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PubMedDate not supplied

Melodic intonation in the rehabilitation of Romanian aphasics with bucco-lingual apraxia.

The main objective of the present study was to assess the efficiency of the melodic intonation therapy (MIT) in the rehabilitation of Romanian aphasics. Eighty predominantly Broca aphasics used the melodic intonation therapy when no other therapy methods were very efficient. The speech therapist intonated the respective word, then together with the patient and finally let him continue alone. The control group counted 80 aphasics and it applied other therapy methods. Each patient, regardless of the group, was tested twice, before and after therapy. Since most of the patients displayed severe language disorders, and other therapy methods failed in rehabilitating them, MIT was considered an efficient method in the early stages of Broca aphasia with bucco-lingual apraxia.

Adolescent↗
PubMed1998

Auditory integration training and facilitated communication for autism. American Academy of Pediatrics. Committee on Children with Disabilities.

This statement reviews the basis for two new therapies for autism-auditory integration training and facilitative communication. Both therapies seek to improve communication skills. Currently available information does not support the claims of proponents that these treatments are efficacious. Their use does not appear warranted at this time, except within research protocols.

Adolescent↗
PubMed1994

Pharmacotherapy of aphasia. A critical review.

BACKGROUND: Communication problems are a common sequela of cerebrovascular disease and other central nervous system disorders. Behavioral treatment of these disorders aims to harness uninjured parts of the brain to improve the communicative life of the individual. While pharmacotherapy has held promise for the treatment of aphasia for over 50 years, it has not fulfilled this promise. This article reviews both the promise and the disappointment of aphasia pharmacotherapy. SUMMARY OF REVIEW: Diverse theories of the underlying neurological deficits in aphasia have led to different pharmacologic rationales for therapy. Animal studies have demonstrated decreased levels of brain catecholamines after cortical stroke and more rapid stroke recovery with therapy aimed at augmenting brain norepinephrine and dopamine. These studies have led to recent attempts to hasten or extend language and sensorimotor rehabilitation after human stroke by administration of catecholaminergic drugs. When used as an adjunct to behavioral therapy, such pharmacotherapy appears to have benefit. CONCLUSIONS: While drug therapy is unlikely to revolutionize the treatment of aphasia, it nonetheless holds promise as an adjunct to behavioral speech and language therapy to decrease performance variability and consequently to improve mean performance in patients with mild to moderate language dysfunction. Additional studies with carefully designed methods are necessary to assess the full potential of aphasia pharmacotherapy.

Animals↗
PubMed1978

Evaluation of speech and language in neuropsychiatric disorders.

Changes of language and speech in neuropsychiatric patients are described by use of a quantifying procedure. In the transcript of a standardized interview the following variables are evaluated (by estimation of indices): rate of speech, pauses, indistinct and incomprehensible articulations, aphasic disturbances, subordinate: principal clause ratio, stuttering, neologisms, grammatical mistakes, thought disconnections, perseverations/verbigerations, vague utterances, disturbances of orientation, utterances with unusual though content, euphoric utterances, dysphoric utterances, and change of the affective state. Reliability of these indices is tested by inter-rater comparison. The course of speech-language reorganization during therapy is followed. The present method does not intend to give a detailed psycholinguistic analysis, but it yields an objective measure of clinical impressions on abnormalities of language and speech in neuropsychiatric disorders.

Aphasia↗
PubMed2005

University faculty preparation of students in using natural environment practices with young children.

155 university faculty teaching students in physical therapy, occupational therapy, speech and language pathology, early childhood special education, or multidisciplinary studies programs were surveyed to assess how the students were taught how to use everyday family and community activities as natural learning opportunities for young children. Analysis showed that the faculty provided very little training in using community activity settings as contexts for children's learning and that physical therapy faculty provided less training in using natural environments as sources of children's learning opportunities than faculty in the other disciplines.

Adult↗
PubMed2005

[Specific remedial therapy in a specialist unit: evaluation of 31 children with severe, specific language or reading disorders over one academic year].

