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Language development in children at risk for language impairment: cross-population comparisons.

At 3 years of age the spontaneous language of 17 typically developing children was compared to two groups of toddlers who were at risk for language delay for very different reasons. One at-risk group, late talkers, appeared normal in all respects except for their delayed language. These 20 children scored at or below the fifteenth percentile for expressive vocabulary on the MacArthur Communicative Development Inventory (Fenson et al., 1993) when originally identified at 20-27 months of age and within the normal range on the Bayley Scales of Infant Development (Bayley, 1969). The other group, 21 children with unilateral focal brain injury, suffered localized damage to their brain prenatally, perinatally, or within the first 6 months of life. Results indicated that both of the at-risk groups were still significantly lower in vocabulary diversity and grammar at 3 years of age. There was also significantly greater variability in the at-risk groups than in the control groups, and in the children with focal brain injury than in the late talkers in both areas. The importance of language comprehension to development in this period was supported by two findings. First, children with focal brain injury had significantly lower scores than late talkers on the Index of Productive Syntax, a test of emerging grammar, and had been lower in comprehension on a standardized test of language comprehension a year earlier. Second, late talkers with delay in comprehension as well as production had significantly lower scores on IPSyn than those with normal comprehension, suggesting that they are at greater risk for continued delay. Qualitative analyses indicated that the at-risk groups produced the same kinds of errors, but that late talkers produced a substantially greater proportion of errors in obligatory contexts than did children with focal brain injury.

Brain Injuries↗

Communication development and its disorders: a psycholinguistic perspective.

There is a reciprocal relationship between the study of language disorders and research in normal language development. Recent studies in normal acquisition have led to a model of language development that includes not only linguistic achievements, but the development of social and cognitive abilities that lay the basis for the transition from prelinguistic communication to the use of conventional forms. This model has been applied to the study of developmental disorders of language learning. Such a model allows the more puzzling disorders of language development, such as childhood aphasia and primary autism, to be placed in a framework that predicts language disruption when underlying perceptual, cognitive, or social abilities are lacking. Assessment procedures that can be drawn from the model of language disorders are presented. It is argued that the study of these disabilities is important in the building of theoretical models of intact language processing that specify more precisely the contribution of underlying skills to overall functioning. Questions for future research that serve this reciprocal purpose are discussed.

Autistic Disorder↗

The development of early literacy skills among children with speech difficulties: a test of the "critical age hypothesis".

This article presents a longitudinal study of the early literacy development of 47 children with speech difficulties from ages 4 to 7 years. Of these children, 19 with specific speech difficulties were compared with 19 children with speech and language difficulties and 19 normally developing controls. The risk of literacy difficulties was greater in the group with speech and language difficulties, and these children displayed deficits in phoneme awareness at 6 years. In contrast, the literacy development of children with isolated speech problems was not significantly different from that of controls. A path analysis relating early speech, language, and literacy skills indicated that preschool language ability was a unique predictor of phoneme awareness at 5;8 (years; months), which, together with early reading skill, predicted literacy outcome at 6;9. Once the effects of phoneme awareness were controlled, neither speech perception nor speech production processes predicted variation in literacy skills. However, it is noteworthy that children with persisting speech difficulties at 6;9 were particularly vulnerable to deficits in reading-related processes.

Age Factors↗

Longitudinal influence of prenatal cocaine exposure on child language functioning.

The present study estimates the longitudinal effects of in utero cocaine exposure on language functioning at 3, 5 and 7 years of age in an urban sample of 443 full-term children (236 cocaine-exposed and 207 noncocaine-exposed) participating in the Miami Prenatal Cocaine Study. The sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview and urine and meconium toxicology assays. Language functioning was measured at ages 3 and 5 years using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P) and at age 7 years using the Core Language Domain of the NEPSY: A Developmental Neuropsychological Assessment. Longitudinal Generalized Linear Model and Generalized Estimating Equations (GLM/GEE) analyses revealed an association between prenatal cocaine exposure and deficits in total language functioning after statistically controlling for child sex, visit age, prenatal exposure to alcohol, marijuana and tobacco and over 20 additional medical and sociodemographic covariates drawn from potentially confounding influences assessed at birth and follow-up visits (D=-0.17; 95% CI=-0.32, -0.03; P=.019). The link from prenatal cocaine exposure to later language deficits does not appear to be mediated by cocaine-associated deficits in birth weight, length or head circumference. Overall, the evidence tends to support an inference of a stable cocaine-specific effect on indicators of language functioning during early childhood through age 7 years.

