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PubMed2005

Progression of language complexity during treatment with the Lidcombe Program for early stuttering intervention.

The Lidcombe Program is an operant treatment for early stuttering. Outcomes indicate that the program is effective; however, the underlying mechanisms leading to a successful reduction of stuttering remain unknown. The purpose of this study was to determine whether fluency achieved with the Lidcombe Program was accompanied by concomitant reduction of utterance length and decreases in linguistic complexity. Standardized language tests were administered pretreatment to 4 male preschool children. Spontaneous language samples were taken 2 weeks prior to treatment, at Weeks 1, 4, 8, and 12 during treatment, and 6 months after the onset of treatment. Samples were analyzed for mean length of utterance (MLU), percentage of simple and complex sentences, number of different words (NDW), and percentage of syllables stuttered. Analysis revealed that all participants presented with language skills in the average and above average range. The children achieved an increase in stutter-free speech accompanied by increases in MLU, percentage of complex sentences, and NDW. For these preschool children who stutter, improved stutter-free speech during treatment with the program appeared to be achieved without a decrease in linguistic complexity. Theoretical and clinical implications are discussed.

Child, Preschool↗
PubMed1992

Language disorders in disruptive behavior disordered homicidal youth.

Eight homicidal youths were assessed for language disorders and psychiatric diagnoses using a battery of standardized language tests and the Diagnostic Interview for Children and Adolescents. Both language disorders and Diagnostic and Statistical Manual III-R psychiatric diagnoses were present in all subjects.

Adolescent↗
PubMed1982

The potential of language tasks for identifying senile dementia.

More than two million elderly Americans suffer from senile dementia, an age-related disease affecting memory, intellect, and communication. The purpose of this study was to explore the diagnostic efficacy of language tasks for identifying senile dementia. The performance of 35 dementia patients was compared to that of 28 normal senescents on five language tasks and certain psychological measures reputed to be sensitive to the disease such as the Block Design and Similarities subtests of the Wechsler Adult Intelligence Scale, the Mental Status Questionnaire (MSQ), and the Nonsense Syllable Learning Tests. Language tasks presented were: Story-retelling, Naming, Sentence Disambiguation, Verbal Expression, and Sentence Correction. A discriminant analysis found the Sentence Correction Task, the MSQ, and the Verbal Expression Test to best discriminate patients with senile dementia from normal aged subjects. Semantic functions were found to be more vulnerable than phonologic and syntactic to the effects of progressive cortical atrophy.

Aged↗
PubMed2000

Predictors of Patient Inability to Cooperate during Intraoperative Language Mapping.

We examined the demographic, seizure history, personality, and intellectual variables in seizure surgery patients who underwent intraoperative language mapping to identify variables that may help predict inability to cooperate with intraoperative mapping. Of 26 patients who had intraoperative language testing during left hemisphere lobectomy, 9 were unable to cooperate with language mapping procedures. Mapping "failure" consisted of an inability to conform to task demands due to anxiety, inattention, immaturity, or confusion that necessitated changing from local to general endotracheal anesthesia. Patients who were unable to cooperate with intraoperative mapping had significantly lower IQs, lower educational attainment, and higher Depression scale scores on the Minnesota Multiphasic Personality Inventory (MMPI) relative to cooperative patients. There were no statistically significant differences between groups with respect to age, handedness, sex, age of onset of habitual seizures, seizure type, site of seizure focus, presence of a lesion, or previous psychiatric history.

Journal Article↗
PubMed2006

Early N400 development and later language acquisition.

Recent developmental research on word processing has shown that mechanisms of lexical priming are already present in 12-month-olds whereas mechanisms of semantic integration indexed by the N400 mature a few months later. In a longitudinal setting we investigated whether the occurrence of an N400 at 19 months is associated with the children's language skills later on. To this end children were retrospectively grouped according to their verbal performance in a language test at 30 months. Children with later age-adequate expressive language skills already displayed an N400 at 19 months. In contrast, children with later poor expressive language skills who have an enhanced risk for the development of specific language impairment (SLI) did not show an early N400. The results imply that children who have deficits in their expressive language at the age of 30 months are already impaired in their semantic development about one year earlier.

