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PubMed2000

Screening for developmental language disability in 3-year-old children. Experiences from a field study in a Swedish municipality.

This study evaluates a screening instrument for identification of severe developmental language disability (DLD) in 3-year-old children, which is used as a routine assessment at several child health centres (CHCs) in Sweden. The results are reported in terms of clinical outcome (false- and true-positive rates), kind and extent of DLD, signs of comorbidity and relation between nurses' and parents' observations. More than 60 CHC nurses, all with experience of the screening instrument, assessed in all 2359 3-year-old children (98% of the whole population) by direct observation of their language comprehension, language production and level of co-operation. In addition to the screening parents answered a questionnaire. Children who failed the screening had their hearing assessed and were clinically examined by trained speech and language therapists. Forty-four (34 boys and ten girls) of the 65 referred children were clinically examined. Apart from two false-positive cases most of them were diagnosed as generally and severely language disabled. According to the nurses' observations attention deficit was common among the referred boys, which was later confirmed by the speech therapist in two-thirds of them. Agreement between nurses and parents was poor and only half of the parents were concerned about their child's language development. In the light of this result, continued application of the screening and the use of parent questionnaires is discussed.

Child, Preschool↗
PubMed2000

Early detection of speech and language delays in the Netherlands. The case for integrating primary and secondary prevention.

The early detection of speech and language delays has been an important feature of the child health services in the Netherlands for some 15 years. During this period ideas about both the purpose of screening and the methods themselves have changed considerably. There are four key outstanding issues: What is the best age to identify children? What screening measures are available? How can we detect speech and language delays in multilingual children? Which groups are best able to detect speech and language difficulties: parents, teachers, playgroup leaders, doctors, nurses, or speech and language therapists? These questions are influenced by social, demographic developments and an increase in the understanding of language delay. This article examines the Dutch solutions to these problems. The conclusion reached is that early language screening can only be part of the answer to early detection both because the available measures are not yet sufficiently accurate and because the growing group of multilingual children (e.g. in Amsterdam more than 50% of the children under the age of 4 years are multilingual) makes the application of specific measures at a population level unworkable. An alternative method is suggested, namely primary prevention by giving information and support to parents, playgroup leaders, doctors, etc.

Child↗
PubMed2003

Subcortical aphasia: three different language disorder syndromes?

The study analyses clinical presentation of language functions of 32 patients with subcortical aphasia induced by stroke. The patients have been divided into three groups according to neuroanatomic localization of the lesion, defined by CT and MRI examination (striato-capsular aphasia, aphasia associated with white matter paraventricular lesions and thalamic aphasia). The following batteries and tests were used: the neurologic examination, CT scan, MRI, Doppler ultrasound, Mini Mental State Examination, Boston Diagnostic Aphasia Examination (BDAE), Boston Naming Test (BNT), Token Test and Verbal Fluency Test. Clinical presentation of subcortical aphasias is characterized with preserved repetition, however, some groups differ by certain specific features of language impairment. Striato-capsular aphasia and aphasia associated with white matter paraventricular lesions are characterized with lack of speech fluency, occurrence of literary paraphasias, mainly preserved comprehension and naming. Thalamic aphasia, however, is characterized with fluent output, impaired comprehension and naming with predominant verbal paraphasias. The specific features of language impairment suggest that subcortical structures contribute to language organization. Considering the results of language tests we presume that the most prominent feature in striato-capsular aphasia is phonetic impairment of language, opposite to thalamic aphasia where lexical-sematic processing seems to be affected.

Adult↗
PubMed2001

Unsuspected atypical hemispheric dominance for language as determined by fMRI.

PURPOSE: We sought to illustrate the value of functional magnetic resonance imaging (fMRI) in the presurgical assessment of hemispheric dominance for language by means of an illustrative case report. METHODS: fMRI with two language paradigms was performed in a right-handed patient without familial sinistrality suffering from a left frontal focal epilepsy. RESULTS: Both fMRI paradigms revealed unequivocally lateralized right hemispheric activation. Atypical language representation was confirmed by Wada test. The further presurgical workup could be restricted to subdural strip recordings instead of the initially intended grid implantation. After resective surgery, no language deficits were apparent. CONCLUSIONS: Hemispheric dominance for language should be assessed by fMRI in all patients before surgery in areas potentially relevant for language in either cerebral hemisphere. fMRI may influence the further diagnostic workup and should be performed before other invasive diagnostic procedures.

