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PubMed2005

[Relationship between secretory otitis media and language disorder in children: analysis of 1108 cases].

OBJECTIVE: To discuss the relationship between secretory otitis media (SOM) and language disorder in children. METHOD: In 1108 language disorder cases, auditory brainstem responses (ABR) and acoustic immittance were measured respectively. According to the ABR threshold, all the children were divided into four groups: the normal group, the mild hearing loss group, the middle hearing loss group and the severe hearing loss group. RESULT: Of all the ears examined, 59.5% had hearing loss, while 12.64% had SOM. In the children of language disorder, the distribute of the "B" type tympanograph from much to little was:the mild hearing loss group, the middle hearing loss group, the severe hearing loss group and the normal group ( P < 0.01). The average hearing threshold of a part children with SOM decreased after therapy ( P < 0.01). The children with the severe hearing loss had no evident changes after therapy. CONCLUSION: Hearing disorder is the main cause of language disorder in children. While SOM recovers in children with mild or middle hearing loss, the language in part of them could be improved. However, the language in those who with severe hearing loss probably remains the primary level.

Adolescent↗
PubMed2006

English language narratives of Filipino children.

PURPOSE: The current study focuses on describing the English language narrative skills of children who have been exposed to the Filipino language. METHOD: Eight children between the ages of 6;0 (years;months) and 7;7 who spoke primarily English but who were exposed to the Filipino language at home participated. Each child produced three narrative samples based on wordless picture books. Samples were analyzed for narrative complexity as well as measures of productivity and grammaticality. RESULTS: The complexity of children's narratives was comparable to that reported in the literature for monolingual English-speaking children. Grammaticality measures show use of an average of 16.55% Filipino-influenced English forms across three stories. The observed patterns of Filipino-influenced English were predictable based on the comparison of English and Filipino structures. Variability in maze use was related to the amount of exposure to Filipino. CLINICAL IMPLICATIONS: Care should be taken to evaluate grammaticality with respect to nonstandard English forms predicted by the rules of the language in contact with English. Further, maze use may be related to level of exposure to another language and should be further explored when using such information in language evaluation.

Child↗
PubMed2006

English-language competency of self-declared English-speaking Hispanic patients using written tests of health literacy.

INTRODUCTION: Hispanic patients comprise the largest minority population in the United States. The federal government mandates that healthcare providers be able to communicate with those patients who have limited English ability. The primary purpose of this study was to assess the English-language proficiency of self-declared English-speaking Hispanic patients in the emergency department (ED). The secondary purpose was to determine concordance between patients' tested English proficiency and perceived proficiency by nurses and physicians. We hypothesized that many patients who state that they are able to speak English do not in fact possess sufficient ability to communicate in English. METHODS: A convenience study was conducted in an urban level-1 pediatrics and adult trauma center with 45,000 annual visits. Participants included adult patients and parents of pediatric patients, all of which spoke Spanish as their first language. Since there were no verbal tests of English-language ability used in medicine, two written tests were used as surrogates-the Rapid Estimate of Adult Literacy in Medicine (REALM) and the Short Test of Functional Health Literacy in Adults (STOFHLA). Research assistants administered these tests to patients with Hispanic surnames to assess the English comprehension of patients who stated that they spoke English. Score of seventh grade or better on the REALM and > or = 23 on the STOFHLA was considered a level of English competency. Data was entered into SPSS and analyzed for correlations. This study was approved by the institutional review board as exempt. RESULTS: Three-hundred-fifty-four patients with Hispanic names were approached and asked if they spoke English, Spanish or both. One-hundred-five patients, all self-proclaimed English speakers, were enrolled in the study. Patients ranged from 18-89 years of age, with 37.1% (39/105) male and 62.9% (66/105) and female; 49% (50/102) patients had only completed grade school. Sixty-five of 98 (66.3%) of self-proclaimed English speakers scored at or above a seventh grade reading level on the REALM, and 72.0% (67/93) scored in the category of adequate or better on the STOFHLA. There was a significant difference between patients' tested level of English competency and the physicians' and nurses' assessments of the patients' language competency (p=0.002). CONCLUSION: This study demonstrated that a significant number of patients who report English proficiency have an inadequate level of English health literacy and therefore English-language ability. Furthermore, there was a discrepancy between level of English competency found in the study and in the perceived English competency of the patients in the judgment of the physicians and nurses in the ED. This study demonstrated that that there was significant lack of English-language ability of self-declared Hispanic patients, suggesting that a more liberal use of interpreters may be indicated.

