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PubMed2004

[Evaluation of some aspects of the acquisition and development of language in pre-term born children].

The correction of the age of pre-term infants for the motor evaluation has been the accepted practice but it has not been clear in other areas. This study compared indicators of the acquisition and development of language, considering corrected and chronological ages. Twenty healthy infants born between the 28th and 36th week of gestation (median 32 weeks), weighing 800g to 2380g (median 1590g), 9 AGA and 11 SGA, were followed up to 15 months age. As a reference for normality, evaluation of Costa et al. (1992) was used, which groups predictable behavior in 5 levels. For receptive language, considering the chronological age, normal performance occurred at all levels except for Level I (0-3 months). For expressive language, considering the chronological age, 6 (12%) of the 50 evaluations showed normal performance. With their age corrected, in 16 evaluations (40%) the infants achieved the expected level, mainly at 6 and 12 months age. On the whole, for the chronological age, there was a larger number of AGA with normal performance (p<0.05). We conclude that with the use of the Costa method, it was unnecessary to correct the age for receptive language evaluation, and that, for the expressive, the high frequency of normal results at the corrected ages for 6 and 12 months, suggests that these ages constitute periods of intensification of vigilance.

Birth Weight↗
PubMed2005

Developing a language for nonreligious spirituality in relation to serious illness through research: preliminary findings.

The preliminary findings presented in this article are part of a research program that is concerned with exploring the notion of spirituality for those dealing with serious illness. The aim of the program is not only to deepen our understanding of how individuals construct their spirituality in the face of life-threatening illness, but also to respond to such insights by beginning to develop a language reflective of the commonalities of experience. The development of such a language involves a three-phase process including the thematic development of qualitative data, comparative analysis of findings from disparate sample groups, and expert reflection of conceptual notions within the context of the richness of traditional philosophical/theological literature. This discussion focuses on the preliminary process of qualitative data development based on in-depth interviews with survivors of a hematological malignancy. The findings indicate that, for those who have a nonreligious framework, there is no shared language readily available to communicate their insights and experience with serious illness. However, the qualitative analysis also indicates that such survivors share a number of identifiable conceptual notions. These notions are articulated as a preliminary step in language development.

Adult↗
PubMed1984

Issues in the development of language intervention programmes.

An attempt has been made in this paper to address some issues involved in the development of language intervention programmes. The relative neglect of 'language' in the paper is justified by the importance of more general issues. After cursory attention to prescriptiveness in programmes, the concentration has been on the 'training of the trainers' and the need for an adequate and effective instructional model. Particular attention is given to evaluation and the need for a design which while acknowledging the practicalities of life in the field can nevertheless assist in determining the effects of the intervention (with a nod in the direction of casting the net sufficiently wide to encompass possible unintended effects). Finally, there is discussion of implementation, covering guidelines to bear in mind the developing the intervention and stressing that without successful implementation even the most effective programme fails, as it disappears like water in to the sands of the desert.

Child↗
PubMed1980

Children's language disorders: recent research advances.

Between 3 and 8% of preschool children in Britain and the United States are delayed in their language development by more than a year below the normal range. Evidence suggests that such children are particularly impaired in acquiring syntactic and morphological rules, although well-defined syndromes of impaired language development have not yet been determined. The effects of preschool impairments in language development on subsequent school achievement are significant: 60% of these children are in special classes for the learning impaired at 9 years of age. Auditory processing deficits have been demonstrated in language-impaired children, but the contributions of such deficits to language development difficulties have yet to be determined. While autistic children have severe cognitive disorders and visual and auditory perceptual disturbances, the difficulties of nonautistic language-impaired children seem confined more to language expression and comprehension. Recent neuropsychological evidence concerning brain organization for language behavior suggests that these children have deficiencies in language functions which normally depend on left hemisphere functioning.

Achievement↗
PubMed1979

Effect of middle-ear dysfunction and disease on hearing and language in high-risks infants.

The effect of middle-ear dysfunction and disease on hearing and language development at one year of age was evaluated for 143 high-risk infants. These infants were categorized as normal or abnormal based on otologic history, otoscopic examinations, and on tympanometric examinations. Language was significantly related to gestational age, being delayed by approximately the amount of prematurity. Language scores were therefore adjusted for gestational age. Speech-detection threshold was not related to gestational age, and was used as the measure of hearing. Hearing levels were negatively correlated with adjusted language quotients. Infants with abnormal otologic histories reported were not different from infants with normal histories in either hearing or language development. Infants with bilateral otoscopic abnormalities had significantly higher speech-detection thresholds, but did not differ in language development from those with bilaterally normal otoscopy. Infants who were abnormal bilaterally by tympanometric examination had significantly higher speech-detection thresholds as well as significantly delayed language development. A significant effect on both hearing and language was found among those infants bilaterally abnormal by tympanometry for whom evidence of middle-ear disease was not visualized by otoscopic examination. Implications of these findings are discussed.

