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PubMed2000

Redefining the survival of the fittest: communication disorders in the 21st century.

OBJECTIVES: To determine the economic effect on the US economy of the cost of caring for people with communication disorders as well as the cost of lost or degraded employment opportunities for people with such disorders, including disorders of hearing, voice, speech, and language. STUDY DESIGN: Survey of available historical and contemporary governmental and scholarly data concerning work force distribution and the epidemiology of disorders of hearing, voice, speech, and language. METHOD: Analysis of epidemiological and economic data for industrialized countries, North America, and the United States. RESULTS: Communication disorders are estimated to have a prevalence of 5% to 10%. People with communication disorders may be more economically disadvantaged than those with less severe disabilities The data suggest that people with severe speech disabilities are more often found to be unemployed or in a lower economic class than people with hearing loss or other disabilities. Communication disorders may cost the United States from $154 billion to $186 billion per year, which is equal to 2.5% to 3% of the Gross National Product. CONCLUSIONS: Communication disorders reduce the economic output of the United States, whose economy has become dependent on communication-based employment. This trend will increase during the next century. The economic cost and the prevalence rates of communication disorders in the United States indicate that they will be a major public health challenge for the 21st century.

Communication Disorders↗

PubMed1990

Communication disorders and emotional/behavioral disorders in children and adolescents.

Recent research in child psychiatry has demonstrated a high prevalence of speech, language, and communication disorders in children referred to psychiatric and mental health settings for emotional and behavioral problems. Conversely, children referred to speech and language clinics for communication disorders have been found to have a high rate of diagnosable psychiatric disorders. Most of the emerging knowledge regarding relationships between communication disorders and psychiatric disorders has been presented in the child psychiatric literature. Speech-language pathologists and audiologists also need to be familiar with this information; an understanding of the complex interrelationship between communication disorders and emotional and behavioral disorders is important for diagnosis, assessment, and treatment. The purpose of this article is to review recent research and discuss clinical implications for professionals in speech-language pathology and audiology working with children and adolescents who have, or who are at risk for, developing emotional and behavioral disorders. Issues to be addressed include differential diagnosis, prevention, intervention, and the role of speech-language pathologists serving these children and adolescents.

Adolescent↗

PubMed1994

Communicative disorders. The first year of life.

Disorders of communication have high incidence and prevalence in the fetus, neonate, and infant, and optimal care is dependent on early recognition and intervention. This article reviews receptive disorders, expressive disorders, and their diagnoses.

Communication Disorders↗

PubMedDate not supplied

[Communication disorders in schizophrenic patients. Cognitive explanation and clinical reconsideration].

The definition of schizophrenic patients communication disorders sets many problems (partly linked to the descriptive vagueness of the Bleuler mental dissociation syndrome) and leads today to give up those signals, considered as of little specification, for symptoms of easier definition. Nevertheless, french clinicians go on using the dissociation concept to make the diagnostic of schizophrenia, faithful to Bleuler teaching according to which the communication of these patients would be very specific. The object of this article is to take up with the Bleuler logic and to propose hypothesis of cognitive abnormalities that underlie the symptomatic expression of the communication troubles of these patients and point out, from these hypothesis, how a more specific rereading of the language, thought and communication disorders is possible. Two cognitive abnormalities are suggested by the literature data to explain some schizophrenic communication disorders, abnormalities which seem at least partly independent. The first one can be described in the terms of a model of action and brings down communication to its dimension of discursive action. The authors define it as a trouble of a mechanism of action supervision, of the action monitoring, or of the planning of discourse. The symptomatic expressions of this trouble may be described when the subject is under interview conditions soliciting it Examples of such clinical situations are given. The second abnormality may be described in the terms of the "Theory of Mind" and concern the difficulties of some schizophrenic patients to attribute mental states to their interlocuters. Here again, examples of clinical conditions are given, allowing us to investigate this abnormality.

Attention↗

PubMed1993

[Mild hearing loss in children with communication disorders].

The prevalence of MHL in 202, 1 to 6 year-old children with communication disorders who visited our clinic in 1991 was investigated. 1) 31% of the subjects had MHL bilaterally. The prevalence of MHL was 44% at age 1 year, 20% at age 2 years, 36% at age 3 years, 24% at age 4 years, 39% at age 5 years, 33% at age 6 years. 2) 88% of children with MHL had OME, 10% had mild sensorineural hearing loss, and 2% had cerminous plug. 3) The prevalence of MHL in children with mental retardation and autistic disorders was 9%, that with stuttering was 9%, that of OME accompanied by moderate and severe hearing disorders was 6%. 4) The primary causes in 191, except for those with stuttering, were as follows; the prevalence of MHL was 30%, that of mental retardation and autistic disorders was 24%, and that of articulation disorders was 28%. 5) On the other hand, the prevalence of MHL in children with retarded language development and articulation disorders was 30%, which was significantly higher than that of the other communication disorders. Accordingly, the results of this study suggest that MHL in early childhood greatly influences communication disorders.