Acculturation↗
PubMed2006

Language as a barrier to care for Xhosa-speaking patients at a South African paediatric teaching hospital.

BACKGROUND: Disease is closely linked to the social context in which we live. Difficulty with communication, cultural incompatibility between patients and health care providers and socioeconomic obstacles are important barriers to quality care when doctors and patients come from different backgrounds and speak different languages. Red Cross War Memorial Children's Hospital (RCH) is a paediatric teaching hospital in Cape Town where staff members communicate mainly in English or Afrikaans, while many patients speak Xhosa as their first language. OBJECTIVES: The study aimed to identify barriers to optimal care for Xhosa-speaking parents of patients at RCH. The contribution of language difficulties was assessed as a possible barrier to health care for this group. DESIGN: A questionnaire was developed and administered to 53 Xhosa-speaking parents of children admitted to the short-stay ward at RCH. The questionnaire examined parents' perceptions of barriers to their children's care, using openended questions, closed-ended questions and selection from lists. RESULTS: Parents experienced significant structural and socioeconomic barriers to access of health care for their children. Language and cultural barriers were cited by more parents as a major barrier to health care than structural and socioeconomic barriers. Parents did not have access to same-language practitioners, as only 6% of medical interviews were conducted partly or wholly in the patient's home language. Of the 94% of interviews where no Xhosa was spoken by medical staff, 21% were conducted with the aid of an interpreter (formal or ad hoc) and in 79% no interpreter was used. Parents experienced difficulties with understanding the doctors (64%), making themselves understood (54%) and asking questions (38%). Sixty-nine per cent of parents were dissatisfied with communication between themselves and their doctors and 45% were concerned about negative effects of poor communication on them or their children. Parents tended to blame their own linguistic limitation rather than those of the doctors.

Adolescent↗
PubMed1992

[A longitudinal study of children with language delay at 3 years of age; later WPPSI and school attendance].

Ninety-four children (eighty-three boys and eleven girls), who were delayed in verbal expression (expressive language less than two-thirds of the standard for their chronological ages) at the age of three years, were evaluated for school attendance and intelligence at the age of six. The Yamada's Check List for Language Development and Wechsler Preschool and Primary Scale of Intelligence (WPPSI) were used to assess language problems and the intelligence quotient (IQ). Thirty children (32%) were delayed in verbal expression only, and sixty-four (68%) were delayed in both: verbal expression and comprehension were less than two-thirds of the standard for their chronological ages. Of children with delay in verbal expression only, 36% of them had low full-scale IQs (less than 70), and 27% had required special tutoring. Of children with delayed development of verbal expression and comprehension, 85% had low full-scale IQs, and 89% had required special tutoring or had attended schools for mentally retarded children. In expressive and comprehensive language delay, forty-one children avoided personal relations at the age of three years. Later thirty of these children were diagnosed as suffering from infantile autism. Poor mental outcome could be predicted by the delay of expressive and comprehensive language at the age of three years. The high prevalence of developmental disorders at later stages for the children in this study suggests the need for close monitoring of children with delayed language.

Child, Preschool↗
PubMed1991

[Language and thought].

