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PubMed1995

Praxic and nonverbal cognitive deficits in a large family with a genetically transmitted speech and language disorder.

A pronounced speech and language disorder affecting half of the 30 members of the four-generational KE family has been attributed by some researchers to a specific defect in the generation of morphosyntactic rules. The reported selectivity of the impairment has led to the view that the affected members suffer from a grammar-specific disorder. Our investigations of the same KE family indicate that the inherited disorder has a broad phenotype which transcends impaired generation of syntactical rules and includes a striking articulatory impairment as well as defects in intellectual, linguistic, and orofacial praxic functions generally. Although the evidence from this family thus provides no support for the existence of "grammar genes," their linguistic difficulties do constitute a prominent part of their phenotype. Investigations of the neural and genetic correlates of their disorder could therefore uncover important clues to some of the bases of the primary human faculties of speech and language.

Cognition Disorders↗
PubMed2007

[Critical factors for subjective burden of mothers of children with developmental language disorders].

BACKGROUND: In earlier studies, it was found that mothers of children with developmental language disorders had a higher incidence of anxiety and depression in comparison to the normal population. This study concentrated on the following questions: is the perceived stress, anxiety and depression of mothers with children with developmental language disorders higher than in the normal population, even for those mothers who are not exposed to any further stressors? and what environmental factors play an important role in the mental health of the mothers? MATERIALS AND METHODS: A total of 90 mothers (aged 32.9+/-4.7 years) of preschoolers diagnosed with a developmental language disorder, but with otherwise normal development, participated in the study. The mental health of the mothers was assessed using the Perceived Stress Scale (PSS) and the German version of the Hospital Anxiety and Depression Scale (HASD-D). Environmental factors were captured by a structured anamnestic procedure. Predictors of mental health were determined using multivariate regression analysis. RESULTS: The entire sample demonstrated significant levels of stress, anxiety and depression. In comparison to the standardized values, those mothers of children with developmental language disorders who were not exposed to any further stressors, were also shown to have significantly higher rates of stress and depression on the scales used, although not significantly higher levels of anxiety. A significant predictor of positive overall mental health of the mothers was the extent of adequate support in child rearing. CONCLUSIONS: Health professionals dealing with children with developmental language disorders must reckon with a considerable number of mothers whose mental health is negatively affected. When treating a child with a developmental language disorder, measures to improve the mother's state of well-being should be considered, including counseling and self-help groups.

Adult↗
PubMed1982

The role of new and old information in the verbal expression of language-disordered children.

The present study used an experimental method to investigate the marking of new and old information in the verbal expression of language-disordered children beyond the one-word stage. The results showed that language-disordered children selectively mark new information in verbal communication, just as normal children do. Language-disordered and normal children, furthermore, manifest the same developmental sequence of strategies for deemphasizing old information--children at an MLU level of 3 tend to omit it, whereas children at an MLU level of 5 tend to pronominalize it. Although both normal and language-disordered children demonstrated the same verbal strategies, a subgroup of language-disordered subjects (over half) pronominalized old information more frequently than normal subjects. These language-disordered subjects demonstrated a proportionately different combination of language features than would be expected at their MLU level.

Child↗
PubMed1995

Training sentence production in agrammatism: implications for normal and disordered language.

This paper presents an overview of our work concerned with treatment of sentence production deficits seen in agrammatic (Broca's) aphasic individuals. Using a single-subject experimental research paradigm, we examined emergent sentence production patterns in a subset of Broca's subjects who evinced sentence production (and comprehension) deficits involving "complex" sentences in which noun phrases (NPs) have been moved out of their canonical positions. We used aspects of Chomsky's Principles and Parameters approach of Government Binding (GB) Theory (Chomsky, 1986, Chomsky & Lasnik, 1991), as well as findings from the psycholinguistic and neurolinguistic literature as a basis for selecting sentences entered into our experiments and for designing our intervention approach, in general. Subjects were trained to produce sentences which rely on NP-movement (i.e., passives) or WH-movement (i.e., wh-questions, object clefts)--sentences formed by applying the rule "Move-alpha" in which moved constituents leave behind a "trace" or "gap" of their movement. Training emphasized the lexical and syntactic properties (e.g., thematic role assignment, NP-movement) of target sentences. Throughout this training we carefully measured generalization to untrained sentences relying on similar movement operations and error patterns were examined as they evolved over time. Results of our work indicated not only improved sentence production abilities in all subjects under study, but also--in many cases--generalization of sentence production across linguistic lines. That is, training WH-movement structures (e.g., object clefts) improved production of untrained WH-movement constructions (e.g., wh-questions) that are very different in their s-structure representation; however, no effect of this training on NP-movement structures occurred. In addition, within the class of wh-questions, generative production across questions relying on argument (direct object NP) movement (i.e., what- and who-questions) occurred in the absence of generalization to wh-questions requiring movement from adjunct position (i.e., where- and when-questions) for some subjects. For others, generalized production occurred only when wh-morphemes were the focus of treatment, indicating that at least two processes must be completed for successful wh-question production to take place: movement of the wh-item itself and control of sublexical features that determine wh-morpheme selection. These data are discussed in terms of the contribution that detailed recovery data, controlled for lexical and syntactic properties of sentence production, can make both to understanding the nature of sentence production deficits and to issues regarding normal sentence production.