Hearing Disorders↗
PubMed2006

Speech, language and aided communication: connections and questions in a developmental context.

PURPOSE: This discussion paper focuses on four potential complexities in the language development of children with severe congenital speech impairments, who use graphic symbols as a primary means of expression. METHOD: Some of the literature in relation to language development in aided communication is reviewed. RESULTS: Four potentially significant connections are discussed, relating to: (i) the features of graphic symbols; (ii) the complexity of multi-modal communication; (iii) the impact of selection and production on the process of developing a language system; and (iv), the connection between development and learning. CONCLUSIONS: It is proposed that the connections outlined are of fundamental significance in guiding intervention planning and in supporting language development in ways that have theoretical coherence.

Child↗
PubMedDate not supplied

Instruments for the screening of speech/language development in children.

This article discusses issues relevant to the use of an instrument that screens speech and language development and reviews instruments that are currently available for screening general speech and language development in children age birth through 8 years. Five instruments for the assessment of general speech and language development are reviewed. Each of these instruments has strengths, but none completely meets the requirements of psychometric soundness and practicality for use in most ambulatory pediatric settings. Each practitioner should consider the strengths and limitations associated with each instrument, as well as the needs and characteristics of the population who will be screened to make an informed decision about the most appropriate instrument(s) for use in their practice.

Child↗
PubMed2000

Behavior phenotype of FG syndrome: cognition, personality, and behavior in eleven affected boys.

In this study we examined several behavioral, personality, and cognitive characteristics of boys with FG syndrome. We confirmed high rates of attention and activity level problems, which were described previously. Nine of the 11 patients met criteria for attention deficit/hyperactivity disorder. The boys did not manifest autistic behavior, and none met criteria for an autism spectrum disorder, though their parents reported substantial repetitive behavior. The personalities of the participants often were described as friendly, good-natured, and cheerful, but they did not differ empirically on a standardized measure of personality structure from typically developing comparison children, even after controlling for the effects of IQ. Specifically, higher rates of agreeableness and extraversion were not confirmed, though these constructs do not correspond perfectly with the traits of affability and gregariousness described in earlier published case studies of FG syndrome. In terms of neuropsychological assessment, the boys had relatively less developed language, fine motor, and executive function skills, and visual-spatial abilities were a relative strength. Limitations and suggestions for future research are discussed.

Adolescent↗
PubMed2004

Binge alcohol consumption by non-alcohol-dependent women during pregnancy affects child behaviour, but not general intellectual functioning; a prospective controlled study.

Effects of binge ethanol consumption during early gestation on child neurodevelopment have not been elucidated. To study whether binge drinking affects cognitive abilities and behavior of exposed children, a prospective observational study comparing 51 children exposed to binge drinking during the first trimester of pregnancy to 51 children not exposed to any teratogens was conducted. The children's physical development, intelligence, language abilities and behavior were assessed. Temperament test results showed that children exposed in utero to maternal binge drinking displayed a greater degree of disinhibited behavior and that this behavior was associated with early drinking variables. Although binge alcohol drinking by non-alcohol-dependent women during the first trimester of pregnancy does not appear to affect intelligence or cognitive and language development of young children, binge drinking in pregnancy does increase the likelihood of certain behavioral characteristics that might predispose these children to later behavioral dysfunction.

Adult↗
PubMed1991

The natural history and predictive value of early language delays in very low birth weight infants.

A cohort of 28 VLBW (less than or equal to 1500 g) infants was assessed at 1 and 3 years of age for hearing, language development and neurological status. Language delays were detected in 11 (39%) infants at 1 year, and in four (15%) at follow up at 3 years of age (P less than 0.05). Language quotients were significantly associated with perinatal variables at 1 but not at 3 years of age. Infants with neurological abnormalities had significantly lower language quotients at the 3-year follow up. No child with a normal language profile at 1 year exhibited a delay at 3 years of age.

Child, Preschool↗
PubMed2005

Auditory processing deficits in rats with neonatal hypoxic-ischemic injury.