Mixing, however briefly, with aphasic subjects is sufficient to show that though survives language alterations. Everyone's experience of forgetting proper names and common nouns clearly shows that concepts outlive words. Analyzing puns and allusions also reveals that the meaning of a word depends on a context of signification which may or may not be supplied verbally. Studying thought without language in both animals and infants provides evidence not only that language facilitates the exercise of cognitive functions but also that the initial progress facilitates the exercise of cognitive functions but also that the initial progress made by children is not related to language but to brain maturation. Dealing with the question of right hemisphere performance in patients with a brain split by callosotomy demonstrates, better than anything else, that each position taken on this question is underlain by philosophical presuppositions. In contradistinction with philosophies derived from that of Wittgenstein and from logical positivism and functionalist cognitivist theories, the author argues that all we know is through and within our thought, that all we say is thought and that, consequently, no scientific, philosophical, poetical or other discourse is able to apprehend or restrain thought. Thought extends far beyond language, including scientific language.

Animals↗
PubMedDate not supplied

[Language disorders in children: diagnostic, pathogenetic and developmental aspects].

Several Authors report the pathogenetic factors of developmental language disorders, some clinical features, the evaluation criteria, the treatment prospects aimed also at learning disorders. 163 children with language disorders have been examined: M98, F65; range 2.8-6.2 ys, mean 5.1 ys. The study of verbal comprehension and production and the evaluation of cognitive level, of language function, of communicative abilities, of handedness was performed. The diagnostic evaluation results: uncomplicated language retardation (31.2%), developmental dysphasia (7.4%), acquired aphasia (0.6%), dysphasia/cognitive retardation (36.8%), language retardation/deafness (10.4%), stuttering (6.8%), relational disorders (6.8%). The pathogenetic features are the following: organic factors (early brain damage 51%, early otopathies 10%), environment factors (24%, partly as joined factors), emotive disorders (11%), familiarity (10%), no determinable etiology (2%). The Author remarks some therapeutic strategies and evolution prospects of the different language disorders. In order to attain early diagnosis and treatment it seems advisable to increase cognitive-linguistic examination in preschool age and to start rehabilitation services at nursery-school.

Age Factors↗
PubMed1990

[Disordered speech and language development as a pedagogic problem. Reaction of parents to child speech problems].

Since children live with their parents and meet other children, we looked into the possible effects of language disorders in children on their interactions with the social surroundings. Language disorders are woven into the fabric of communication between parents and child and are not attributes of the child alone. Language-disturbed children are not more difficult in their behavior than normal-speaking children at the same age. However, the parental emotions about the language problem lead to the perception of more difficult behavior. Parents of language-disturbed children try to stimulate the language development of their child. In this they get disappointed by the reactions of the child and become less stimulating. It seems as if in the interactions between parents and child, the child partly creates his own--negative--surroundings.

Child, Preschool↗
PubMed1989

[Language and reality: the origin of man].

The author proposes: 1. That a lineage of living systems is constituted by the reproductive conservation of a manner of living under the form of an ontogenic phenotype. 2. That language is a manner of living in recurrent consensual coordinations of consensual coordinations of actions. 3. That the human manner of living entails among other things, a braiding of languaging and emotioning that we call conversation. 4. That human beings arise in the history of bipedal primates with the origin of language, and the constitution of a lineage defined by the conservation of an ontogenic phenotype that includes conversations as part of it. 5. That the magnitude of the involvement of the brain and anatomy of the larynx and face in speech as our main manner of languaging indicate that language cannot have arisen later than two to three millions year ago. 6. That rationally pertains to the operational coherences of languaging and that different rational domains are constituted by different basic notions that are accepted a priori. That is, on preference. 7. That responsibility and freedom are a function of our awareness of the participation of our emotions (preferences) in the constitution of the rational domains in which we operate.

Biological Evolution↗
PubMed1988

What is the role of reinforcement in early language acquisition?

Monolingual American and Mexican 2- and 3-year-old children were exposed to a foreign language in a naturalistic but controlled environment. Children were randomly assigned to 2 groups. 1 group was differentially reinforced throughout the study for the use of foreign vocabulary. The control group was first reinforced nondifferentially for use of the native language or the foreign language and later was switched to differential reinforcement for the foreign language. Frequencies of spontaneous foreign word production and other verbal responses were computed, and formal assessments of comprehension and production of the foreign words were conducted. Differential reinforcement resulted in accelerating frequencies of spontaneous foreign language use and better performance on both comprehension and production tests. Under nondifferential reinforcement, rates of spontaneous foreign language use were low and static. Results are interpreted as evidence that the acquisition of expressive vocabulary is a function of socially mediated reinforcement.

