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Delayed language onset as a predictor of clinical symptoms in pervasive developmental disorders.

DSM-IV states that Asperger Disorder may be distinguished from Autistic Disorder by a lack of a delay in early language development. The aim of this study was to establish whether the presence or absence of early language delay would predict autistic symptomatology in children diagnosed with a PDD/autism spectrum disorder. Forty-six language-delayed and 62 normal language onset individuals (M age 11 years) were compared on ICD-10 research criteria and DSM-IV criteria, receptive language, and developmental history variables. Retrospective data were also obtained to determine whether language onset predicted autism symptomatology when young (< 6 years). We found that early language delay predicts more autistic symptomatology when young, but not at an older age. Early language delay is also associated with developmental motor milestone delays and lower receptive language abilities. The results question the use of early language delay as a valid discriminating variable between PDD subgroups.

Adolescent↗

Developmental implications of idiopathic toe walking.

OBJECTIVE: To determine whether children with persistent toe walking, without suspected developmental problems, and with normal results after neurologic examination, who were seen in an orthopedic clinic demonstrate delays in language development, gross or fine motor skills, visuomotor development, sensory integration function, or evidence of behavioral problems through a comprehensive multidisciplinary evaluation. STUDY DESIGN: A prospective, descriptive study of 13 children (mean age = 3.9 years) referred for idiopathic toe walking. Each child was evaluated by a pediatric neurologist, developmental pediatrician, speech/language pathologist, occupational therapist, and physical therapist. RESULTS: On developmental screening, 7 of 13 children demonstrated delays and 3 were questionably delayed; all 10 had speech/language deficits. Speech/language evaluation showed that 10 of 13 (77%) had receptive or expressive language delays or both. Occupational and physical therapy evaluations found 4 of 12 (33%) had fine motor delays, 4 of 10 (40%) had visuomotor delays, and 3 of 11 (27%) had gross motor delays. CONCLUSIONS: Idiopathic toe walking was most often associated with speech/language delays, but delays in other areas were also present. We suggest that idiopathic toe walking should be viewed as a marker for developmental problems and recommend that any child with this condition should be referred for a developmental assessment.

Child, Preschool↗

Proverb comprehension in context: a developmental study with children and adolescents.

Although previous studies have reported that proverb comprehension remains quite literal before adolescence, the results of the present study indicated that fourth graders performed well on a proverb comprehension task involving contextual information and a written multiple choice format. It was also found that performance on the proverb task steadily improved at least through the eighth grade and was significantly correlated to performance on a perceptual analogical reasoning task. The study contributes to the small but growing body of information concerning language development during the preadolescent and adolescent years and may have some important implications for the assessment of youngsters of this age range who have comprehension deficits that are troublesome, yet difficult to document.

Adolescent↗

Otitis media, auditory sensitivity, and language outcomes at one year.

The relationship among otitis media, auditory sensitivity, and emerging language was examined in a group of 1-year-old children who were prospectively followed since birth. Pneumatic otoscopy was used to document the otologic status of the children's ears at each medical visit. There were 13 babies with normal ratings in each ear at 80% more of their visits (designated as "otitis free") and 12 babies with bilaterally positive otoscopy results at 30% or more of their first year visits (designated "otitis positive"). In comparison to the otitis free infants, the group of otitis positive babies demonstrated reduced auditory sensitivity as measured by auditory brain stem response (ABR) and poorer expressive language abilities. However, differences in receptive language were not detected. These results suggest that otitis media may have an impact on auditory sensitivity and developing language as early as 1 year of age.

Audiometry, Evoked Response↗

Word fluency in relation to severity of closed head injury, associated frontal brain lesions, and age at injury in children.

Effects of closed head injury (CHI) severity, focal brain lesions, and age at injury on word fluency (WF) were studied longitudinally in 122 children (78 severe, 44 mild); 112 CHI patients (68 severe, 44 mild CHI) and 104 uninjured normal controls participated in a cross-sectional study. WF was measured by asking the child to generate as many words as possible beginning with a designated letter within 60 s, repeated for three letters. Intellectual ability, receptive vocabulary, narrative discourse, and word list recall were also measured. Results of the cross-sectional study showed a significant group effect with poorer WF in severe CHI than mild CHI and control groups. Growth curve analysis of longitudinal data revealed an interaction of age, follow-up interval, and CHI severity as WF recovery was slower after severe CHI in younger children as compared to severe CHI in older children or mild CHI in younger children. An interaction of left frontal lesion with age and interval indicated a more adverse effect on WF in older children. Right frontal lesion effect was nonsignificant and did not interact with age. Correlations of WF with receptive vocabulary, word list recall, and narrative discourse were moderate and weak with estimated intellectual ability. Differences in focal lesion effects after traumatic versus nontraumatic brain injury in children, the contribution of diffuse white matter injury, reduced opportunity for language development, and functional commitment of left frontal region at time of CHI were discussed.

Adolescent↗

Why do infants begin to talk? Language as an unintended consequence.