Adult↗
PubMed2001

Investing in emergent literacy intervention: a key role for speech-language pathologists.

Emergent literacy is a developmental period that is receiving renewed and increased emphasis in the fields of education and speech-language pathology because of its influence on the later literacy development and achievement of students. With their strong background in language, language development, and language disorders, speech-language pathologists (SLPs) can make significant contributions to the acquisition of emergent literacy skills. This article focuses on SLP direct-service roles for students with identified communication impairments and on indirect roles of assisting teachers and others to promote the emergent literacy skills of all students. In addition to the acknowledged importance of general oral language, guidelines, suggestions, and resources are offered to foster emergent literacy skills in five specific areas: (1) early phonological awareness, (2) joint book reading and sense of story, (3) alphabetic letter knowledge, (4) adult modeling of literacy activities, and (5) experience with writing materials.

Awareness↗
PubMed2006

[Television in a child's bedroom--a possible risk factor for expressive language impairment in 5- and 6-year-old children].

OBJECTIVE: There are a number of established risk factors for expressive language-impairment. Does reading aloud with children reduce the risk? Are extensive TV viewing and a TV set in the child's bedroom associated with an increased risk in preschool kids? PATIENTS AND METHODS: Testing for expressive language impairment was carried out as part of the school entrance health examinations in four Bavarian districts. Testing included: correct use of the plural, comparative/superlative forms, syntax, verb flexion and use of articles (a maximum of 5 mistakes could be made). Parents were asked to answer a questionnaire on a number of biographic, sociodemographic and lifestyle factors potentially related to expressive language impairment. RESULTS: The participation rate in the 4 districts was 88.3 % on average. Complete data were acquired for 3234 children. The prevalence for expressive language impairment (more than one mistake) was 12.2 (95 % CI: 11.3-13.2 %). Children who did not speak German predominantly at home were more often affected than children of German nationality: 44.4 % (95 % CI: 32.3-54.6 %) versus 9.9 % (95 % CI: 8.9 %-10.8 %). Logistic regression analyses identified only a TV set in the child's bedroom as an independent risk factor for expressive language impairment: OR 1.82 (95 % CI: 1.15-2.88). CONCLUSIONS: Possession of an own TV in a child's bedroom appears to be an important, independent risk factor for expressive language impairment in preschool children.

Child↗
PubMed2005

Deficits in speech perception predict language learning impairment.

Specific language impairment (SLI) is one of the most common childhood disorders, affecting 7% of children. These children experience difficulties in understanding and producing spoken language despite normal intelligence, normal hearing, and normal opportunities to learn language. The causes of SLI are still hotly debated, ranging from nonlinguistic deficits in auditory perception to high-level deficits in grammar. Here, we show that children with SLI have poorer-than-normal consonant identification when measured in ecologically valid conditions of stationary or fluctuating masking noise. The deficits persisted even in comparison with a younger group of normally developing children who were matched for language skills. This finding points to a fundamental deficit. Information transmission of all phonetic features (voicing, place, and manner) was impaired, although the deficits were strongest for voicing (e.g., difference between/b/and/p/). Children with SLI experienced perfectly normal "release from masking" (better identification in fluctuating than in stationary noise), which indicates a central deficit in feature extraction rather than deficits in low-level, temporal, and spectral auditory capacities. We further showed that speech identification in noise predicted language impairment to a great extent within the group of children with SLI and across all participants. Previous research might have underestimated this important link, possibly because speech perception has typically been investigated in optimal listening conditions using non-speech material. The present study suggests that children with SLI learn language deviantly because they inefficiently extract and manipulate speech features, in particular, voicing. This result offers new directions for the fast diagnosis and remediation of SLI.