Child, Preschool↗
PubMed1985

The behavioral and linguistic interactions of specifically language-delayed and normal boys with their mothers.

3 studies were based on subgroups selected from larger pools of either normal children or children with delays in the expression and/or comprehension of language but normal nonverbal abilities. In Study 1, younger (28-50 months) and older (51-68 months) normal (N = 27) and language-delayed (N = 33) boys were observed interacting with their mothers in free play and structured task situations. Although language-delayed children initiated fewer interactions, their responsiveness to maternal interactions, questions, and commands did not differ from that of normal children. Mothers questioned language-delayed children less frequently during tasks but did not differ from mothers of normal children on other measures of interaction, responsiveness, control, or reward strategies. In Study 2, the complexity of maternal speech directed to normal (N = 11) and expressively delayed (N = 11) boys who were matched on the basis of comprehensive skills did not differ. Maternal speech to boys with delays in both language expression and comprehension (N = 11) was significantly less complex. In Study 3, the discrepancy between the speech complexity of mothers and that of their language-delayed children (N = 47) was greatest in younger children with greater expression and comprehension delays, who initiated fewer interactions and proved less responsive to maternal interactions and questions.

Child↗
PubMed1984

The relation of play and sensorimotor behavior to language in the second year.

The concurrent and predictive relations of sensorimotor behavior and play to language in the second year were assessed. 19 preterm and 20 full-term infants were tested at 13 1/2 and 22 months of age. Functional play directed toward dolls and other persons and meaningfully related sequences of functional and symbolic acts at 13 1/2 months were associated with language measured at 13 1/2 months and 9 months later. Concurrent positive relations between sensorimotor behavior and language were found only at 22 months for object-permanence skills. There were no significant positive relations between sensorimotor behaviors at 13 1/2 months and language at 22 months. The consistent relations found between play and language in this research derived from the infants' ability to translate experience into symbols that are used as a means of interacting and communicating with others. Sensorimotor behavior and language were much more loosely associated in the same age period.

Cognition↗
PubMed1983

Speech and language development in 41 children with sex chromosome anomalies.

Forty-one children with sex chromosome anomalies identified from the chromosome screening of a newborn population were blindly evaluated by a speech-language pathologist, along with a control group of 31 siblings. 47,XXX girls and 47,XXY boys were found to have increased problems in auditory perception, receptive language, and expressive language; the problems of the 47,XXY boys were less severe than those of the 47,XXX group, and reflected specific deficits in their ability to process linguistic information rather than a deficit in comprehension. An increased occurrence of speech production problems among the 45,X girls was associated with the presence of oral/structural malformations that often had no measurable effect on their production of speech sounds. Although the 45,X girls and 47,XYY boys had no significant increase of problems in auditory reception, receptive language, and expressive language, the trend of the data suggested more difficulty than in the control groups. The mosaic children were not different from the control subjects. Some children in all groups were found to have normal speech and language development.

Adolescent↗
PubMed1982

Prediction of IQ and language skill from perinatal status, child performance, family characteristics, and mother-infant interaction.

193 basically healthy working-class and middle-class mothers and their infants participated in a 4-year longitudinal study which focused on the relative potency of several clusters of variables for predictions of intellectual and language outcome during the preschool years. The major results were: (1) Measures of perinatal or infant physical status were extremely weak predictors of 4-year IQ or language. (2) Assessments of child performance were poor predictors prior to 24 months, but excellent predictors from 24 months on. (3) Assessments of mother-infant interaction and general environmental quality were among the best predictors at each age tested, and were as good as measures of child performance at 24 and 36 months in predicting IQ and language. (4) Measures of the family ecology (level of stress, social support, maternal education) and parent perception of the child, especially when assessed at birth, were strongly related to child IQ and language within a low-education subsample, but not among mothers with more than high school education. Patterns of prediction were similar for 48-month IQ and 36-month receptive language; predictions were notably weaker for 36-month expressive language.