Scholars have addressed a range of questions about language development, but for some reason have neglected to ask why infants begin to talk. Biologists often prefer 'how' to 'why' questions, but it is possible to ask about the immediate consequences of developing behaviours--an acceptable strategy for attacking causation--and psycholinguists can study the immediate consequences to the infant of behaviours that lead to linguistic competence. This process is demonstrated with a series of illustrative proposals as to the short- and long-term consequences of vocal learning and utterance storage, two developmental phases that lead to talking, as well as the act of talking itself. The goal is to encourage investigation of behavioural dispositions that nudge the child, by degrees, towards proficiency in the use of spoken language.

Child Language↗

[Communication interventions: windows of opportunity].

OBJECTIVE: An understanding of how verbal and non verbal language develops and how it is related to social behavior is essential in order to devise effective interventions for children with disorders of communication. We review the literature on interventions for children with communication disorders from the perspective of the clinical neurologist emphasizing both therapeutic and pharmacological interventions. FINDINGS: Our knowledge on effective interventions in children with disorders of communications is limited due to the heterogeneity of the population and the lack of well controlled studies. There is some limited data suggesting that therapeutic interventions for children with language impairments are most effective if all forms of communication are emphasized. Interventions should be adapted to the age of presentation and associated clinical findings of the child. CONCLUSIONS: A multimodal intervention approach is essential to maximize the potential of children with communication disorders. The role of medication in interventions for children with disorders of communication is limited to the treatment of associated symptoms that may interfere with the ability of a child to receive non pharmacological therapeutic interventions.

Brain↗

Neurodevelopmental testing of children born to human immunodeficiency virus type 1 seropositive and seronegative mothers: a prospective cohort study in Kigali, Rwanda.

OBJECTIVE: The results of developmental testing of 218 children born to human immunodeficiency virus (HIV)-seropositive mothers and infected or uninfected themselves were compared with those of 218 children born to HIV-seronegative mothers in an ongoing cohort study in Kigali, Rwanda. METHODS: When the children were 6, 12, 18, and 24 months of age, a specific neurodevelopmental examination was performed blindly by study physicians assessing gross motor development, fine motor development, language acquisition, and social contacts. RESULTS: Only one acute severe HIV-related encephalopathy was identified among the 50 infected children. The proportion of abnormal neurologic examinations in HIV-infected children varied from 15% to 40% according to age and was always higher than in HIV-uninfected children born to HIV-seropositive and seronegative mothers (< or = 5% or less of abnormal examinations at each time period). After excluding those children with clinical acquired immunodeficiency syndrome (AIDS) from the analysis, the proportion of abnormal examinations in infected children was 12.5% at 6 months, 16% at 12 months, 20% at 18 months, and 9% at 24 months of age and was still more frequent than in HIV-uninfected children. The developmental delay was principally due to significantly lower gross motor scores. CONCLUSIONS: HIV-1-infected children are more frequently developmentally delayed than uninfected children during the first 2 years of life in this African population. This developmental delay is related to the AIDS stage of pediatric HIV infection.

Child Development↗

Language behaviour and child psychotherapy.

The dichotomy between non-verbal or play therapy for the younger and verbal psychotherapy for the older child is questionable in view of the fact that lexical representation begins in the second year of life. It is equally doubtful whether, in the absence of certain communications expressed in verbal symbols, any type of interaction between therapist and child may be called psychotherapy. Language, in varying forms of syntactical and semantic complexity, constitutes the matrix which connects and makes coherent all interactive processes in psychotherapy. This paper attempts to relate some notions of language development to current concepts of child psychotherapy. Linguistic growth is characterized by a fixed gross developmental schedule as well as a specific and universal sequence of acquisition. For the preschooler, still lacking a flexible grammer and syntax to express intricate relationships of perceived events, the value of "interpretations" is doubted; simple statements concerning expression of affect are seen as a rudimentary psychotherapeutic intervention. For the latency child the play situation, with its familiar concrete activity, fuels the child's linguistic competence. Not the play itself but the resulting language becomes the major element of psychotherapy. In late childhood distancing devices and role playing may correct the sociolinguistic asymmetry (adult-child) which inhibits verbal behaviour.

Adolescent↗

Critical periods for the transmission of tactual information.

There is good evidence for critical periods in the development of sensory processes (particularly vision and hearing) and language functions. If appropriate experience is absent during these critical periods, later performance is impaired. This principle is of importance to designers of devices which use the skin as an alternative channel of communication for the blind of the deaf. The implications are that: (a) Some promising devices may have been prematurely abandoned because they were tested on adults rather than children. (b) Tactile devices should be evaluated in studies with children who have not yet passed through the critical period for touch and language development. It is argued that early exposure to a tactile transformation of speech (for example) might provide the profoundly deaf with two significant advantages. Firstly, early exposure increases the chance that the cutaneous system will develop neural connections appropriate to the handling of the transformed speech signal. In other words, tactile sensitivity can be optimized. Secondly, early exposure to language as a process associated with the cutaneous system (rather than the auditory system) might favour the development of cortical connections consistent with the sensory substitution system. Such plasticity might no longer exist when the critical period has passed.

Brain↗

Communication disorders in children: a challenge for health care.