Hypoxia-ischemia (HI) refers to reduced blood oxygenation and/or a diminished amount of blood perfusing the brain, and is associated with premature birth/very low birth weight (VLBW). HI represents a common cause of injury to the perinatal brain. Indeed, a significant number of premature/VLBW infants go on to demonstrate cognitive/behavioral deficits, with particularly high incidence of disruptions in language development. Auditory processing deficits, in turn, have been suggested to play a causal role in the development of language impairments. Specifically, the inability to identify fast elements in speech is purported to exert cascading detrimental effects on phonological discrimination, processing, and identification. Based on this convergent evidence, the current studies address auditory processing evaluation in a rodent model of HI injury induced on postnatal days 1, 7, or 10 (which in turn is well accepted as modeling HI-related injury to the perinatal human). Induced injuries were followed by a battery of auditory testing, and a spatial maze assessment, performed both during juvenile and adult periods. Results indicate that rats suffering from these early HI insults performed significantly worse than shams on tasks requiring rapid auditory processing, and on a test of spatial learning (Morris water maze (MWM)), although these effects were not seen on simpler versions of auditory tasks or on a water escape assessment (thus ruling out hearing/motor impairments). Correlations were found between performance on rapid auditory and spatial behavioral tasks and neuroanatomical measures for HI animals such as: the volume of the hippocampus, cerebral cortex, ventricles, and/or the area of the corpus callosum. Cumulative findings suggest that perinatal HI injury in the rat may lead to neurodevelopmental damage associated, in turn, with auditory processing and/or learning and memory impairments. As such, the current model may have critical implications for the study of neurophysiological underpinnings of cognitive deficits in premature/VLBW infants.

Aging↗
PubMed1997

Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation.

OBJECTIVE: We determined the sensitivity and specificity of neonatal brain-stem auditory evoked potentials (BAEP) as markers for subsequent hearing impairment and for developmental problems found later in infancy and childhood. METHODS: BAEP studies were performed before discharge in infants treated with extracorporeal membrane oxygenation (ECMO), and two specific abnormalities were analyzed: elevated threshold and delayed central auditory conduction. Behavioral audiometry was repeated during periodic follow-up until reliable responses were obtained for all frequencies, and standardized developmental testing was also conducted. The sensitivity and specificity of an elevated threshold on the neonatal BAEP for detecting subsequent hearing loss, and the relationship of any neonatal BAEP abnormality to language or developmental disorders in infancy, were calculated. RESULTS: Test results for 46 ECMO-treated infants (57.5%) were normal, and those for 34 infants (42.5%) were abnormal, with either elevated wave V threshold, prolonged wave I-V interval, or both on neonatal BAEP recordings. Most significantly, 7 (58%) of the 12 children with subsequent sensorineural hearing loss had left the hospital after showing normal results on threshold tests. There was no significant difference in the frequency of hearing loss between subjects with abnormal (5/21, or 24%) and those with normal BAEP thresholds (7/59, or 12%; Fisher Exact Test, p = 0.28). Therefore the sensitivity of neonatal BAEP testing for predicting subsequent hearing loss was only 42%. Neonatal BAEP specificity for excluding subsequent hearing loss was 76%. In contrast, on language development testing, 19 children demonstrated receptive language delay. Of these children, 12 (63%) had abnormal neonatal BAEP recordings and 7 (37%) had a normal BAEP threshold, normal central auditory conduction test results, or both (p = 0.04). CONCLUSIONS: Neonatal BAEP threshold recordings were of limited value for predicting subsequent hearing loss common in ECMO-treated survivors. However, an abnormal neonatal BAEP significantly increased the probability of finding a receptive language delay during early childhood, even in those with subsequently normal audiometry findings. Because neonatal ECMO is associated with a high risk of hearing and receptive language disorders, parents should be counseled that audiologic and developmental follow-up evaluations in surviving children are essential regardless of the results of neonatal BAEP testing.

Acoustic Impedance Tests↗
PubMed1979

Relational meaning encoded in the two-word utterances of stage 1 Down's syndrome children.

This study explored the early two-word utterances from four Down's syndrome children to determine if they encode the same relational meanings as children developing language normally. Nine semantic categories were established to classify the subject's two-word constructions. Absolute and proportional frequencies of relational types were then used to analyze the relational meanings. The results reveal that this classification system accounts for a combined 79% of the two-word utterances expressed by these Down's subjects. It is suggested that Down's children demonstrate as much diversity in their use of relational meanings as normals at the same linguistic stage. These findings are discussed with respect to what Down's children know about the world as they begin to produce two-word combinations.

Child↗
PubMed1993

Conversations with children who are language impaired: asking questions.

Samples of conversational language were elicited with a standardized interview protocol from 24 children, aged 2:6 to 7:8, half with specific language impairment (SLI), half with normally developing language (LN), matched for language level. Samples were analyzed to determine whether there were associations between adult questioning and children's use of ellipsis. For the SLI children, but not the LN children, increased proportions of questions were significantly correlated to increased proportions of ellipsis. This finding has implications for the use of MLU measures in clinical and research practice.

Case-Control Studies↗
PubMedDate not supplied

When novel sentences spoken or heard for the first time in the history of the universe are not enough: toward a dual-process model of language.