Adolescent↗
PubMed2004

Phonological and language disorders in children who stutter: impact on treatment recommendations.

In the profession of speech-language pathology, it is commonly reported that children who stutter, as a group, are more likely to have phonological and language disorders than their non-stuttering peers. Some support for this belief comes from survey studies that have questioned speech-language pathologists about the children on their caseloads who stutter. Recently, one such study reported that 44% of children who stuttered had at least one additional communication disorder (Arndt & Healey, 2001). In the present investigation, speech-language pathologists (n = 127) who were treating children with speech and language disorders were questioned about their views on the treatment of stuttering. The results indicated that children who stutter and have at least one additional disorder are more likely to be recommended for treatment than those whose only disorder is stuttering. This suggests that caseload surveys may overestimate the rate of additional communication disorders in children who stutter. The results provide reason to question the widespread belief that children who stutter have a high rate of concomitant disorders, especially when it is based on caseload surveys. Suggestions are offered for ways to determine more precisely the frequency with which stuttering co-occurs with other speech and language disorders in children through large-scale epidemiological research.

Age Factors↗
PubMedDate not supplied

Phonological acquisition in preschoolers learning a second language via immersion: a longitudinal study.

Phonological development in first and second languages (L1 and L2 respectively) has not been extensively studied in young children who are acquiring a second language via immersion. This lack of information is unfortunate, as the number of children who are acquiring a second language in this context is growing and such children make up a part of the clinical caseload of many speech-language pathologists. To address the need for information regarding phonological development of children acquiring a second language in immersion, the present investigation sought to provide longitudinal data on the development of both L1 and L2 phonologies. Five preschoolers who were acquiring English as a L2 and who spoke different L1s participated in the study. A picture identification task was used to assess productive phonological skills in L1 and English. Analyses included a description of the children's phonetic inventories, accuracy rates, and non-target response patterns. Both within child (across languages) and between child comparisons were made to discern possible patterns of use and to identify factors that may impact phonological skill in the L1 and L2. Results of the investigation suggest that children who are learning a L2 utilize their knowledge of the L1 to aid them in acquiring the phonological system of the L2. At the same time, they appear to maintain, at least as measured via perceptual analysis of their speech, distinct phonological systems.

Child Language↗
PubMed2005

ADL dependence and perceived health among elderly deaf sign-language users: a comparison with a matched group of elderly hearing people.

The main purpose of the study was to investigate dependence in ADL and perceived health among elderly deaf sign-language users and to compare these findings with data from a matched hearing elderly population sample. Data on the deaf population were collected through assessments and structured interviews in sign language. Data on the hearing population were retrieved from the Swedish National Study and Ageing and Care (SNAC), while only a few variables from the questionnaire were used in the present study. Each deaf individual was matched by three hearing persons. Matching was performed according to gender, age, and living situation. The main finding is that elderly deaf sign-language users are more dependent in ADL but simultaneously report better health than their hearing counterparts. The differences in ADL dependence can be explained by factors linked to the communication problems experienced by deaf sign-language users, but also by cultural factors. The better health reported by the deaf sample may be attributed to adaptive mechanisms that deaf sign-language users have been claimed to develop. This research provides new information on a vulnerable group of elderly people, i.e. deaf sign-language users, that has previously been given little scientific attention.

Activities of Daily Living↗
PubMed2005

Pathophysiology of language switching and mixing in an early bilingual child with subcortical aphasia.

Acquired aphasia after circumscribed vascular subcortical lesions has not been reported in bilingual children. We report clinical and neuroimaging findings in an early bilingual boy who incurred equally severe transcortical sensory aphasia in his first language (L1) and second language (L2) after a posterior left thalamic hemorrhage. Following recurrent bleeding of the lesion the aphasic symptoms substantially aggravated. Spontaneous pathological language switching and mixing were found in both languages. Remission of these phenomena was reflected on brain perfusion SPECT revealing improved perfusion in the left frontal lobe and left caudate nucleus. The parallelism between the evolution of language symptoms and the SPECT findings may demonstrate that a subcortical left frontal lobe circuity is crucially involved in language switching and mixing.