Adult↗

Unusual phonological patterns and their underlying representations: a case study.

An unusual phonological pattern exhibited by a child aged 2;9 is described. The pattern involved the production of word-final strident continuants in words whose adult forms contain these features in initial, rather than final position (e.g. [ops] for soap). The data are interpreted as compatible with models of child phonology that permit direct mapping of features to final position.

Articulation Disorders↗

A 12-month follow-up of preschool children investigating the natural history of speech and language delay.

AIM: The aim of this paper is to examine the natural history of early speech and language delay in preschool children over a 12-month period. METHODS: The study reports data on 69 children under the age of 3.5 years who were referred for speech and language therapy because of early speech and language delay. The children were monitored over a 12-month period but received no direct intervention during that time. Assessment of their comprehension, expressive language and their phonology took place at baseline and again at 6 and 12 months after baseline. RESULTS: The results show a general picture of improvement, although there was considerable individual variation. By the end of the 12 months, two-thirds of the children were still eligible on the study intake criteria. Therapist's rating of a child's functional communication at the outset was a significant predictor of the child's outcome at the end of the 12-month period. DISCUSSION: The paper discusses the appropriateness of a 'monitoring' approach to the management of early language delay and highlights the need to consider the social issues and views of parents as well as the severity of a child's difficulties.

Articulation Disorders↗

Concomitant use of the matrix strategy and the mand-model procedure in teaching graphic symbol combinations.

Matrix strategies employing parts of speech arranged in systematic language matrices and milieu language teaching strategies have been successfully used to teach word combining skills to children who have cognitive disabilities and some functional speech. The present study investigated the acquisition and generalized production of two-term semantic relationships in a new population using new types of symbols. Three children with cognitive disabilities and little or no functional speech were taught to combine graphic symbols. The matrix strategy and the mand-model procedure were used concomitantly as intervention procedures. A multiple probe design across sets of action-object combinations with generalization probes of untrained combinations was used to teach the production of graphic symbol combinations. Results indicated that two of the three children learned the early syntactic-semantic rule of combining action-object symbols and demonstrated generalization to untrained action-object combinations and generalization across trainers. The results and future directions for research are discussed.

Child↗

Psychosocial outcomes at 15 years of children with a preschool history of speech-language impairment.

BACKGROUND: Evidence suggests there is a heightened risk of psychiatric disorder in children with speech-language impairments. However, not all forms of language impairment are strongly associated with psychosocial difficulty, and some psychiatric disorders (e.g., attention deficit/hyperactivity disorder (ADHD)) are more prevalent than others in language-impaired populations. The present study assessed the psychosocial adjustment in adolescence of young people with history of speech-language impairment, and investigated specific relationships between language deficits and psychiatric disorders. METHODS: Seventy-one young people (aged 15-16 years) with a preschool history of speech-language impairment were assessed using a psychiatric interview (K-SADS) supplemented by questionnaires probing social encounters and parental reports of behaviour and attention. Their psycho-social adjustment was compared with that of a cross-sectional control group of age-matched controls. RESULTS: Overall the rate of psychiatric disorder was low in the clinical sample and children whose language delay had resolved by 5.5 years had a good outcome. For those whose language difficulties persisted through the school years, there was a raised incidence of attention and social difficulties. These difficulties were partially independent and associated with different language profiles. The group with attention problems showed a profile of specific expressive language difficulties; the group with social difficulties had receptive and expressive language difficulties; and the group with both attention and social difficulties was of low IQ with global language difficulties. CONCLUSIONS: Amongst children with speech-language delays at 5.5 years, those with more severe and persistent language difficulties and low nonverbal IQ are at higher risk of psychiatric morbidity in adolescence.

Adolescent↗

Relationships among language domains in preterm children.

Measures of performance in phonology, syntax, semantics, and pragmatics were obtained from the language samples of 29 preterm children at preschool age. A correlation of .43 was found between measures of phonology and syntax but other significant relationships were not found. Results are discussed relative to other research.

Articulation Disorders↗

Language, articulation, voice and resonance characteristics in 4 children with Goldenhar syndrome: a pilot study.