Data Interpretation, Statistical↗
PubMed1985

The transition stages between the main aphasic syndromes.

One of the basic features of most aphasic patients is their clinical dynamics, i.e. the continuous change in language function. The functional Dynamic Approach on which our rehabilitation program is based, can be expressed as a model of dynamic movement in which a patient's progress from one syndrome to another can be documented quantitatively. In this study we have concentrated on the initial emergence of patients out of the major syndrome categories. Our language test "I.L.A.T." provides for the evaluation of changes in the four language functions. Relative changes are charted by establishing a theoretical maximum performance to be expected in an aphasic population and noting improvements from the initial condition towards that point. Quantification of the proposed transitional stages are currently being developed to document our clinical insights.

Anomia↗
PubMed2004

Preschool outcome of less than 801-gram preterm infants compared with full-term siblings.

OBJECTIVE: Extremely low birth weight (ELBW) infants are at greater risk for neurodevelopmental delay than full-term infants. Outcomes may be compromised secondary to abnormal brain development associated with complications of prematurity. Long-term cognitive outcome has also been reported to be significantly influenced by postnatal factors. The objective of this study was to clarify the effects of prematurity separate from environmental factors on growth and neurodevelopmental outcomes by comparing ELBW children with their full-term siblings. METHODS: The study consisted of 25 ELBW children, a subset selected from a larger population of infants who were <801 g birth weight and enrolled in a longitudinal follow-up project from birth and their 25 full-term, full-weight siblings. Twenty-three sets of siblings were evaluated at 5 years of age and 2 sets at 3 years of age with standardized medical, social, cognitive, motor, and language testing. Physical and neurodevelopmental outcomes were compared between groups, controlling for gender and socioeconomic status (SES). RESULTS: At follow-up, ELBW children were lighter, were shorter, and had smaller head circumference. The ELBW children had lower Stanford-Binet IQs (85 +/- 12 [mean +/- SD] and 95 +/- 11), with lower Stanford-Binet subtests except short-term memory and quantitative reasoning, lower spelling scores on the Wide Range Achievement Test, and lower Peabody motor quotients (79 +/- 11 and 92 +/- 17). Preschool Language Scale quotients were not different, but other receptive language measures were lower for ELBW children. High SES seemed to modify the impact of preterm status on cognitive and language but not motor scores. The mean IQ for high-SES ELBW children was equivalent to that of the low-SES term siblings. CONCLUSIONS: Preschool-age cognitive and language functioning in ELBW children seemed to be affected by both prenatal and birth influences (preterm status) and postnatal influences (SES variables). Motor scores were significantly related to preterm status but not to SES.

Child Development↗
PubMed2003

Reliable serial measurement of cognitive processes in rehabilitation: the Cognitive Log.

OBJECTIVE: To evaluate the reliability and utility of a brief quantitative measure of cognitive recovery, the Cognitive Log (Cog-Log), developed for daily use with rehabilitation inpatients to provide information about the recovery of higher neurocognitive processes including verbal recall, attention, working memory, motor sequencing, and response inhibition. DESIGN: Descriptive study of the Cog-Log's normative scores, reliability (interrater, internal consistency), and validity as shown by its relationship to standard neuropsychologic measures. SETTING: Inpatient rehabilitation hospital affiliated with a large university medical center. PARTICIPANTS: One hundred fifty neurorehabilitation inpatients with acquired brain injury; 83 young adults without acquired brain injury were included to provide normative data. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Cog-Log; standardized neuropsychologic measures of memory (Wechsler Memory Scale-Revised, Rey Auditory Verbal Learning Test), language, attention (Wechsler Adult Intelligence Scale-Revised), and reasoning (Trail Making Test). RESULTS: Reliability analysis showed strong interrater reliability across items (Spearman r, .749-1.00) and high internal consistency (Cronbach alpha=.778). Factor analysis of the Cog-Log using principal components extraction revealed a unitary factor (eigenvalue=3.48). Cog-Log items designed to measure working memory and immediate and delayed verbal memory were most strongly predictive of performance on similar standardized neuropsychologic measures administered on the same day. CONCLUSION: The Cog-Log appears to be a reliable and efficient tool for measuring ongoing neurocognitive recovery during inpatient rehabilitation.