Aphasia, Broca↗
PubMed2000

Diagnostic assessment of communicative and interactive behaviours in children with autism and receptive language disorder.

Children with autism and children with a severe specific receptive language disorder both show clear deficits in communicative language skills and in social relationships. In this study the usefulness of the Autism Diagnostic Observation Schedule (ADOS) in the differential diagnosis between these two groups of developmentally impaired children is assessed. 11 children with early infantile autism and 20 children with a specific receptive language disorder participated in the study. 18 children with an expressive language disorder were used as a control group. The ADOS was individually administered to all children by the same examiner. The results showed that on most of the ADOS measures the autistic children were clearly more deviant than the language impaired children. There were no significant differences between the two groups of language impaired children. Eight out of 11 autistic children reached the defined cut-off values on the measures "language and communication" and "social interaction" of the ADOS algorithm, whereas only three autistic children did so on the measure "stereotyped behaviour". None of the language-impaired children reached the cut-off values on more than one measure. The ADOS allowed for good assessment of certain types of behaviour. However, to confirm the diagnosis of infantile autism, additional information from parents is required.

Autistic Disorder↗
PubMed2005

[Relationship between secretory otitis media and language disorder in children: analysis of 1108 cases].

OBJECTIVE: To discuss the relationship between secretory otitis media (SOM) and language disorder in children. METHOD: In 1108 language disorder cases, auditory brainstem responses (ABR) and acoustic immittance were measured respectively. According to the ABR threshold, all the children were divided into four groups: the normal group, the mild hearing loss group, the middle hearing loss group and the severe hearing loss group. RESULT: Of all the ears examined, 59.5% had hearing loss, while 12.64% had SOM. In the children of language disorder, the distribute of the "B" type tympanograph from much to little was:the mild hearing loss group, the middle hearing loss group, the severe hearing loss group and the normal group ( P < 0.01). The average hearing threshold of a part children with SOM decreased after therapy ( P < 0.01). The children with the severe hearing loss had no evident changes after therapy. CONCLUSION: Hearing disorder is the main cause of language disorder in children. While SOM recovers in children with mild or middle hearing loss, the language in part of them could be improved. However, the language in those who with severe hearing loss probably remains the primary level.

Adolescent↗
PubMed1992

Progressive language disorder due to lobar atrophy.

Sixteen patients with progressive language disorder have been studied longitudinally. Anomia was a prominent presenting characteristic and mutism ultimately occurred. Patients, however, were clinically heterogeneous. Some exhibited nonfluent, agrammatic features, whereas others demonstrated a fluent aphasia, with profound loss of word meaning. Although language disorder remained the sole symptom in a minority of patients, in others an associative agnosia or personality and behavioral changes, or both, emerged. Findings on computed tomography and single photon emission tomography mirrored the areas of dysfunction suggested by the neuropsychological profiles and demonstrated abnormalities restricted to the left hemisphere or involving bilateral frontotemporal cortices. Brains of 3 patients, with distinctive clinical pictures, have been examined at autopsy. Each revealed a focal distribution of atrophy, gliosis and spongiform change, and an absence of senile plaques and neurofibrillary tangles. There was clinical and pathological overlap with frontal lobe dementia. We argue that progressive language disorder is clinically heterogeneous and forms part of a spectrum of clinical presentations of non-Alzheimer lobar atrophy.

Aged↗
PubMed2001

[Acute language disorder in elderly patients: ischemic or epileptic origin?].

