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PubMed1992

Symbolic play development in toddlers with expressive specific language impairment (SLI-E).

Twenty toddlers with expressive specific language impairment (SLI-E) and 20 toddlers with normal language development were compared in their symbolic play development. The groups did not differ in amount of engagement with the toys or in functional conventional play behaviors. However, the children with SLI-E displayed less decentered play (use of play schemes with a doll or another person), less well-developed sequential play, and fewer occurrences of symbolic play transformations (use of a neutral object or an absent object to carry out pretending). The provision of structure in the form of thematically related toy sets, instructions, and modeling did not reduce the discrepancy between demonstrated play behaviors of toddlers with SLI-E and their normally developing peers. Three possible explanations for this discrepancy are considered: a "stylistic" difference in play, a developmental lag in symbol use, or a deficit in retrieval of stored symbolic representation.

Child Behavior↗
PubMed2005

Non-verbal cognitive development and language impairment.

BACKGROUND: Specific language impairment (SLI) is currently partly defined by the presence of non-verbal IQ scores in the normal range. However, not only is there a debate concerning where 'normal thresholds' should be, but increasing information about the presence of processing deficits in SLI have led some researchers to question the use of IQ criteria in clinical diagnosis. In particular, little is known about the longitudinal and developmental patterns of cognitive performance in this population. METHOD: Data from a long-term follow-up study of SLI was examined in 82 children defined at original participation as having SLI who had IQ measurements at 7, 8, 11 and 14 years. RESULTS: Analyses revealed a significant fall between 7 and 14 years of over 20 IQ points. This fall took place mainly between 8 and 11 years but was still continuing between 11 and 14 years. Further investigation revealed different groups of children showing different developmental patterns in IQ, even after controlling for baseline measurement. These groups also showed significantly different language outcomes at 14 years. Analyses controlling for IQ at 7 were also performed that suggested a dynamic process between language and cognitive development. CONCLUSIONS: These findings appear to be in agreement with a model of impairment that views 'Residual Normality' as unlikely (Karmiloff-Smith, 1998; Thomas & Karmiloff-Smith, 2002). The implications are therefore discussed in relation to the dynamic development of systems along with the possible cognitive mechanisms (such as working memory) that might interact with language to create an SLI profile.

Adolescent↗
PubMed2004

[Individual and family factors influencing vocabulary development in toddlers].

OBJECTIVE: Many researchers have conducted studies on child language development and relevant risk factors, but most of these studies were about English-speaking children and few of them were on Chinese-speaking children, and less reports of studies on language development of infants or toddlers are available as compared to those on children above 3 years of age. The objective of this study was to assess the level of vocabulary development of healthy toddlers in urban Beijing and to investigate toddlers' physical and psychological development and socioeconomic status of toddlers' family so as to identify factors related to toddlers' language development and provide basis for instructing parents child-rearing. METHOD: This is a quantitative cross-sectional study. Using Chinese Communicative Development Inventory mandarin version, (CCDI) and related background questionnaire, a survey was conducted among the parents or care givers of 1056 healthy toddlers (16 approximately 30 months), randomly stratified and selected from two areas of four urban districts in Beijing. The children who were born prematurely, who had low birth weight, or who were deaf, dumb or with disability, were excluded from this study. The mothers who were deaf, dumb or having disability were not included in this study, either. Rank sum test was used to compare the vocabulary scores between boys and girls at the same age. Single and multiple factors analysis were used to find related factors. RESULTS: By 16 months of age, boys could speak about 22 words and girls 84 words on the CCDI. By 29 - 30 months of age, boys could speak about 725 words and girls 752 words on the CCDI. The level of vocabulary development of healthy toddlers in urban Beijing was higher than that reported in previous studies of English-speaking children. Girls had higher vocabulary scores than boys in a few different age groups. Single factor analysis showed that the ages of father and mother, income of father, the language used by care-givers and GDP of the families were factors related to families of toddlers and the age, gender, height, weight and the age at which the toddlers began to speak were factors related to individuals. Multiple factors analysis showed that higher education level of mothers, younger father, earlier beginning of children to speak, toddlers' amiable disposition and emotion, girls, toddlers' age and height positively correlated with toddlers' vocabulary score. CONCLUSION: The level of vocabulary development of healthy toddlers in urban Beijing is on the high side. Certain individual and familial factors may influence toddlers' language development. It is suggested that health workers should pay attention to the toddlers' language development. The toddlers' parents and caregivers should be taught how to interact with and talk to their children and how to promote children to develop healthy disposition and emotion.

