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PubMed1980

The prevalence, stability and significance of developmental language delay in preschool children.

A sample of 937 children in Dunedin, New Zealand, was assessed at ages three and five years in order to estimate the nature, prevalence, stability and significance of developmental language delays in three-year-olds. Assessments included language development, intelligence, and fine and gross motor-co-ordination. Detailed results are given which described three types of language delay at age three: delayed verbal comprehension only, delayed verbal expression only, and delayed development in both aspects of language. Follow-up testing at age five indicated that the specific language delays were not highly stable, whereas delays in both aspects were highly stable. A large proportion of the latter children gained very low scores on the measures at age five, and they accounted for 84 per cent of all children with very low intelligence. The implications of the results for a screening programme to identify three-year-old children at high risk of later developmental delays are considered.

Child, Preschool↗
PubMed1994

Word skills of children normal and impaired in communication skills and measures of language and speech development.

Results from two related investigations are reported, one using 60 normal language learners, ages 3-5 and one using 34 children with communication disorders, ages 5.4-8.5. Tasks involving the sequential recall of words from five categories (nouns, verbs, adjectives, adverbs, and prepositions) were given to the subjects in each investigation, thus providing an opportunity to compare group performances. A hierarchy of recall strengths of words from different categories and the organizational pattern of scores was determined for each group. Each group's word category scores were used as independent variables in regression analyses to predict scores from a battery of language tests and a test of phonology. The results were anticipated to be capable of contributing to descriptions of children's mental dictionaries, have implications for word category differences in normal and impaired language learners, and clinical relevance. Comparisons of the word recall accuracy of skills of children from each group revealed that the younger normal Ss had word scores equal to the older language and speech impaired children. However, the hierarchy of word category strengths and the patterns of organization within each group's mental dictionary were essentially the same in both groups. Word category scores predicted language and speech scores in both investigations, but the prediction was stronger in the children having impaired language or speech.

Child↗
PubMed1977

A syntactic investigation of verbal autistic, mentally retarded, and normal children.

The syndrome of childhood autism is typified by major abnormalities in language development, yet there are few systematic descriptions of autistic children's linguistic systems. We have, therefore, begun a comprehensive investigation of the language of verbal autistic children and concentrate in this paper on comparing the syntax used by 10 verbal autistic children matched for nonlinguistic mental age with a group of mentally retarded subjects and normal controls. Two different means of assessing syntactic development were utilized: Lee's Developmental Sentence analysis and Chomsky's Transformational analysis. The autistic group was found to rank significantly lower than either the mentally retarded or the normal groups in terms of Developmental Sentence Scores. When a transformational grammar was used to describe the language samples of our subjects the autistic children were typified by a higher error rate and lower level of complexity compared to the other two groups. However, the results also indicate that the grammatical system of autistic children is rule-governed and probably not unlike that of young normal or retarded children. In conclusion, it appears that the syntactic abnormalities characteristic of autism are attributable to an extreme delay in language development as well as to an impaired ability to make use of linguistic rules.

Autistic Disorder↗
PubMed1998

Cases of exceptional language in mental retardation and Down syndrome: explanatory perspectives.

Recent studies of exceptional language development and functioning in mentally retarded people raise questions regarding basic issues in language disorders. These studies are summarised and their implications discussed. Possible reasons for the existence of such cases are examined including language training, general cognitive functioning, working memory, cerebral dominance, and deep-seated variation at brain level.

Cognition↗
PubMed1996

Otitis media, communication style of primary caregivers, and language skills of 2 year olds: a preliminary report.

The association between early otitis media, styles of primary caregivers, and language development was prospectively examined in 26 2-year-old children from lower socioeconomic backgrounds (of mixed perinatal status) followed prospectively since birth. Based on otoscopic evaluations during the first year of life, there were 14 children who were classified as bilaterally otitis-free (OM-) and 12 children who were classified as bilaterally otitis-positive (OM+). At 2 years of age, all children were administered standardized measures of cognitive and language function along with a 20-minute videotaped play session with one of their primary caregivers. The language of both the children and caregivers was analyzed. Results indicate that caregivers of OM+ and OM- children used language nearly identically when interacting with their children. However, caregivers of OM+ children whose communication style was marked by a high percentage of directives and a corresponding low percentage of both questions and information-giving had the children with the lowest scores on all measures of naturalistic language. Controlling for neonatal illness did not alter the relationships found. The results suggest that caregiver language may compensate for some of the auditory deprivations associated with otitis media.

Brain Damage, Chronic↗
PubMed1987

Epilepsy-aphasia syndrome in children: an unusual presentation to psychiatry.

