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Hormonal influences in developmental learning disabilities.

Developmental language and learning disabilities in children can take many different forms and can result from a variety of causes. Research to date has focused primarily on specific disabilities in learning, which are characterized by a significant delay or disorder in one aspect of learning against a background of otherwise normal development. Learning disabilities affecting language and/or reading acquisition (developmental dysphasia and dyslexia) have been studied most thoroughly. Verbal learning disabilities occur more frequently in boys than in girls, and there is a higher than expected incidence of left-handedness among affected children. Although there are many reasons why a child may have delayed or disordered language development, differential diagnosis of specific developmental language or reading disorders calls for ruling out mental retardation, peripheral auditory or visual dysfunction, autism, frank neurological impairments such as hemiplegia or seizure disorder, and severe social deprivation or lack of educational opportunity. The typical profile of a developmentally dysphasic or dyslexic child is one who shows a marked discrepancy between nonverbal (performance) IQ and verbal IQ, with a history of delayed or disordered speech, language and/or reading development. Such a child usually performs quite normally on visual spatial tasks, while demonstrating severe deficits in tasks of auditory temporal processing, motor sequencing, phonological processing and memory, language, reading and spelling. This characteristic neuropsychological profile may suggest left hemisphere dysfunction or a failure to develop normal cerebral lateralization. The etiology of these developmental learning disorders is unknown, but there is evidence of familial aggregation, indicating a potential genetic basis. Although these children respond to remediation, longitudinal studies have shown that the symptoms often persist into adulthood (see Tallal, 1988, for a more detailed discussion).

Female↗

A fluent language disorder following antepartum left-hemisphere brain injury.

This article describes the development of language in a left-handed girl with a left middle cerebral artery infarction. Seven language samples of parent-child interaction, obtained when she was between 36 and 60 months of age, were transcribed and analyzed using the Child Language Data Exchange System. At 36 months of age, only 42 (20%) of the child's 214 utterances contained words; the other 80% were composed of jargon or interactional markers such as "uh-huh" and "uhn-uhn." Jargon incorporated familiar intonational contours and prosodic features to convey emotional states and communicative functions. Between 36 and 45 months of age, her jargon became differentiated into increasing approximations of English sentences. Simultaneously, her use of words and word combinations increased. By 54 months of age, no jargon was heard. The pattern of development observed in this child can be described as a transient jargon or fluent aphasia. It may have resulted from initial reliance on an uninjured right hemisphere. However, given the similarity between this pattern and the expressive or gestalt style of learning seen in some normal children, the pattern may also be related to other variables including characteristics of the parental input.

Adult↗

[Psychiatric manifestations in children with speech disorders with and without minimal brain dysfunction].

Several studies have shown not only that children with psychiatric problems are having more speech and language disorders than control groups. Moreover it has been shown that other developmental disorders are more common in groups with speech and language disorders. In a study in Munich including all children with diagnosis of specific developmental disorders of speech and language seen in our outpatient department from 1981 to 1986 we found significantly more psychiatric diagnoses in a subgroup of children with MBD. This was proved for the boys only however not for the smaller group of girls. The results are compared to studies reported in the literature and further research is suggested.

Attention Deficit Disorder with Hyperactivity↗

Molecular genetic approaches to the study of language.

The application of the techniques of modern molecular biology to the study of the genetic control of language development poses many significant challenges. Because language is a complex function, disruption of any of a number of systems can impair language development. The diagnostic classification of specific language impairment includes individuals with an apparently inherited form of disordered language development, and therefore some aspects of this clinical phenotype may be useful for positional cloning studies of genes related to language. Known genetic disorders with specific deficits in language functions may also serve to identify candidate genes for language development. In addition to these specific approaches, the current general strategies for positional cloning and candidate gene studies are reviewed.

Animals↗

Levels of cognitive and linguistic development in Angelman syndrome: a study of 20 children.