The purpose of this study was to describe the language, articulation, voice and resonance characteristics in children with Goldenhar syndrome. The 4 Dutch-speaking subjects were 2 boys (age 4.5 and 10.2 years) and 2 girls (aged 5.0 and 5.4 years) with normal cognitive functioning. Language testing showed a delay in the development of morphosyntactic abilities. Speech analysis showed that these four children were capable of producing all the sounds of their mother tongue. One type of distortion error, namely dentalization, was found in 2 children. Phonological process analysis revealed the persistence of processes such as final consonant deletion, unstressed syllable deletion and cluster reduction, which are normal in young children but are suppressed with maturation. Also the substitution process of devoicing was observed in these 4 children. It is not clear how the speech and language problems demonstrated in these 4 children are to be explained. It must be taken into consideration that the Goldenhar syndrome has a variable expression. It is possible that the presence of a mandibular defect, hearing impairment, the type and severity of palatal abnormality and decreased linguistic processing skills influence articulation in an individual child. The voices of 2 children were characterized by the presence of slight roughness, corresponding with a higher jitter percentage. How the occurrence of the hoarse voices is to be explained is not quite clear. Laryngoscopic evaluation of the vocal folds showed no organic or functional voice disorder. Regarding resonance, only the child with a cleft palate showed hypernasality and nasal emission. The ENT specialist and the speech-language pathologist must be aware of these communication disorders in order to start preventive and early 'tailor-made' speech and language intervention as soon as possible.

Articulation Disorders↗

Pragmatic language impairment and social deficits in Williams syndrome: a comparison with Down's syndrome and specific language impairment.

BACKGROUND: The social communication strength of individuals with Williams syndrome described by some researchers contrasts with the picture of social difficulties painted by others. AIMS: To study the pragmatic aspects of language, social relationships and unusual interests in a group of children and adults with Williams syndrome, and to compare them with a group of children and adults with Down's syndrome, children with specific language impairment, and a group of typically developing children. METHODS & PROCEDURES: Parents or teachers completed the Children's Communication Checklist or a modified version of it with wording appropriate for adults. Study groups consisted of 19 children and young adults with Williams syndrome, 24 with Down's syndrome, 17 children with specific language impairment and 32 typically developing children. OUTCOMES & RESULTS: Checklist ratings for the group with Williams syndrome indicated significant levels of pragmatic language impairment, and difficulties with social relationships. Together with evidence of unusual or restricted interests, the results suggested deficits across all three domains covered by the checklist. CONCLUSIONS: Despite earlier reports that emphasize a strong social interest and empathy, this study suggests that individuals with Williams syndrome have pragmatic language impairments, poor social relationships and restricted interests. Far from representing the polar opposite of autism, as suggested by some researchers, Williams syndrome would seem to share many of the characteristics of autistic disorder.

Adolescent↗

Changes in language development among autistic and peer children in segregated and integrated preschool settings.

Five young children with autism enrolled in a segregated class, five other children with autism in an integrated class, and four normally developing peer children in the integrated class were compared for developmental changes in language ability as measured by the Preschool Language Scale before and after training. The results, based on Mann-Whitney U tests, showed that (a) all of the children as a group made better than normative progress in rate of language development, (b) the scores of the autistic children were significantly lower than the peers before and after treatment, and (c) there were no significant differences in changes in language ability between the autistic children in the segregated and integrated classes.

Autistic Disorder↗

Converging evidences on language impairment in Landau-Kleffner Syndrome revealed by behavioral and brain activity measures: a case study.

OBJECTIVE: To assess the linguistic abilities of a boy having Landau-Kleffner Syndrome, and relate the focal disturbance of brain activity due to epilepsy to the cognitive and linguistic deficits. METHODS: Several kinds of assessments were carried out, including epileptic source analysis using electronic source localization methods and PET, neuropsychological assessment of cognitive functions, and assessment of speech perception skills (discrimination of phonetic and stress cues) using ERPs. RESULTS: The source of epileptic activity was localized in the left superior temporal lobe. The neuropsychological assessment showed dissociation between verbal and nonverbal functions, and the performance in former was bellow the normal range. ERPs obtained to the processing of phonetic and stress speech cues indicated that the two cues were processed asymmetrically: the mismatch negativity component (MMN) was obtained for the phoneme difference, but not for the stress pattern difference. CONCLUSIONS: Our data converged as it showed that the patient presented a selective impairment of the language system, and the verbal working memory system appeared to be especially defective. It is suggested that the language deficit is at least partly due to the focal disturbance of those neural networks that underlie the functioning of the working memory system. SIGNIFICANCE: LKS is a childhood language disorder that might serve as a model in studying what happens to the language system if, in the course of development, the essential neural circuits are severely disturbed.

Brain Mapping↗