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Development in children following abuse and nonorganic failure to thrive.

Thirty-nine children who had been abused an average of 5 1/2 years earlier and 14 children who had been admitted to the hospital with nonorganic failure to thrive (NOFTT) 13 years earlier were studied to look at similarities and differences in their development. Each group was studied in relation to a comparison group matched for age, sex, social class, and ethnic background. The abused children and those with NOFTT were similar in their language ability, and were significantly behind their comparison groups in language development, reading age, and verbal intelligence. The abused children, but not the group who had NOFTT, were significantly behind their comparison group in general intelligence, interpersonal relations, and self-concept, but in contrast to the children with NOFTT they were not delayed in social maturity. The long-term adverse sequelae of these two conditions emphasize the need for a long-term, child-centered approach.

Adolescent↗

Language recovery after left hemispherectomy in children with late-onset seizures.

We investigated the language capabilities of the isolated right hemisphere in 6 children (age, 7-14 years) after left hemidecorticectomy for treatment of Rasmussen's syndrome. Patients were right-handed before surgery and had at least 5 years of normal language development before the onset of seizures. Language testing included speech sound (phoneme) discrimination, single word and phrasal comprehension, repetition, and naming. Within 4 to 16 days after surgery, patients showed improved phoneme discrimination compared with their performance shortly before surgery. Other language functions remained severely impaired until at least 6 months after surgery. By 1 year after surgery, receptive functions were comparable with, or surpassed, patient presurgery performance. Although word repetition was intact by 1 year after surgery, naming remained impaired, and patient speech was limited largely to production of single words. These results suggest that the right hemisphere is innately capable of supporting multiple aspects of phoneme processing. Recovery of higher level receptive and, to a lesser extent, expressive language functions is attributed to plasticity of the right hemisphere, which appears to persist beyond the proposed critical period for language acquisition and lateralization.

Adolescent↗

An update on laboratory information management systems.

The realization that a laboratory is an effective information generator within an organization has begun to influence the functions required of a laboratory information management system (LIMS): different laboratories require different functions. The trends in general computing such as open systems, adoption of relational database technology, and the use of more efficient development languages, are also impacting on the development of LIMS. These trends, plus the development of standards for both LIMS and analytical data interchange, will allow the development of systems that are quicker to implement, easier to maintain and meet the business need better.

Clinical Laboratory Information Systems↗

Perinatal dioxin exposure and later effects--a review.

Negative effects of perinatal exposure to background levels of dioxins and PCBs in Europe and the USA have been documented. Four facets of development are reviewed in this paper: 1. Brain development and thyroid hormone metabolism. 2. Hepatic effects. 3. Hematopoietic system effects. 4. Lung function. Effects on IQ and behaviour have been documented in children on both sides of the Atlantic Ocean. Non-dioxin-like PCBs, measured in maternal and cord blood and current plasma samples have been implicated. Interference with thyroid hormone metabolism in the mother, in the foetus and in the newborn baby could be responsible for these effects on brain development. During early gestation the foetus is completely dependent on maternal thyroxine (T4). Lower T4 levels in the mother, caused by dioxins and PCBs, might negatively influence (early) brain development. It is plausible that the intrauterine dependency on maternal T4 and the high T4 need shortly after birth makes both these periods vulnerable for environmental influences. Effects of dioxin exposure on thyroid hormone metabolism have been described in the period shortly after birth. These effects are no longer found after two years of age indicating a transient effect. In animal studies, in utero exposure has led to effects on brain development due to abnormal induction of liver enzymes. This induction resulted in lower testosterone and estrogen levels, interfering with brain development in the vulnerable period of language development and the development of visuo-spatial abilities. In humans this developmental period occurs around the thirtieth week of pregnancy. Follow-up studies in puberty and adolescence of the different cohorts studied is necessary to evaluate these negative influences. Damaging effects on the liver found shortly after birth have proven to be transient. Effects on the haematopoietic system are clear immediately after birth, for instance on white blood cells and thrombocytes. An increase in middle ear infections (otitis media) in relation to current levels of PCBs at the age of 4 years was described in the Rotterdam study. Negative effects on lung function in the sense of increased obstruction was found after 8 years in relation to perinatal exposure to dioxins in the Zaandam study. This rather new finding might explain the sharp increase in lung problems in children in the Western world.

