Detection and treatment of communication disorders characterized by hypernasal speech in the absence of a cleft palate.
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Communication problems form one of the key diagnostic criteria for autism, but there is a wide variety of manifestations. The theory that autistic individuals are unable to represent mental states can shed light on both the nature and range of communication impairments. This theory predicts that the specific communication deficit lies in the use of language to affect other minds. Language is not special in this respect, and is important only in so far as it may be used to give evidence of a speaker's thoughts and intentions. Thus, in autism, language level would be expected to relate strongly to performance on standard tests of theory of mind. Normal language acquisition appears to build upon the ability to recognize and orient towards ostensive behaviour. For this reason, it may not be necessary to postulate additional language impairments in order to explain the almost universal prevalence of language delay in children with autism. Autism, then, provides a model for studying the important distinction between language and communication, and demonstrates the vital part which mind-reading plays in normal human verbal and non-verbal interaction.
Dysmorphophobia shall be described as an example for a communicative disorder and be deliminated from other syndromes under which it has been subsumed so far. On the background of available literature, the "fear of deformity" is to be elaborated as feeling ashamed of the contemptuous look of another person, whose look has turned into the own view. This results in a discrepancy with the ego and the own self conveyed by others, finally leading to depersonalisation. This basic interpersonal appearance shall be further illustrated by two individual examples.
Communication problems are believed to play a central role in many sexual dysfunctions. The present study behaviorally assessed communication patterns within heterosexual couples in which the woman was experiencing female orgasmic disorder and within two groups of control couples. The sexually dysfunctional couples evidenced significantly poorer communication than controls, primarily but not exclusively when discussing sexual topics. Specifically, women with orgasmic disorder or their male partners demonstrated more blame and less receptivity. We discuss the etiologic and treatment implications of these findings.
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In this paper we review the aspects linked with the comorbidity of attention deficit hyperactivity disorder (ADHD). The disorders most frequently associated with ADHD are: Tourette syndrome, generalised development disorders, communication disorders, learning disorders, coordination development disorders, behavioural disorders, anxiety disorders, affective disorders and mental retardation. From the neurocognitive point of view, the executive functions play an important role in ADHD and from the neuroanatomical point of view there is involvement of the frontostriatal circuits. The functional model of ADHD based on these functions and these structures enables us to understand the comorbidity with the above mentioned processes. Given the high rate of comorbidity of ADHD it is important to identify the associated problems in order to rationalise the psychological approach and pharmacological treatment employed. We also review the therapeutic implications that comorbidity entails.
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A total of 63 patients were investigated in order to provide a psychological analysis of schizophrenia-related early childhood autism (ECA). Need and motivation were shown to play a major role in the disordered interpersonal communication characteristic of two types of mental dysontogenies in the pattern of ECA under this investigation. The dysontogeny type showed a relation to the nature and depth of communicative disorder. The ways of its psychological correction targeted at the ECA children's social rehabilitation were outlined.
Despite increasing consumer utilization of complementary and alternative medicine (CAM) and growing evidence of its positive effects on certain physical (e.g., chronic pain, insomnia) and psychiatric (e.g., anxiety) disorders, few empirical investigations have explored using CAM to treat neurogenic disorders of communication or cognition. Accordingly, to spur clinical and research interest in CAM, we review two forms of CAM, relaxation therapy and acupuncture, that have been used to address the needs of patients with neurogenic cognitive or communicative disorders. For each technique, we describe general therapy procedures, summarize and critique the extant research, and delineate areas in need of further empirical investigation.
This article discusses the impact of cognitive-communicative and behavior problems on oral intake. Data on the swallowing outcomes of a group of patients in an acute rehabilitation facility are presented. These data illustrate the relationships among severity of dysphagia, admission and discharge Functional Independence Measure (FIM) scores, admission and discharge cognitive FIM scores and length of stay. Two case studies that describe the effect of cognitive-communicative disorders on dysphagia are provided.
Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric condition. Many believe that the central disability is impaired inhibition, which leads to reduced abilities in social skills, self-control, organization and time management. The behaviors identified by clinicians as problematic--inattention, hyperactivity and impulsivity--have been incorporated into several evolutionary models as selectively adaptive cognitive skills for surviving the challenges of a variable Pleistocene environment. We propose that the "disabilities" exhibited by individuals with ADHD are maladaptive, and we concur with Barkley that there is a central impairment in the behavioral inhibition system. The underlying neural anatomy and physiology support the possibility that neurotransmitter pathology may have an impact on other interlinked systems (including language), and may also account for the frequent comorbidity of aggression, anxiety, depression, and learning disabilities (many of which are language-related). Language skills compete with other cognitive activities for the attentional system, and thus the evolution of language could not in fact be independent of the evolution of attention. If language represents the ultimate expression of the attentional system, and some individuals with ADHD are seriously impaired in the coordination of interlinked neural systems (including language), then ADHD fits Jerome Wakefield's definition of "harmful dysfunction," and communication impairments should be investigated more thoroughly by clinicians.
The importance of the care given by the pediatric otolaryngologist to the individual child encompasses the traditional purposes of medicine. This field has its special focus on interventions that preserve, restore and/or otherwise improve hearing, speech, voice, gustation, olfaction, deglutition, respiration, appearances, etc. The value-added dimension of pediatric otolaryngology is of essential importance because it enhances communication-language--through the vehicles of hearing, voice, and speech. This critical role is manifest in two ways. The first relates to the economic bases of society. Comparison of the consequences of communications disorders in three different countries ranging, currently, from one very highly dependent upon communication skills (The Netherlands), to one highly dependent upon communication skills (the United States), to a developing nation less dependent upon communication skills (the Philippines) is presented. All three nations are adversely affected economically and socially by communication disorders. It is estimated that the United States loses between 2.5 and 3% of its gross domestic product from the economic sequel of communication disorders. It also appears that communication disorders contribute to crime, since the prevalence of communication disorders is many times greater in populations of juvenile delinquents than in the general population. Communication disorders may act synergistically with diminished economic and social resources and other factors in the causes of violent behavior and crime.
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Reading disability shows substantial genetic influence, and it is in this area of early-onset cognitive delays that genetic research has made the most progress. Reading disability also provides the first success story for identifying replicable quantitative trait locus linkage for behavioral disorders. Language and communication disorders also show substantial genetic influence, as does general cognitive ability (intelligence), which plays a role in most cognitive disabilities. The genetics of reading disability, communication disorders, and mental retardation are reviewed. Early-onset cognitive disabilities are prime targets for molecular genetic studies that will eventually identify specific genes that can predict risk, assist diagnosis and treatment, and provide discrete windows through which we can investigate the development of brain mechanisms that lie between genes and behavior.
Thought disorder and communication patterns during an interactional task were examined in families of children with schizophrenia-spectrum disorders (schizophrenia and schizotypal personality disorder), depressed children, and normal controls. Children with schizophrenia-spectrum disorders showed significantly more thought disorder than their normal peers; levels of thought disorder among depressed children fell between those observed in the other two groups but did not differ significantly from either of them. Similarly, mothers of children with schizophrenia-spectrum disorders showed more thought disorder than mothers of normal control children but did not differ from mothers of depressed children. Children with schizotypal personality disorder did not differ from children with schizophrenia. These findings demonstrate that the thought disorder present in childhood-onset schizophrenia and schizotypal personality disorders is manifest in an important social context, the family.