Child Development↗
PubMed1994

[An analysis of the process of language deformation in the beginning stages of schizophrenia].

The author analyzed the process of language deformation in the beginning stages of schizophrenia in three cases. Through this analysis, the author obtained the following results. 1. The first symptoms and signs which appeared at the beginning stages of schizophrenia were the deformation of both perceptions and thoughts. Though schizophrenics could recognize each object separately, deformation made them unable to grasp objects as a coherent structure for perceptions and thoughts. 2. Once the certainty of perceptions and thoughts wavered, the use of language changed. Schizophrenics became fixated on words used by others, and thereby unable to choose language appropriate to the situation. 3. The change of language use made schizophrenics isolated from others. Therefore, schizophrenics tried to communicate with other persons indirectly by using a mere shell of language. And then, they constructed delusions and hallucinations in schizophrenia. Based on these results of the analysis, the author herein investigated the beginning stages of schizophrenia which began in the deformation of perceptions and thoughts by using the Wittgenstein's "Language-game Sprachspiel" hypothesis.

Adolescent↗
PubMed1996

Topography of auditory evoked cortical potentials in children with severe language impairment.

Development of normal speech and language functions is closely related to normal hearing. However, most children with delayed or disturbed speech development show normal tone thresholds and here the investigation has to include higher levels in the auditory system. There is evidence for a connection between language impairment and a central auditory processing disorder, but the underlying mechanisms are not well understood. There is also a need for objective diagnostic methods of central auditory function. In the present study, a computerised method of mapping the scalp topography of long-latency (cortical) auditory evoked potentials (LAEP) was used for assessment of the function in central auditory pathways. Topographic mapping of the LAEP component N1, in adults and normal children, showed reproducible and valid results. In adults, a focal negativity, focus of NI (FNI), with a frontocentral position and contralateral to the stimulated ear was observed. The N1 maps in normal children showed a pattern similar to that in adults, but with some age-related changes. The N1 latencies declined significantly with age in normal children and reached adult values at the ages of 14-16 years. The topography of the LAEP components N1, P2, N2 and the T complex was investigated in 20 children with severe language impairment (LI). The study also included auditory brainstem responses (ABR), electroencephalography (EEG), quantitative EEG (qEEG) and magnetic resonance imaging (MRI). Twenty normal children served as controls (C). A similar topographic pattern was found in the LI and the C children, but with a higher proportion of deviating and non-focal maps in the LI group. The latencies of all components were significantly longer in the LI than in the C children. The diagnostic value of LAEP topography, latency and amplitude was estimated with a scoring system, whereby significantly higher scores were found in the LI group than in the C group. With all three parameters together the sensitivity was 65%, with a specificity of 90%. There was a high degree of pathological EEGs in the LI group. ABR abnormalities were seen in some LI subjects. MRI was normal in all but two LI children. There was no significant correlation between the results of EEG, ABR, MRI and the total score of LAEP, but some LI children showed a wide pathological pattern. In 17 of the 20 LI subjects a pathological result was obtained in one or more of the investigations. In conclusion, our results may indicate that language impairment has a dual pathophysiology, a specific auditory disorder (LAEP, ABR) and a non-specific general cerebral disturbance (EEG, MRI). The highly varying results among the present LI children, with specific and/or non-specific deviations, may be due to heterogeneity of the group with different aetiologies of their language impairment, or to a general developmental disturbance with a varying distribution and penetrance. The scoring system of LAEP proved to be the most sensitive method in separating the LI children from the controls. This may be a promising model for individual diagnostic criteria and for classification of language impairment.

Adolescent↗
PubMed1996

[A longitudinal study of three-year-old children with delayed development of language].