Although interest in the language sciences was previously focused on newly created sentences, more recently much attention has turned to the importance of formulaic expressions in normal and disordered communication. Also referred to as formulaic expressions and made up of speech formulas, idioms, expletives, serial and memorized speech, slang, sayings, clichés, and conventional expressions, non-propositional language forms a large proportion of every speaker's competence, and may be differentially disturbed in neurological disorders. This review aims to examine non-propositional speech with respect to linguistic descriptions, psycholinguistic experiments, sociolinguistic studies, child language development, clinical language disorders, and neurological studies. Evidence from numerous sources reveals differentiated and specialized roles for novel and formulaic verbal functions, and suggests that generation of novel sentences and management of prefabricated expressions represent two legitimate and separable processes in language behaviour. A preliminary model of language behaviour that encompasses unitary and compositional properties and their integration in everyday language use is proposed. Integration and synchronizing of two disparate processes in language behaviour, formulaic and novel, characterizes normal communicative function and contributes to creativity in language. This dichotomy is supported by studies arising from other disciplines in neurology and psychology. Further studies are necessary to determine in what ways the various categories of formulaic expressions are related, and how these categories are processed by the brain. Better understanding of how non-propositional categories of speech are stored and processed in the brain can lead to better informed treatment strategies in language disorders.

Aphasia↗
PubMedDate not supplied

Management of middle ear effusions in infants with cleft palate.

Middle ear effusion is now generally recognized as a virtually universal complication in infants with cleft palate. Such infants may therefore be assumed to experience conductive hearing loss of some degree or other throughout infancy. Hoping to prevent not only deficits in intellectual and language development, but also permanent otic and auditory handicaps, we have routinely treated such infants as early as practicable with myringotomy and tympanostomy tube insertion. Subsequently, we have repeated the operation whenever blockage or extrusion of the tubes resulted in recurrence of persistent effusion. In this manner we have been able to maintain most infants in satisfactory middle ear status most of the time. Otorrhea, however, has been a frequent complication. Preliminary findings suggest that infants managed according to this regimen may eventually develop better language function than those not receiving such management. A current study is designed to test the advantages and disadvantages that might result from deferring the initial routine myringotomy until somewhate later in infancy.

Cleft Palate↗
PubMed1986

Interview, diagnostic, and legal aspects in the forensic psychiatric assessments of deaf persons.

Forensic psychiatric assessments rely on many underlying presumptions concerning the language development and abilities of their subjects. Although these assumptions may apply across a culturally diverse group of hearing subjects, they probably do not apply to those who are prelingually deaf because such deaf persons never developed verbal language. In this article, a review of the range of literature focusing upon the unique aspects of interviews, diagnosis, and legal understanding of the deaf is conducted. An attempt to illuminate those features believed to be most relevant to forensic assessments of this unique population is made. The demands of interviews conducted in manual language are discussed and particular attention is paid to the impact of the interpreter upon confidentiality, privilege, agency, and the dynamics of the interview. It is also suggested that many of the baseline behaviors of the deaf may, at least partly, result from differences in communication style between the deaf and hearing. This article reports that many major mental disorders occur with the same frequency among the deaf and hearing and include many of the same symptoms. However, organic mental disorders may occur at a somewhat greater rate among the deaf because of the organic basis of deafness. Finally, the ways in which deafness and the use of an interpreter may influence the deaf person's ability to understand and relate to legal concepts and process are discussed. It is noted that many of these problems may arise from a deaf persons inexperience or undereducation about legal matters rather than psychopathology.

Deafness↗
PubMed1994

[Hearing capacity and speech production in 417 children with facial cleft abnormalities].

Children with cleft palates often suffer from chronic conductive hearing losses, delayed language acquisition and speech disorders. This study presents results of speech and language outcomes in relation to hearing function and types of palatal malformations found. 417 children with cleft palates were examined during followup evaluations that extended over several years. Disorders were studied as they affected the ears, nose and throat, audiometry and speech and language pathology. Children with isolated cleft lips were excluded. Among the total group, 8% had normal speech and language development while 92% had speech or language disorders. 80% of these latter children had hearing problems that predominantly consisted of fluctuating conductive hearing losses caused by otitis media with effusion. 5% had sensorineural hearing losses. Fifty-eight children (14%) with rhinolalia aperta were not improved by speech therapy and required velopharyngoplasties, using a cranial-based pharyngeal flap. Language skills did not depend on the type of cleft palate presents but on the frequency and amount of hearing loss found. Otomicroscopy and audiometric follow-ups with insertions of ventilation tubes were considered to be most important for language development in those children with repeated middle ear infections. Speech or language therapy was necessary in 49% of the children.

Articulation Disorders↗