Angelman syndrome (AS) is a genetic disorder associated with severe developmental delay. The purpose of this study was to investigate cognitive and linguistic development in AS. Piaget's developmental model was used to evaluate the test results. The participants comprised 20 children (14 boys and 6 girls) aged 2-14 years (median age 7.4 years). AS was diagnosed either according to typical clinical criteria or confirmatory genetic testing. Cognitive functioning was evaluated with Griffiths' Mental Development Scale. Language development was also evaluated with Receptive-Expressive Emergent Language Scale 2 (REEL-2). Cognitive functioning, based on results on the Performance Scale, never exceeded Piaget's sensorimotor stage, 0-2 years. The median mental age for language development was 9 months. Expressive verbal vocabulary consisted of less than 2 words (n = 11), 2-3 words (n = 7) and 4-5 words (n = 2). Analyses according to REEL-2 did not indicate a consistent discrepancy between impressive and expressive language.

Adolescent↗

Language disorders in preschool children: predictors of outcome -- a preliminary report --.

Child neurologists are often asked to evaluate young children who have failed to develop speech despite adequate hearing and skills for non-verbal tasks. At our center, in addition to a standard neurologic evaluation, hearing test, and EEG, we obtain videotape recordings of the child and his mother in play interaction. These observations enable us to assess the child's non-verbal communicative abilities, his affect, his ability to utilize toys symbolically and creatively, and his attention span. Approximately 20 preschool children who were non-verbal or had very limited speech at entry into our study are being followed longitudinally. Readily observable aspects of language and behavior were scored by reviewed the serial videotapes obtained over a 2-year period. Predictors of outcome that do not require detailed linguistic analysis of the child's utterances are tentatively identified and discussed.

Brain Damage, Chronic↗

A longitudinal study of a hyperlexic child: hyperlexia as a language disorder.

The longitudinal study of a hyperlexic girl, A.E., is described. Although her WISC-R IQ was 58, her reading was significantly advanced for age and level of intellectual functioning. She was socially withdrawn and displayed repetitive and self-stimulation behaviors. At birth she weighed 1000 g and was 32 weeks gestational age. She had severe respiratory distress, seizures and apnea in the perinatal period. She had a history of significantly delayed development, although the delays were more pronounced in language than in perceptual motor skills. She demonstrated difficulties with semantic and syntactic processing of language and could read words and sentences of which she had little or no comprehension. The existence of reading in spite of severely disordered language suggests that reading may occur by visual and/or phonological routes but that semantic and syntactical processing of words is not essential.

Child↗

MRI findings in boys with specific language impairment.

Magnetic resonance imaging scans of specifically language-impaired (SLI) boys were examined to determine whether atypical cerebral findings could be documented in children whose primary deficits were in language skills. Clinical examination of the scans failed to reveal any visually obvious lesions or abnormalities. In contrast, measurement of the scans revealed atypical perisylvian asymmetries in most of these subjects. The distribution of perisylvian asymmetries in SLI subjects was significantly different from the distribution in controls (p less than .01). Measurement of other brain regions revealed that extraperisylvian areas were occasionally deviant in individual SLI subjects; but no one region was consistently deviant across the SLI group. Thus, only atypical perisylvian asymmetries were linked to the language disorder. These neuroanatomical findings suggest that a prenatal alteration of brain development underlies specific language impairment.

Brain Damage, Chronic↗

Selection of children with specific language deficits.

A standard approach to the selection of children with specific language deficit was devised. The approach was based on a current definition of specific language deficit that depends heavily on exclusion criteria. Children with known language deficit who had hearing impairment, cognitive deficit, neurologic deficit, or emotional or behavioral disorder were excluded. Both the exclusion criteria and the criteria dealing with required extent of language impairment were specified in considerable detail. A total of 132 language-impaired children aged 4-8 1/2 years were assessed. Criteria for selection of a matched group of normal-language children were also specified. The language-impaired children were referred to the project by speech and language clinicians in accordance with a set of broadly defined criteria. Contrary to expectation, less than one third of the children from this group met the more precisely defined criteria employed in the project. In addition, those who were selected did not form a homogeneous group but showed considerable variation in expressive versus receptive language and in articulation skill. The selection approach and its effectiveness for the purposes of clinical research and intervention studies are discussed.

