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PubMed2005

Parent concerns and professional responses: the case of specific language impairment.

BACKGROUND: GPs and health visitors are usually the first to be approached by parents concerned about their child's speech and language development in the early years. The role health professionals play in early detection of speech and language difficulties is therefore crucial to ensure timely referral for speech and language therapy. AIM: To examine parental accounts of health visitor and GP involvement in the assessment and diagnosis of their children's speech and language impairment. DESIGN OF STUDY: Qualitative retrospective interviews. SETTING: Two Local Education Authorities in Merseyside. METHOD: In-depth interviews were conducted with 40 parents. Interviews were transcribed and thematically analysed. Twenty per cent of interviews were analysed by an independent researcher and consensus reached on thematic content. RESULTS: In many cases, parents were the first to realise that there was something wrong with the speech and language development of their child. Parents reported that health professionals tended to underestimate speech and language problems, and failed to take parental views into account. In some cases, parents found that attending a specialist unit or hospital resulted in the children reaching school age before referral to speech and language therapy was made. In other cases, health professionals appeared to rely on the possibility of spontaneous recovery, and gave inappropriate advice to parents, which resulted in delayed referral to speech and language therapists. CONCLUSIONS: Health professionals failed to use systematic, evidence-based approaches in responding to early parental concerns. For this group of parents, such an approach resulted in long delays in referral for specialist intervention.

Adolescent↗
PubMed1990

The decision-making process in child language assessment.

The task of assessing a child's language for the purpose of intervention requires the ability to interpret information from a variety of sources. Knowing how that information is to be used during therapy plays an important part in deciding what type of information needs to be collected and how it will be interpreted. There needs to be a plan that will assist the speech therapist in analysing and interpreting most of the data that would be needed when making therapy-related diagnostic statements. A systems approach offers concepts and methods for devising a plan which will outline the necessary decisions. The purpose of this paper is to present, in a flow chart, the questions that need to be asked in the process of assessing a child's language development for the purpose of intervention; to indicate the type of information that would be needed to answer the questions; to state how the information would be interpreted; to suggest the type of tools that would be needed to collect this information; and to outline how the information can be presented so that a greater quantity of data can be summarised and interpreted in a systematic manner.

Child↗
PubMed1996

["Specific" versus "audiogenic" speech development disorder. Quantitative speech development index in a controlled group comparison].

The language development of hearing-impaired children is disordered, especially in children with impairment before starting linguistic development. Binaural sensorineural-impaired children are likely to acquire a deficient oral vocabulary. Two population samples between the ages of 2 and 5 years (n = 110 specific language-impaired children vs. n = 34 bilateral sensorineural-impaired children with individual hearing aids) were compared with 66 normal children of similar age with respect to their expressive vocabulary. All groups were tested with a nonverbal intelligence test and reached average or better scores. The two clinical samples showed no significant difference in their lexical performance, but there was a difference in comparison with the normal children. The results are discussed on the background of degree, onset of hearing impairment and attending kindergarten. It is suggested that specific language impairment is a more serve development disorder than audiogenic language impairment because it seems to be neurobiologically founded. Early diagnosis by a phoniatrician is important.

Child, Preschool↗
PubMed1982

Breast-feeding and cognitive development in the first seven years of life.

The relationship between breast-feeding practices and childhood intelligence and language development at ages 3, 5 and 7 years was examined in a birth cohort of New Zealand children. The results showed that even when a number of control factors including maternal intelligence, maternal education, maternal training in child rearing, childhood experiences, family socio-economic status, birth weight and gestational age were taken into account, there was a tendency for breast-fed children to have slightly higher test scores than bottle-fed infants. On average, breast-fed children scored approximately two points higher on scales with a standard deviation of 10 than bottle-fed infants when all control factors were taken into account. It was concluded that breast-feeding may be associated with very small improvements in intelligence and language development or, alternatively, that the differences may have been due to the effects of other confounding factors not entered into the analysis.

Age Factors↗
PubMed2005

A retrospective journal-based case study of an infant with autism and his twin.