This paper describes the psychiatric and clinical manifestations of the epilepsy-aphasia syndrome which occurs in children. In 1957, Landau and Kleffner reported the development of receptive and expressive aphasia at 5 to 6 years of age, in six children with normal language development at that time. Since this first report, further accounts of acquired language disabilities associated with EEG abnormalities have appeared. However, the clinical syndrome remains ill defined and its pathophysiology is poorly understood. There are no reported cases of this syndrome presenting initially to psychiatry. This paper reports a child who presented to psychiatry with severe aggression associated with the clinical syndrome of epilepsy-aphasia. The discussion examines the relationships between the aggressive behavior and the EEG findings and aphasia.

Aphasia↗
PubMed1997

Look who's talking: a prospective study of familial transmission of language impairments.

Language impairments have been hypothesized to have a genetic component. Previous studies of the familial aggregation of language impairments have relied on a retrospective approach based on parental/self-reported history of language development. This study examined familial aggregation prospectively, by investigating language acquisition and cognitive development in the younger siblings and offspring of individuals with well-defined language impairments. It was predicted that children with a positive family history for language impairments would be more likely to show delays in language acquisition than would age- and gender-matched controls. Similar delays were not expected in nonlinguistic domains, such as conceptual, gestural, or general cognitive development. Ten children with a positive family history and 10 age- and gender-matched controls were tested. Analyses of linguistic and cognitive assessments at 16 to 26 months confirmed the predictions. Children with a family history of language impairments had lower receptive and expressive language scores than controls, with 50% of them scoring at least 1.5 SD below the mean for their age. At the same time, performance on a number of tasks that did not rely on language abilities did not differ as a function of family history. These results indicate that children with a positive family history for language impairments are at risk for language delay; the results also support a familial component to language impairments.

Birth Order↗
PubMedDate not supplied

Components of child and parent interviews in cases of alleged sexual abuse.

Considerable discussion in child sexual abuse evaluation centers around minimizing the number of victim interviews, however, the completeness of one professional's interview is not always addressed. In this study, professionals (medical, social, law enforcement/legal, mental health) indicated what components they included in their interviews of sexual abuse victims and their parents. Components included: details of abuse, family relationships, school situation/performance, child's development (toilet training, bed wetting, language development, etc.), child's knowledge of body part names, child's knowledge of body part functions, child-rearing practices (bathing, sleeping), medical history (illnesses, surgery), behavior problems, psychological symptoms (nightmares, sadness), physical complaints (pain, discharge), parental teaching about sex, and child's access to sexually explicit television or magazines. Interview components varied by profession, consistent with expected professional bias. This study demonstrates some professional bias in interviewing children and parents and suggests that having a single interview or interviewer may not always be optimal for a thorough evaluation. Increased communication and teamwork among professionals, and cross-training among disciplines could facilitate both the recognition of appropriateness of some "multiple interviews" as well as provide efforts to consolidate interviews when possible.

Adult↗
PubMed2004

Effective strategies to prepare infants and families for home tracheostomy care.

In neonates tracheostomies are most often indicated to provide a stable airway for infants with congenital or acquired airway obstructions and to provide long-term mechanical ventilation. Learning to care for an infant with a tracheostomy can be challenging for both professionals and families. This article provides an overview of tracheostomy care and the essential elements of family teaching. The surgical procedure and basic anatomical changes are reviewed. Complications such as accidental decannulation, mucus plugging, infection, bleeding, and granulation tissue formation are discussed. Humidification is critical for the infant with a tracheostomy and humidification delivery methods are discussed. Further, an overview of the impact of the tracheostomy on normal development, such as swallowing and language development, is provided. Teaching parents to safely care for the infant with a tracheostomy at home requires careful planning and systematic education. The parents must acquire a unique set of technical skills demonstrating competence and comfort in providing stoma care, suctioning, and tube changes. Parents must be prepared to initiate cardiopulmonary resuscitation (CPR) and need to understand alterations in CPR techniques in infants with a tracheostomy. They also need to develop critical thinking skills to handle emergency situations. A safe transition to the home can be accomplished by using a multidisciplinary approach to coordinate all facets of care.

Adult↗
PubMed2003

A procedure for identifying regions preferentially activated by attention to semantic and phonological relations using functional magnetic resonance imaging.

