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Speech and language development in preschool twins.

While language, articulation and reading problems have been well documented in young twins, it is not clear how extensive such problems can be or how early in childhood they become evident. At the age of 30 months, twin boys in the La Trobe Twin Study were 8 months behind matched singletons and twin girls on expressive language and 6 months behind on verbal comprehension. They were also 5 months behind on symbolic play and this delay was closely related to language. "Secret" language characterised most of the twin boys but not the girls and the relation of this to articulation delays is discussed. To examine if exposure to other children helps the twin boys, 38-53 month old twins and singletons were matched on the Columbia Mental Maturity Scale at the time of starting preschool. The twin boys had more articulation problems and all twins scored much lower on a Sociability questionnaire completed by the teacher. After 8 months at preschool, all children had advanced in Sociability, but the twins remained just as far behind with poor Sociability relating to poor articulation. The role of intervention programs is discussed.

Articulation Disorders↗

Defense preference and stutterers' speech disfluencies: implications for the nature of the disorder.

Psychological defense mechanism preference was assessed in 16 adult stutterers. From this group, two subgroups of six subjects each were identified by their opposite extremes in defensive style: (1) expressive defenders; (2) avoidance defenders. Subsequently, these subgroups were found to be significantly different in measures of stuttering frequency and disfluency type. The expressive defenders showed higher frequency stuttering than the avoidance defenders (21.5% vs. 4.66%) while the avoidance subgroup showed preference for the use of accessory-type disfluencies; that is, interjections, phrase repetitions, and whole word repetitions. The possibility that the speech disfluencies of stutterers may vary as a function of defense preference is discussed in relation to: (1) definitions of stuttering phenomena and the disorder; (2) the developmental nature of stuttering as a problem and the role of learning; (3) different syndromes of stuttering; and (4) the contributions of etiologic versus pathogenic factors to the origins of the disorder.

Adult↗

Hearing loss in speech-language delayed children.

An infant begins to communicate with his/her environment from the first months of life. However, true words do not appear until the age of 12-15 months, following a rather predictable sequence. Delay or failure of normal language development is not a rare situation in childhood and may be due to a variety of reasons. Among these, hearing undoubtedly plays a leading part in the language acquisition process. The purpose of this study was to assess the percentage of hearing-impaired children in a group of phenotypically healthy children presenting with speech-language delay. Between March 1993 and March 1999, 726 speech-language delayed children were examined in our department. In 72 of them, various diseases or syndromes had already been diagnosed and so they were excluded from the study. The remaining 654 apparently healthy children entered the study and underwent a thorough audiological assessment for determination of their hearing thresholds. Eighty-seven children (13.3%) showed various degrees of hearing loss. Most of them (55 children, 8.4%) suffered from sensorineural hearing impairment, while in 32 children (4.9%) a conductive hearing loss was discovered. The increased prevalence of hearing impairment found in our population mandates a thorough hearing evaluation for every case of speech-language delay, even for those children who show no evidence of other handicaps. This will help in the early diagnosis of hearing loss, allowing proper management to be instituted as early as possible.

Audiometry↗

Naturalistic observations of spontaneous communication in autistic children.

Thirty children with autism were observed during their everyday school activities in order to examine patterns of spontaneous communication. The forms, functions, and targets of their communication were recorded by trained observers. The prototypical communicative event consisted of a child directing a motoric form of communication toward the teacher to request something or to attract attention to himself or herself. However, communication patterns were found to vary as a function of the child's cognitive level and severity of autism. Deficits in joint attention functions were observed, and were most striking in the subgroup of children who did not use speech. Results are discussed with reference to Wetherby's (1986) model for the development of communicative functions in autistic children.

Adolescent↗

Early speech development, articulation and reading ability up to the age of 9.

Speech development, the occurrence of articulatory errors, speech therapy received and literacy were evaluated in children at preschool and school age. Data were obtained with questionnaires sent to the parents and teachers of 1,708 second-grade children in 119 school classes selected by multistage random sampling among Finnish-speaking schools throughout the country. Completed questionnaires were received from 1,531 parents (89.6%) and 1,601 teachers (93.7%). Early speech development was slower among the boys than among the girls. The proportion of children with articulatory errors decreased from 32.5% at the age of 5 years to 18.4% at 7 years and 7.4% at 9 years, and the boys had more articulation problems than the girls. Errors in two or more sounds at school age were rare, and more than 90% of all errors were in the sounds /r/, and /s/. About one fourth of the girls (26.7%) and one sixth of the boys (18.1%) had gained preschool literacy; 2.9% of the girls and 6.6% of the boys were still not able to read fluently by the middle of the fourth term. The difference between the sexes was seen both in the early development of speech and articulatory problems and in literacy at the age of 9.

Articulation Disorders↗

Children's language learning: an interactionist perspective.

This review of children's language learning considers historical accounts of acquisition and individual variation, recent advances in methods for studying language learning, research on genetic and environmental input that have contributed to the interactionist perspective, and the relevance of cross-disciplinary work on language disorders and the biology of learning to future theories. It concludes that the study of children's language development is converging on an interactionist perspective of how children learn to talk, incorporating the contributions of both nature and nurture to emergent, functional language systems. Language learning is viewed as an integration of learning in multiple domains.

