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PubMed1997

Identification and diagnostic evaluation of hearing impairments in early childhood in German-speaking infants.

The present study was devised to gather epidemiological information to aid in understanding the etiology, identification, and management of children with permanent hearing losses in Lower Saxony as a defined geographical area of Germany. All infants and preschool children were identified in the Department of Phoniatrics and Pediatric Audiology during a 1-year period (October 1994 until October 1995). Forty-four hearing-impaired children were identified, of whom 41 (93%) had sensorineural losses and 3 had pure conductive losses. Thirty-two children (73%) had bilateral hearing impairments. The causes of hearing loss were unknown in 17 children (39%). The median age of identification for the study group was 32 months, with a median age of 35.5 months when fitting hearing aids. Severity of hearing loss was inversely associated with age of identification. Prelingually deaf children had the worst comprehension levels of all children tested psychologically. Results were tabulated and special references to other studies were discussed. Our findings show again that the successful out-come of speech and language development depends on early identification and management of the hearing loss, and on continued assessment of the progress of habilitation. These require a basic assessment of the stage of language development (in perception and expression) as relevant rehabilitation measures. The next step is the treatment of existing linguistic deficits followed by retests at regular intervals.

Child, Preschool↗
PubMed1987

Medical profile of the language-delayed child: otitis-prone versus otitis-free.

Delay in language development may be associated with an underlying anatomical, neurosensory, or psychological disorder such as: deafness, cerebral palsy, cleft palate, autism, or mental retardation. A condition called specific developmental language delay may occur in children devoid of any other identifiable disorder or developmental delay. Language delay associated with early onset, severe-to-profound hearing impairment has been well documented. Controversial studies have also appeared in the communicative disorders' literature suggesting that fluctuating conductive hearing loss in early childhood can significantly affect the development of language and related academic skills. Some authors have claimed that these deleterious effects can be irreversible. This study focuses on 3 groups of preschool children, in whom hearing acuity has been documented: One group with recurrent otitis and language delay; a second group with an equally well documented otitis history but without language delay; and a third group with documented language delay in the absence of any known predisposing conditions, including early-onset, recurrent otitis media. Prenatal, birth and developmental histories of the children in each group were compared in detail to identify any factors which may enhance or ameliorate the effects of fluctuating conductive hearing loss on language development. In a population of 1864 children (ages 9-59 months) referred for otolaryngologic and/or communicative evaluation, 480 otherwise normal children (67.6% males; 32.4% females) were found to have a history of early-onset, recurrent otitis media and/or delayed speech and language development on the basis of an extensive evaluation battery. This population was further subdivided into 3 groups (I = otitis-positive/normal language; II = otitis-positive/language delay; and III = otitis-free/language delay). Among the 329 children with positive histories for early otitis media (Groups I & II), a significantly higher percentage of those demonstrating language delay were from homes in the lower socio-economic category. Race and sex showed no significant relationship to language delay among the otitis-positive groups, although males were twice as numerous as females in the over-all study population. Articulation errors on speech measures and borderline delays in other developmental milestones (standing, walking, and toilet training) were also significantly greater in the language-delayed group when compared with otitis-positive children whose language was age-appropriate.(ABSTRACT TRUNCATED AT 400 WORDS)

Child Development↗
PubMed1998

[Cochlear implantation in deaf children].

OBJECTIVE: To evaluate the results of cochlear implantation in deaf children. DESIGN: Descriptive. SETTING: Ear, nose and throat department, Academic Hospital, Nijmegen, and Institute for the Deaf St. Michielsgestel, the Netherlands. METHODS: The results in 29 totally deaf children implanted with a 22-channel Nucleus implant--partly in a project supported by the National Fund for Investigative Medicine--in the period 1990-1996 were determined. Six of the children had congenital deafness, the others were deaf as a sequel to meningitis. The operation had no serious complications. All children were followed for at least two years. Progress in auditory perception and speech-language development were measured with structured tests. RESULTS: There was a marked improvement in auditory performance, and language development (measured with Reynell test), although the level of normal hearing children was not reached by most of the operated children. The results were better for children with total insertion of the electrodes than for those with partial insertion (n = 4); of these last, one stopped using the implant. CONCLUSION: Cochlear implantation can limit the consequences of total deafness in children.

Adolescent↗
PubMed2002

Cross-mapping the ICNP with NANDA, HHCC, Omaha System and NIC for unified nursing language system development. International Classification for Nursing Practice. International Council of Nurses. North American Nursing Diagnosis Association. Home Health Care Classification. Nursing Interventions Classification.

