[Acute language disorders. Sylveline's case].
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The relationship between epilepsy, language, behavior, and cognition is not well understood. Developmental and acquired disabilities such as autistic spectrum disorders, Landau-Kleffner Syndrome, electrical status epilepticus in sleep, and developmental dysphasias have been associated with epileptiform abnormalities. These disorders share many common features and raise important questions regarding this intricate relationship. This article reviews these disorders and discusses the proposed interaction between epileptiform abnormalities and cognitive dysfunction. Diagnostic and treatment issues will also be reviewed.
OBJECTIVE: To review the past 10 years of research in child language or communication disorders, which are highly prevalent in the general population and comorbid with childhood psychiatric disorders. METHOD: A literature search of 3 major databases was conducted. The child language literature, describing the domains of language development--phonology, grammar, semantics, and pragmatics--is reviewed. RESULTS: Disorders of grammar, semantics, and pragmatics, but not phonology, overlap significantly with childhood psychiatric disorders. Receptive language disorders have emerged as high-risk indicators, often undiagnosed. Language disorders and delays are psychiatric risk factors and have implications for evaluation, therapy, and research. However, they are often undiagnosed in child mental health and community settings. The research has focused mostly on monolingual English-speaking children. CONCLUSION: Awareness of basic child language development, delay, and deviance is crucial for the practicing child and adolescent psychiatrist, who must diagnose and refer relevant cases for treatment and remediation. Future research needs to address the growing language diversity of our clinical populations.
Three groups of age- and PIQ-matched children (Autism, Receptive Developmental Language Disorder, and normal controls) participated in two event-related brain potential (ERP) experiments. Each of these experiments was aimed at evaluating whether either of the two clinical groups of children demonstrated abnormalities in two auditory ERP components, N1 and P2, which are known to be dependent on stimulus characteristics (frequency, intensity, and probability), and believed to be generated within primary and secondary cortex. Results of Experiment 1 provide partial support for the idea that both clinical groups failed to fully process changes in stimulus intensity as indexed by the N1 component. Results are discussed in reference to potential abnormalities in serotonergic regulation of auditory cortex.
Memory, and particularly short-term memory or "working memory" (Baddeley), is involved in language acquisition in children. We have studied short-term memory, with verbal-and non verbal tests, of 8 children suffering from developmental dysphasia compared with other ones, matched in terms of age and performance I.Q. (W.I.S.C.-R.). The digit span did not significantly differ in the two groups, while the visuo-spatial span was lower in the dysphasic group. The memorization of a list of monosyllabic words by dysphasic children was poor in the absence of visual presentation and improved by it. Differences between dysphasic and control-children are unlikely to be due to speech rate which does not significantly differ from one group to the other one. The results suggest the existence, in language disordered children, of cognitive functions disorders much more important than those directly involved in the speech production.
The longitudinal study of a hyperlexic girl, A.E., is described. Although her WISC-R IQ was 58, her reading was significantly advanced for age and level of intellectual functioning. She was socially withdrawn and displayed repetitive and self-stimulation behaviors. At birth she weighed 1000 g and was 32 weeks gestational age. She had severe respiratory distress, seizures and apnea in the perinatal period. She had a history of significantly delayed development, although the delays were more pronounced in language than in perceptual motor skills. She demonstrated difficulties with semantic and syntactic processing of language and could read words and sentences of which she had little or no comprehension. The existence of reading in spite of severely disordered language suggests that reading may occur by visual and/or phonological routes but that semantic and syntactical processing of words is not essential.
M. Hughes and H. M. Sussman (1983, Brain and Language, 19, 48-64) suggest that the time-sharing paradigm "does not serve as an adequate behavioral index for language lateralization in children." The merits of this conclusion are considered and general interpretative issues regarding manual interference in dual-task/time-sharing studies are discussed.
Speech and language development is a sensitive and important diagnostic tool for the family physician. Speech defects and delayed speech and language development can be the presenting evidence for neurologic abnormalities, cognitive difficulties and abnormal hearing. They can also be signs of emotional, social, family and behavioral problems. Finally, they can signify the need for evaluation of abnormalities of tracheal and laryngeal function and oral-motor development.