Child↗

Answering contextually demanding questions: pragmatic errors produced by children with Asperger syndrome or high-functioning autism.

UNLABELLED: This study examined irrelevant/incorrect answers produced by children with Asperger syndrome or high-functioning autism (7-9-year-olds and 10-12-year-olds) and normally developing children (7-9-year-olds). The errors produced were divided into three types: in Type 1, the child answered the original question incorrectly, in Type 2, the child gave a correct answer, but when asked a follow-up question, he/she explained the answer incorrectly, and in Type 3, the child first gave a correct answer or explanation, but continued answering, which ultimately led to an irrelevant answer. Analyses of Type 1 and 2 errors indicated that all the children tried to utilize contextual information, albeit incorrectly. Analyses of Type 3 errors showed that topic drifts were almost non-existent in the control group, but common in the clinical group, suggesting that these children had difficulties in stopping processing after deriving a relevant answer. LEARNING OUTCOMES: The reader becomes aware of the different instances which may lead to the irrelevance of answers and get knowledge about features of answers of children with AS/HFA.

Aptitude↗

Autism and developmental receptive language disorder--a follow-up comparison in early adult life. II: Social, behavioural, and psychiatric outcomes.

This paper focuses on general social functioning in two groups of young men, one with autism and one with developmental receptive language disorders, who were first assessed at the ages of 7-8 years. At that time, although matched for nonverbal IQ (mean 92-93) and expressive language, the Language group showed significantly fewer social and behavioural problems. At follow-up, when aged on average, 23 to 24 years, the Autism group continued to show significantly more impairments in terms of stereotyped behaviour patterns, social relationships, jobs, and independence. However, problems in all these areas were also common in the Language group. Many still lived with their parents, few had close friends or permanent jobs, and ratings of social interaction indicated abnormalities in a number of different areas. On a composite measure of social competence only 10% of the Language group was assessed as having severe social difficulties compared to 74% of the Autism group. Nevertheless, 65% were rated as having moderate social problems and only 25% were rated as being of near/normal social functioning. Two individuals in the Language group, but none in the Autism group, had also developed a florid paranoid psychosis in late adolescence. As in the follow-up of cognitive and linguistic functioning (see Mawhood et al., 2000, this volume, pp. 547-559), discriminant function analysis, which had clearly distinguished between the groups as children, now showed much greater overlap between them. Regression analysis indicated that although early language ability appeared to be related to outcome in the Autism group, there was little association between any measures of childhood functioning and prognosis in the Language group. Theoretically, these findings have implications for our understanding of the nature of autism and other pervasive language disorders, and of the relationship between them. Practically, they demonstrate the very persistent problems experienced by individuals with developmental language disorders, and their need for much greater help and support than is presently available.

Activities of Daily Living↗

Gesture development: a review for clinical and research practices.

The aim of this article is to provide clinicians and researchers a comprehensive overview of the development and functions of gesture in childhood and in select populations with developmental language impairments. Of significance is the growing body of evidence that gesture enhances, not hinders, language development. In both normal and impaired populations, gesture and language development parallel each other and share underlying symbolic abilities. Gesture serves several functions, including those of communication, compensation, and transition to spoken language. In clinical practice, gesture may play a valuable role in diagnosis, prognosis, goal selection, and intervention for children with language impairments. Where available, supporting evidence is presented. Needs for additional research on gesture are also highlighted.

Autistic Disorder↗

Theory-of-mind development in oral deaf children with cochlear implants or conventional hearing aids.

BACKGROUND: In the context of the established finding that theory-of-mind (ToM) growth is seriously delayed in late-signing deaf children, and some evidence of equivalent delays in those learning speech with conventional hearing aids, this study's novel contribution was to explore ToM development in deaf children with cochlear implants. Implants can substantially boost auditory acuity and rates of language growth. Despite the implant, there are often problems socialising with hearing peers and some language difficulties, lending special theoretical interest to the present comparative design. METHODS: A total of 52 children aged 4 to 12 years took a battery of false belief tests of ToM. There were 26 oral deaf children, half with implants and half with hearing aids, evenly divided between oral-only versus sign-plus-oral schools. Comparison groups of age-matched high-functioning children with autism and younger hearing children were also included. RESULTS: No significant ToM differences emerged between deaf children with implants and those with hearing aids, nor between those in oral-only versus sign-plus-oral schools. Nor did the deaf children perform any better on the ToM tasks than their age peers with autism. Hearing preschoolers scored significantly higher than all other groups. For the deaf and the autistic children, as well as the preschoolers, rate of language development and verbal maturity significantly predicted variability in ToM, over and above chronological age. CONCLUSIONS: The finding that deaf children with cochlear implants are as delayed in ToM development as children with autism and their deaf peers with hearing aids or late sign language highlights the likely significance of peer interaction and early fluent communication with peers and family, whether in sign or in speech, in order to optimally facilitate the growth of social cognition and language.