Acute language disorder is highly suggestive of cerebrovascular disease, but when accompanied by behavioral disturbance, particularly in elderly patients, it may express a different etiology. Six women aged 71 to 84 years presented with a mild behavioral disturbance followed by a language disorder that included fluent dysphasia, paraphasia, dysnomia, perseveration, and impaired understanding of complex orders. They fully recovered within 24 h. MR-imaging, including diffusion-weighted sequences in five of them, showed no acute lesions. EEG showed epileptogenic waveforms in three cases and slow waves in the other three, in a location that included the left temporal region. These findings disappeared in subsequent controls. All of these tests were performed during the acute episode or up to 72 h after onset. No patient has presented a new episode so far. The high sensitivity of new neuroimaging techniques forces the search for non-vascular etiologies in those patients in which no structural lesions that could account for the symptoms can be demonstrated. EEG can be useful in the diagnosis of some of these stroke mimics. Acute language disorders accompanied by disturbed behavior in the elderly may reflect a partial seizure of the temporal lobe.

Aged↗
PubMed1991

Causes and associations of severe and persistent specific speech and language disorders in children.

Eighty-two school-age children with severe and persistent specific speech and language disorders were studied. 71 had specific developmental language disorders, three had structural malformations (cleft palate) and eight had disorders acquired after a period of normal language development, including five with Landau-Kleffner syndrome. The sex ratio was 3.8 boys to one girl. Nearly half had a family history of speech-language disorder, with one in 5.2 affected siblings. Aetiological factors were found in 26 per cent: 11 per cent prenatal, 3 per cent perinatal and 12 per cent postnatal. 21 per cent had had a seizure and 7 per cent had had seizures after the age of eight. 29 per cent were left-handed, 90 per cent were clumsy and 22 per cent first walked after 18 months. The complex origins of specific speech and language disorders are discussed.

Brain Damage, Chronic↗
PubMed1991

[Developmental language disorder in children of severely dysfunctional families].

Developmental language disorder (DLD) is the most common type of language disorder and involves difficulty in comprehending oral language (receptive type) or in expressing verbal language (expressive type). The relationship between DLD encountered in general practice and severe family dysfunction was evaluated. Severely dysfunctional families are characterized by chronic and persistent conflicts, absence of closeness and lack of trust between parents, bad relations between parents and children, and lack of parental support. 20 children, 3.6% of a study population of 550 children aged 3-5 years, were found to be suffering from DLD. The proportion of boys with this disorder from severely dysfunctional families was considerably higher than from control families (73.5% vs 9.5%, p less than 0.0001). In girls, the excess of those from severely dysfunctional families was smaller, and the difference was not significant (20.3% vs 6.6%, p greater than 0.3). Mean years of education of fathers of children with DLD was significantly less than that of fathers of control families (p = 0.04), and less than that of mothers of children with DLD (not significant, but control sample small). It was also less than that of mothers of control families (p = 0.02). In control families there was no difference between the education of fathers and of mothers. The excess of cases of DLD in dysfunctional families was significantly greater when there were more than 4 children in the families (p = 0.01). There was a predominance of the expressive as compared to the receptive type of DLD. Early detection of severely dysfunctional families and of children with DLD may promote early intervention and increase effectiveness of treatment.

Child, Preschool↗
PubMed1981

Auditory perceptual impairments in children with specific language disorders: a review of the literature.

This article reviews the literature on auditory perceptual impairments in children with language disorders. It is suggested that, rather than a higher-order cognitive or "linguistic" deficit, the underlying deficit in childhood language disorders is a perceptual one. The perceptual impairment may consist of a deficiency in detecting acoustic features in the speech wave that normally cue certain phonemes. Support for this hypothesis comes from clinical observations and experimental studies of aphasic adults as well as language-disordered children. The most consistent finding of the studies with language-disordered children has been that they have difficulty making perceptual judgments of the order of rapid sequences of brief sounds, such as synthetic speech and non-speech stimuli. However, these children perceive the sequences more accurately if the duration of the stimuli or the inter-stimulus intervals are extended. This suggests a "rate-specific" auditory perceptual deficit in language-disordered children for rapid acoustic information, such as the distinctive acoustic features of speech sounds. Treatment and future research implications are discussed.

Aphasia↗
PubMed2001

The use of the ADI-R as a diagnostic tool in the differential diagnosis of children with infantile autism and children with a receptive language disorder.

