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The validity of discrepancy criteria for identifying children with developmental language disorders.

Empirical data from two studies address the clinical validity of discrepancy criteria for identification of children with developmental language disorders (DLD). Study 1 involved 256 preschoolers clinically defined as DLD and meeting inclusionary criteria for normal hearing, intellectual, neurological, and psychiatric status. Application of alternative psychometrically derived discrepancy criteria identified only 40% to 60% of the clinically defined group as language disordered. Study 2 applied nonverbal IQ-language performance discrepancy criteria to 368 eight-year-old, randomly selected control subjects, resulting in over 45% of the controls being identified as DLD. Factors contributing to underidentification in Study 1 and over-identification in Study 2 are discussed, raising questions regarding the validity of discrepancy criteria for identification of DLD children.

Achievement↗

Frequency discrimination and literacy skills in children with mild to moderate sensorineural hearing loss.

It has been suggested that specific reading disability (SRD) may be attributable to an impaired ability to perceive spectral differences between sounds that leads to a deficit in frequency discrimination and subsequent problems with language and literacy. The objective of the present study was three-fold. We aimed to (a) determine whether children with mild to moderate sensorineural hearing loss were impaired in their ability to discriminate frequency, (b) assess the extent to which any such deficits may be due to an inability to use information derived from phase locking, and (c) examine whether frequency discrimination abilities were predictive of measures of word and nonword reading and nonword repetition. Difference limens for frequency (DLFs) were obtained for 22 children with mild to moderate hearing loss (SNH group) and 22 age-matched controls (CA group) at central frequencies of 1 kHz, where phase-locking information is available, and 6 kHz, where it is not. A battery of standardized tests of language and literacy was also administered. The SNH group exhibited significantly elevated DLFs at both 1 and 6 kHz relative to controls, despite considerable variability of thresholds in both groups. Although no group differences were found for receptive and expressive vocabulary, receptive grammar, and nonword reading, the SNH group performed worse than controls on word reading and nonword repetition, even though word reading scores were age-appropriate. Frequency discrimination abilities were associated with reading and nonword repetition across groups, but these correlations largely disappeared when the two groups were analyzed separately. Together, these results provide evidence for a dissociation between impaired frequency discrimination and relatively "spared" language and literacy in children with mild to moderate sensorineural hearing loss. These results cast doubt on the assertion that a deficit in frequency discrimination necessarily leads to marked deficits in the development of language and literacy.

Adolescent↗

Cerebellar agenesis II: motor and language functions.

In a former study of a patient with cerebellar agenesis (HK) mild motor deficits, problems in delay eyeblink conditioning and mild to moderate deficits in IQ, planning behavior, visuospatial abilities, visual memory, and attention were found. The present study reports additional findings in the same patient. In the motor domain, impairments in fine motor manipulations, trace eyeblink conditioning and motor imagination in a functional magnetic resonance (fMRI) study were found. Based on fMRI findings; however, cortical areas involved in a tapping task did not significantly differ from a healthy control group. In the cognitive domain, deficits in speech comprehension as well as verbal learning and declarative memory were present. No significant affective symptoms were observed. Although problems in executive, visuospatial and language tasks are in agreement with the so-called cerebellar cognitive affective syndrome-other possibilities remain. Non-motor impairments in HK might also be a consequence of lacking motor abilities in development and motor deficits may interfere with the performance of parts of the cognitive tasks. In addition, lack of promotion and learning opportunities in childhood may contribute and mental retardation based on extracerebellar dysfunction cannot be excluded.

Affect↗

Language skills and cognitive processes related to poor reading comprehension performance.

Eleven tests were administered to 20 high school readers with learning disabilities (LD) and 20 controls. The objective was to examine the relation between reading comprehension performance and performance on tests of language skills and cognitive processes. As a whole, the performance of the group with LD was significantly below the performance of the controls on all measures. However, the variance on nonverbal tests was greater for the group with LD than for controls; some individuals with learning disabilities performed as well as the controls. Results are discussed in terms of how performance deficits are amenable to remediation by instruction.

Adolescent↗

A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD.

PURPOSE: This randomized group experiment compared the efficacy of 2 communication interventions (Responsive Education and Prelinguistic Milieu Teaching [RPMT] and the Picture Exchange Communication System [PECS]) on spoken communication in 36 preschoolers with autism spectrum disorders (ASD). METHOD: Each treatment was delivered to children for a maximum total of 24 hr over a 6-month period. Spoken communication was assessed in a rigorous test of generalization at pretreatment, posttreatment, and 6-month follow-up periods. RESULTS: PECS was more successful than RPMT in increasing the number of nonimitative spoken communication acts and the number of different nonimitative words used at the posttreatment period. Considering growth over all 3 measurement periods, an exploratory analysis showed that growth rate of the number of different nonimitative words was faster in the PECS group than in the RPMT group for children who began treatment with relatively high object exploration. In contrast, analogous slopes were steeper in the RPMT group than in the PECS group for children who began treatment with relatively low object exploration.