Brain Chemistry↗

An investigation into aspects of the Mayo early language screening test.

The concurrent validity and inter-tester agreement on the Mayo early language screening test (MELST), and the concurrent validity of parental anxiety about speech and language development as a screening measure were investigated. A sample (aged 18 months to 5 years) comprising 120 children referred to the Mayo speech and language therapy department during 1995 and 80 controls, was assessed on the MELST by their local public health nurse. Within a calendar month each child was reassessed on the MELST by the therapist, who also administered the Reynell developmental language scales (RDLS) and the Edinburgh articulation test (EAT) as criterion measures. Overall, the MELST achieved moderately high sensitivity and specificity measures. Phonological problems were identified with more accuracy than language problems and the test was equally sensitive to impairments in comprehension and expression. The test tended to over-refer and was least accurate in screening the language skills of children at the highest age level (4-5 years). A significant association was found between parental concern and pass/failure on each of the MELST, RDLS and EAT. As a screening measure, parental anxiety achieved high sensitivity, moderate specificity and a moderate positive predictive value. However, it also tended to over-refer, and was also least accurate in identifying speech and/or language disorders at the highest age level. Moderately high inter-tester agreement measures were found, with greater agreement between scoring for controls than referrals. The phonology sections were scored significantly higher by the public health nurses than by the therapist. The results of this study imply that the MELST is sufficiently accurate and reliable to recommend its continued use in child surveillance programmes.

Child, Preschool↗

Lasting effects of otitis media with effusion on language skills and listening performance.

Otitis media with effusion (OME) and its related hearing loss has been associated with delayed language development, particularly if the disease is recurrent or of long duration. To find out more about the long-term effects of OME on language skills and listening performance we performed a retrospective study. A group of 19 otherwise healthy 9-year-old children with an earlier history of long lasting bilateral OME were compared with an age-matched control group of 19 children with no history of OME or hearing impairment and normal otoscopy, tympanometry and audiometry. The children in the OME group had an average of 1.4 treatments with ventilation tubes. Mean hearing levels for 500, 1,000 and 2,000 Hz in the OME group were 13 dB in the right ear and 11.3 dB in the left ear. All children were examined with the Illinois test of psycholinguistic abilities (ITPA), test for articulation, Boston naming test, dichotic listening tests with additional tasks of directed attention and tests for word and sound discrimination. In the OME group we found significant lower scores in the articulation test and small, but significant, lower scores in the test regarding sound discrimination. No significant differences on other language skills were detected in the ITPA test or Boston naming test. We found a significantly higher degree of right ear advantage and lower attentional effectiveness in the OME-group.

Attention↗

Morbidity and neurological function of very low birthweight infants from the newborn period to 4 y of age. A prospective study from the south-east region of Sweden.

All 107 infants weighing < or = 1500 g at birth (VLBW) and born alive in the south-east region of Sweden during a 15-month period in 1987-88 were enrolled in a prospective study to determine the prevalence of handicap and to assess neurological function in comparison with controls. Eighty-six (80%) infants survived. Twenty (19%) had intracranial haemorrhages (ICH) assessed by ultrasound examinations in the neonatal period and 2 (2.3%) retinopathy of prematurity stage 3 or more. The VLBW infants who survived had fewer optimal neurological responses than the controls at 40 weeks post-conceptional age. Eighty-two VLBW children were followed to 4 y of age. Three (4%) children had a neurological handicap and 9 (11%) had a moderate neurological deviation. Neither the size of ICH nor neonatal optimality score correlated to neurological outcome at 4 y of age. The VLBW children without neurological handicap or deviation (n = 70) had a delay in psychomotor development in comparison with the controls. Mental development and school performance, in particular language development, will be examined at school age.

Child, Preschool↗

Working memory and novel word learning in children with hearing impairment and children with specific language impairment.