Child Development↗
PubMed1989

Early bilingual development: one language or two?

It is commonly thought that children learning two languages simultaneously during infancy go through a stage when they cannot differentiate their two languages. Virtually all studies of infant bilingual development have found that bilingual children mix elements from their two languages. These results have been interpreted as evidence for a unitary, undifferentiated language system (the unitary language system hypothesis). The empirical basis for these claims is re-examined and it is argued that, contrary to most extant interpretations, bilingual children develop differentiated language systems from the beginning and are able to use their developing languages in contextually sensitive ways. A call for more serious attention to the possible role of parental input in the form of mixed utterances is made.

Child, Preschool↗
PubMed2006

[A review of the alert and psycholinguistic intervention model in attention deficit hyperactivity disorder].

INTRODUCTION: In every class in our schools, teachers are faced with one or two children with attention deficit hyperactivity disorder (ADHD), a neurobiological disorder with three main clinical axes: lack of attention, hyperactivity and impulsiveness. Generally speaking, these children develop poorer psycholinguistic skills, although over 50% of these problems remain undetected because they are concealed by the child's behaviour. Most of the children will see some kind of adverse effect on their academic performance, chiefly in areas concerning reading and writing. DEVELOPMENT: The language disorders in ADHD are mainly related to the areas of semantics and pragmatics and, to a lesser extent, to phonetic-phonological aspects. They are discernible from the earliest months of life, during the preverbal stage, which is the time when the infant's character is being shaped. In this case, our experience shows that the character can be classed as difficult or inflexible and explosive in 56.5% of children diagnosed with ADHD. Moreover, we know that many children with this disorder find it difficult to engage in play, and 30% of them have retarded language development. A rather undefined percentage of children can have similar problems to those of children with autism spectrum disorders, which makes the differential diagnosis even more complicated. CONCLUSIONS: The mixed model of intervention in ADHD includes language work within the context of cognitive-behavioural programmes and the development of narrative skills and social competencies through a literary creativity workshop. This study offers a review of the psycholinguistic problems affecting children with ADHD in the light of our own experience, together with other clinical evidence.

Attention Deficit Disorder with Hyperactivity↗
PubMed2002

Postlingual collapse of language and its recovery after cochlear implantation.

A 6-year-old boy lost his normally-developed language ability within 2 months after bilateral sudden peripheral deafness. The boy became non-communicative with others, restless with frequent meaningless bursts of shouts (communication skills equivalent to 9-11 months of language development: a rapid breakdown of language). Since conservative methods were ineffective, cochlear implantation was performed. A surprising success was observed: he regained the language retracing the normal developmental stages and caught up with his contemporaries in 2 years. Behavioral improvement paralleled his language development. This case (1) provides insights into the brain function with respect to language acquisition, in relation to the plasticity during the 'critical period' of language learning, (2) reveals the close relationship between language development and behavior, and (3) suggests the predominance of auditory stimulation in learning language.

Child↗
PubMedDate not supplied

Levels of evidence: universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI).

UNLABELLED: Levels of evidence differ according to the audience addressed. Implementation of universal newborn hearing screening requires responses to a complex myriad of diverse groups: the general public, families with children who are deaf or hard of hearing, the deaf and hard of hearing communities, hospital administrators, physicians (pediatricians, general practitioners, ear nose and throat physicians, geneticists), managed care, Medicaid, insurance agencies, and politicians. The level of evidence required by medical/health agencies and task forces may differ from the levels of evidence available in education and intervention. Issues related to the low incidence of the disability, the lack of a normal distribution within the disability study, the obstacles to random assignment to treatment, and designs that include a control group with "no treatment" have implications legally and ethically for the professional providing services to families and children who are deaf or hard of hearing. This session will discuss issues related to "convenience samples," number of subjects included in research studies, and the population required to obtain a large enough sample of children with low-incidence disabilities. The level of evidence required to demonstrate sensitive periods of development, which are a critical element for justification of implementing a universal newborn hearing screening includes both behavioral and neurological information. Sensitive periods may have different duration for different aspects of development, such as social-emotional development, auditory and speech development, or language development. Further complicating the question of sensitive periods of development are the distinct possibility that different sensitive periods exist for development of age-level vocabulary, for establishing English phonology, or for mastering English syntax. Research outcomes provide evidence that age of identification of hearing loss is reduced, that age of intervention initiation is lowered, and that the outcomes of intervention are better because of the establishment of a screening program. Most professionals in communication disorders believe that screening is not the actual cause of better developmental outcomes but that the age when children begin to have access to language and communication and the characteristics of the intervention are the primary cause of better outcomes. Screening is the avenue through which access to quality intervention is made available. The research still remains at an infant level of development such that there is very little evidence for the efficacy of specific characteristics of the intervention provided. LEARNING OUTCOMES: (1) The learner will be able to identify the obstacles in conducting research on the effectiveness of intervention of children identified through universal newborn hearing screening programs. (2) The learner will be able to identify the type of research on developmental outcomes of children with early-identified hearing loss.