Adolescent↗
PubMed2005

Beyond verbal fluency: investigating the long-term effects of bilateral subthalamic (STN) deep brain stimulation (DBS) on language function in two cases.

Cognitive functioning has been described as largely impervious to chronic STN-DBS administered over 12-month periods. In relation to the domain of language, however, the effects of STN-DBS are yet to be thoroughly delineated. Verbal fluency tasks represent an almost exclusively applied index of linguistic proficiency relative to neuropsychological research within this population. Comprehensive investigations of the impact of STN-DBS on language function, however, have never been undertaken. The more precise elucidation of the role of the STN in the mediation of language processes, by way of assessments which probe language comprehension and production mechanisms, served as the primary focus of this research. Longitudinal analysis also afforded consideration of the way in which cognitive-linguistic circuits respond to STN-DBS over time. Bilateral STN-DBS primarily effected clinically reliable fluctuations (i.e., both improvements and declines) in performance in both subjects on tasks demanding cognitive-linguistic flexibility in the formulation and comprehension of complex language. Of particular note, both subjects demonstrated a cumulative increase in the proportion of reliable post-operative improvements achieved over time. The findings of this research lend support to models of subcortical participation in language which endorse a role for the STN, and suggest that bilateral STN-DBS may serve to enhance the proficiency of basal ganglia-thalamocortical linguistic circuits over time.

Aged↗
PubMedDate not supplied

Bilingual children in language units: does having 'well-informed' parents make a difference?

Findings from a large-cohort study of children with speech and language impairments in language units attached to primary schools across England have suggested that in 11% of the cohort who were bilingual form a subgroup with distinct characteristics. In particular, bilingual children's language difficulties seemed to be more complex and possibly more severe than those of their monolingual peers. It was suggested that these findings might reflect differences in the way that the bilingual children were identified and assessed for speech and language difficulties. Parents of the bilingual children in the original study were interviewed to explore the kind of experiences they had with the identification and assessment process. Differences were found between the bilingual parents and a group of monolingual parents who were also interviewed. Moreover, differences were found between two subgroups of the bilingual parents: those who were 'more informed' and 'less informed' about the process. These differences were found to be related to several other factors, including attitudes to language use within the family and the nature of the parents' relationship with the language unit.

Adult↗
PubMedDate not supplied

Use of cognitive state predicates by language-impaired children.

Two studies of the use of cognitive state predicates by children with specific language impairment (SLI) were conducted. Study I analysed longitudinal language samples collected from 26 children with SLI and 25 children with normal language (NL) development, aged 4;4 and 2;11, respectively, at Time I. Study II analysed samples from SLI children with more severe delays at an earlier language stage. There were 10 SLI children and 10 NL children, aged 4;11 and 2;8, respectively, matched by MLU. All cognitive state predicates were identified using both broad and narrow definitions. In Study 1, the SLI children used cognitive state predicates less frequently than their mental age peers, and with no greater frequency or variety than their younger, language peers. In Study II, children with SLI used more predicates referring to communication events, but there were no further group differences. These findings are discussed as they relate to two current psycholinguistic issues: the possible dissociation of grammar and the lexicon, and the role of language in the development of children's theory of mind.

Age Factors↗
PubMedDate not supplied

Demographic and epidemiological analysis of patients referred to speech and language therapy at eleven centres 1987-95.

This retrospective study analyses data collected on an information system developed specifically for the use of speech and language therapists and the management of their services. The age, gender, medical diagnoses, and speech and language therapy diagnoses associated with the referral of > 73,000 clients to 11 speech and language therapy providers between 1987 and 1995 are reviewed. In 1987, 34.8% of the patients referred to speech and language therapy did not have a formal medical diagnosis and this was commonly associated with children with speech and language delay or disorders. However, by 1995, the group not having a formal medical diagnosis had fallen to 17.2% of referrals. Whereas in 1987, 22.7% of the referrals with a medical diagnosis to speech and language therapy were associated with stroke, this has increased in 1995 to 32.0%. Dysphagia represented 0.94% of the referrals in 1987 but 20.6% of referrals in 1995. The gender balance of referrals has remained remarkably constant over the period of study: 60% of referrals were male and 40% female. Whilst nearly half of all referrals were aged under 5 years, the proportion of all referrals represented by this age group has fallen slightly over these years. This has been matched by an increase in the proportion of the caseload aged over 70.