Autistic Disorder↗

Language, learning, and behavioral disturbances in childhood: a longitudinal perspective.

OBJECTIVE: Investigate longitudinally the course of development of preschool learning impaired (LI) children to better understand the interaction between neurodevelopmental delay, behavioral/emotional disorders, and language development and disorders. METHOD: Relationships between developmental language disorders and emotional problems were investigated in 99 8-year-old specifically language impaired and control children originally assessed at age 4 years using the Achenbach Child Behavior Checklist and the Conners' Parents Questionnaire. RESULTS: LI children received higher behavior problem scores and were more likely to score in the clinical range than were control children. Neither degree of early language impairment nor amount of language improvement predicted 8-year behavioral/emotional status. LI children with the largest drop in IQ between ages 4 and 8 received the highest behavior problem scores. No significant comorbid relationship was seen between LI and attention-deficit hyperactivity disorder. CONCLUSIONS: The enhanced incidence of behavior problems reported heretofore may be related more to lower IQ than to linguistic deficit per se. Care must be taken to differentiate the symptoms of neurodevelopmental delay and emotional disturbance, however, preschool children with scores in the clinical range on such measures should be referred for additional evaluation.

Attention Deficit Disorder with Hyperactivity↗

Comparative study of visual and verbal short-term memory in English and Spanish speakers: testing a linguistic hypothesis.

It has been proposed that differences in digit span performance between English and Spanish speakers are due to the greater number of syllables per digit in the Spanish language. To test this hypothesis, we studied the performance of 30 English- and 30 Spanish-speaking elders on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Span Subtest, a modified digit span test that was linguistically comparable for both languages, and the Corsi Block Test. Consistent with previous reports, we found that English speakers scored significantly higher than Spanish speakers on WAIS-R Digit Span Forward. Group differences were reduced on the modified Digit Span Forward, but remained significant. English and Spanish speakers scored comparably on Digit Span Backward (WAIS-R and modified) and Visual Span. We suggest that although differences in the number of syllables per digit string are in part responsible for the lower performance of Spanish speakers on Digit Span Forward, cultural and educational issues also contribute to the observed differences between English and Spanish speakers.

Adult↗

Grammatical tense deficits in children with SLI and nonspecific language impairment: relationships with nonverbal IQ over time.

The relationship between children's language acquisition and their nonverbal intelligence has a long tradition of scientific inquiry. Current attention focuses on the use of nonverbal IQ level as an exclusionary criterion in the definition of specific language impairment (SLI). Grammatical tense deficits are known as a clinical marker of SLI, but the relationship with nonverbal intelligence below the normal range has not previously been systematically studied. This study documents the levels of grammatical tense acquisition (for third-person singular -s, regular and irregular past tense morphology) in a large, epidemiologically ascertained sample of kindergarten children that comprises 4 groups: 130 children with SLI, 100 children with nonspecific language impairments (NLI), 73 children with low cognitive levels but language within normal limits (LC), and 117 unaffected control children. The study also documents the longitudinal course of acquisition for the SLI and NLI children between the ages of 6 and 10 years. The LC group did not differ from the unaffected controls at kindergarten, showing a dissociation of nonverbal intelligence and grammatical tense marking, so that low levels of nonverbal intelligence did not necessarily yield low levels of grammatical tense. The NLI group's level of performance was lower than that of the SLI group and showed a greater delay in resolution of the overgeneralization phase of irregular past tense mastery, indicating qualitative differences in growth. Implications for clinical groupings for research and clinical purposes are discussed.

Cognition Disorders↗

Development of language comprehension in preschool children: a picture identification test in the assessment of the comprehension of grammatical structures.

A language comprehension test based on picture identification was administered to 180 normal children aged between 3 1/2 and 6 years. Of the 20 test items 11 correlated with age and with the development of linguistic abilities. The test is sufficiently discriminant in respect of comprehension of morphological-syntactic structures between the ages of 4 and 6 years.

Child↗

Relationship between expressive language ability and rhythm perception, pitch perception, vocal range, and vocal midpoint among mentally retarded adults.