Adolescent↗
PubMed1982

Establishing generalized, productive verb-noun phrase usage in a manual language system with moderately handicapped children.

Strategies for producing generalized language skills continue to be of considerable interest to those working with severely language-delayed children. Research on generalized instruction-following suggested that strategies employing linguistic elements (verbs, nouns, adjectives, etc.) arranged in systematic combination matrices were successful in producing generalized and novel responses among handicapped children. The efficacy of a training matrix in the development of expressive verb-noun phrase usage was demonstrated. Two of the three students showed considerable gains in trained responses as well as predicted, novel responses, while a third who had much less training, showed some gains. Increases were also found in the overall development of expressive language tests. This approach is discussed in relation to other experimental approaches to language development.

Child↗
PubMed1996

Cognition, communication, and hearing in young children with cleft lip and palate and in control children: a longitudinal study.

OBJECTIVE: To compare a group of children with cleft lip and palate (CLP) with a group of noncleft, matched control children on measures of cognitive development, speech and language abilities, and audiologic status at 12 and 24 months of age. DESIGN: Using a prospective, longitudinal study design, a group of 16 children with CLP and a group of 16 noncleft control children matched for race, sex, birth order, and socioeconomic status were compared using the Bayley Scales of Infant Development, the Receptive-Expressive Emergent Language Scale, the Sequenced Inventory of Communication Development-Revised (SICD-R), the Preschool Language Scale-Revised (PLS-R), the mean length of utterance, audiometric evaluation, and impedance screening at 12 and 24 months of age. All were free of other congenital abnormalities or known causes of neurodevelopmental dysfunction. RESULTS: Children with CLP had lower mental developmental index (MDI) and psychomotor developmental index scores than control children. They had lower language comprehension scores on the SICD-R and PLS-R and lower expressive language scores on the Receptive-Expressive Emergent Language Scale, SICD-R, and PLS-R than control children. The group with CLP had a significantly higher number of children with abnormal tympanogram results or ventilation tubes at 12 and 24 months. There was a positive correlation between language test scores at 24 months and MDI scores at 24 months (r = .73 to .85). Seventy-five percent of children with CLP who had hearing loss at 12 months had MDI scores more than 1 SD below the mean versus 0% of children with normal hearing. There was a relationship between hearing status at 12 months and comprehension and expressive language scores at 24 months. CONCLUSIONS: Children with CLP had significantly lower scores on tests of cognition, comprehension, and expressive language abilities than matched control children at 12 and 24 months of age. They also had a higher frequency of middle-ear disease and ventilation tubes than control children, although no significant difference in hearing sensitivity was found between groups. Early identification and treatment of these delays may reduce subsequent verbal deficits, hearing loss, and academic difficulties.

Acoustic Impedance Tests↗
PubMed2002

Speech perception outcomes in older children who use multichannel cochlear implants: older is not always poorer.