Nursing language plays an important role in describing and defining nursing phenomena and nursing actions. There are numerous vocabularies describing nursing diagnoses, interventions and outcomes in nursing. However, the lack of a standardized unified nursing language is considered a problem for further development of the discipline of nursing. In an effort to unify the nursing languages, the International Council of Nurses (ICN) has proposed the International Classification for Nursing Practice (ICNP) as a unified nursing language system. The purpose of this study was to evaluate the inclusiveness and expressiveness of the ICNP terms by cross-mapping them with the existing nursing terminologies, specifically the North American Nursing Diagnosis Association (NANDA) taxonomy I, the Omaha System, the Home Health Care Classification (HHCC) and the Nursing Interventions Classification (NIC). Nine hundred and seventy-four terms from these four classifications were cross-mapped with the ICNP terms. This was performed in accordance with the Guidelines for Composing a Nursing Diagnosis and Guidelines for Composing a Nursing Intervention, which were suggested by the ICNP development team. An expert group verified the results. The ICNP Phenomena Classification described 87.5% of the NANDA diagnoses, 89.7% of the HHCC diagnoses and 72.7% of the Omaha System problem classification scheme. The ICNP Action Classification described 79.4% of the NIC interventions, 80.6% of the HHCC interventions and 71.4% of the Omaha System intervention scheme. The results of this study suggest that the ICNP has a sound starting structure for a unified nursing language system and can be used to describe most of the existing terminologies. Recommendations for the addition of terms to the ICNP are provided.

International Council of Nurses↗
PubMedDate not supplied

[Impact of otitis media on language acquisition in children].

OBJECTIVE: To review the literature concerning the impact of otitis media on language acquisitions in children. SOURCES OF DATA: Medline. The following keywords were used for searching: otitis media, hearing, language and children. SUMMARY OF THE FINDING: The hearing loss observed in otitis media may be a result of: 1) structural disorders in the middle ear; 2) ultrastructural lesions and biochemical anomalies in the cochlea or 3) abnormalities in the central auditory pathways. About 50% of cases of secretory otitis media, for instance, are accompanied by mild fluctuating hearing loss. According to the literature, since the first three years of life are critical for language development, children affected by otitis media in this period are at risk for presenting disturbances in language acquisition, behavior and later academic achievement. CONCLUSIONS: The main consequences of otitis media and hearing loss on language acquisition are phonetic and speech articulation problems, as well as impairment of reading comprehension.

Child↗
PubMed1995

Conversation at home: a case study of a young deaf child's communication experiences in a family in which all others can hear.

In the past, much research on deaf children's language development has been conducted in schools and clinical settings to examine children's achievement of standard English or to study the effectiveness of mode of communication. The purpose of this study was to examine a deaf child's pragmatic development, her abilities as a language user in the naturally occurring situations of her everyday life at home. Observations, videotaping, and interviews were used to collect descriptive data of the child's conversation experiences with hearing family members. Findings reveal that deafness has had an impact on the family's beliefs and communication practices. Data show the child to be a competent communicator as she uses language appropriately for a variety of purposes, demonstrates her knowledge of the structural features of conversation, and employs an array of communication strategies to achieve mutual understanding with family members.

Adolescent↗
PubMed1993

A developmental deficit in short-term phonological memory: implications for language and reading.

QU, an eight-year-old boy, was identified from a large scale normative study on the basis of his greatly reduced digit span, combined with normal long-term memory and non-verbal intelligence. Further investigation indicated that his visual STM was normal, but that he was clearly impaired on two verbal STM tests, nonword repetition, and memory span for words. His span showed clear effects of phonological similarity and word-length, suggesting qualitatively normal functioning of the phonological loop component of working memory, despite a quantitative impairment in level of performance. This pattern resembles that found in an earlier study of children with a specific language disorder. We tested QU on measures of vocabulary, syntax, and reading, and found him to be substantially below the age norms on all three. The implications of these findings are discussed for the role of the phonological loop in language development.

Auditory Perception↗
PubMed1976

Phonological investigation of verbal autistic and mentally retarded subjects.

A review of the pertinent literature indicates that autistic children are likely to show normal but delayed development of speech sounds. In contrast, atypical phonological development is suggested by experiments demonstrating that autistic subjects are deficient in their ability to extract the components of structured auditory input. A systematic investigation of the speech sound systems of verbal autistic and mentally retarded children reveals a delay in phoneme acquisition, as well as a relative uniformity of error types in both groups. The autistic subjects, however, differ significantly from the mentally retarded in the phonemic substitutions which they make. Autistic subjects are also characterized by a high correlation between frequency of phonological errors and level of overall language development. The findings are interpreted as supporting the hypothesis that the autistic group shows a more global delay in language development.