This report describes the development of an infant who was later diagnosed with autism, and a direct comparison of his development to that of his twin, from a prenatal period through the age of 4 years, through the examination of personal journals and medical records kept by the mother of the twins. Examination of these journals revealed several differences in development between the twins, some as early as 6 months of age. In the first year of life, the infants already differed in language development, social development, sleep patterns, and sensitivity to pain. This rare opportunity to view early autistic development gives direction to developmental theories of autism and clinically useful cues to early signs of autism.

Autistic Disorder↗
PubMed2005

Multisite study of infants with single-suture craniosynostosis: preliminary report of presurgery development.

OBJECTIVE: To evaluate the cognitive and language development of untreated infants with a single suture craniosynostosis at time of diagnosis. DESIGN AND PARTICIPANTS: The study presents time 1 assessments on the first 100 infants with a single suture craniosynostosis (sagittal, metopic, unilateral coronal, and lambdoid) referred to the Infant Learning Project, a prospective, multisite, longitudinal study evaluating neurocognitive development. MAIN OUTCOME MEASURES: Infants were assessed with the mental (Mental Development Index [MDI]) and motor scales (Psychomotor Developmental Index [PDI]) of the Bayley Scales of Infant Development and the Preschool Language Scale receptive (PLS-AC) and expressive (PLS-EC) language scales. Mothers completed the Parenting Stress Inventory, a brief measure of intelligence (maternal IQ [MAT-IQ]), and provided information regarding family socioeconomic status (SES). RESULTS: As a group, infants scored significantly lower than the normative data on the MDI (91.9), PDI (83.5), PLS-AC (90.4), and PLS-EC (95.8), and the distribution of scores differed significantly from the expected distribution. MAT-IQ and SES were significantly correlated (.47, p < .01) with mothers of higher IQ coming from higher SES groups. Both MAT-IQ and SES were significantly negatively correlated with life stress events; however, neither MAT-IQ nor SES was correlated with any of the infant development scores. CONCLUSIONS: There may be a greater developmental risk for infants with a single suture craniosynostosis than previously believed. However, control group data will be necessary to confirm findings.

Child, Preschool↗
PubMed2004

Psychoeducational treatment of children with autism and reactive attachment disorder.

The aim of the study was to evaluate and compare the efficacy of short-term psychoeducational treatment in children with autism and reactive attachment disorder (RAD). Ten boys with autism aged 24-66 months and 11 children with RAD (nine boys and two girls) aged 30-70 months were included in the study. The Ankara Developmental Screening Inventory was used to monitor progress following a 14-session psychoeducational programme. This focused on establishing a reciprocal-dyadic interaction between children and their caregivers and it also provided an educational programme for emotional, social, and language development. Although both groups showed significant changes on all scales of the ADSI, the children with RAD showed greater improvement than the autism group in their total development score, on the language-cognitive subscale, and in social/self-care abilities.

Autistic Disorder↗
PubMed2003

Twins as a natural experiment to study the causes of mild language delay: II: Family interaction risk factors.

BACKGROUND: Twins tend to lag behind singletons in their language development, but the causes were unknown. METHOD: Ninety-six twin pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC), for whom birth was after at least 33 weeks of gestation, were compared with 98 pairs of singletons, no more than 30 months apart in age. Parental qualities and family interaction were assessed through standardised questionnaires and interviews and both structured and unstructured observations in the home at 20 months and 36 months. The possible causal role of postnatal family influences was assessed through five criteria: i) the feature had to differ between twins and singletons; ii) individual differences in that feature had to relate to individual differences in language level within the sample of singletons and of twins; iii) the feature as measured at 20 months had to predict language as assessed at 36 months; iv) that had to apply after controlling for language level at 20 months; and v) introduction of the predictive feature into an overall model had to obliterate the twin-singleton difference in language level. RESULTS: Patterns of parent-child interaction and communication met these five criteria. The maternal factors all concerned aspects of interaction that were broadly concerned with communication: encouraging the child to speak, providing elaborating comments, engaging in reading to the child and talking about the story and its illustrations. The HOME inventory findings provided similar findings with respect to responsiveness, involvement and level of experiences involved. Family features that might have been influential, but which were not, included parental depression, breast-feeding, family size, and style of sibling interaction. CONCLUSION: Patterns of parent-child interaction and communication within the normal range have environmentally mediated effects on language and account for twin-singleton differences in language developmently. The results indicate the value of a natural experiment in testing competing causal hypotheses, and show the role of environmental factors as influences on language variations within the normal range, for both twins and singletons.