Autistic Disorder↗

Language cannot be reduced to biology: perspectives from neuro-developmental disorders affecting language learning.

The study of language knowledge guided by a purely biological perspective prioritizes the study of syntax. The essential process of syntax is recursion--the ability to generate an infinite array of expressions from a limited set of elements. Researchers working within the biological perspective argue that this ability is possible only because of an innately specified genetic makeup that is specific to human beings. Such a view of language knowledge may be fully justified in discussions on biolinguistics, and in evolutionary biology. However, it is grossly inadequate in understanding language-learning problems, particularly those experienced by children with neurodevelopmental disorders such as developmental dyslexia, Williams syndrome, specific language impairment and autism spectrum disorders. Specifically, syntax-centered definitions of language knowledge completely ignore certain crucial aspects of language learning and use, namely, that language is embedded in a social context; that the role of envrironmental triggering as a learning mechanism is grossly underestimated; that a considerable extent of visuo-spatial information accompanies speech in day-to-day communication; that the developmental process itself lies at the heart of knowledge acquisition; and that there is a tremendous variation in the orthographic systems associated with different languages. All these (socio-cultural) factors can influence the rate and quality of spoken and written language acquisition resulting in much variation in phenotypes associated with disorders known to have a genetic component. Delineation of such phenotypic variability requires inputs from varied disciplines such as neurobiology, neuropsychology, linguistics and communication disorders. In this paper, I discuss published research that questions cognitive modularity and emphasises the role of the environment for understanding linguistic capabilities of children with neuro-developmental disorders. The discussion pertains to two specific disorders, developmental dyslexia and Williams syndrome.

Genotype↗

[Hearing and language sequelae in survivors of a neonatal intensive care unit].

INTRODUCTION: The purpose of this study is to record the hearing and language sequelae in a sample of children from the Intensive Care Unit between the ages of two and three. MATERIALS AND METHODS: Forty-one children were studied after being submitted to neuropsychological, hearing and language tests. Both normal and abnormal parameters for each test allowed the categorization of the children. RESULTS: In the general sample there were 24 full-term children versus 17 preterm children. The neurological testing showed a tendency towards normality. The same was seen in language testing since the proportion of normality corresponded to those children born after a full term. There were practically no differences in those suspected from both groups and a greater percentage of abnormal children were found among the pre-term infants. From an audiological standpoint there was a predominance of normal children; there was only one patient with severe bilateral hypoacusis who needed an electric auxiliary hearing device and two other patients with peripheral ear dysfunction classified as serous middle ear otitis. CONCLUSIONS: The incidence of hypoacusis in this sampling type is similar to that reported in the literature. Those patients with a history of assisted mechanical ventilation have been later found to have, as a sequelae, serous middle ear otitis, which corresponds to that reported by Paradise. The development of language stages were altered more so in preterm children. In some patients, the lack of stimulation associated with a low socioeconomic back group favors the delay in the development of language skills.

Child, Preschool↗

Infant heart transplantation at Stanford: growth and neurodevelopmental outcome.

OBJECTIVE: To evaluate the growth and neurodevelopmental outcome of 18 surviving Stanford patients who received heart transplantations before their second birthday. METHODS: We compared the growth and neurodevelopmental outcome of these 18 patients with a second group of age-matched comparison patients who underwent other heart surgery requiring cardiopulmonary bypass. RESULTS: Difficulties with growth and development were more common in the transplant group as were neurologic abnormalities. Speech and language delays as well as hearing problems were also more common in the transplant group. CONCLUSION: Multicenter prospective longitudinal neurodevelopmental outcome studies of infant heart transplant patients should be conducted to provide a more efficient basis for evaluating management protocols and assessment of long-term outcomes and of the need for early intervention services.

Cardiopulmonary Bypass↗

Down's syndrome and the acquisition of phonology by Cantonese-speaking children.

The phonological abilities of two groups of 4-9-year-old intellectually impaired Cantonese-speaking children are described. Children with Down's syndrome did not differ from matched non-Down's syndrome controls in terms of a lexical comprehension measure, the size of their phoneme repertoires, the range of sounds affected by articulatory imprecision, or the number of consonants, vowels or tones produced in error. However, the types of errors made by the Down's syndrome children were different from those made by the control subjects. Cantonese-speaking children with Down's syndrome, as compared with controls, made a greater number of inconsistent errors, were more likely to produce non-developmental errors and were better in imitation than in spontaneous production. Despite extensive differences between the phonological structures of Cantonese and English, children with Down's syndrome acquiring these languages show the same characteristic pattern of speech errors. One unexpected finding was that the control group of non-Down's syndrome children failed to present with delayed phonological development typically reported for their English-speaking counterparts. The argument made is that cross-linguistic studies of intellectually impaired children's language acquisition provide evidence concerning language-specific characteristics of impairment, as opposed to those characteristics that, remaining constant across languages, are an integral part of the disorder. The results reported here support the hypothesis that the speech disorder typically associated with Down's syndrome arises from impaired phonological planning, i.e. a cognitive linguistic deficit.

Articulation Disorders↗