Children with infantile autism and children with a specific receptive language disorder often show similar behavioural problems, making the differentiation between these two diagnostic categories difficult. The purpose of this study is to evaluate the usefulness of parental information in the differential diagnosis of the two types of disorders mentioned above. Sixteen children with a receptive language disorder and 11 children with infantile autism participated in the study. All children had normal non-verbal IQs. The ADI-R (Autism Diagnostic Interview-Revised) was performed with all children. The results showed that the ADI-R items reflecting behavioural features at pre-school age (age range 4-5 years) were better suited to differentiate the groups than the items reflecting behavioural features at the time of the investigation (mean age: 9 years). The items on the dimension "Reciprocal social interaction" and "Communication and language" discriminated the groups better than the items of the dimension "Restricted interests". According to the ICD-10 algorithm of the ADI-R one child with autism and one child with a receptive language disorder were falsely classified. These false classifications were mainly due to a distorted parental perception of the child's behaviour. The ADI-R is a useful tool in the differential diagnosis of developmental disorders.

Algorithms↗
PubMed1982

Parent-child interactions in normal and language-disordered children.

Interactions between young children and their parents or guardians are critical factors in child language acquisition. The purpose of this study is to describe verbal and nonverbal communication patterns that occur in parent-to-child and child-to-parent interactions with normally developing children and children with language disorders. Thirty verbal and nonverbal behaviors were analyzed from videotapes of mother-child interactions. As a group, the mothers of normally developing children did not differ from the mothers of children with language disorders in the frequency of use of verbal or nonverbal interactions or in the mean length of utterance. There were no significant differences between the groups of children in frequency of use of each interaction pattern. What was different was the number of significant relationships between measures of linguistic maturity of the normally developing children and their mothers' interaction patterns that were not apparent for the language-disordered children and their mothers. Mothers' frequency of interactions as expansions, exact, reduction imitation, use of questions, answers, acknowledgements, providing information, total nonverbal behaviors, and use of nonverbal deixis all were related to some measures of the normal child's linguistic maturity. These relationships were infrequent with the language disordered group.

Child Language↗
PubMed2026

Effectiveness of Caregiver-Mediated Spoken Language Interventions for Children Under Five at Risk of Developmental Language Disorder: A Systematic Review and Meta-Analysis.

BACKGROUND AND AIMS: Caregiver-mediated interventions are commonly used by Speech and Language Therapists to support early language development. Developmental Language Disorder (DLD) is associated with reduced quality of life throughout the lifespan. Understanding factors that predict intervention success is essential for developing appropriate, cost-effective therapy provision for the approximately 12% of preschool children who present with early markers for Developmental Language Disorder (DLD). This systematic review and meta-analysis examined the effectiveness of caregiver-mediated spoken language interventions for under-fives at risk of DLD, and factors influencing intervention effectiveness. METHODS: A systematic review following PRISMA guidelines was conducted. Five electronic databases were searched to identify experimental studies comparing caregiver-mediated spoken language interventions to control conditions in under-fives presenting with risk factors for DLD. Risk factors included prematurity, socioeconomic factors, caregiver language development concerns, and formal or informal language screening or assessment scores. Twenty-six experimental studies with 1407 child participants were included in qualitative synthesis. Meta-analysis was performed on nine Randomised Controlled Trials involving 947 children. RESULTS: Effectiveness was examined for outcomes including child language gains, child wellbeing, inclusion and attainment. Meta-analysis indicated a significant effect of caregiver-mediated spoken language interventions on language outcomes compared to treatment-as-usual, non-language intervention or waitlist control conditions. Non-language outcomes were evaluated via qualitative synthesis. Interventions significantly improved language development trajectories for under-fives presenting with risk factors or early markers for DLD. CONCLUSION AND IMPLICATIONS: This review contributes to the growing evidence base demonstrating that caregiver-mediated interventions can positively impact language development and wellbeing outcomes for children under five at risk of DLD. These findings support the implementation of caregiver-mediated environmental language interventions in clinical practice to maximise accessibility and cost-effectiveness while delivering optimal outcomes for vulnerable populations. WHAT THIS PAPER ADDS: What is already known on this subject Previous research on caregiver-mediated spoken language interventions has highlighted gaps in the evidence regarding the impact of risk factors, demographic characteristics, dosage and intervention components on child language outcomes. Developmental Language Disorder has relatively high population prevalence, estimated at 7%. Prevalence is associated with risk factors including low household socioeconomic status (SES), prematurity and late language emergence. In contrast to its prevalence, there is low public and professional awareness of DLD and a low diagnostic rate. Therefore, a strengthened evidence base and additional insights into the factors affecting success of family-based interventions is important in order to increase the effectiveness of service provision and care planning for this underserved population. Timely and effective intervention with young children presenting with early markers for DLD has the potential to offer lifelong improvement to their wellbeing, inclusion and attainment outcomes. Recent systematic reviews of the effectiveness of caregiver-mediated language interventions had differences in population age range and diagnostic inclusion criteria. What this paper adds to existing knowledge Our review examines the effectiveness of caregiver-mediated early spoken language interventions on child language, attainment and wellbeing, and on caregiver self-efficacy and adherence to language support strategies. Our population was children under five presenting with risk factors for Developmental Language Disorder, in the absence of other neurodevelopmental or genetic conditions such as intellectual disability or autism. This review adds depth and detail to the evidence base supporting the effectiveness of caregiver-mediated spoken language interventions in improving outcomes for this population of young children, and factors that influence their success. What are the potential or actual clinical implications of this work? The high prevalence of Developmental Language Disorder, estimated at around 7% of the population, and the strong association with risk factors including low SES, prematurity and late language emergence, coupled with the low awareness of DLD and low diagnostic rate, mean that a strengthened evidence base and additional insights into the factors affecting success of family-based interventions can increase the effectiveness of service provision and care planning for this population. Timely and effective intervention in this group of young children has the potential to improve wellbeing and attainment outcomes across the lifespan. This review contributes to our understanding of how to implement cost-effective, socially valid and maximally engaging partnership working with families of young children at risk for DLD.