Adolescent↗
PubMed1991

Otitis media in early childhood and later language.

The relationship between early otitis media with effusion (OME) experience and later language development was examined in a prospective cohort study of 30 children from middle-class families and 33 children from low-income families. Ear status was monitored using otoscopy and tympanometry during wellness and illness periods between birth and 3 years of age. Language was assessed using standardized tests and a language sample between 4 1/2 and 6 years. Findings suggested no reliable relationship between early OME experience and later language development.

Child, Preschool↗
PubMed2000

Linguistic difficulties in language and reading development constrain skilled adult reading.

This study investigated whether the quality and specification of phonological representations in early language development would predict later skilled reading. Two perceptual identification experiments were performed with skilled readers. In Experiment 1, spelling difficulties in Grade 1 were used as a proxy measure for poorly specified representations in early language development. In Experiment 2, difficulties in perceiving and representing liquid and nasalized phonemes in final consonant clusters were used for the same purpose. Both experiments showed that words that were more likely to develop underspecified lexical representations in early language development remained more difficult in skilled reading. This finding suggests that early linguistic difficulties in speech perception and structuring of lexical representations may constrain the long-term organization and dynamics of the skilled adult reading system. The present data thus challenge the assumption that skilled reading can be fully understood without taking into account linguistic constraints acting upon the beginning reader.

Adult↗
PubMed1983

Communication development in young children with long-term tracheostomies: preliminary report.

Communication development was studied in 77 subjects with long-term tracheostomies ranging in age from two months to 7 years. Children were categorized according to tracheostomy status (cannulated or decannulated), presence of speech practice prior to cannulation, and level of language development (prelinguistic or linguistic) at the time of decannulation. All were aphonic and consequently deprived of speech experience for extended periods while tracheostomized. Twenty-three children have been studied post-decannulation. Results for the children decannulated during the prelinguistic stage revealed that speech and language skills were attained commensurate with intellectual functioning. This evidence led to the conclusion that extensive, audible prespeech practice (cooing and babbling) was not needed for later spoken language development. All children decannulated during the linguistic stage exhibited specific spoken language delays including phonological impairment at the time of decannulation. The presence of speech practice prior to cannulation did not appear to be a factor in the severity of phonological impairment. The children who were cannulated for more lengthy time periods, extending into the linguistic stage, however, demonstrated more severe phonological impairment than those who were decannulated during the prelinguistic stage. With direct speech/language therapy, 20 of the 23 decannulated children eventually compensated for these difficulties, demonstrating appropriate spoken language skills. Alternative communication modalities were felt to be crucial in reducing communicative frustrations during cannulation.

Child↗
PubMed1992

The Scottish low birthweight study: II. Language attainment, cognitive status, and behavioural problems.

Of the 636 survivors of a total geographically based population born in Scotland in 1984, who weighed less than 1750 g at birth, 611 (96%) were assessed at 4.5 years to determine the prevalence of language, cognitive, and behavioural problems. Language development was significantly related to birth weight, gestational age, and social class for comprehension, less so for expressive language. Mean (SD) intelligence quotient (IQ) on the British ability scales was 92.9 (14.7). Within this population there were no significant differences between birthweight groups. Overall they performed poorly on visual recognition, verbal comprehension and number skills subscales--in the latter those with birth weights less than 1000 g were significantly worse than the heavier children. Only 5% had IQs less than 70, but a further 3% could not be tested because of other physical disability. Among those with normal IQs were groups of children who exhibited patterns of skill deficits in different subscales raising the possibility of specific learning difficulties. Poor attention span was reported in 47%, and parents said the study children had more behavioural problems than their siblings.

Attention↗
PubMed1996

Referencing skills in children with autism and specific language impairment.

This study presents the data on the referencing strategies used in dialogue by 10 young autistic children, eight with specific language impairment, and eight with normal language development. The three groups of children were matched for language age (including mean length of utterance (MLU), receptive vocabulary, and syntax). Correct and erroneous use of pronominal, demonstrative, and comparative cohesive ties of reference were examined by use of Halliday and Hasan's (1976) method of discourse cohension analysis. The study found that autistic children were able to use all of the above cohesive ties of reference, but their use was less successful than that of the other two groups of children. The autistic children also differed qualitatively in the types of errors that they made. Findings were discussed in relation to various developmental, linguistic, and social factors that may underlie the successful usage of different cohesive ties and subtypes of ties.

