analyzed. The findings are as follows: 1. In the first, health screening they pointed out some developmental disorders of 21.2%. About 80% of them are "to continue with follow-up observation". And 20% are "to go to the hospital and are to have an examination at once". Almost all of the above problems are related to psychomotor developmental disorders and physical growth delay. 2. The number of the children who made use of public expense was only 7 in 1st health screening. 3. The major complaints of the 2nd health screening are as follows: 1) speech and language delay 130 (36.4%); 2) motor behavior delay 117 (32.8%); 3) physical growth retardation 51 (14.3%); 4) emotional disturbances 12 (4.8%). The results of medical diagnosis for 2 years (1988-1990) were as follows: 1) speech and language disorders 55 (27.5%); 2) mental retardation 29 (14.5); 3) motor disturbances 28 (14.0%). The number of children without any problems is 18 (9.0%). 5. After they took the 2nd health screening, 138 (38.7%) children consulted with this clinic, and still keep consulting. 107 (30.0%) children had a medical examination, and 44 other children (12.3%) were introduced to other related facilities. As matters stand, there are not enough nurseries or training facilities for borderline children, and high-risk children. We don't have a complete system for border and high-risk children. The facilities for border and high-risk children do not give any specific details as to the various special services available. In the future, we forecast that the number of children with speech disorders and children with emotional disorders including infantile autism will increase, we should analyze the system of border and high-risk infants and children in connection with the 2nd health screening and discuss how to serve high-risk children effectively.

Ambulatory Care Facilities↗

PubMedDate not supplied

Two further investigations of autobiographical memory in semantic dementia.

A number of investigations in semantic dementia have documented better retrieval of recent personal events compared to those in the more distant past (Graham and Hodges, 1997). Westmacott et al. (2001) challenged this result, however, finding relative preservation of remote memories in a single case of semantic dementia when he was tested using family photographs. In Experiment 1, we tested two possible explanations for the discrepancy between the published papers: (a) that there is a significant effect of modality in autobiographical retrieval in semantic dementia (e.g., patients will show better, or even preserved, remote memory when tested on nonverbal, compared to verbal, tasks); and (b) that the distinct pattern seen between patients is attributable to the different methods adopted for scoring the episodic quality of the memories. A patient with semantic dementia, AM, produced autobiographical memories to both words and family photographs. These personal events were scored by two raters using the scoring method described by Westmacott et al. (2001) and that reported by Graham and Hodges (1997). It was found that AM showed similar levels of remote memory impairment regardless of whether the cue was verbal or nonverbal. In addition, significant effects of time were revealed in AM's performance on the verbal memory test, regardless of which method was used to score the memories. In Experiment 2, we investigated a related question: whether the relatively better retrieval of memories in semantic dementia could be due to over rehearsal of highly salient recent experiences? Four patients were tested on their ability to remember a recent event (either a trip to London or events from a Formula One Grand Prix race) using specially designed autobiographical questionnaires. It was found that all four were able to perform this task, although one patient showed evidence of some forgetting over three months, and another exhibited difficulty discriminating between two similar events. Together, the two experiments further confirm that patients with semantic dementia show a modality independent autobiographical memory deficit, with better retrieval of recent events.

Aged↗

PubMed1985

Chronic pediatric tracheotomy: assessment and implications for habilitation of voice, speech and language in young children.

The effect of chronic tracheotomy on the acquisition of voice, speech, and language skills was studied. Children with chronological ages of 16 months to 41 months were evaluated for Receptive Communication Age (RCA) and Expressive Communication Age (ECA). Results indicate a consistent deviation of (on the average) 4.8 months delay in RCA and 9 months delay in ECA. An habilitation program for early intervention in voice, speech and language stimulation is described, with follow-up data on 3 children. A progression from non-meaningful, non-vocal communication to more meaningful and functional communication is noted. The evidence indicates that, without therapeutic intervention, children with tracheotomies are at risk for delays in receptive and expressive language development, as well as deficits in oral/vocal speech and voice production.

Child Language↗

PubMed2000

Speech and language screening for audiologists.

Speech and language screening by audiologists is not new, although few audiologists screen speech and language, which should be an integral component of the audiological evaluation. This article considers ASHA's views about speech and language screening by audiologists, screening tests available to audiologists, and the training of audiologists to screen speech and language.

Audiology↗

PubMed1979

A comparison of language samples elicited at home and in the clinic.

One of the most common methods of obtaining diagnostic information about a child's language production is to collect and analyze a spontaneous language sample. Usually, this sample is collected in a clinical setting by a speech-language pathologist. Because children's language production seems very sensitive to situational variables, there is some question about the representativeness of language samples obtained in clinical settings. This study compared language samples obtained in the home by the mothers with those obtained in the clinic by speech-language pathologists. Subjects were three- to five-year-old children who had been referred for speech and language diagnostics. Results were that the children's mean-length-of-utterance (MLU) scores were better for the home sample, although there was no difference between their Developmental Sentence Scores (DSS) for the home sample and the clinic sample. The home samples yielded higher MLU stage placements (Brown, 1973) and higher estimated language ages on the DSS (Lee, 1974) for most of the children. Clinical implications of the results are discussed.

Child, Preschool↗

PubMed1993

Two approaches to the facilitation of grammar in children with language impairment: an experimental evaluation.

Two approaches to grammar facilitation in preschool-age children with language impairment were evaluated. One approach was administered by a speech-language pathologist and the other was presented by the subjects' parents, who were trained by the speech-language pathologist. Both treatment packages ran for 4 1/2 months and made use of focused stimulation procedures and a cyclical goal-attack strategy. Subjects were 30 children between the ages of 3:8 and 5:10 (years:months) who had marked delays in grammatical development. Children who served in a delayed-treatment control group averaged no gains over their no-treatment period. In contrast, large treatment effects were observed for both treatment groups on three of four measures of grammatical expression. However, closer inspection of the data revealed that the effects for the clinician treatment were more consistent across treatment administrations than were those for the parent treatment. Although the specific contributions of the focused stimulation procedures and the cyclical goal attack strategy were not evaluated, the results support the viability of these components as parts of larger treatment packages. The results also support the participation of parents as primary intervention agents in grammar facilitation programs. When parents take such a large role in the intervention process, however, it is imperative that the children's progress be monitored carefully and that program adjustments be made whenever gains are smaller than expected.

Child↗