BACKGROUND: Working memory is considered to influence a range of linguistic skills, i.e. vocabulary acquisition, sentence comprehension and reading. Several studies have pointed to limitations of working memory in children with specific language impairment. Few studies, however, have explored the role of working memory for language deficits in children with hearing impairment. AIMS: The first aim was to compare children with mild-to-moderate bilateral sensorineural hearing impairment, children with a preschool diagnosis of specific language impairment and children with normal language development, aged 9-12 years, for language and working memory. The special focus was on the role of working memory in learning new words for primary school age children. METHODS & PROCEDURES: The assessment of working memory included tests of phonological short-term memory and complex working memory. Novel word learning was assessed according to the methods of. In addition, a range of language tests was used to assess language comprehension, output phonology and reading. OUTCOMES & RESULTS: Children with hearing impairment performed significantly better than children with a preschool diagnosis of specific language impairment on tasks assessing novel word learning, complex working memory, sentence comprehension and reading accuracy. No significant correlation was found between phonological short-term memory and novel word learning in any group. The best predictor of novel word learning in children with specific language impairment and in children with hearing impairment was complex working memory. Furthermore, there was a close relationship between complex working memory and language in children with a preschool diagnosis of specific language impairment but not in children with hearing impairment. CONCLUSIONS: Complex working memory seems to play a significant role in vocabulary acquisition in primary school age children. The interpretation is that the results support theories suggesting a weakened influence of phonological short-term memory on novel word learning in school age children.

Adolescent↗

[Neonatal hearing screening].

Approximately 1 to 2 per thousand live-born infants suffer from a serious perceptive hearing loss. Normal hearing from birth is essential for optimal human development (language and speech, social and emotional development, communicative skills and learning). The earlier the hearing loss is diagnosed the better the prognosis for the infant with a hearing impairment. Suitable methods are now available for neonatal hearing screening: automated measurement of auditory brain stem response and measurement of oto-acoustic emissions. Screening must be viewed as only the first step in a program of diagnosis, treatment and habilitation of these children. The ultimate goal of the implementation of neonatal hearing screening is: identification of bilateral hearing losses before the age of 3 months and start of therapy and counselling before the age of 6 months.

Age Factors↗

Social interaction and developmental competence of preterm and full-term infants during the first year of life.

37 mother-preterm and 42 mother-full-term infant pairs were assessed at 1, 4, 8, and 12 months following hospital discharge. The psychosocial functioning of the families was assessed at 1 and 8 months by interview, infants received developmental assessments at 4 and 12 months, and mother-infant interactions were observed in unstructured and semistructured situations at 4, 8, and 12 months. Significant differences were found in both mothers' and preterm infants' interactive behavior across the first year of life, extending the findings of previous research that had noted differences during early infancy. Additionally, preterms performed significantly below full-terms on measures of cognitive and language development corrected for gestational age. Results are discussed in terms of the persistence of interactive differences in mother-preterm pairs and the possible effects on their relationship and infant developmental outcome.

Affect↗

[Voice and vibration sensations in the speech forming organs: clinical and theoretical aspects of rare symptoms specific for schizophrenia].

When studying 750 psychiatric in-patients with psychoses of various diagnostic groups, the symptoms of voice sensations and vibration feelings could only be found among patients with paranoid schizophrenia. In addition, these symptoms were located exclusively in body areas that are involved in the peripheral motor production of voice and speech (areas of head, throat, thorax). In 11 of 15 such cases that could be identified, the sensations of voices and vibrations occurred simultaneously and in identical body parts; in the remaining 4 cases only voices without vibration sensations were reported. Therefore these symptoms can be considered as highly specific for schizophrenia. According to the terminology of Bleuler these two symptoms are because of their rareness to be taken as accessoric symptoms; according to the terminology of Kurt Schneider they have the value of first rank symptoms because of their highly diagnostic specifity for schizophrenia. The pathogenesis of these symptoms is on the one hand discussed under the perspective of language development and the changing function of language for behaviour control; on the other hand, the pathogenesis of these symptoms is discussed from the viewpoint of cybernetic, or neurophysiological-neuroanatomical foundation of speech production and speech control. Both models of explanation have in common that the ideational component of speech is noticed as acustic halluzinations and the motor proprioceptive part of speech is noticed as sensation of vibrations, both in a typically schiphrenic manner, i.e. dissociated and ego-alienated.