Chi-Square Distribution↗

PubMed2000

Assessing the executive function abilities of adults with neurogenic communication disorders.

Whereas it is known that executive function abilities are often impaired in clients having neurogenic communication disorders, few assessments of this cognitive domain are available that consider the speech and language deficits of this population. This article provides an overview of current procedures for assessing executive functions including a discussion of team approaches to assessment, a review of currently available neuropsychological and functional tests of executive function abilities, as well as a critique of those assessment procedures. In addition, suggestions are provided for how best to use or modify appropriately current tests of executive functioning for clients having acquired speech and language disorders as a result of brain damage.

Adult↗

PubMed1999

Assessing communication in children with psychiatric and communication disorders.

This article presents issues related to the communication assessment of children with psychiatric and communication disorders. Challenges inherent in assessing this population are discussed. Frequently used assessment instruments and procedures are described. Consideration is given to the assessment of very young or low-functioning children and older or high-functioning children.

Adolescent↗

PubMed1979

Communicative disorders at a health-care center.

The purpose of this study was to identify the prevalence of communicative disorders in a Children and Youth Program during the 5-yr period 1973-1977. It appears that the numerous speech and hearing surveys recorded fail to do the following: (a) identify speech, language, and hearing pathologie from a comprehensive health-care center and/or hospital; (b) study types of clientele longitudinally; (c) study prevalence and needs of minority groups specifically; and (d) study prevalence of communicative disorders in preshool children. For the Black community under study, it appears that the prevalence of communicative disorders is greater than reported in other surveys. In addition, the current study identifies a community not receiving services. In reviewing the facilities available to this socieconomic community, one finds inadequacies. These inadequacies may be reflected in manpower and equipment rather than programs and resources. The data indicate a tremendous need to expand available services.

Adolescent↗

PubMed1998

Measurement of functional outcome in preschool children with neurogenic communication disorders.

Intervention programs for preschool children with neurogenic communication disorders are now being evaluated on their ability to achieve functional communication change. Documentation of functional gains in speech and language skills will likely determine who will deliver and receive intervention services in the future. However, few tools are available that measure functional gains in young children with severe communication deficits. This article discusses some of the issues that clinicians must consider when developing and using functional communication measures in a clinical service delivery setting.

Brain Diseases↗

PubMed2001

Memory impairments in adults with neurogenic communication disorders.

Over the past few decades, there has been increasing interest in the nonlinguistic, cognitive abilities of adults with neurogenic communication disorders. In particular, a growing literature has documented deficits in a number of memory functions in this population. The purpose of this article is to summarize that literature and provide an overview of the presence and nature of memory impairments in aphasia, right hemisphere disorders, traumatic brain injury, and dementia. Ways that memory impairments may interact with the communication abilities of individuals with neurogenic communication disorders also are discussed.

Aphasia↗

PubMed1975

Communication disorders: a power analytic assessment of recent research.

This study assessed the relative statistical power of contemporary research in communication disorders. Results of the analysis, based upon an evaluation of two major journals, revealed overall mean power figures of 0.16, 0.44, and 0.73 for small, medium, and large effect sizes, respectively. Interdisciplinary comparisons indicated that low statistical power is not unique to research in communication disorders, but is apparent in other behavioral science areas as well. Several alternatives are offered to the researcher who will want to ensure sufficient power for his investigation on an a priori basis. The implications of this study are discussed in reference to the experimenter/clinician model.

Audiology↗

PubMed1979

Thought, language, and communication disorders. II. Diagnostic significance.

This investigation evaluates the frequency of various subtypes of thought, language, and communication disorders in 113 patients with diagnoses of mania, depression, and schizophrenia. It indicates that some types of thought disorder considered important occur so infrequently as to be of little diagnostic value, such as neologisms or blocking. The traditional concept of thought disorder, which emphasizes associative loosening, is also of little value, since associative loosening occurs frequently in mania as well as in schizophrenia. This investigation demonstrates that associative loosening can no longer be considered pathognomonic of schizophrenia. On the other hand, an approach that defines various subtypes of thought disorder and uses a concept of negative-vs-positive thought disorder does often permit a distinction between mania and schizophrenia. It is recommended that the practice of referring globally to "thought disorder," as if it were homogeneous, be avoided in the future and instead that the specific subtypes occurring in particular patients be noted in both clinical practice and research.

