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The influence of vocabulary size, phonotactic probability, and wordlikeness on nonword repetitions of children with and without specific language impairment.

Research has shown that children repeat high-probability phoneme sequences more accurately than low-probability ones. This effect attenuates with age, and its decrease is predicted by developmental changes in the size of the lexicon (J. Edwards, M. E. Beckman, & B. Munson, 2004; B. Munson, 2001; B. Munson, J. Edwards, & M. Beckman, 2005). This study expands on these findings by examining relationships between vocabulary size and repetition accuracy of nonwords varying in phonotactic probability by 16 children with specific language impairment (SLI), 16 chronological-age-matched (CA) peers with typical speech and language development, and 16 younger children matched with the children with SLI on vocabulary size (VS). As in previous research, children with SLI repeated nonwords less accurately than did CA children. The children with SLI and the VS children showed similar levels of nonword repetition accuracy. Phonotactic probability affected repetition accuracy more for children with SLI and VS children than for CA children. Regression analyses showed that measures of vocabulary size were the best predictor of the difference in repetition accuracy between high- and low-probability sequences. Analyses by items showed that measures of phonotactic probability were stronger predictors of repetition accuracy than judgments of wordlikeness. Taken together, the results support research demonstrating that vocabulary size mediates the influence of phonotactic probability on nonword repetition, perhaps due to its influence on the ongoing refinement of phonological categories.

Analysis of Variance↗

Risk of hearing impairment in pediatric liver transplant recipients: a single center study.

As survival rates following liver transplantation have increased, health care providers must assess the impact of transplantation on dimensions other than traditional medical measures. Hearing impairment may adversely impact social, emotional, cognitive, academic, and speech and language development. We hypothesized that children who undergo liver transplantation are at risk for hearing impairment due to exposure to ototoxic drugs. We conducted a review of 74 children who had undergone liver transplantation between December 1996 and September 2000 at Cincinnati Children's Hospital Medical Center. Hearing was assessed at discharge by an audiologist using age and developmentally appropriate techniques. The principal outcome measure was sensorineural hearing impairment. Independent variables were age at transplantation, United Network for Organ Sharing (UNOS) status at transplantation, primary diagnosis, post-transplant length of hospital stay, days of treatment with aminoglycosides, and days of treatment with loop diuretics. Eleven of 74 children (15%) had sensorineural hearing loss, of whom four had severe to profound hearing loss. Multivariate analyses showed that the adjusted relative risk for hearing loss in patients with hepatoblastoma was 66 and that there was a 5% increase risk for hearing loss for each additional day of hospitalization. Age at transplantation, UNOS status, and days of treatment with loop diuretics or aminoglycosides did not achieve significance in the model. Sensorineural hearing impairment occurs in a subset of pediatric patients following liver transplantation. Patients with hepatoblastoma or those who experience prolonged hospitalization after transplantation are at increased risk. Our observations are of particular importance for pediatric liver transplant recipients since the median age at transplantation is 12-18 months, a critical period for language acquisition.

Biliary Atresia↗

Age-of-acquisition effects in native speakers and second-language learners.

Two lexical decision experiments were conducted to study the locus of age-of-acquisition (AoA) effects in skilled readers with English or Dutch as their first language. AoA effects have generally been explained in terms of phonological processing. In Experiment 1, Dutch elementary school and secondary school students were presented with words factorially manipulated on surface frequency and AoA). Two main effects and an interaction were found, confirming findings reported for English speakers by Gerhand and Barry (1999). In addition, a language development effect was established: AoA effects decreased with reading age. Elementary school students showed the largest AoA effects. Experiment 2 used two groups of subjects. The first group consisted of Dutch students enrolled in a master's degree program in English. The second group consisted of native speakers of English. All subjects were presented with the experimental set of words used by Gerhand and Barry (1999). British subjects showed the same response pattern as reported by Gerhand and Barry (1999). The question of interest was whether Dutch subjects would show an AoA effect on the English set or not. The answer was affirmative. Dutch subjects produced identical response patterns as the British group, showing only an overall 94-msec latency delay. This result challenges predictions of the phonological completeness hypothesis. Alternative accounts in terms of semantic processing are discussed.

Adolescent↗

Prelinguistic predictors of vocabulary in young children with autism spectrum disorders.

PURPOSE: The goal of the current study was to identify a predictive model of vocabulary comprehension and production in a group of young children with autism spectrum disorders. Four prelinguistic behaviors were selected for consideration as predictors based on theoretical and empirical support for the relationship of these behaviors to language development. METHOD: The study used a longitudinal correlational design. Participants were twenty-nine 2- and 3-year-olds diagnosed with autism spectrum disorders. The prelinguistic behaviors-attention-following, motor imitation, commenting, and requesting-were measured at the initial visit. Vocabulary comprehension and production were measured 6 months later. RESULTS: Commenting was the only unique predictor of comprehension after the degree of cognitive delay was controlled. Both commenting and motor imitation of actions without objects were unique predictors of production over and above the other skills and when the degree of cognitive delay was controlled. CONCLUSIONS: The finding that both commenting and motor imitation simultaneously accounted for unique variance in vocabulary production is new to the literature and requires replication. However, results suggest that increasing behaviors that allow children with autism to make their current focus of attention obvious to social partners may be an effective approach for supporting word learning in young children with autism.

Autistic Disorder↗

State programs for universal newborn hearing screening.