Adult↗

The development of abused children.

Thirty-nine children were reviewed who had suffered child abuse at an average of 5 1/2 years earlier. In comparison with a group matched for socio-economic status, the abused children performed significantly lower on the Wechsler Intelligence Scale, and were more delayed in language development and reading ability. Their teachers' assessments of behaviour showed significantly more abnormal profiles than in the comparison group. These differences could not be accounted for by the small proportion of known head-injuries in the abused group. Child abuse has long-term effects, so it is necessary that these children are thoroughly assessed at first presentation, and that they are followed with a specific programme aimed at preventing these sequelae.

Adolescent↗

The development of gesture and speech as an integrated system.

Children, even at the one-word stage of language development, spontaneously produce gestures along with their speech, just as adults do. Although there appears to be a brief period prior to the onset of two-word speech during which gesture and speech do not form a well-integrated system, the ability to coordinate gesture and speech to convey a single message--and to "read" others' gestures with their speech to comprehend a message--develops early and is maintained throughout life. Gesture-speech combinations deliver a coherent message to the listener despite the fact that they consist of two different modalities of expression. According to McNeill (1992; Chapter One), this coherence is possible because gesture and speech share a common cognitive representation; that is, before the communication unfolds, gesture and speech are part of a single idea. As expression proceeds the message is parsed, with most information channeled into speech but some information channeled into gesture. Speech conveys information in a segmented, combinatorial format, whereas gesture conveys information in a global, mimetic format (see Goldin-Meadow, McNeill, and Singleton, 1996). Thus gesture and speech need not, and in fact often do not, convey the same information within a single utterance. Because gesture and speech form a unified system, mismatches between them can be a source of insight into the cognitive state of the speaker. And, indeed, it turns out that in both the young, one-word speaker and the older child (and possibly adults as well; Perry and Elder, 1996), a difference--or mismatch--between the information conveyed in gesture and the information conveyed in speech can signal readiness for cognitive growth. Whether the actual production of gesture-speech mismatches contributes to cognitive growth is an open question. That is, does the act of expressing two different pieces of information across modalities but within a single communicative act improve a child's ability to transpose that knowledge to a new level and thus express those pieces of information within a single modality? More work is needed to investigate whether the act of producing gesture-speech mismatches itself facilitates transition. Even if it turns out that the production of gesture-speech mismatches has little role to play in facilitating cognitive change, mismatch remains a reliable marker of the speaker's potential for cognitive growth. As such, an understanding of the relationship between gesture and speech may prove useful in clinical settings. For example, there is some evidence that children with delayed onset of two-word speech fall naturally into two groups: children who eventually achieve two-word speech, albeit later than the norm (that is, late bloomers), and children who continue to have serious difficulties with spoken language and may never be able to combine words into a single string (Feldman, Holland, Kemp, and Janosky, 1992; Thal, Tobias, and Morrison, 1991). Observation of combinations in which gesture and speech convey different information may prove a useful clinical tool for distinguishing, at a relatively young age, children who will be late bloomers from those who will have great difficulty mastering spoken language without intervention (see Stare, 1996, for preliminary evidence that the relationship between gesture and speech in children with unilateral brain damage correlates with early versus late onset of two-word combinations. In sum, for both speakers and listeners, gesture and speech are two aspects of a single process, with each modality contributing its own unique level of representation. Gesture conveys information in the global, imagistic form for which it is well suited, and speech conveys information in the segmented, combinatorial fashion that characterizes linguistic structures. The total representation of any message is therefore a synthesis of the analog gestural mode and the discrete speech mode. (ABSTRACT TRUNCATED)

Child Development↗

Development of infants of drug dependent mothers.