Autistic Disorder↗
PubMed2006

Two languages, one developing brain: event-related potentials to words in bilingual toddlers.

Infant bilingualism offers a unique opportunity to study the relative effects of language experience and maturation on brain development, with each child serving as his or her own control. Event-related potentials (ERPs) to words were examined in 19- to 22-month-old English-Spanish bilingual toddlers. The children's dominant vs. nondominant languages elicited different patterns of neural activity in the lateral asymmetry of an early positive component (P100), and the latencies and distributions of ERP differences to known vs. unknown words from 200-400 and 400-600 ms. ERP effects also differed for 'high' and 'low' vocabulary groups based on total conceptual vocabulary scores. The results indicate that the organization of language-relevant brain activity is linked to experience with language rather than brain maturation.

Acoustic Stimulation↗
PubMed2001

The early acquisition of verb meaning in German by normally developing and language impaired children.

The research reported here focuses on the early acquisition of event structure in German. Based on longitudinal studies from 5 normally developing (ND) and 6 language-impaired (LI) children, a model of "event structural bootstrapping" is presented that spells out how ND children log into the verb lexicon. They project a target-consistent event tree, depicting the head-of-event of transitions. Young LI children, failing to employ this bootstrapping strategy, resort to radically underspecified event representations. The results from a truth-value judgment experiment with 16 ND and 16 LI children showed that ND children perform correctly on transitional verbs, while LI children perform at chance level on the same tasks. These findings are accounted for by the model of event structural bootstrapping to the extent that LI children lack an explicit representation of the head-of-event.

Adult↗
PubMed1989

Language and neurodevelopmental outcome of low-birthweight infants at three years.

Forty low-birthweight (LBW) infants (28 AGA, 12 SGA) and 16 fullterm infants have been followed for three years with neurological, developmental, language, behavior and audiometric assessments. Only two (5 per cent) of the LBW infants were neurologically abnormal at three years. The AGA infants continued to lag cognitively and in receptive language in comparison with the fullterm infants. Socio-economic factors had a significant effect on the language development of all three groups. Short gestation and neurological status at eight months continued to have a significant effect on language performance. A variety of behavioral characteristics correlated with cognitive and language scores, and impaired middle-ear status was associated with lower cognitive function. These data support the concept that language development of LBW infants is influenced by perinatal, neurological and socio-economic factors, and by behavioral characteristics and middle-ear status.

Child Behavior↗
PubMed2005

Utility of the MacArthur-Bates communicative development inventory in identifying language abilities of late-talking and typically developing toddlers.

The present study investigated the validity of the MacArthur-Bates Communicative Development Inventory (CDI) for a group of toddlers 30 months of age. Study 1 examined the concurrent validity of the CDI for a group of 38 late talkers. Significant correlations were found between the CDI and direct measures of language abilities. Study 2 used likelihood ratio analysis to determine how well the CDI sorted 100 toddlers (38 late talkers and 62 children with a history of normal language development) according to language status based on direct assessment measures. The analyses showed that the CDI was effective in identifying children with low language skills up to the 11th percentile and in identifying children with normal language skills above the 49th percentile.

Case-Control Studies↗
PubMed2003

Phonetic, phonological, and language skills of children with a cleft palate.

OBJECTIVE: To evaluate the language, phonetic, and phonological skills at age 3 years of two groups of young children with a cleft palate, with different expressive language proficiency at 2 years of age. DESIGN: Two groups of children with a cleft palate with differing abilities in early expressive language skills were identified at age 2 years. Comparisons across groups were made over a range of speech and language measures at age 3 years. PARTICIPANTS: Twenty children with cleft palate were allocated to two groups dependent on expressive language abilities at age 2 years. One group had normal language development, and the second group had been identified as having significantly delayed (8 to 12 months' delay) expressive language development. MAIN OUTCOME MEASURES: The children were assessed at 3 years of age using standardized assessments and spontaneous speech samples. Comparisons between the two groups were made on a range of language measures including comprehension, expressive language, and speech. RESULTS: Group differences were found on both language and speech abilities at age 3 years. Significant group differences were found in expressive language, percentage of consonants correct, phonetic inventory, and phonological process usage. The group with delayed early expressive language abilities at 2 years continued to have expressive language difficulties at 3 years of age and had more disordered speech development, compared with the nondelayed group. CONCLUSIONS: A subgroup of children with a cleft palate was identified who exhibited delays in early expressive language and continued to have delayed language and disordered phonological patterns at a later age. Support for three possible etiologies including a structural/anatomical deficit, cognitive/linguistic delay, or language/phonological disorder are discussed.

Articulation Disorders↗