Humans↗
PubMedDate not supplied

[Language disorders in children: diagnostic, pathogenetic and developmental aspects].

Several Authors report the pathogenetic factors of developmental language disorders, some clinical features, the evaluation criteria, the treatment prospects aimed also at learning disorders. 163 children with language disorders have been examined: M98, F65; range 2.8-6.2 ys, mean 5.1 ys. The study of verbal comprehension and production and the evaluation of cognitive level, of language function, of communicative abilities, of handedness was performed. The diagnostic evaluation results: uncomplicated language retardation (31.2%), developmental dysphasia (7.4%), acquired aphasia (0.6%), dysphasia/cognitive retardation (36.8%), language retardation/deafness (10.4%), stuttering (6.8%), relational disorders (6.8%). The pathogenetic features are the following: organic factors (early brain damage 51%, early otopathies 10%), environment factors (24%, partly as joined factors), emotive disorders (11%), familiarity (10%), no determinable etiology (2%). The Author remarks some therapeutic strategies and evolution prospects of the different language disorders. In order to attain early diagnosis and treatment it seems advisable to increase cognitive-linguistic examination in preschool age and to start rehabilitation services at nursery-school.

Age Factors↗
PubMed1983

Performative and presuppositional skills in language-disordered and normal children.

The presuppositional and performative abilities of language-disordered and normal children were compared, controlling for the children's ability to use the lexical items required in the experimental tasks. Subjects were 36 children, 18 normal and 18 language-disordered, functioning at a single-word level of linguistic development. Results revealed that both the language-disordered and the normal children showed a tendency to encode changing rather than unchanging situational elements. The two groups of children also demonstrated similar levels of imperative and declarative performance intent. For both groups, performative and presuppositional behaviors were usually in the form of word productions. Discrepancies between the findings of this and other investigations are discussed with respect to the size of the children's lexicons, their expressive command of the lexicon, chronological age, and representational skills.

Child Language↗
PubMed2003

[Confusing stories, not always confusion! Language disorders and dementia].

Sometimes confusing stories may have unexpected causes. A confused patient is not necessarily delirious or demented. We present three patients in which diagnosis was difficult. Their confusion appeared to be caused only partially by memory impairment. Dementia often presents with memory impairment, but sometimes a language disorder is more prominent. Ten percent of the dementias show language disturbances as the first sign. Language disturbances may exist for a long time, even before the onset of the memory impairment. The language disorder causes difficulty in proper judgment of memory. Logopedic examination is necessary to diagnose the language disorder. Neuropsychological testing should take the language disorder into account. Diagnostic accuracy is important. Distinguishing dementia from a language disorder has implications for the judgment of the patient's (dis)abilities and management.

Aged↗
PubMed2004

Psychiatric implications of language disorders and learning disabilities: risks and management.

This article reviews the relationship between different learning disabilities, language disorders, and the psychiatric disorders that are commonly associated with learning disabilities and language disorder: attention-deficit hyperactivity disorder (ADHD), anxiety disorders, depression, and conduct or antisocial personality disorder. The complex associations between language disorders and specific learning disabilities--dyslexia, nonverbal learning disorder, dyscalculia--and the various psychiatric disorders are discussed. Clinical vignettes are presented to highlight the impact of these disorders on a child's social and psychological development and the importance of early recognition and treatment.

Adaptation, Psychological↗