[Early screening for hearing disorders].
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The study aimed to describe parents' views of their early perception and detection that something was wrong with their child and to give a comprehensive description of early signs to help primary health care nurses to focus on relevant symptoms. Participants were 66 parents from a total of 37 families, a population-based sample from a Swedish county. Interview data were analyzed by manifest content analysis. The results indicated a few critical periods: around the birth, early speech development, and school start. The diagnosis of autistic spectrum disorders was delayed. The parents' reports were congruent with earlier observation studies.
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The category knowledge and receptive language skills of 16 autistic, mentally retarded, and normal children were assessed. The autistic children's knowledge of function, form, and color categories was comparable to that of the mental-age-matched mentally retarded and normal comparison groups. Category knowledge and receptive language were more closely associated for mentally retarded and normal children than for autistic children. The findings indicate that category knowledge is not sufficient for the development of receptive language in autistic children.
BACKGROUND: Children with intellectual disability (ID) have a higher risk for psychiatric disturbance than their peers with normal intelligence, but research data on risk factors are insufficient and partially conflicting. METHOD: The subjects comprised 75 children with ID aged 6-13 years. Data were obtained from case files and the following four questionnaires completed by their parents or other carers: Developmental Behaviour Checklist, American Association of Mental Deficiency (AAMD) Adaptive Behavior Scale, a questionnaire on additional disabilities, and a questionnaire on family characteristics and child development. RESULTS: The risk of psychopathology was most significantly increased by moderate ID, limitations in adaptive behaviour, impaired language development, poor socialization, living with one biological parent, and low socio-economic status of the family. CONCLUSIONS: The risk of psychopathology in children with ID is increased by factors related to family characteristics and child development. Identifying these factors will help diagnose and possibly prevent psychiatric disorders in these children.
Of all the problems experienced by children with learning disabilities, a language disorder may be the most detrimental to school performance. Because the problems of a child with a language disorder are frequently not recognized until he begins school, it is important that the educational clinician, teacher, related professional, and parents understand what a central auditory disorder is, that it may manifest itself as language disorder, and the way it can academically and emotionally affect a child. Evaluation and identification of a child with a central auditory disorder is vital at an early stage of development; however, testing, while it appears simple, is an extremely complex process and is not always exact. Therefore, the educational clinician must be skilled and understand the frailties which exist in the test instrument and the testing situation. It must be remembered, also, that testing in only part of the diagnostic procedure. Organized, perceptive classroom observations are essential. These must be followed by multidisciplinary meetings that generate remedial procedures and directions to be taken by parents and teachers. Finally, parents must be accepted by professionals as reasonable, concerned, and able to offer knowledgeable insight into their child's learning problems. If a language disorder is suspected, professional help should be sought immediately. Truth is better than fiction or fantasy in helping a child become a happy, adjusted, productive human being.
Childhood psychosis is a group of disorders characterized by numerous behavioral abnormalities, the most significant of which may well be in the area of language. Absence, delay, or deficit in linguistic development are frequently contributing factors to the retardation often associated with childhood psychosis. The literature on language in childhood psychosis covering the general characteristics of the linguistic deficits, the importance of language in diagnosis and prognosis, mother-child linguistic interaction, and intervention programs is reviewed. Recent psycholinguistic studies in normal development point up the present inadequacies or lack of structural linguistic studies in childhood psychosis. Some assumptions about innate linguistic capacities prerequisite to normal development are discussed and a hypothesis relating to a dysfunction in these capacities in childhood psychosis as well as directions for further research are proposed.
A study was done of eight children with phonologic programming deficit syndrome (PPDS) and of eight normally developing children, to evaluate learning and recall of Blissymbols and of Signed English manual signs. The results support the view that children with this syndrome not only have motor speech deficits, but also deficits in symbolic processing. Decisions about intervention for nonverbal children should take account of their probable deficits in symbol learning.
The paper discusses the individual childhood speech disorders: articulation, phonation, and rhythm disorders as well as the dysfunction of speech. In addition to the causes of retarded speech development, the authors discuss especially childhood aphasias. As an all-important characteristic feature of childhood aphasia they give emphasis to the rapid regression of speech disorders as well as to the absence of a dependence upon the localization of the lesion. They also discuss the existing nomenclature. Also discussed were the congenital speech disorders for which they suggest the term "congenital abnormality of speech reception and expression".