A procedure is introduced for using functional magnetic resonance imaging (fMRI) techniques to identify neural regions associated with attention to semantic and phonological aspects of written words within a single group of subjects. Short lists (16 words/list), consisting of visually-presented semantically-related words (bed, rest) or rhyming words (weep, beep) were presented rapidly to subjects, who were asked to attend to the relations among the words. Regions preferentially involved in attention to semantic relations appeared within left anterior/ventral inferior frontal gyrus (IFG, approximate Brodmann Area, BA47), left posterior/dorsal IFG (BA44/45), left superior/middle temporal cortex (BA22/21), left fusiform gyrus (BA37), and right cerebellum. Regions preferentially involved in attention to phonological relations appeared within left inferior frontal cortex (near BA6/44, posterior to the semantic regions within IFG described above) and within bilateral inferior parietal cortex (BA40) and precuneus (BA7). This method is notable in that a comparison of the two tasks within some of the individual subjects revealed activation patterns similar to the group average, especially within left inferior frontal and left superior/middle parietal cortices. This fact combined with the efficiency with which the data can be obtained (here, in about an hour of functional scanning) and the adaptability of the task for many different subject populations suggests a wide range of possibilities for this technique: it could be used to track language development (e.g. in children), compare language organization across subject populations (e.g. for dyslexic or blind subjects), and identify language regions within individuals (e.g. potentially to aid in surgical planning).

Adolescent↗
PubMed1990

Homelessness and cognitive performance in children: a possible link.

The developmental impact of homelessness on children was assessed by using a screening battery to measure cognitive and language delays as well as emotional status. The results of testing 88 children in a family shelter program indicate a possible significant impact of homelessness on both the cognitive and language development of these children, with language more severely affected. Emotional pathology, however, was not detected with the screening instruments used. Most service providers who deal with homeless children fail to recognize their special programming needs. It is important for the social worker to advocate with the educational system for these children's special needs.

Child↗
PubMed1985

Facial expressions of emotion in mother-infant interaction.

Face movements of infants 2 months of age when they are interacting with their mothers give evidence both for innate representation of the mother as a partner in communication and for an emotional system that evaluates her expressions and regulates their interpersonal contact. Although the facial neuro-motor system is immature in infancy, it can generate many expressions that compare closely with those by which adults transmit emotions and control engagements and relationships. It also expresses rudiments of special motivation for speaking. Even newborns show clear evidence of organized facial expressions defining distinct communicative states that respond to maternal care. Emotional communication is multimodal; as infants gain in perceptuo-motor and cognitive powers, they both express and respond to simultaneous signals of affect in multiple channels of voice, gesture and postural change. Face expressions form but part of a stream of motor evidence of central affective state and its changes. Mothers present to infants a form of expressive activity (baby talk) that has clearly marked synchronous visible and audible features. The precocious expressive capacities and sensitivities of infants and maternal fostering of them would appear to be a human adaptation to facilitate development of observational learning and language. Developments in the first year expand the scope of communication and play without changing the fundamental emotional code by which infant and familiar caretakers construct and defend their special relationships.

Adult↗
PubMedDate not supplied

[Early identification of developmental language disorders--predictive value of the German version of the CDI--infant form (ELFRA-1)].

BACKGROUND: Early identification of developmental language disorders is a precondition for early intervention and therefore of high clinical relevance. The ELFRA-1 was constructed to identify children at risk for language disorders in the context of the routine examination of children at the age of 12 months. The aim of the study was to determine the predictive validity of this screening tool. SUBJECTS AND METHOD: 121 parents completed the questionnaire for their 12 months old children. One year later the language development was assessed by means of the ELFRA-2, the German version of the CDI for two year old children. RESULTS: 63% of the children were correctly classified. The sensitivity amounted to 52% and the specificity to 65%. The RATZ-index (relative improvement of the hit rate in comparison to the random hit rate) was 23%, which has to be considered as unsatisfying. Improvement of language abilities were less likely in boys compared to girls and in cases of low educational background of the mother. CONCLUSIONS: The prognostic validity of the ELFRA-1 is insufficient and too low to identify children at risk for later language impairment. The screening overlooked too many late talkers and classified too many normally developed children as language impaired. The ELFRA-1 can not be recommended as a useful method for the early identification of language impaired children at the age of 12 months.

Child, Preschool↗
PubMedDate not supplied

Language after hemispherectomy.

We studied the spoken language of 49 children who had undergone hemispherectomy as part of the UCLA Pediatric Epilepsy Surgery Research Program and analyzed, among a number of clinical factors, the relation between acquired vs developmental pathology and spoken language outcomes. In this paper we will briefly review the results of our study and attempt to explain (1) why "the early" is not always better, (2) why so many right hemispherectomies fail to develop language, and (3) why some left hemispherectomized children develop remarkably good language despite removal of the "language" hemisphere. This account will rest on the proposed model of brain maturation and progressive lateralization.

Brain↗
PubMedDate not supplied

Interaction before conflict and conflict resolution in pre-school boys with language impairment.