Breast Feeding↗
PubMed2004

Consonant production and language skills in Mandarin-speaking children with cochlear implants.

OBJECTIVES: To investigate the phonemic inventories of syllable-initial consonants in Mandarin-speaking children with cochlear implants, assessing the relationship between the children's mastery levels of consonant production and their receptive and expressive language skills. DESIGN: Descriptive study. SETTING: Chi-Mei Medical Center, Tainan, Taiwan. PATIENTS: The 30 prelingually deaf children with cochlear implants who participated in the study ranged in age from 6 years to 12 years 6 months, and their age at implantation ranged from 2 years 3 months to 10 years 3 months. The average length of device experience was 3 years 7 months (range, 1 year 7 months to 6 years 5 months). None of the children was identified with concomitant learning disabilities. OUTCOME MEASURES: The 21 Mandarin syllable-initial consonants were elicited using a set of 105 pictures. Two language assessment tools were used to evaluate the children's receptive vocabulary skills as well as their overall receptive and expressive language development. RESULTS: The mean +/- SD score for correct consonant production was 57.9% +/- 19.5%. Regarding the manner of articulation, plosives received the highest average correct percentage whereas nasals, affricates, fricatives, and the lateral approximant /l/ were less frequently correct. The children's overall percentage of correct scores for consonant production and receptive vocabulary measure were significantly correlated (r = 0.51; P =.005). Additionally, correlation coefficients were significant between the overall score for correct consonant production and both the scores for receptive language measure (r = 0.65; P<.001) and expressive language measure (r = 0.76; P<.001). The participants' consonant production skills were negatively correlated with age at implantation (r = - 0.46; P =.01) and positively correlated with length of experience with cochlear implant (r = 0.45; P =.02). CONCLUSIONS: Mastery levels of Mandarin syllable-initial consonants remained moderately low in prelingually deaf children with cochlear implants. The present results suggest a significant association between consonant production skills and language development in these children.

Asian People↗
PubMedDate not supplied

A clinical rationale for assessing rapid automatized naming in children with language disorders.

Three continuous rapid naming tasks (Semel, Wiig, & Secord, 1995) were administered to 2,450 American, English-speaking, academically achieving individuals with typical language development and intellectual ability (ages 6 to 21 years) and 136 individuals with primary language disorders (LD; ages 6, 7, 9, 11, 12, 15-16). Naming time in seconds differed significantly (p < .01) between the groups for color naming (Task 1) at age 12, shape naming (Task 2) at age 6, and color-shape naming (Task 3) at ages 6, 7, 9, and 12. Naming accuracy did not differ significantly (p > .01) between groups at the majority of the age levels compared. In the normative group, naming speed increased with age in a monotonic progression. The developmental trajectory in the LD group was essentially parallel, but elevated. The percentages of individuals who failed the naming-time criteria for Task 3 (color-shape naming) differed significantly in the two groups at all ages compared (p < .05). These findings indicate that the requirements for two-dimensional, continuous naming (Task 3 color-shape naming) resulted in reduced naming speed (longer total times) and interference with fluency in language production in about half of the clinical sample.

Adolescent↗
PubMed1993

Language and development in FG syndrome with callosal agenesis.