Cost-Benefit Analysis↗
PubMed1982

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↗
PubMed2003

Screening children in the first four years of life to undergo early treatment for otitis media with effusion.

BACKGROUND: Otitis media with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioural problems. This condition has a prevalence of about 20% at the age of two years, a time of rapid language development. It is most often asymptomatic. Effective treatment exists for clearing effusions. Some have argued, therefore, that children should be screened and treated early if found to have clinically important OME. However, there is a high rate of spontaneous resolution of effusions and for some children, effusions may represent a physiological response that does not reduce hearing significantly or impact negatively on language development or behaviour. Previous reviews of the effect of screening and treatment have included studies using non-randomised designs. OBJECTIVES: The aim of this review was to assess evidence from randomised controlled trials about the effectiveness, on language and behavioural outcomes, of screening and treating children with clinically important OME in the first four years of their life. The focus was on the first four years of life because this is the time of most rapid language development. The consequences of hearing loss are likely to be most serious during this time. In addition, children of this age are least likely to be able to report or seek help for impaired hearing, particularly if these problems have a slow onset and are subtle. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register (the Cochrane Library Issue 1, 2002), MEDLINE (1966-2002) and EMBASE (1974-2002) (all in February 2002) and reference lists of all studies. We also contacted the first authors of the studies we included in this review. SELECTION CRITERIA: 1. Randomised controlled trials evaluating interventions for OME among children with OME identified through screening. 2. Comparison of outcomes for children randomised to be screened for OME and outcomes for children who were not randomised to be screened for OME. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. MAIN RESULTS: We identified no trials comparing outcomes for children randomised to be screened for OME with outcomes for children who were not randomised to be screened for OME. We identified three trials evaluating interventions for OME among children with OME identified through screening. From these trials, we found no evidence of clinically important benefit in language development from screening and treating children with clinically important OME. Although there was a beneficial effect on the resolution of OME and improved hearing in the short-term (six months), this effect largely disappeared in the long-term (12 months). REVIEWER'S CONCLUSIONS: The identified randomised trials do not show an important benefit from screening of the general population of asymptomatic children in the first four years of life for OME on language development and behaviour.

Child, Preschool↗
PubMed2005

Disorders of speech development: diagnostic and treatment aspects.

Language acquisition is a complex process relying on the well-tuned interaction of a variety of factors. Its genetic base is still little explored, but perhaps plays the most important role during the early periods of this process. In addition, neurological, cognitive and emotional abilities of the child as well as verbal stimulation from the environment are crucial. Language development disorders manifest themselves as late onset, slow progression or as erroneous course of the language development. Because of the multitude of factors involved, their aetiology is frequently difficult to determine. Diagnosis of such disorders commonly requires the cooperation of several professionals, like paediatricians, otolaryngologists, psychologists, and speech pathologists. The "late bloomer" hypothesis suggests, that up to 50% of children presenting with language problems in early years, make up for them without intervention up to age four years. Nevertheless, treatment for a language problem, as soon as it appears, is generally recommended in order to minimize adverse effects on succeeding developmental steps.

Child↗
PubMed1990

A cultural model for the acquisition of language: implications for the innateness debate.

In contrast to other aspects of species-specific development, language development represents both the universal thrust of biologically based capacities and the socially differentiated results of human experience in culturally structured worlds. This article presents a theoretical approach for understanding the ways that children's language development is channeled through the culturally constructed microenvironment, or "developmental niche." The approach is illustrated with examples from research on mother-child speech in a rural Africian community and American parents' discourse about their children's language development. The cultural model proposed here suggests a wider range of environmental input than has been acknowledged by innatist views, and proposes that there are cross-cultural differences in the ways that language functions in representing experience to the self and communicating about it to others.

Child Language↗
PubMed1986

Relations between sensorimotor attainments and development of language comprehension in retarded children.