BACKGROUND: Today's children will participate in a society whose economic basis will be information and communication and they must have optimal communication skills to be able to be functional optimally within the information society. Heretofore, in the United States, there has been no systematic attempt to diagnose and care for children with communication disorders. METHODS: It is essential that the child be diagnosed early because there appears to be a critical period for language development. CONCLUSION: If interventions do not occur early, in the area of communication disorders, there is a high probability of significant morbidity because of impaired communication abilities. This morbidity can manifest itself in a social activity and loss of economic opportunity.

Adolescent↗

Children's comprehension of sentences with focus particles.

We report three studies investigating children's and adults' comprehension of sentences containing the focus particle only. In Experiments 1 and 2, four groups of participants (6-7 years, 8-10 years, 11-12 years and adult) compared sentences with only in different syntactic positions against pictures that matched or mismatched events described by the sentence. Contrary to previous findings (Crain, S., Ni, W., & Conway, L. (1994). Learning, parsing and modularity. In C. Clifton, L. Frazier, & K. Rayner (Eds.), Perspectives on sentence processing. Hillsdale, NJ: Lawrence Erlbaum; Philip, W., & Lynch, E. (1999). Felicity, relevance, and acquisition of the grammar of every and only. In S. C. Howell, S. A. Fish, & T. Keith-Lucas (Eds.), Proceedings of the 24th annual Boston University conference on language development. Somerville, MA: Cascadilla Press) we found that young children predominantly made errors by failing to process contrast information rather than errors in which they failed to use syntactic information to restrict the scope of the particle. Experiment 3 replicated these findings with pre-schoolers.

Adult↗

Automatic disambiguation of morphosyntax in spoken language corpora.

The use of computer tools has led to major advances in the study of spoken language corpora. One area that has shown particular progress is the study of child language development. Although it is now easy to lexically tag every word in a spoken language corpus, one still has to choose between numerous ambiguous forms, especially with languages such as French or English, where more than 70% of words are ambiguous. Computational linguistics can now provide a fully automatic disambiguation of lexical tags. The tool presented here (POST) can tag and disambiguate a large text in a few seconds. This tool complements systems dealing with language transcription and suggests further theoretical developments in the assessment of the status of morphosyntax in spoken language corpora. The program currently works for French and English, but it can be easily adapted for use with other languages. The analysis and computation of a corpus produced by normal French children 2-4 years of age, as well as of a sample corpus produced by French SLI children, are given as examples.

Humans↗

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↗

[Speech disorders in ENT practice].

The most frequent speech and language disorders which ENT doctors are confronted with are generally known to be and presented as: delayed speech and language development, dystalia, dysglossia, rhinolalia, dysarthria, and verbal fluency disorders (stuttering, cluttering). The diagnostic portion in comparison to the therapeutic part is always greater and quite different. The close cooperation with representatives of phoniatrics and pedaudiology, as well as logopedics and other specialities such as neurology, and internal medicine is highly necessary.

Adult↗

Hyperornithinemia and gyrate atrophy of choroid and retina. Report of a case.

A case of hyperornithinemia and gyrate atrophy of choroid and retina has been observed in a 3-year and 9-month-old girl. She presented also mild mental retardation, delayed language development and speech defects. The restriction of protein intake to a minimum of 0.8 g/kg/day induced a significant reduction of plasma ornithine levels. In some of the previous reports of the syndrome, a deficient ornithine-ketoacid transaminase activity has been found in cultured fibroblasts.

Atrophy↗

Persistence of neurological damage induced by dietary vitamin B-12 deficiency in infancy.

A case is reported of a 14 month old boy with severe dietary vitamin B-12 deficiency caused by his mother's vegan diet. Clinical, electroencephalography (EEG), and haematological findings are described. Cranial magnetic resonance imaging (MRI) showed severe frontal and frontoparietal cranial atrophy. Vitamin B-12 supplements led to a rapid improvement of haematological and neurological symptoms. Serum vitamin B-12 and urinary methylmalonate excretion were normal 10 days after treatment began. After six weeks, EEG was normal and cranial MRI after 10 weeks showed complete disappearance of all structural abnormalities. Cognitive and language development, however, remained seriously retarded at the age of 2 years. It is concluded that infantile vitamin B-12 deficiency induced by maternal vegan diets may cause lasting neurodisability even though vitamin B-12 supplementation leads to rapid resolution of cerebral atrophy and electroencephalographic abnormality.

Adult↗

Effect of "missing" information on fast mapping by individuals with vocabulary limitations associated with intellectual disability.

One phenomenon of language development is a dramatic increase in vocabulary size, driven by rapid word learning. For individuals with intellectual disabilities, the size of the lexicon often lags behind what would be expected both for CA and MA. I examined how well individuals with severely limited receptive vocabulary associated with intellectual disability retained a new word-picture map after a single exposure under conditions of varying difficulty. This study was a direct replication of a previous investigation with typically developing preschool children, enabling a direct comparison. Individuals with intellectual disabilities performed equally as well as control children in the initial exposure phase but poorer when asked to remember the initial map in the presence of other novel distracters or labels.

Adolescent↗