BACKGROUND: Children with language impairment (LI) experience social difficulties, including conflict management. The factors involved in peer-conflict progression in pre-school children with LI, and which of these processes may differ from pre-school children with typical language development (TL), is therefore examined. AIMS: To describe the relationship between opponents interacting before conflict, aberrant conflict causes, the conflict-resolution strategy reconciliation (i.e. friendly contact between former opponents shortly following conflict termination), and conflict outcome in the form of social interaction after a conflict has run its course. It is hypothesized that without social interaction before conflict, children with LI will experience increased difficulties attaining reconciliation. METHODS AND PROCEDURES: Unstructured play of 11 boys with LI (4-7 years old), at a specialized language pre-school, and 20 boys with TL (4-6 years old), at mainstream pre-schools, were video filmed. Conflicts were identified and recorded according to a validated coding system. Recorded conflict details include social interaction between conflict in the pre-conflict period, behavioural sequences constituting conflict cause (conflict period), reconciliatory behaviours in the post-conflict period, and social interaction between former opponents in the succeeding non-conflict period. The group's mean proportion of individual children's conflicts in which specific behavioural sequences occurred were calculated and compared between and within the groups. OUTCOMES AND RESULTS: When conflicts with and without pre-conflict social interaction were analysed separately, aberrant caused conflicts occurred more often in LI group conflicts than in TL group conflicts. However, in conflicts without social interaction in the pre-conflict period, boys with LI exhibit reconciliatory behaviours in, and reconcile a comparatively smaller proportion of, conflicts. Social interaction in the succeeding non-conflict period was proportionately less for boys with LI. This appears to stem from lower reconciliation rates in LI conflicts that do not begin with social interaction in the pre-conflict period. It was also confounded by the larger number of aberrant caused LI conflicts that were rarely reconciled. In turn, non-reconciliation and aberrant caused conflicts were independently associated with comparatively less social interaction in the succeeding non-conflict period. CONCLUSIONS: The results suggest that in addition to traditional psycholinguistic training, children with LI may gain from interventions that support concluding behavioural turns, as in aberrant caused conflicts; and in initiating contact in conflict situations, even when a frame of reference is not immediately available, as was the case when opponents have not established social interaction in the pre-conflict period.

Case-Control Studies↗
PubMed1975

Perceptual and linguistic factors in the language impairment of developmental dysphasics: an experimental investigation with the token test.

Twelve developmental dysphasics and twelve control children were tested on De Renzi and Vignolo's Token Test. The performance of the dysphasics, though significantly poorer than that of the controls on Parts 2-5 of the test, seemed to follow a similar pattern. Both groups were errorless on the initial parts of the test. As the demand on auditory retention increased on subsequent parts of the test, the performance of both groups progressively deteriorated. However, the addition of grammatical complexity on Part 5, rather than causing even further deterioration in performance, actually served to improve the performance of both groups, though not significantly. Although the pattern of errors made by the two groups was similar, the quantity of errors made by the dysphasics, as compared to the normal control children, demonstrated the magnitude of the dysphasic children's receptive language impairment. Analysis of errors indicated that dysphasic children have greater difficulty with auditory retention and verbal memory than they do with the grammatical or structural complexity of language. It is suggested that the observed gross language impairment of developmentally dysphasic children does not result, at least primarily, from a specific inability to analyze the linguistic components of language. Rather, the language impairment of these children appears to reflect their primary inability to analyze the rapid stream of acoustic information which characterizes speech and is essential to normal speech perception and language development.

Aphasia↗
PubMedDate not supplied

Prenatal exposure to methylmercury and child development: influence of social factors.

BACKGROUND: In the Seychelles Child Development Main Study (SCDS), at 19 months of age, enhanced MDI scores were associated with increasing methylmercury (MeHg) exposure in higher caregiver IQ groups at several levels of family income. We performed a similar analysis of the 66-month evaluations to determine if the modifying influences of social and environmental factors were consistent with those previously observed. METHODS: Prenatal MeHg exposure was determined by analysis of maternal hair growing during pregnancy. Children in the cohort (N=711) were evaluated for cognitive ability (McCarthy Scales of Children's Abilities), language development (Preschool Language Scale), drawing and copying (Bender Gestalt Test), scholastic achievement (the Woodcock-Johnson Test of Achievement), and behavior (the Child Behavior Checklist). Interactions between prenatal MeHg exposure and caregiver intelligence, socioeconomic status (SES), home environment, and gender were examined by multiple regression analysis. RESULTS: The median prenatal MeHg exposure was 5.9 ppm (range=0.5-26.7 ppm). Gender significantly influenced the association between prenatal exposure and drawing and copying; however, the effects were not consistent. Prenatal exposure interacted with one or more social or environmental covariates for general cognitive ability, overall language ability, and prearithmetic achievement. Again, the effects were not consistent across either endpoints or covariate categories. CONCLUSIONS: Evidence of a small influence by social and environmental variables at 66 months is neither internally consistent nor consistent with earlier results. Overall, a consistent pattern of effect modification (EM) has not been observed, suggesting that the results may be due to chance.

Achievement↗