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PubMed1989

Early Language Milestone Scale and language screening of young children.

The purpose of this project was to evaluate the use of the Early Language Milestone Scale (ELM) in screening language skills in young children. In this study, 657 children from birth to 36 months of age were evaluated with the ELM. The overall failure rate was 8%. Children who failed the ELM screening were evaluated with the Sequenced Inventory of Communication Development (SICD) that was used as the "gold standard" for diagnosing language disorders. In the 12-month age and younger group, there was poor agreement between the ELM Scale and the SICD. For infants 13 to 24 months of age, there was moderately good agreement between the SICD and a second ELM that was administered 1 to 2 weeks after the initial screening. In the 25- to 36-month age group, there was excellent agreement between the SICD and a rescreen ELM. The agreement between the two instruments indicated that the rescreen ELM correctly classified 79% of the 13- to 24-month-old infants and 89% of the 25- to 36-month-old toddlers.

Child, Preschool↗
PubMed2003

Influence of prenatal cocaine exposure on early language development: longitudinal findings from four months to three years of age.

The influence of prenatal cocaine exposure on children's language functioning was evaluated longitudinally at six time points from 4 months to 3 years of age. The Miami Prenatal Cocaine Study prospectively enrolled 476 full-term African-American infants at birth, categorized as cocaine-exposed (n = 253) or non-cocaine-exposed (n = 223) by maternal self-report and bioassays (maternal/infant urine, meconium). The Bayley Scales of Infant Development, scored using the Kent Scoring Adaptation for language, was administered at 4, 8, 12, 18, and 24 months. The Clinical Evaluation of Language Fundamentals-Preschool was administered at 3 years. In longitudinal analyses using Generalized Estimating Equations, cocaine-exposed children had lower overall language skills than non-cocaine-exposed children (D = -0.151; 95% CI = -0.269, -0.033; p =.012). Longitudinal findings remained stable after evaluation of potential confounding influences including other prenatal substance exposures and sociodemographic factors. Preliminary evidence also indicated possible mediation through an intermediary effect involving cocaine-associated deficits in fetal growth.

Case-Control Studies↗
PubMed1984

Identification of speech disorders.

This article focuses on the early identification and referral of children who may have speech disorders. A distinction is made between speech and language, i.e., speech is the spoken vehicle by which we communicate our thoughts, as expressed symbolically through language. The evaluation of speech should be performed systematically by the assessment of four basic components of speech: phonation, resonance, articulation, and prosody. Suggestions regarding management and referral are presented.

Articulation Disorders↗
PubMed1991

Though disorder in high-functioning autistic adults.

Examined thought disorder in a sample (n = 11) of high-functioning autistic young adults and older adolescents (mean IQ = 83) utilizing objective ratings from the Thought, Language and Communication Disorder Scale (TLC Scale) and projective data from the Rorschach ink blots. Results from the TLC Scale pointed to negative features of thought disorder in this sample (e.g., Poverty of Speech). Rorschach protocols revealed poor reality testing and perceptual distortions in every autistic subject, and also identified several areas of cognitive slippage (e.g., Incongruous Combinations, Fabulized Combinations, Deviant Responses, Inappropriate Logic). Comparing TLC Scale and Rorschach results to schizophrenic reference groups, autistic subjects demonstrated significantly more Poverty of Speech and less Illogically on the TLC Scale, and on the Rorschach they evidenced features of thought disorder that are encountered also in schizophrenia. Results are discussed in relation to the measures employed, and to areas of similarity and difference between autism and schizophrenia.

Adolescent↗
PubMed1990

Concomitant speech and language disorders in stuttering children: a critique of the literature.

This article presents a critical review of the literature concerning concomitant speech and language disorders in stuttering children. Studies published since the 1920s that examined language onset and disorders of articulation, syntax and morphology, semantics, and word finding are analyzed. Collectively, the studies present a mixed impression of stutterers, not only because of methodological variations, but also because of the tremendous variability that exists among children who stutter. Although the evidence is not convincing that stutterers as a group are more likely than nonstutterers to have deficits in any of these areas, it is clear that some stutterers do have concomitant speech and language problems that may bear some relationship to their stuttering. The message from this body of research is that individual differences among stuttering children should not be ignored during clinical or research activities.

Articulation Disorders↗
PubMed1983

The contribution of perceptual learning to performance on the repetition task.

The hypothesis that the Repetition Task partially reflects the listener's level of perceptual learning was tested in this study. Specifically, it was predicted from data on auditory temporal processing that performance on the Repetition Task would improve with experience. Ten kindergarten children with no known communication problems were given 10 sets of the Repetition Task over a span of 5 days. Analysis of the data revealed a significant difference in performance across interstimulus intervals (ISI) and also over the training period. Performance improved as a function of increments in ISI and number of days of training. The data reflected a significant training effect, thereby supporting the experimental hypothesis. These results suggest the possibility that differences between dysphasic and normal children on the Repetition Task may result from differences in perceptual learning.

Auditory Perceptual Disorders↗
PubMed1985

Homonymy and the voiced-voiceless distinction in the speech of children with specific language impairment.