INTRODUCTION: Up to 3 percent of the children in France present severe and specific language and/or reading disorders, despite regular remedial therapies. Few studies have measured the effectiveness of treatment administered in a specialist unit. PATIENTS AND METHOD: The aims of this study, focusing on children diagnosed as dysphasic and/or dyslexic, were: During the academic year 2001-2002, 31 children (18 dyslexic and 13 dysphasic) were attending school in our unit. The teaching program and intensive speech therapy (3 hours/week) were tailored for each child according to his/her specific disorders. Reading, spelling and numeracy developmental skills of each child were evaluated by appropriate tools at the beginning and at the end of the year. Impairment was defined by measuring the gap between the observed and the expected skills, according to each child's age. Using a self-control method, progress achieved by each child throughout the year was calculated with each tool, in each subject, by subtracting the impairments disclosed at the beginning from those disclosed at the end of the year. Progression was classified within three groups according to the progress normally expected over an academic year (i.e. nine months) from children with no disabilities attending school regularly; a progression fewer than three months was considered as no progression. Uni- and multivariate analyses including age (< or= or />9), type of pathology (dysphasia/dyslexia), and intellectual quotient (IQ) as covariates was carried out to search for independent prognosticators. RESULTS: The entire group demonstrated during the year significant progress for reading (p = 0.0001), spelling (p = 0.0001) and numeracy (p = 0.0001). Nineteen children (61 percent) showed more progress in reading than normally expected over nine months. Out of the remaining 12 children, 10 demonstrated more progress in spelling and/or numeracy than normally expected over nine months. All three reading evaluation tools disclosed a progression although one was less efficient (p = 0.05). Multivariate analysis disclosed age< or=9 and dysphasia as independent progress prognosticators. CONCLUSION: Placement in a specialist unit allows children suffering from severe dyslexia and dysphasia to lessen the gap in reading, spelling and numeracy. The two prognosticators disclosed highlight the importance of early diagnosis (i.e. before nine years old) and treatment of specific language and/or reading disorders.

Aphasia↗
PubMed1984

Speech--language rehabilitation for children in Switzerland.

Speech therapy for children is well known in Switzerland, but not all regions get the same supply. The average age of children who receive speech therapy is 7.9 years. This late beginning of treatment leads to longer duration of therapy. Therapy costs are shared by various institutions, to a wide extent by the Schweizerische Invaliden-Versicherung. The public has to be further informed about the meaning of speech and language rehabilitation.

Adolescent↗
PubMed1998

[Communication disorders in children; experiences with a multidisciplinary outpatient diagnosis].

Communication disorders in children can be caused by impaired hearing. However, also other factors can adversely influence speech and language development, such as mental retardation, lack of language stimulation and anatomical defects of speech organs. Speech and language development can be regarded as a symptom; therefore a multidisciplinary diagnostic procedure is essential to the planning of an adequate therapy programme. In the Netherlands a great variety in diagnosis and treatment exists. A child with a communication disorder is usually seen by five specialists, and the interval between recognition of the communication problem by the parents and the final diagnosis, after which therapy starts, sometimes lasts almost three years. Besides that, in a majority of cases speech and language therapy is offered. In order to change this process for the better a prospective research programme was started in the Academic Hospital Groningen, the Netherlands, with a protocolled multidisciplinary diagnostic approach. The first findings are encouraging: 89% of 209 children with supposed communication disorders were diagnosed after one visit to the outpatient clinic.

Adolescent↗
PubMed2000

The interface between ADHD and language impairment: an examination of language, achievement, and cognitive processing.

Language impairments are commonly observed among children referred for psychiatric services. The most frequent psychiatric diagnosis of children with language impairment (LI) is Attention Deficit Hyperactivity Disorder (ADHD). It is not clear whether there are differences between children with ADHD and comorbid LI and children with other psychiatric disorders who are also comorbid for LI. In the present study the language, achievement, and cognitive processing characteristics of 166 psychiatrically referred 7-14-year-old children were examined using a 2 x 2 (ADHD, LI) design to examine four groups: children with ADHD + LI, children with ADHD who have normally developing language, children with psychiatric diagnoses other than ADHD with a language impairment (OPD + LI) or without a LI (OPD). Results indicated that children with LI were at the most disadvantage regardless of the nature of the psychiatric diagnosis. Contrary to prediction, working memory measures, used to tap the core cognitive deficit of ADHD in executive functions, were more closely associated with LI than with ADHD. It was concluded that caution must be exercised in attributing to children with ADHD what might be a reflection of problems for children with language impairment generally. As most therapies are verbally based it is notable that language competence is rarely evaluated systematically before such therapies are undertaken.