Speech perception outcomes for early-deafened children who undergo implantation as teenagers or young adults are generally reported to be poorer than results for young children. It is important to provide appropriate expectations when counseling adolescents and their families to help them make an informed choice regarding cochlear implant surgery. The considerable variation of results in this group makes this process more difficult. This study considered a number of factors in a group of 25 children who underwent implantation in Melbourne between the ages of 8 and 18 years. Each subject completed open-set speech perception testing with Bamford-Kowal-Bench sentences before and after implantation and preoperative language testing with the Peabody Picture Vocabulary Test. Data were collected regarding the type of hearing loss, age at implantation, age at hearing aid fitting, audiometric details, and preoperative and postoperative communication mode. Results were submitted to a stepwise multiple linear regression analysis with postoperative open-set sentence scores as the dependent variables. The analysis suggested that 3 factors have a significant predictive value for speech perception after implantation: preoperative open-set sentence score, duration of profound hearing loss, and equivalent language age. These 3 factors accounted for 66% of the variance in this group. The results of this study suggest that children who have useful speech perception before implantation, and higher age-equivalent scores on language measures, would be expected to do well with a cochlear implant. Consistent with other studies, a shorter duration of profound hearing loss is also advantageous. The mean sentence score for this group, 47%, was not significantly different from the mean result across all children in the Melbourne program.

Adolescent↗
PubMed2004

Sign language interpreter training, testing, and accreditation: an international comparison.

The article explores sign language interpreter training, testing, and accreditation in three major English-speaking countries, Australia, the United Kingdom, and the United States, by providing an overview of the training and assessment of sign language interpreters in each country. The article highlights the reasons these countries can be considered leaders in the profession and compares similarities and differences among them. Key similarities include the provision of university interpreter training, approval for training courses, license "maintenance" systems, and educational interpreting guidelines. Differences are noted in relation to training prerequisites, types and levels of accreditation, administration of the testing system, and accreditation of deaf interpreters. The article concludes with predictions about future developments related to the establishment of the World Association of Sign Language Interpreters and the development of sign language interpreting research as a research discipline.

Accreditation↗
PubMed1998

[Higher touch and kinesthetic functions in children with former speech/language development disorders: a neuropsychological study].

Two groups of children took part in this study to test the hypothesis that children diagnosed in infancy as specific speech/language-impaired have deficits in tactile-kinesthetic functions: A formerly clinical group of 25 German-speaking pupils with a mean age of 8;7 years (SD 7.1 months) who have previously been identified as specific speech/language-impaired (on average at 4;11 years, SD 10.6 months) and a control group of 25 normal pupils in elementary school without a former or actual speech/language disorder (mean age: 9;2 years, SD 8.3 months). The control group was matched with the formerly clinical group for gender and age. Performance scores of both groups on a nonverbal intelligence test (the Raven's Matrices), on a tactile-kinesthetic subtest (Berliner-Luria-Neuropsychologisches Verfahren f¿r Kinder), and on a developmental language test (Heidelberger Sprachentwick- lungstest) were compared. There was a significant difference (p < 0.05) in the mean tactile-kinesthetic performance of both groups (3.1 vs. 4.0) who present a nearly identical nonverbal intelligence. Thirty-two percent of the formerly clinical group demonstrated a performance below the norm. Analysis of the laterality did not reveal significant differences in performance between left and right hand, neither in right-handers nor in left-handers of both groups. Nevertheless right-handers demonstrated on average a better somatosensory performance with their left hand. Mean language and tactile-kinesthetic performance correlate significantly in the formerly clinical group (r = 0.45, p < 0.05), but not in the control group (r = 0.08). The formerly clinical group was inferior in performance to the normal subjects especially in complex functions as in the tactile discrimination of sharp/blunt and in topognosia.

Child↗
PubMed1999

Language recovery after left hemispherectomy in children with late-onset seizures.