UNLABELLED: From January 1982 to December 1986, 113 three-year-old children (100 boys and 13 girls) visited the department of pediatrics, Asahikawa Medical College, because of delayed development of language (their expressive language age less than two-year-old). Of these children, 102 children (90%) have visited until they graduated from junior high school for the evaluation of intelligence quotient (IQ), diagnosis, the type of attended school and complications. The mean follow-up period was 10.8 years. The 113 children ware classified as 32 cases of developmental language disorder (DLD), 38 of autistic disorder (Au), 39 of mental retardation (MR), and 4 of deafness based on the results of clinical examination (DSM-III-R), ABR and WPPSI/WISC-R. The purpose of this study is to compare the assessment of language development at the age 3 with the prognosis for intelligence, academic achievement and behavioral adjustment. At the age of three, we divided them into three groups using the Enjoji shiki hattatsu kensa-hyo. Group A including 31 children (29 boys and 2 girls) means delayed development in verbal expression only. Group B including 23 children (17 boys and 6 girls) means delayed development in verbal expression and comprehension. Group C including 59 children (54 boys and 5 girls) means delayed development not only in verbal expression and comprehension but also in communication skills. RESULTS: ABR: Four (2 boys and 2 girls) of 113 children did not show any significant waves on ABR at aged 3, and were also diagnosed as deafness by another audiometry. Comparison between the assessment of verbal expression at aged 3 and full scale IQ (FSIQ): FSIQs in 77% of group A were more than 70, while FSIQs in 79% of groups B and C were 70 or below. The assessment of verbal comprehension at aged 3 was significantly related with FSIQ (x2 = 23.88, p < 0.01). Classification of disorders and type of schools according to the assessment at aged 3: [Group A] Thirty one children were classified as 25 cases of DLD and 6 of MR. Before a graduation from junior high school, 20 children attended regular classes and 8 attended special classes for MR. [Group B] Twenty three children were classified as 4 cases of DLD, 10 of MR, 5 of Au and 4 of deafness. Before a graduation from junior high school, 4 children attended regular classes, 8 attended special classes for MR, 6 attended special schools for MR and 4 attended schools for deafness. [Group C] Fifty nine children were classified as 3 cases of DLD, 23 of MR and 33 of Au. Before graduating from junior high school, 10 children attended regular classes, 18 attended special classes for MR, 19 attended special schools for MR and 2 entered educational facilities. CONCLUSION: 1. Poor mental outcome could be predicted by delayed development of both expressive and comprehensive language, particularly associated with dysfunction of communication skills at the age of three. 2. ABR is a useful method for detecting of hearing loss in non-cooperative young children with delayed development of language.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

Attitudes toward the use of gender-inclusive language among residency trainees. The McMaster Residency Training Program Directors.

OBJECTIVE: To explore postgraduate medical trainees' attitudes toward the use of gender-inclusive language. DESIGN: Self-administered questionnaire. SETTING: Seven residency training programs at McMaster University, Hamilton, Ont., from July 1993 to June 1994. PARTICIPANTS: Of 225 residents in the programs, 186 responded to the survey, for a response rate of 82.7%. Men and women were equally represented among the respondents. OUTCOME MEASURES: Categorization of attitudes about the use of language as gender-inclusive or gender-exclusive; characteristics predicting a gender-inclusive attitude. RESULTS: Factor analysis and Cronbach's alpha (0.90) supported the existence of a construct related to attitudes about language use, the poles of which were categorized as gender-inclusive and gender-exclusive. The authors classified residents with respect to their attitudes to language use from their responses to the questionnaire. In univariate analyses, sex, residency program and country of graduation significantly predicted a gender-inclusive attitude (p < 0.01). Only the first 2 variables were significant in a multivariate model; residency program explained 18% of the variance and sex 3%. Residents in obstetrics and gynecology and psychiatry had the most gender-inclusive attitudes, whereas residents in surgery and anesthesia had the most gender-exclusive attitudes. CONCLUSIONS: Residents' values are reflected in the language they choose to use. Language use may provide an index of underlying attitudes that may create hostile environments for female trainees.

Adult↗