This study investigated the relationship between expressive language ability and rhythm perception, pitch perception, vocal range, and vocal midpoint for 28 mentally retarded adults. A standardized speech test determined language scores, a standardized music test assessed rhythm and pitch perception, and vocalization determined vocal range and midpoint. Multiple correlation and multiple linear regression analyses indicated a significant correlation between expressive language ability and rhythm perception. Further research with music tests more appropriate for mentally retarded adults is recommended.

Adult↗

Mild conductive hearing loss and language development: a one year follow-up study.

Thirteen children aged 3 to 5 years with mild conductive hearing losses and histories of otitis media were pair-matched with audiologically normal children on age, sex, socioeconomic status, family intactness, and first language (English). The Test for Auditory Comprehension of Language, the Northwestern Syntax Screening Test, and the Developmental Sentence Scoring Procedure were administered. Phonology errors were tabulated from the spontaneous language sample. The language evaluation was repeated after a 1-year interval. All measures differentiated the groups at highly significant levels on the initial assessment. All tests except the Test for Auditory Comprehension of Language continued to show significant differences a year later. The results support the hypothesis that children who experience recurrent middle ear problems are at risk for persistent language delay.

Child↗

An international test battery for cochlear implant patients.

It is now clear that cochlear implants can provide useful hearing for profoundly deaf adults, and that multichannel devices give the brain more information than most single-channel devices. We are in a dilemma as to how to compare the many multichannel devices, because of the language barrier. Virtually no multichannel wearer is equally testable in two, let alone more languages. A test battery that abstracts beyond language is proposed, utilizing carefully constructed non-linguistic syllables and its development underway.

Cochlear Implants↗

A direct test for lateralization of language activation using fMRI: comparison with invasive assessments in children with epilepsy.

This study introduces a direct method of assessing cerebral lateralization for language based on fMRI activation. The method, derived from a voxel-based morphometry study by C. H. Salmond et al. (2000, Hum. Brain Mapping 11, 223-232), bases lateralization on the direct statistical comparison of the magnitude of task-induced activation in homotopic regions of the two hemispheres. Lateralization results obtained with this direct method were compared to those obtained with a widely used method which involves the calculation of a laterality index (LI) based on the number of significantly activated voxels in the inferior frontal gyrus of each hemisphere. In order to compare the validity of the two methods, a covert verb-generation task was performed by eight children with epilepsy whose language lateralization was examined using invasive techniques. Lateralization results derived from fMRI activation showed that the calculation of a LI presented some limitations. Importantly, the LI value was dependent on the activation threshold chosen to calculate that LI. As a consequence, the correlation between the LI and the invasive methods could vary with the chosen threshold. By contrast, the proposed direct method gave some indication of the reliability of the lateralization and provided results that, in all eight children, were consistent with those obtained using invasive techniques. It is suggested that the direct method could be used in future fMRI studies to establish hemispheric lateralization for cognitive functions.

Adolescent↗

Influence of repetitive magnetic stimuli on verbal comprehension.

The influence of repetitive magnetic transcranial stimulation over the temporo-parietal cortex on verbal comprehension was investigated in 44 healthy subjects. In right-handed subjects, trains of 50 Hz magnetic stimuli over the left hemisphere produced more errors than stimulation over the right hemisphere. The result is not very clearcut, however; thus the test cannot be used for diagnostic investigation of language dominance.

Adolescent↗

A comparative study of hearing-impaired and normal-hearing young adults--verbal and nonverbal abilities.

This report describes the results of a study comparing three groups of hearing-impaired young adults with a group of normal-hearing young adults on various measures of perceptual and memory abilities. Twelve paper-and-pencil tests representing intellectual capacity, closure, association, nonverbal short-term memory, and verbal short-term memory were used as dependent variables. Results show that there was no difference between the four groups of subjects except for tests requiring some verbal facility.

Adult↗

Long-term neuropsychological impact of brief occupational exposure to organic solvents.

This case series describes the cognitive functioning of 10 individuals who were briefly exposed to a mixture of organic solvents as a result of an industrial accident. Data were obtained 10 years after the exposure on measures of intellect, memory, attention, and executive functioning, using standardised neuropsychological measures including WAIS III, WMS III, Hayling and Brixton Tests, The Trail Making Test, Controlled Oral Word Association, Rey-Osterrieth Complex Figure Test, and The Speed and Capacity of Language-Processing Test. The group performed in the average range across the majority of measures but deficits (z > 1.0 S.D.) were observed on tests that measure speed of information processing, memory, attention, and verbal fluency. Discrepancy scores between the NART and the WAIS suggest subtle but statistically significant decline in performance IQ following solvent exposure.

Accidents, Occupational↗