We investigated the language capabilities of the isolated right hemisphere in 6 children (age, 7-14 years) after left hemidecorticectomy for treatment of Rasmussen's syndrome. Patients were right-handed before surgery and had at least 5 years of normal language development before the onset of seizures. Language testing included speech sound (phoneme) discrimination, single word and phrasal comprehension, repetition, and naming. Within 4 to 16 days after surgery, patients showed improved phoneme discrimination compared with their performance shortly before surgery. Other language functions remained severely impaired until at least 6 months after surgery. By 1 year after surgery, receptive functions were comparable with, or surpassed, patient presurgery performance. Although word repetition was intact by 1 year after surgery, naming remained impaired, and patient speech was limited largely to production of single words. These results suggest that the right hemisphere is innately capable of supporting multiple aspects of phoneme processing. Recovery of higher level receptive and, to a lesser extent, expressive language functions is attributed to plasticity of the right hemisphere, which appears to persist beyond the proposed critical period for language acquisition and lateralization.

Adolescent↗
PubMed1989

Regional metabolic correlates of Token test results in cortical and subcortical left hemispheric infarction.

We investigated 26 right-handed patients who had aphasia caused by a single infarct in the territory of the left middle cerebral artery (MCA) with cranial CT, positron emission tomography, and a standard language test battery including the Token test. The patients represented an unselected sample of various infarct locations within the left MCA territory and showed a wide range of aphasia types and severity. Stepwise regression analysis revealed that Token test performance mainly depended on parietotemporal metabolism, irrespective of infarct location. Frontal and basal ganglia metabolism did not contribute significantly to Token test performance. These results suggest that disturbance of language comprehension is due to parietotemporal cortical dysfunction in all types of left MCA infarction. Infarcts restricted to basal ganglia or the anterior part of the MCA territory apparently do not disturb language comprehension directly, but via their remote effects on parietotemporal metabolism.

Adult↗
PubMed1998

Language deficits in a child with omolateral (left) temporo-basal and cerebellar lesions.

We report the case of an 8-year-old boy with two distinct brain lesions, probably hamartomas or low grade gliomas: one in the left basal temporal region, with involvement of the fusiform gyrus, the other in the white matter of the left cerebellar hemisphere. Both lesions were diagnosed at seven, when NMR was performed because of partial complex seizure. A mild delay in the first language acquisition and a long-lasting difficulty in word retrieval were reported. On neuropsychological testing, language was impaired more in production tasks than in comprehension ones, with severe deficit in word finding. The etiological role of the two different lesions is discussed in relation to experimental evidence of the existence of a distinct language area in the basal temporal region (fusiform gyrus).

Brain Neoplasms↗
PubMedDate not supplied

Seven-year follow-up of speech/language-impaired and control children: speech/language stability and outcome.

OBJECTIVE: This study examined the 7-year outcome of speech/language (S/L) impaired and control children selected from a community sample at age 5 years. METHOD: Two hundred fifteen children completed a variety of speech and language tests at age 12 years. Children with S/L impairment were further classified as "speech only," "language only," or "speech and language impaired." RESULTS: More than 72% of children who had S/L impairment at age 5 remained impaired at age 12. Children with both speech and language problems were most likely to remain S/L impaired; 81% had some kind of S/L impairment at follow-up. Similarly, children with both expressive and receptive language impairment were more likely to show expressive or receptive impairment at follow-up than children with expressive impairment alone. One third of time 1 controls had S/L problems at follow-up, and of these 82% had speech impairment only. CONCLUSIONS: S/L impairment identified at age 5 has long-lasting effects. More pervasive problems were associated with poorer outcomes. Screening at age 5 may be useful, as most serious S/L problems that emerged by middle childhood could be identified at age 5. The effects of S/L treatment require further study.

Adolescent↗
PubMed1995

Visuo-spatial working memory limitations in low visuo-spatial high verbal intelligence children.

Visuo-spatial working memory was investigated in a group of 37 children aged between 10 and 14 years with low visuo-spatial intelligence. Their performance was poorer than that of a matched control group on a series of tests devised to ascertain visuo-spatial working memory yet was broadly similar in a language test and in school achievement tests. It is argued that low visuo-spatial intelligence children typically present limitations in the storage capacity of a passive system of the visuo-spatial working memory (with a raw measure of four-five stored elements) and especially in the operations required to process that information.

Adolescent↗