Child↗

Relevance theory and pragmatic impairment.

This paper summarizes aspects of relevance theory that are useful for exploring impairment of pragmatic comprehension in children. It explores data from three children with pragmatic language difficulties within this framework. Relevance theory is seen to provide a means of explaining why, in a given context, a particular utterance is problematic. It thus enables one to move on from mere description of problematic behaviours towards their explanation. The theory provides a clearer delineation between the explicit and the implicit, and hence between semantics and pragmatics. This enables one to place certain difficulties more firmly within semantics and others within pragmatics. Relevance, and its maximization in communication, are squarely placed within human cognition, which suggests a close connection between pragmatic and cognitive (dis)functioning. Relevance theory thus emerges as a powerful tool in the exploration and understanding of pragmatic language difficulties in children and offers therapeutically valuable insight into the nature of interactions involving individuals with such impairments.

Adolescent↗

Language disorders in childhood and adolescence: implications for learning and socialization.

Children and adolescents with language disorders encounter disruption in the fluency of social interaction. Because of the chronic nature of language disabilities, problems in academic achievement and success become the hallmark of the disorders during the school years. Since adolescence represents a time of experimentation and definition of the self, individuals with language disorders are at high risk for the development of fragmented and inappropriate perspectives about themselves. Treatment must address, in a functionally coordinated manner, the acquisition of essential linguistic and basic academic skills, the learning of curriculum content, and the development of appropriate perspectives of the self and the environment.

Adolescent↗

A prospective study of the relationship between specific language impairment, phonological disorders and reading retardation.

Language and literacy skills were assessed in 83 8 1/2-year olds whose language development had been impaired at 4 years of age. Provided that language problems had resolved by age 5 1/2 years, literacy development was normal, but many of the children who still had verbal deficits at 5 1/2 years of age did have reading difficulties and persisting oral language impairments later on. In these children, reading comprehension tended to be poor relative to reading accuracy. Syntactic competence in the preschool period accounted for a substantial proportion of the variance in literacy attainments, after allowing for the effects of non-verbal ability. There were only weak links between expressive phonological disorders and later ability to read either meaningful text or non-words.

Articulation Disorders↗

Developmental influences in teaching language forms to individuals with developmental disabilities.

The purpose of this experiment was to test the assumption that the sequencing of language goals for individuals with developmental disabilities should be based on the normal developmental sequence. In a series of two studies, phonetic sounds and syntactic structures representing different levels of normal development were taught to individuals with developmental disabilities. The results showed that (a) the majority of earlier emerging forms were acquired in fewer trials, (b) there was never an instance when the later emerging form was acquired and the earlier emerging form was not, and (c) the majority of earlier emerging forms were correctly produced at higher levels than the later emerging forms during probe sessions conducted 6 months after training. The results are discussed in terms of their implications for the development of language curricula for individuals with developmental disabilities.

Adolescent↗

The predictive validity and accuracy of a screening test for language delay and auditory perceptual disorder.

Infants (321) who had been screened for language delay and auditory perceptual problems at 9 months of age were evaluated 1 year later. Of these infants 88.6% were correctly classified as at-risk or not-at-risk of delayed linguistic development. The correlation between performance on the screen and on a language scale was 0.49. The great majority of those with receptive and expressive delay continued to show problems at 2 years of age, whereas half of those with expressive delay alone were within normal limits. No evidence was found that a history of fluctuating hearing loss contributed to the development of either language delay or auditory perceptual problems.

Auditory Perceptual Disorders↗

Familial aggregation of a developmental language disorder.

This paper investigates the etiology of developmental dysphasia and its linguistic properties. Data are presented that suggest that at least some cases of dysphasia are associated with an abnormality in a single dominant gene. The results of a series of tests on a large three-generation family, in which half of the members have dysphasia, are reported. These results show that abstract morphology is impaired in these subjects. It is argued further that the data are consistent with the hypothesis that the dysphasics learn the feature-marked lexical items of language as unanalyzed lexical items. They do not have the underlying capacity to learn language by constructing paradigms.

Adolescent↗