The FG syndrome is characterized by unusual facies, sudden infant death, developmental delay, and abnormalities of the cardiac, gastrointestinal, and central nervous systems. No longitudinal data on development in surviving patients are currently available. Serial evaluations of a patient with FG syndrome, whose sole central nervous system anomaly was agenesis of the corpus callosum, showed a consistent pattern over time. Specific language impairments in syntactic and pragmatic-semantic areas are emerging. These findings represent the first detailed data on which expectations for children with the FG syndrome can be based. The findings also fit theoretical constructs on the function of the corpus callosum and may therefore be generalized to provide expectations for other patients with isolated agenesis of the corpus callosum. Given the information gained from this case, it is clear that language intervention/consultation should be a pivotal service for such children, and that the speech-language pathologist should play a role in the development of an integrated educational services plan.

Abnormalities, Multiple↗
PubMed2003

Cochlear implants in young children.

The cochlear implant is best characterized as a device that provides access to the sound environment. The device enables the hearing pathway to respond to environmental and speech sounds, providing informational cues from the surroundings and from others that may escape visual detection. As the developmental effects of a profound hearing loss are multiple, cochlear implants have been applied to ever younger children in an attempt to promote a more normal level of developmental learning through audition. In deafness, transducer elements of the inner ear fail to trigger auditory nerve afferent nerves in the presence of sound input. However, large reserves of afferent fibers exist even in the auditory nerve of a profoundly deaf patient. Furthermore, these nerve fibers retain the ability to respond to prosthetic activation. Through developmental learning in the early, formative years, auditory centers of the brain appear capable of processing information from the implant to provide speech comprehension and oral language development. Multichannel implants have replaced original single channel designs. multichannel devices enable larger percentages of recipients to recognize the spoken word without visual cues because they provide spectral information in addition to temporal and intensity cues. Testing under conditions of auditory (implant)-only input reveals significant open-set speech understanding capabilities in more than 75% of children after three years of device use. The benefit provided by implants may vary with a number of conditions including: hearing history, age of deafness onset, age at implantation, etiology of deafness, linguistic abilities, and the presence of a motivated system of support of oral language development. Patient variables should be given individual consideration in judging candidacy for a cochlear implant and in planning rehabilitative and education services after surgery and activation of the device.

Child↗
PubMed2003

[Benefit of bilateral cochlear implantation on congenital prelingually deafened Chinese-speaking children].

OBJECTIVE: To evaluate the benefit of bilateral cochlear implants (BCIs) in prelingually deafened children on hearing rehabilitation as well as on speech and language development. METHOD: Two cases of congenital profound deaf children, who received unilateral cochlear implantation (CI, MEDEL C40+) on the age of 2 and 7.5, respectively, were performed secondary CI in the contralateral ear on their age of 5 and 9.5, respectively. One year after the secondary CI, the cochlear implant aided hearing threshold and speech discrimination rate were tested for both ears separately and together. The pronounce/speech distinct rate of the BCIs users were evaluated by their parents, surgeon and audiologist. RESULT: In comparison to unilateral aided ear, the mean hearing threshold at the frequency 250-4,000 Hz of the 2 cases with BCIs decreased by 13 dB and 11 dB, respectively. The speech discrimination rate of the BCIs users increased by 9% and 10%, respectively. The speech recognition in noise was improved. And their pronounce/speech distinct was improved. CONCLUSION: BCIs can provide a significant benefit in hearing, speech understanding, language development and pronounce/speech rehabilitation for prelingually deafened children.

Child↗
PubMed1997

Syntactic bootstrapping in children with specific language impairment.

Syntactic bootstrapping was assessed in six children with normally developing language (NL) and six children with specific language impairment (SLI), ages 6 and 8, respectively. Children earned normal range non-verbal IQs and were matched by raw scores on a test of sentence comprehension. They were asked to listen to sentences containing novel verbs and to act out the meanings with toys. The SLI children earned reliably lower scores, but their errors suggested processing limitations rather than deficits in syntactic representation.

Child↗
PubMed2004

A prosodically controlled word and nonword repetition task for 2- to 4-year-olds: evidence from typically developing children.