Although cognitive precursors of language production have received considerable attention, the relationship between cognitive development and language comprehension is still largely unknown. We report here on an investigation into the relationship between sensorimotor attainments and receptive language skills in normal and retarded infants aged 12-26 months. A major goal of this study was to translate some current notions about onset of representational language and its cognitive prerequisites into some clinically useful procedures both for early diagnosis and treatment of disabled infants. The Uzgiris-Hunt ordinal scales and receptive language tests were administered to 32 infants with motor delay and to 15 normal infants matched for chronological age. Comparison of the resulting scores indicated significant differences in favor of the normal infants on the six Uzgiris-Hunt scales and on the receptive language measures. The cognitive profile of the retarded infants was not homogeneous, some sensorimotor areas (object permanence, vocal and gestural imitation, schemes in relation to objects) showing later onset and slower development than others. Evidence for the parallel emergence of representational ability in language and thought was not as strong as stated by Piagetian theorists. No single stage of sensorimotor functioning prerequisite to language comprehension could be discerned, especially in the retarded infants, who showed considerable gaps between the two domains.

Age Factors↗
PubMed2005

[Speech comprehension and speech usage in hearing impaired children--an empirical follow-up study].

In a mean follow-up duration of 19 months the oral language development of 18 sensorineural hearing-impaired children without multiple handicaps was serially measured at regular intervals (three time points t1 - t3) using the receptive and expressive language scales of the "Münchener Funktionellen Entwicklungsdiagnostik für das 2. und 3. Lebensjahr". Results are presented as developmental quotients (DQ). In case of language retardation the rate of language development is less than one. At t1, the average language development was considerably delayed (DQ receptive: 0.37; DQ expressive: 0.51) and slowly increased over time (receptive: 0.37/0.48/0.55; expressive: 0.51/0.51/0.55) at approximately half the rate of normal hearing children. With the hearing-impairment increasing, the DQs became smaller. Children who were identified as hearing-impaired before the age of 18 months exhibited on average generally greater DQs. A significant impact of speech/language therapy on language development at t3 could not be demonstrated. Finally, the results and health care requirements were discussed.

Child, Preschool↗
PubMed1995

A randomized clinical trial of home intervention for children with failure to thrive.

OBJECTIVE: To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive (NOFTT). DESIGN: Randomized clinical trial. PARTICIPANTS: The NOFTT sample included 130 children (mean age, 12.7 months; SD, 6.4) recruited from urban pediatric primary care clinics serving low income families. All children were younger than 25 months with weight for age below the fifth percentile. Eligibility criteria included gestational age of at least 36 weeks, birth weight appropriate for gestational age, and no significant history of perinatal complications, congenital disorders, chronic illnesses, or developmental disabilities. Children were randomized into two groups: clinic plus home intervention (HI) (n = 64) or clinic only (n = 66). There were no group differences in children's age, gender, race, or growth parameters, or on any of the family background variables. Most children were raised by single, African-American mothers who received public assistance. Eighty-nine percent of the families (116 of 130) completed the 1-year evaluation. INTERVENTIONS: All children received services in a multidisciplinary growth and nutrition clinic. A community-based agency provided the home intervention. Families in the HI group were scheduled to receive weekly home visits for 1 year by lay home visitors, supervised by a community health nurse. The intervention provided maternal support and promoted parenting, child development, use of informal and formal resources, and parent advocacy. MEASUREMENTS: Growth was measured by standard procedures and converted to z scores for weight for height and height for age to assess wasting and stunting. Cognitive and motor development were measured with the Bayley Scales of Infant Development, and language development was measured by the Receptive/Expressive Emergent Language Scale. Both scales were administered at recruitment and at the 12-month follow-up. Parent-child interaction was measured by observing mothers and children during feeding at recruitment and at the 12-month follow-up, and the quality of the home was measured by the Home Observation Measure of the Environment 18 months after recruitment. ANALYSES: Repeated-measures multivariate analyses of covariance were used to examine changes in children's growth and development and parent-child interaction. Analyses of covariance were used to examine the quality of the home. Independent variables were intervention status and age at recruitment (1.0 to 12.0 vs 12.1 to 24.9 months). Maternal education was a covariate in all analyses. When changes in developmental status and parent-child interaction were examined, weight for height and height for age at recruitment were included as covariates. RESULTS: Children's weight for age, weight for height, and height for age improved significantly during the 12-month study period, regardless of intervention status. Children in the HI group had better receptive language over time and more child-oriented home environments than children in the clinic-only group. The impact of intervention status on cognitive development varied as a function of children's ages at recruitment, with younger children showing beneficial effects of home intervention. There were no changes in motor development associated with intervention status. During the study period, children gained skills in interactive competence during feeding, and their parents became more controlling during feeding, but differences were not associated with intervention status. CONCLUSIONS: Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors. Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income, urban infants with NOFTT: Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT:

Child Development↗
PubMed1976

A therapeutic milieu for establishing and expanding communicative behaviors in psychotic children.