Two studies are reported in which homonymy in the speech of children with specific language impairment (SLI) was examined. In the first study, the degree of homonymy reflected in the speech of 14 SLI children was found to resemble that seen in the speech of a group of language-matched children with normal language (NL). Within each group there was considerable variation in the degree of homonymy observed. An examination of the sound changes that contributed to the children's use of homonymy suggested that homonyms arising from prevocalic voicing were more frequent in the speech of the NL children. The second study represented a more systematic examination of prevocalic voicing differences between NL and SLI children. Minimal pairs differing only in the voicing feature of the initial consonant were produced by four SLI and four language-matched NL children. The SLI children showed greater ability to distinguish the minimal pairs by means of a voiced-voiceless initial consonant contrast, as measured by voice onset time as well as by phonetic transcription. The linguistic and neuromotor factors contributing to the findings are discussed.

Articulation Disorders↗
PubMed1981

Hearing, speech, and language in survivors of severe perinatal asphyxia.

Hearing, speech, and language were studied in 26 children who survived severe perinatal asphyxia. The results of hearing tests showed that most children had a favourable outcome. Only 1 child had sensorineural deafness. Hearing loss in 6 others was due to middle-ear disease which resolved after treatment, and on retesting was found to be normal. The study also showed that neither gentamicin treatment nor incubator noise seemed to affect hearing. The results of speech and language assessment were less encouraging and about one-third of the children without serious mental or physical handicap had deficits in speech and language. It is suggested that the quality of life in such children could be improved if these deficits were detected early and adequately treated.

Asphyxia Neonatorum↗
PubMed1992

Psychological and speech studies in Rubinstein-Taybi syndrome.

Forty individuals with Rubinstein-Taybi syndrome were tested using an extensive test battery to obtain more insight about their intelligence level, social competency, temperament, and behavior as well as articulation and receptive and expressive language level. Examination of individuals in the Netherlands who have this rare syndrome has been extensive, allowing some generalizations to be made. The intelligence level of affected individuals is usually low, although some persons have much higher scores than do others. The tested individuals were remarkably consistent in their social competency, temperament, and behavior. They were able to make good use of their limited verbal abilities. Comparable studies of other groups of persons with a specific syndrome are needed to determine whether the present findings are specific for Rubinstein-Taybi syndrome or may be found among persons with other syndromes.

Adolescent↗
PubMed1991

Very-low-birthweight children and speech and language development.

Very low birthweight (VLBW) is often considered to be a risk factor for speech and language disorders, yet data are equivocal. The present study compared speech and language comprehension and production between 249 very-low-birthweight (VLBW: less than 1.5 kg) and 363 normal-birthweight 8-year-olds, randomly sampled in a geographic area. Mean performance for the entire group of VLBW children and for the group when 24 VLBW children with major neurologic abnormalities were excluded, was significantly lower than for controls on the majority of speech and language measures. Further analyses addressed the clinical significance of these statistically significant differences. Test scores were converted to standard scores and grouped according to standard deviation intervals, thus portraying each child's performance in terms of the magnitude of discrepancy from each test's mean. When the 24 children with major neurological abnormalities were excluded, no significant differences between the VLBW and control children were observed. Using discrepancy between WISC-R performance IQ and language to define specific language impairment (SLI), a higher percentage of control than VLBW children were identified as having SLI. Neonatal risk factors did not differentiate between VLBW children with or without SLI. A higher proportion of VLBW than control children did present subnormal language associated with IQ less than 85, hearing deficits, and/or major neurological impairments. Thus, SLI is not more common among VLBW than control children. Language deficits accompanied by more general developmental problems, however, are more frequent.

Chi-Square Distribution↗
PubMed1997

Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation.

OBJECTIVE: We determined the sensitivity and specificity of neonatal brain-stem auditory evoked potentials (BAEP) as markers for subsequent hearing impairment and for developmental problems found later in infancy and childhood. METHODS: BAEP studies were performed before discharge in infants treated with extracorporeal membrane oxygenation (ECMO), and two specific abnormalities were analyzed: elevated threshold and delayed central auditory conduction. Behavioral audiometry was repeated during periodic follow-up until reliable responses were obtained for all frequencies, and standardized developmental testing was also conducted. The sensitivity and specificity of an elevated threshold on the neonatal BAEP for detecting subsequent hearing loss, and the relationship of any neonatal BAEP abnormality to language or developmental disorders in infancy, were calculated. RESULTS: Test results for 46 ECMO-treated infants (57.5%) were normal, and those for 34 infants (42.5%) were abnormal, with either elevated wave V threshold, prolonged wave I-V interval, or both on neonatal BAEP recordings. Most significantly, 7 (58%) of the 12 children with subsequent sensorineural hearing loss had left the hospital after showing normal results on threshold tests. There was no significant difference in the frequency of hearing loss between subjects with abnormal (5/21, or 24%) and those with normal BAEP thresholds (7/59, or 12%; Fisher Exact Test, p = 0.28). Therefore the sensitivity of neonatal BAEP testing for predicting subsequent hearing loss was only 42%. Neonatal BAEP specificity for excluding subsequent hearing loss was 76%. In contrast, on language development testing, 19 children demonstrated receptive language delay. Of these children, 12 (63%) had abnormal neonatal BAEP recordings and 7 (37%) had a normal BAEP threshold, normal central auditory conduction test results, or both (p = 0.04). CONCLUSIONS: Neonatal BAEP threshold recordings were of limited value for predicting subsequent hearing loss common in ECMO-treated survivors. However, an abnormal neonatal BAEP significantly increased the probability of finding a receptive language delay during early childhood, even in those with subsequently normal audiometry findings. Because neonatal ECMO is associated with a high risk of hearing and receptive language disorders, parents should be counseled that audiologic and developmental follow-up evaluations in surviving children are essential regardless of the results of neonatal BAEP testing.

Acoustic Impedance Tests↗