Age Factors↗
PubMedDate not supplied

Productivity with word order and morphology: a comparative look at children with SLI and children with normal language abilities.

The study investigated the development of grammatical categories (verb and noun) in young language learners. Specifically, children's ability to mark correctly the semantic roles of agent and patient was investigated. Second, children's productive use of the present tense progressive -ing, past tense -ed, third person singular -s and plural -s inflection was investigated. Twenty-eight children with specific language impairment (SLI) with a mean language age of 35 months and 28 children with normal language (NL) with a mean language age of 34 months were exposed to four novel verbs and four novel nouns during ten experimental child-directed play sessions. The lexical items were modelled with four experimentally controlled argument structures. Furthermore, both groups of children were administered structured tests of grammatical morphology (involving both verbs and nouns). First, children in both groups did not correctly mark semantic roles for agent and patient, unless specific semantic roles had already been modelled in the linguistic input by the experimenter. Second, children's productive use of grammatical morphology in their spontaneous utterances was better for nouns than verbs. Importantly, however, children with NL were significantly better at marking verbs for past tense than in children with SLI, although both groups performed poorly overall. These findings are discussed in relation to current theories of normal and impaired language development, in particular the usefulness of tense marking as a clinical marker of preschool children with SLI.

Child↗
PubMedDate not supplied

Speech and language skills and cognitive functioning in children with Apert syndrome: a pilot study.

There are few studies that report findings on the speech and language characteristics of Apert syndrome and little is known about the cognitive profile of the syndrome. The current study addresses this gap and explores speech, language, resonance/voice, attention oro-motor and cognitive skills in a group of 10 children (4;1-5;11) with Apert syndrome. The speech and language battery included: the CELF-Pre-school, the PLS-3, the Vocal Profile Analysis, GOS.SP.ASS, PACS; and the Brodsky Drooling Scale. Subscales of the BAS II-Early Years Version were used to assess cognition. Data were also collected on other factors that could influence developmental outcome such as audiological history and management; occlusion/dentition; respiratory problems and management; neuroanatomical abnormalities; the number and nature of cranial surgeries; and the occurrence of raised intracranial pressure. All children for whom a Performance IQ was obtained (n = 8) had abilities within the average range and IQ scores were considerably higher than those reported in previous studies. Eight children had moderate or severe language difficulties and expressive language difficulties were the most frequent. These language difficulties were not associated with a general cognitive deficit. All the children had problems with attention, speech and oro-motor skills. Nine had abnormal voice. In addition, a range of other associated factors that could affect functioning were identified. The discrepancies between the current study and previous investigations are outlined. Parameters for assessment are considered. The implications of these findings for valid assessments of children with Apert syndrome are discussed. Multidisciplinary assessment of children with Apert syndrome across a broad range of dimensions is recommended to obtain a profile of each child's strengths and weaknesses to ensure that appropriate educational placements and early interventions are implemented. Considering patterns of development over time at key ages is also argued to be of central importance.

Acrocephalosyndactylia↗
PubMed2003

Processing of natural language queries to a relational database.

MOTIVATION: A new method is developed to query a relational database in natural language (NL). RESULTS: The method, based on a semantic approach, interprets grammatical and lexical units of a natural language into concepts of subject domain, which are given in a conceptual scheme. The conceptual scheme is mapped formally onto the logical scheme. We applied the method to query the FlyEx database in natural language. FlyEx contains information on the expression of segmentation genes in Drosophila melanogaster. The method allows formulation of queries in various natural languages simultaneously, and is adaptive to changes in the knowledge domain and user's views. It provides optimal transformation of queries from natural language to SQL, as well as visualization of information as a hyperscheme. The method does not require specification of all possible language constructions as well as a standard grammar accuracy in formulation of NL queries.

Animals↗