This study describes a clinical intervention program that was used to facilitate development of receptive and expressive language skills in a group of four psychotic children. A group format utilizing an interactive language development teaching procedure combined with a therapeutic milieu was shown to be effective in establishing and expanding communicative behaviors in psychotic children. Nine diagnostic measures were utilized to assess children's performance prior to therapy and at the end of three-month and six-month intervals. Results indicated substantial reduction of delayed and immediate echolalia, jargon, inappropriate stress, pitch, and intonation. Substantial improvement was noted in expressive syntactic and morphological functioning and in the children's ability to generate novel utterances about day-to-day experiences, family, and toys. Increases in children's concept of body image and ego functioning paralleled their improvement in receptive and expressive language development.

Body Image↗
PubMed1984

Brain-stem, middle latency and late cortical evoked potentials in children with speech and language disorders.

The topography of the brain-stem (ABR), middle latency (MLR) and cortical (ACR) evoked responses was investigated in children with normal speech and language development and those with either a language or motor speech disorder. The aim was to determine whether it is possible to discriminate between the groups of children in terms of the evoked potential characteristics. There were significant inter-group differences, particularly relating to the amplitude of the different responses. The ABR in both the language and motor speech groups exhibited smaller amplitudes for waves I, III and V than the control group, with no change in latency. Two explanations were suggested; firstly abnormal functioning of the peripheral hearing mechanism even though the hearing thresholds were normal which could be a secondary effect due to deprivation of normal speech and language development; and secondly far-field recording effects due to differences in the electrical conductivity of tissue and the distance separating the generator site and recording electrodes. The MLR in the motor speech group was significantly larger at the mastoid and temporal electrode sites than either the control or language groups. This was considered to be an enhanced myogenic response like the other exaggerated brain-stem reflexes seen in congenital suprabulbar paresis. Significantly larger amplitudes of the ACR were also recorded from the motor speech group at the Cz electrode site. This was thought to be due to underactivity of some normal cortical inhibitory system and not a direct result of increased MLR amplitude. The ACR in the language disordered children exhibited an abnormal left temporal hemispheric dominance and a more inverted or 'dissimilar' wave form at the T3 electrode site on the correlation analysis. These findings suggest impaired functioning of the left temporal cortex in our children who have failed to develop language normally. We feel that this has more significance for the language abnormality than the low amplitude ABRs which were observed in both the language and motor speech disordered children.

Brain Mapping↗
PubMed2003

Cumulative environmental risk in substance abusing women: early intervention, parenting stress, child abuse potential and child development.

OBJECTIVE: To assess the relationship between cumulative environmental risks and early intervention, parenting attitudes, potential for child abuse and child development in substance abusing mothers. METHOD: We studied 161 substance-abusing women, from a randomized longitudinal study of a home based early intervention, who had custody of their children through 18 months. The intervention group received weekly home visits in the first 6 months and biweekly visits from 6 to 18 months. Parenting stress and child abuse potential were assessed at 6 and 18 months postpartum. Children's mental and motor development (Bayley MDI and PDI) and language development (REEL) were assessed at 6, 12, and 18 months postpartum. Ten maternal risk factors were assessed: maternal depression, domestic violence, nondomestic violence, family size, incarceration, no significant other in home, negative life events, psychiatric problems, homelessness, and severity of drug use. Level of risk was recoded into four categories (2 or less, 3, 4, and 5 or more), which had adequate cell sizes for repeated measures analysis. DATA ANALYSIS: Repeated measures analyses were run to examine how level of risk and group (intervention or control) were related to parenting stress, child abuse potential, and children's mental, motor and language development over time. RESULTS: Parenting stress and child abuse potential were higher for women with five risks or more compared with women who had four or fewer risks; children's mental, motor, and language development were not related to level of risk. Children in the intervention group had significantly higher scores on the PDI at 6 and 18 months (107.4 vs. 103.6 and 101.1 vs. 97.2) and had marginally better scores on the MDI at 6 and 12 months (107.7 vs. 104.2 and 103.6 vs. 100.1), compared to the control group. CONCLUSION: Compared to drug-abusing women with fewer than five risks, women with five or more risks found parenting more stressful and indicated greater inclination towards abusive and neglectful behavior, placing their infants at increased risk for poor parenting, abuse and neglect. Early home-based intervention in high-risk families may be beneficial to infant development.

Adult↗