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PubMed1988

[Diagnosis of aphasia in clinical practice--results of a written survey].

A mail survey of clinics in the Federal Republic of Germany revealed that aphasia assessment is performed primarily by speech & language pathologists, and medical specialists. Psychologists, linguists, and speech educators, on the other hand, are involved to a much lesser degree in the process of aphasia diagnosis. Diagnosticians primarily rely on psychometric aphasia testing. Utilization of these procedures appears to be motivated by their high degree of formalization, which facilitates diagnostic objectivity, and by the good selection, syndrome classification, and severity determination this entails. Criticism is directed at the structural complexity of the tests, insufficient economy, their restricted scope, and insufficient coverage of non-language defect syndromes. Psychometric aphasia testing in many cases is used in combination with other, clinical (i.e. non-standardized) aphasia testing procedures, the advantages of the latter appearing to make up for the disadvantages in the psychometric procedures. Despite their shortcomings of not permitting adequate checks on aphasia course, use of these other procedures is held to be justified in that they are economical to administer; have a broad range of application, i.e. are useable also in acute or very severe conditions; cover non-language disorders, and, finally, are therapy-oriented. Field workers in the survey sample insist on having available both the psychometric and clinical procedures. For those involved in constructing aphasia assessment procedures, this indicates a need for developments in both "directions", which obviously are complementary to each other. Action theoretical criteria may be useful in elaborating clinical procedures.

Aphasia↗
PubMed1985

Disturbances in histidine metabolism in children with speech abnormalities.

Catabolism of histidine was investigated in 24 patients with different speech and language disorders and with significantly low histidase activity in stratum corneum. No classical histidinemia was found. Biochemical investigation of these patients after loading with L-histidine led to the conclusions that low histidase activity in stratum corneum was connected with: disturbances in folic acid metabolism (2 cases); "atypical histidinemia" (1 case); heterozygotes of histidinemia (2 cases); normal liver histidine metabolism but abnormal in other tissues (18 cases); previously unknown error of histidine metabolism (1 case).

Ammonia-Lyases↗
PubMed1988

Autism in association with fragile X syndrome in females: implications for diagnosis and treatment in children.

Fragile X syndrome is the second most common chromosomal cause of mental retardation (MR). The calculated incidence is 1/1000, making accurate and early diagnosis important for specific preventive, pharmacologic, and cognitive treatment. The timely diagnosis in males is facilitated by the characteristic phenotype and an association with autism. In contrast, in females heterozygous for fragile X, the characteristic phenotype and infantile autism are rarely reported. We present two females with cytogenetic expression of the fragile X chromosome for whom the studies were performed because of the presence of autism or prominent autistic features and a behavioral and physical phenotype consistent with fragile X syndrome. The first female, age three years, has autism, hyperactivity, echolalia, language delay, hand stereotypies, and mild MR. The characteristic phenotype was not present nor was there a family history of X-linked MR. Fragile X expression was 6% in the proband, 3% in the mother and 1% (normal) in the father. The second child, seven years old, has prominent autistic features, hyperactivity, mild MR, mild language disorder, and a family history consistent with X-linked MR. Fragile X expression was 3% in the proband and 0% in the mother. These cases support the occurrence of fragile X in autistic females and emphasize the importance of cytogenetic screening for fragile X in this high risk population. Early diagnosis of fragile X allows precise genetic counseling and more specific cognitive and pharmacologic treatment.

Autistic Disorder↗
PubMed1979

[Emancipatory rehabilitation in logopedics (author's transl)].

The authors tries to answer the question whether logopedical rehabilitation in its present form meets the requirements of its object, i.e., the speech impaired individual as seen from the perspective of prevention or reduction of his social and vocational disadvantages resulting from the language disorder. Against the background of society's "deficiency -- classification-attitude" towards the speech impaired, logopedical rehabilitation should enhance more intensively the emancipation of the speech deviant individual. The study of the practical realization of this requirement demonstrates that logopedics -- still considerably influenced by medical conceptual models -- which is understandable both historically and socially, has not made steps towards emancipatory rehabilitation. Prospects and approaches towards emancipatory rehabilitation resulting in an improvement of the speech disorder are demonstrated.

Attitude↗
PubMed1983

Speech training by parents of Down syndrome toddlers: generalization across settings and instructional contexts.

A multiple baseline design was used to investigate the acquisition and subsequent generalization of vocal imitation training skills by parents of language-delayed Down syndrome preschoolers. The use of modeling, prompting, and feedback techniques readily produced increases in correct use of prompts and praise by parents as well as decreases in tangential statements while they were conducting structured imitation training with their children in an experimental preschool. These changes in parental behavior were associated with improved vocal imitation and decreased disruptive behavior by their children. The newly acquired parental skills did not extend to free-play sessions at home. In a subsequent manipulation, parents received instructions to use their skills at home, were taught how to adapt them to the free-play format, and were given feedback based upon audio tapes of the home sessions. This resulted in rapid increases in targeted parental behavior at home as well as increases in children's vocal imitation and spontaneous vocalization.

Child, Preschool↗
PubMed1978

Fluent aphasia after closed head injury.

A case of post-traumatic, contre-coup Wernicke's aphasia resulting from left posterior temporal hemorrhagic contusion localized by angiography and CAT scan is reported. Categorization of aphasia is reviewed, emphasizing that a fluent language disorder can be elusive to laymen and non-neurologically oriented physicians.

Adult↗
PubMed1983

Cognition in cerebral gigantism: are the estimates of mental retardation too high?

The psychological findings on 10 children with cerebral gigantism are reviewed. Infants with cerebral gigantism showed a consistent pattern of psychomotor delay. Preschool age children demonstrated signs of a primary language disorder, and school-age patients had learning disabilities. The incidence of mental retardation was significantly lower than previously reported in the literature. The possibility that some children with cerebral gigantism can be easily misdiagnosed as mentally retarded is discussed.

Child↗