Infants of mothers who used methadone, heroin, cocaine and other drugs during pregnancy were compared with a group of control infants over the first 30 mths of life. Results of repeated examinations with the Bayley Scales of Infant Development showed a difference between the groups in mental development. No differences were found in a non-verbal version of the mental scale, but infants of drug dependent mothers seem to have specific difficulties in early language development. In psychomotor development, in behaviour during testing and on a questionnaire on activity, infants of drug dependent mothers did not differ from the comparison children.

Child Behavior Disorders↗

Narrative discourse in children with language disorders and children with normal language: a critical review of the literature.

This review and analysis of the literature on narrative discourse in children places particular emphasis on children with language disorder. The review (a) describes theoretical perspectives on narrative use, (b) surveys researchers' rationales for the investigation of narrative ability, (c) discusses methodological issues relevant to narrative research, and (d) concludes with a discussion regarding future research. Specific topics contained within these discussions include contributions from allied disciplines, the pragmatic nature of narrative use, narrative ability as an index of language development, methodological issues in research design, and clinical implications of future research.

Child↗

Parents' report of vocabulary and grammatical development of African American preschoolers: child and environmental associations.

This study examined how child and family factors affect individual differences in the language development of African American children between 18 and 30 months of age. Participants were 87 African American children, primarily from low-income families. Children's vocabulary and grammatical skills were assessed at 18, 24, and 30 months of age using the short form of the MacArthur Communicative Development Inventory (CDI), a standardized parent report tool. Standardized language tests were administered repeatedly between 1 and 3 years of age. Results showed that children's vocabulary and utterance length grew linearly over time between 18 and 30 months of age. Children from more stimulating and responsive homes were reported to have larger vocabularies, to use more irregular nouns and verbs, and to use longer utterances, in addition to having more rapid rates of acquisition of irregular forms and longer utterances over time. Girls used longer utterances than boys and more irregular forms. Girls also had larger vocabularies in a secondary analysis that eliminated children whose parent report of their vocabulary was substantially lower than children's scores on a standardized language test. There are indications that some parents may be under-reporting their children's early vocabulary and grammatical development, with a high proportion of the parents reporting their child's 30 month vocabulary and grammatical development as being at or below the 10th percentile according to the CDI norms.

Black or African American↗

Causes and associations of severe and persistent specific speech and language disorders in children.

Eighty-two school-age children with severe and persistent specific speech and language disorders were studied. 71 had specific developmental language disorders, three had structural malformations (cleft palate) and eight had disorders acquired after a period of normal language development, including five with Landau-Kleffner syndrome. The sex ratio was 3.8 boys to one girl. Nearly half had a family history of speech-language disorder, with one in 5.2 affected siblings. Aetiological factors were found in 26 per cent: 11 per cent prenatal, 3 per cent perinatal and 12 per cent postnatal. 21 per cent had had a seizure and 7 per cent had had seizures after the age of eight. 29 per cent were left-handed, 90 per cent were clumsy and 22 per cent first walked after 18 months. The complex origins of specific speech and language disorders are discussed.

Brain Damage, Chronic↗

MANULEX: a grade-level lexical database from French elementary school readers.

This article presents MANULEX, a Web-accessible database that provides grade-level word frequency lists of nonlemmatized and lemmatized words (48,886 and 23,812 entries, respectively) computed from the 1.9 million words taken from 54 French elementary school readers. Word frequencies are provided for four levels: first grade (G1), second grade (G2), third to fifth grades (G3-5), and all grades (G1-5). The frequencies were computed following the methods described by Carroll, Davies, and Richman (1971) and Zeno, Ivenz, Millard, and Duvvuri (1995), with four statistics at each level (F, overall word frequency; D, index of dispersion across the selected readers; U, estimated frequency per million words; and SFI, standard frequency index). The database also provides the number of letters in the word and syntactic category information. MANULEX is intended to be a useful tool for studying language development through the selection of stimuli based on precise frequency norms. Researchers in artificial intelligence can also use it as a source of information on natural language processing to simulate written language acquisition in children. Finally, it may serve an educational purpose by providing basic vocabulary lists.

Adolescent↗