An association has been found between nonword repetition and language skills in school-age children with both typical and atypical language development (C. Dollaghan and T. F. Campbell, 1998; S. Ellis Weismer et al., 2000; S. E. Gathercole and A. D. Baddeley, 1990; J. W. Montgomery, 2002). This raises the possibility that younger children's repetition performance may be predictive of later language deficits. In order to investigate this possibility, it is important to establish that elicited repetition with very young children is both feasible and informative. To this end, a repetition task was designed and carried out with 66 children between 2 and 4 years of age. The task consisted of 18 words and 18 matched nonwords that were systematically manipulated for length and prosodic structure. In addition, an assessment of receptive vocabulary was administered. The repetition task elicited high levels of response. Total scores as well as word and nonword scores were sensitive to age. Lexical status and item length affected performance regardless of age: Words were repeated more accurately than nonwords, and 1-syllable items were repeated more accurately than 2-syllable items, which were in turn repeated more accurately than 3-syllable items. The effect of prosodic structure was also significant. Whole syllable errors were almost exclusive to unstressed syllables, with those preceding stress being most vulnerable. Performance on the repetition task was significantly correlated with performance on the receptive vocabulary test. This repetition task effectively elicited responses from most of the 2- to 4-year-old participants, tapped developmental change in their repetition skills, and revealed patterns in their performance; and thus it has the potential to identify deficits in very early repetition skills that may be indicative of wider language difficulties.

Analysis of Variance↗
PubMed2003

Gender differences in outcome after neonatal intensive care: speech and language skills are less influenced in boys than in girls at 6.5 years.

AIM: To study language development at age 6.5 y in 230 children who had required neonatal intensive care (NIC) and 71 full-term neonatally healthy control children, all born in 1986-1989, with a focus on comparison between genders. METHODS: Eight aspects of spontaneous speech, 3 fine motor functions, 10 linguistic areas, Peabody Picture Vocabulary Test, and digit recall (ITPA) were assessed. RESULTS: Achievements for gender and gestational age groups were analysed (group I, 23-31 wk; subgroup IA, 23-27 wk; IB, 28-31 wk; group II, 32-36 wk; group III, >36 wk), with children with congenital malformations as a separate group. As a group, at 6.5 y NIC girls had more developed spontaneous speech than NIC boys, and performed better than NIC boys in some linguistic areas. NIC girls of group I had lower results than control girls in spontaneous speech aspects such as speech motor function, interaction and motivation, and in many areas of linguistic skills. In contrast, NIC boys of group I had higher results than control boys in auditory memory, and only regarding information and speech motor function in spontaneous speech were their results lower. Analysis of results of matched pairs of group I NIC girls versus control girls and group I NIC boys versus control boys revealed even more marked differences between NIC girls and their matched controls than between NIC boys and their matched controls. CONCLUSION: Language development in extremely or very preterm NIC boys seems to be less influenced than that in NIC girls by the need for and administration of NIC. The neonatal factors associated with low scores in girls are different from those in boys.

Child↗
PubMed2004

Early predictors of language in children with and without Down syndrome.

Predictors of productive and receptive language development in 39 children with intellectual disabilities (17 with Down syndrome) and their parents were identified. Children were in the prelinguistic or first stage of productive language acquisition (Brown, 1973). The Down syndrome and non-Down syndrome groups were matched on several variables, including IQ, CA, and vocabulary level. After controlling for initial language level, we attempted to identify unique early predictors of language measured 6 months later. Results indicate that Down syndrome negatively affected language development. Additionally, frequency of optimal parental responding predicted later productive language above and beyond etiology. Finally, canonical vocal communication and commenting predicted later productive language only in children without Down syndrome.

Child↗
PubMed1998

Verbal contextual generalization in children with and without learning disabilities.

Braine's (1963) model of language development emphasizes the use of auditory or temporal processing so verbal contextual generalization can be produced. Recent literature on auditory or temporal processing skills of children with learning disabilities led to the prediction that these children would find it much more difficult to generalize contextually than would children without learning disabilities. The present study did not support this prediction. The implications were discussed in view of research on auditory or temporal processing skills of children with learning disabilities.

Age Factors↗