The kinetics of 5-HT uptake by platelets was studied in cases of infantile autism and developmental language disorder (DLD) and normal subjects. Two patients of the autism group were twins, and the seven patients of the DLD group were members of four pairs of twins. The Vmax values (means +/- SD) for autism and DLD were 6.46 +/- .90 pmol 5-HT/10(7) cells/min and 4.85 +/- 1.50 pmol 5-HT/10(7) cells/min, respectively. These values were both significantly higher than that of 2.25 +/- .97 pmole 5-HT/10(7) cells/min for normal children. The Km values of the three groups were not significantly different. Data on the five pairs of twins examined suggested that the elevated Vmax of 5-HT uptake by platelets was determined genetically.
Here we report the results of a study that tested what has become known as the Geschwind hypothesis (Geschwind & Galaburda, 1987). This study involved 526 people who were tested by an allergist for IgE-mediated allergies and who filled out a 12-item handedness questionnaire that also included questions about eyedness, prevalence of left-handedness in the immediate family, and familial developmental language problems. A series of log-linear analyses revealed that if the definition of "anomalous" included left-handedness and having a first-order left-handed relative, one was indeed more likely to be allergic than were those not so classified. When the definition of anomalous simply included those classified as left-handed, the results were not significant. Parallel findings resulted when the criterion variable was the presence of developmental language disorders. No evidence was found for relations between allergies and developmental language problems.
A new concept of Agreement (AGR) has been represented as a Formal Feature that can appear in a wide range of different configurations (Chomsky, 1998). A case study from language disorders supports and extends this abstract concept. The child shows no agreement in Inflectional Phrase me can and Determiner Phrase them eyes. We then extend the notion of AGR to include verb-Prepositional Phrase relations, where the child also systematically avoids certain prepositions (go beach). The analysis is supported by intuitional data from compounds (sweep with broom --> broom-swept). We also define a systematic notion of Possible deficit as a premature fixation of functional items which normally require additional Phi-features. The notion of Maximization of Formal Features then emerges as a significant feature of learnability from both a normal and disordered perspective.
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Language disorders developed in a patient following a subcortical infarct involving the left putamen and caudate nucleus. Language was abundant and fluent, with many perseverations, semantic and ideation incoherences, and all activities concerned with verbal or non-verbal expression were affected. Lesions were present in the head and body of the caudate nucleus, the whole of the putamen, the anterior nucleus of the thalamus and the superior part of the internal capsule. The disorder was unique in relation to disturbances of the aphasic type observed in extensive thalamic lesions, or in transcortical sensorial aphasia. Physiopathological interpretation is based on the functional role of the putamen-caudate system in the regulation of many types of behaviour: animal experiments and results of applying stimuli in humans suggests a release of the inhibition exerted by the caudate nucleus on the frontal cortex. Lack of comparable clinicopathological data implies that other similar cases must be reported before the specificity of the disorder can be confirmed.
Advances in understanding the nature of language impairment in children over the past decade have been abundant. In this paper, several recurring hypotheses about the nature of the clinical disorder of language impairment in children and underlying etiologies are explored and the ways in which we are moving forward in our understanding of them are considered. Specifically, in the first part, the recent thinking on the nature of specific language impairment as a clinical concept is examined. Characteristics of the population are reviewed and the search for causation is considered. Literature on the relations between language and cognition and between language and social cognition is probed for contributions to our understanding of developmental disorders of language. Two areas in which we have seen marked progress and which hold promise for development in the coming decade are the focus of the second part of the paper. The focal areas are: computer-assisted language sample analyses and neurophysiological contribution to understanding language impairment in children. Thoughts about future directions for work in the area of developmental disorders of language are offered in conclusion.
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This symposium was focused on habilitation for children with visual and hearing impairment, speech-language disorder, and hyperkinetic disorder. New and variable approaches were reported in topics of habilitation for these handicapped children by an ophthalmologist, an otorhinolaryngologist, a child neurologist, a speech therapist and an educational psychologist. Many points of these approaches were then discussed.
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