The subjects were 46 boys with aggressive conduct disorder who were admitted to a psychiatric ward. We divided them according to level of activity and number of antisocial "symptoms"; then compared the resulting groups on clinical and social variables. Seventy-four per cent of the boys were observed to be hyperactive. Compared to those with a normal level of activity, this group developed their problems earlier, had more frequent speech and language deficits and came from more disrupted homes. Thirty boys were classed as antisocial and 16 as not. The former differed from the latter chiefly in their failure to respond to treatment. At follow-up significantly more non-antisocial boys were improved than antisocial. The results suggest that antisocial behavior affects outcome, while the variations in activity level are related to different origins of the disorder.
Otolaryngologists are in the front line of physicians asked to evaluate children whose language development is lagging. The 4 most prevalent conditions to consider in the differential diagnosis are impaired hearing, mental deficiency, developmental language disorder or dysphasia, and one of the disorders on the autistic spectrum. Guidelines on when to become concerned and what to do about such children are provided. Early diagnosis is essential in order to provide remedial education at the language learning age when intervention is likely to be most efficacious.
BACKGROUND: Non-standardized procedures are used to evaluate, in particular, grammatical performance in most German institutions performing diagnostic procedures on children with impaired speech and language development. This makes a comparison of results difficult. METHODS: We studied 181 boys and 72 girls aged between 5 and 6 years using four subtests of IDIS additionally to the routine procedure. Results were compared to the "degree of dysgrammatism" determined from the traditional evaluation based on expert rating. RESULTS: The new procedure is able to divide the children into groups with normal speech and language ability, with deficits accessible to a traditional logopedic treatment, and with severe speech and language impairment that necessitates intensive treatment. DISCUSSION: The proposed tests allow an accurate evaluation of grammatical performance instead of subjective estimates.
ICD-10 draft research criteria for childhood autism were applied to a previously published data set comparing DSM-III and DSM-III-R to clinicians' diagnoses of autism. The ICD-10 approach paralleled clinicians' patterns of diagnosis and, to a lesser extent, the DSM-III system. Relative to either clinicians, DSM-III, or ICD-10 the DSM-III-R system overdiagnosed the presence of autism. Implications for research and for future revision of diagnostic criteria are discussed.
Language samples were obtained from 40 children in order to examine semantic relations reflected in language usage as a function of chronological age (three and five years) and linguistic status (normal and language disordered). Normal-disordered comparisons were made under both matched utterance length and matched age conditions. Results are interpreted as supporting the notion that the disordered-language usage reflected semantic relations consistent with an earlier level of development.
Developmental language disorder (DLD) is diagnosed when there is a failure of normal language development in a child with normal nonverbal intelligence. The discussion about additional or causal deficits is controversial. In this study a computer-based motor performance series with a tapping, aiming and pegboard movement task and an additional paper-pencil handedness test were applied to a group of children with DLD of the phonologic-syntactic subtype and with normal nonverbal intelligence to describe the additional motor problems. Furthermore we examined whether our DLD children showed a different handedness. Tapping and pegboard with both hands were significantly impaired in our DLD children. Overall our DLD children did not show a different handedness than the control group.
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OBJECTIVE: To assess the screening performance of a specific language-screening instrument at 18 and 24 months of age and to assess its effect on the early detection and prognosis of language delay. DESIGN: Child health care physicians were randomised to the intervention group, in which specific language screening was conducted twice (at age 18 months and 24 months), or to the control group (usual care). The specific screening instrument consisted of a uniform set of questions for the parents and test elements for the child, with scaled scores to assess responses. SETTING: Child health care in the Netherlands and referral of screen-positive children. SUBJECTS: 5734 children in the intervention group and 4621 in the control group. MAIN OUTCOME MEASURES: Test characteristics and disorders at 24 months, and confirmed diagnoses of a language disorder before 36 months in both groups. Gold standard based on reports of parents, specialists and expert panel. Prognosis estimated from two diagnostic language development performance scores at 36 months (in questionnaire). RESULTS: In the intervention group, 3147 of the 5734 children (55%) were screened with the specific screening instrument and 73 of the screened children (2.3%) were screen-positive. Of the screen-positive children, 41 (55%) had confirmed language delay (diagnostic assessment and/or reported treatment). The estimated sensitivity of the test ranged between 24-52% depending on the severity of language disorders. The prevalence of language disorders in three-year olds was estimated to be 2.4-5.3%. In the intervention group, 1.25-2 times more children with language delay had been diagnosed before 36 months. The assessment of language development at 36 months showed no statistically significant differences between the intervention and the control groups. CONCLUSIONS: The inclusion of a specific language-screening instrument in child health centre activities resulted in the earlier detection of children with language delay. Short-term health benefits could not be demonstrated. Large-scale introduction cannot be recommended on the basis of this information alone.