Adult↗

PubMed1993

Communication disorders in children: a challenge for health care.

BACKGROUND: Today's children will participate in a society whose economic basis will be information and communication and they must have optimal communication skills to be able to be functional optimally within the information society. Heretofore, in the United States, there has been no systematic attempt to diagnose and care for children with communication disorders. METHODS: It is essential that the child be diagnosed early because there appears to be a critical period for language development. CONCLUSION: If interventions do not occur early, in the area of communication disorders, there is a high probability of significant morbidity because of impaired communication abilities. This morbidity can manifest itself in a social activity and loss of economic opportunity.

Adolescent↗

PubMed1989

Prevalence of communication disorders in students with learning disabilities.

The prevalence of communication disorders in a population of 242 children with learning disabilities between 8 and 12 years of age enrolled in a school system in Alabama was studied. The prevalence of articulation, language, voice, fluency, and hearing disorders was determined through an individual assessment program. A speech, language, or hearing problem was exhibited by 96.2% (233) of the 242 children studied. Language deficits were found in 90.5%, articulation deficits in 23.5%, voice disorders in 12%, and fluency disorders in 1.2% of the students with learning disabilities. Puretone hearing deficits were observed in 7.4% and middle ear function deficits were observed in 15.7% of the students. Only 6% of the children were receiving the services of a speech-language pathologist.

Alabama↗

PubMed1987

Clinical significance of childhood communication disorders: perspectives from a longitudinal study.

A group of 202 children who were referred for evaluation of communication disorders were also evaluated for psychiatric and learning disorders at two points in time. High rates of both psychiatric and learning disorders were found at initial evaluation, and even higher rates were found at follow-up 3 to 4 years later. Recovery from communication disorder occurred in approximately one fourth of the cases and varied widely depending on the type of disorder involved. Poor psychiatric outcome could be predicted by the presence and severity of initial disorders of language comprehension and expression, and by certain environmental factors (such as psychosocial stress). The high prevalence of linguistic, psychiatric, and development disorders at follow-up for the children in this study suggests the need for close monitoring of children with early communication impairments.

Attention Deficit Disorder with Hyperactivity↗

PubMed1996

Use of the Arizona Battery for Communication Disorders of Dementia in the UK.

The Arizona Battery for Communication Disorders of Dementia (ABCD) (Bayles & Tomoeda, 1993) was given to groups of young and old normal subjects and to subjects with moderate Alzheimer's disease in the UK. Very few significant differences were found between their raw scores and those of the original standardisation sample in the USA, which makes the ABCD an appropriate test to use in the UK. Although some subjects commented on several of the test stimuli, cultural differences in pictures and vocabulary did not produce notable effects on test performance and so alterations to test materials are not required for the test to be used in the UK.

Adult↗

PubMed1999

Comorbidity of psychiatric and communication disorders in children.

The co-occurrence of psychiatric and communication disorders in children is considerable. Many children who are treated by mental health professionals are also in need of speech and language services. This article discusses comorbidity and outlines communication problems that accompany a variety of childhood psychiatric conditions. Empiric studies and clinical impressions of these co-occurring problems are described.

Attention Deficit Disorder with Hyperactivity↗

PubMed1994

Formal communication disorder. Sign language in deaf people with schizophrenia.

BACKGROUND: This study investigates whether anomalies in the sign language of prelingually deaf schizophrenics can be elicited and described systematically. METHOD: Thirty schizophrenic and seven manic adults were recruited on the basis of a British Sign Language (BSL) version of the Present State Examination. Thirty-seven controls were matched for sex, age and ethnicity. Each participant became deaf before the age of two, and uses BSL as the primary means of communication. RESULTS: Analysis reveals: (a) anomalies which are similar to those occurring in the spoken language of hearing schizophrenics; and (b) another series which is closely related to the life experience of deaf subjects and to the visuo-spatial medium itself. CONCLUSIONS: There is evidence that formal communication disorder does occur in sign language. This has implications for more efficient diagnosis and management of deaf persons presenting to psychiatric services, as well as for the mechanisms of schizophrenic symptomatology itself.

Bipolar Disorder↗