Achievement↗
PubMed1999

Forecasting patient outcomes in the management of hyperlipidemia.

BACKGROUND: To forecast adult patient outcomes in the management of hyperlipidemia using adult National Health and Examination Survey III (NHANES III) population statistics and National Cholesterol Education Program (NCEP) guidelines for goals of therapy. METHODS: Review of the hyperlipidemia drug therapy English-language medical literature with emphasis on randomized controlled trials of more than 6 weeks' duration published in the last 7 years, product package inserts, US Food and Drug Administration submission information, and NHANES III population statistics. Data were extracted from studies of lipid-lowering therapy to modify low-density lipoprotein (LDL) levels for primary and secondary prevention of coronary heart disease. The data that were evaluated included sample size, study design, therapeutic intervention, length of study, percentage change in LDL levels, and patient demographics. RESULTS: Cumulative frequency curves of the LDL distribution among the US adult population were constructed. The mean efficacy of drug therapy from qualified studies was used to extrapolate the percentage of the population expected to respond to the intervention and to forecast the patient outcome. CONCLUSIONS: A useful tool for clinicians was constructed to approximate the percentage of patients, based on risk stratification, who would reach NCEP target goal after a given pharmacotherapeutic intervention to decrease LDL levels.

Adult↗
PubMed2026

Novel Proactive Speech-Language Intervention Is More Effective Than Usual Care: Randomized Controlled Trial of Babble Boot Camp for Infants With Classic Galactosemia.

PURPOSE: Speech and language disorders cannot be diagnosed and treated until children are approximately 2-4 years old. To investigate whether these disorders can be prevented, we developed and trialed Babble Boot Camp (BBC), the first proactive sustained intervention starting with precursor skills including cooing and babbling. METHOD: Participants were two randomly assigned groups of 22 infants with classic galactosemia, a metabolic disease with known risks for severe speech and language disorders. One group started BBC at under 6 months of age, and the other started at 15 months of age, both completing BBC at 24 months of age. Coached by a speech-language pathologist in weekly telehealth sessions, caregivers implemented BBC activities and routines daily at home. A typical control group and a group of children with classic galactosemia who received usual care participated as well. All children completed standardized assessments of speech and language at postintervention. RESULTS: Assessment scores showed that BBC was more effective than usual care for both intervention groups. Greatest benefits were seen in the group that started at or before 6 months of age, with a proportion of clinically concerning scores equal to that in the typically developing peers. No effects of sex, genotype, or milk consumption were evident in the outcomes. CONCLUSIONS: Findings motivate a paradigm shift from deficit-based to proactive approaches for infants with classic galactosemia. BBC is extensible to many other disorders, with trials currently underway for infants with Down syndrome and infants born preterm.

Humans↗
PubMed2006

Music therapy in the assessment and treatment of autistic spectrum disorder: clinical application and research evidence.

BACKGROUND: Children and adolescents with autistic spectrum disorder (ASD) presenting with significant limitations in conventional forms of verbal and non-verbal communication are found to respond positively to music therapy intervention involving both active, improvizational methods and receptive music therapy approaches. Improvizational musical activity with therapeutic objectives and outcomes has been found to facilitate motivation, communication skills and social interaction, as well as sustaining and developing attention. The structure and predictability found in music assist in reciprocal interaction, from which tolerance, flexibility and social engagement to build relationships emerge, relying on a systematic approach to promote appropriate and meaningful interpersonal responses. RESULTS: Published reports of the value and effectiveness of music therapy as an intervention for children with ASD range from controlled studies to clinical case reports. Further documentation has emphasized the role music therapy plays in diagnostic and clinical assessment. Music therapy assessment can identify limitations and weaknesses in children, as well as strengths and potentials. Research evidence from a systematic review found two randomized controlled trials that examined short-term effects of structured music therapy intervention. Significant effects were found in these studies even with extremely small samples, and the findings are important because they demonstrate the potential of the medium of music for autistic children. Case series studies were identified that examined the effects of improvizational music therapy where communicative behaviour, language development, emotional responsiveness, attention span and behavioural control improved over the course of an intervention of improvizational music therapy.

Adolescent↗