Published reports of several statewide and hospital-based systems for universal newborn hearing screening demonstrate that successful large-scale programs that appropriately identify infants with hearing loss in the earliest months of life can be developed. These programs are characterized by nursery-based screening rates of 95% or higher, referral rates of 6% or less, and reasonable per-infant costs. Less data are available regarding the outcome of these screening programs in ensuring confirmation of hearing loss by 3 months of age and initiation of intervention by 6 months of age. The results of the MDNC survey provide important information on the status of newborn hearing screening, audiologic assessment, and intervention services in 16 states. The survey reveals that hospitals have initiated universal newborn hearing screening programs using appropriate technology but that confirmation of hearing loss, fitting of amplification, and enrollment in early intervention are often delayed beyond the JCIH recommendations. Several factors might contribute to late confirmation of hearing loss and delayed amplification and intervention. First, as shown in the Colorado report, lack of a mandatory statewide system for tracking and reporting may delay transition of infants and families from screening to diagnosis, and diagnosis to intervention. In addition, many states lack a centralized system for reporting confirmed hearing loss. Successful statewide programs for universal newborn hearing screening, audiologic diagnosis, and early intervention depend on data-reporting strategies that facilitate transition of infants and families through a system of care. Second, lack of understanding about the urgent need for intervention in the earliest months of life may hinder referral to early intervention programs. Recent data from Colorado's universal newborn hearing screening program reveals that infants who are deaf or who have hearing losses achieve significantly better language development outcomes if intervention begins before age 6 months than infants whose intervention begins after 6 months of age. Hopefully, as these data become more widely available, the compelling need for early intervention will facilitate transition into these services. Although universal newborn hearing screening programs are increasing rapidly, states have not yet developed the coordinated systems for linking universal newborn hearing screening programs to audiologic diagnostic services and audiologic diagnostic services to early intervention programs. Key issues impeding development of these systems may be lack of tracking and reporting systems, lack of standardized guidelines for screening, diagnostic audiologic assessment, hearing aid fitting for very young infants, and lack of understanding about the compelling need for intervention in the earliest months of life. Development of complete systems of care must become a priority for universal newborn hearing screening to provide its ultimate benefit.

Colorado↗

Word frequencies in toddlers' lexicons.

Word frequencies in toddlers' lexicons were examined in two studies using the Language Development Survey (LDS), a vocabulary checklist completed by parents (Rescorla, 1989). In Study 1, a high degree of consistency in LDS word frequencies was found when six samples of 24-month-olds were compared (total N = 758). Word frequency correlations in the .90s were found between large, unselected samples of toddlers of roughly similar socioeconomic status (SES). Correlations were somewhat lower but still highly significant when groups varying widely in SES were compared. In Study 2, LDS word frequencies in a sample of 40 late talkers traced from age 2 to 3 were compared to those in a large community sample from Study 1. Both lexicon size and age of the late talker influenced the degree of consistency found with respect to the community sample. The most common words reported in the lexicons of a sample of 422 24-month-olds were consistent with those identified in diary studies as among the highest frequency words used by young children in their early vocabularies.

Child Language↗

Schizencephaly: correlations of clinical and radiologic features.

Schizencephaly is an uncommon congenital disorder of cerebral cortical development. Although a well-recognized cause of seizures and developmental deficits in children, previous reports describe the range of neurodevelopmental outcome in only 47 patients. We report the clinical and cranial imaging features of 47 children with unilateral open-lip (17), unilateral closed-lip (12), bilateral open-lip (12), and bilateral closed-lip (6) schizencephaly, as defined radiologically. The schizencephalic cleft occurred more often in the anterior than in the posterior neocortex. Children with closed-lip schizencephaly presented with hemiparesis or motor delay whereas patients with open-lip schizencephaly presented with hydrocephalus or seizures. Forty-three patients (91%) had associated cerebral developmental anomalies, most commonly absence of the septum pellucidum (45%) and focal cortical dysplasia (40%). There was a history of seizures in 57% of cases, a third of which were classified as difficult to control. Neurodevelopmental outcome was generally poor, with 51% of patients (24/47) having severe deficits, 32% of patients (15/47) having moderate impairment, and 17% of patients (8/47) having mild or no problems. Patients with closed-lip schizencephaly were more likely to have a mild to moderate outcome than those with open-lip type (78% versus 31%; p < 0.05). Children with unilateral schizencephaly had a mild or moderate outcome more frequently than those with bilateral lesions (62% versus 28%; p < 0.05). Children who had involvement of a single lobe accounted for 88% of those with mild outcomes and 53% of those with moderate outcomes. Unilateral closed-lip schizencephaly was associated with the best neurodevelopmental outcome; in contrast, 11 of 12 children with bilateral open-lip clefts had severe disabilities. Language development was significantly more likely to be normal in those children with unilateral schizencephaly than in those with bilateral clefts (48% versus 6%; p < 0.002). Thus, the presentation and outcome of children with schizencephaly are quite variable but are related to the extent of cortex involved in the schizencephalic defect.

Abnormalities, Multiple↗

Phonological representations in children with SLI: a study of French.

The present research examined the quality of the phonological representations of French children with specific language impairment (SLI) and those with normal language development (NLD). Twenty-five children with SLI and 50 children with NLD matched on lexical age level participated in an auditory lexical decision task. The observations gathered in our study can be summarized as follows. First, children with a higher receptive lexical level performed better, and this was true both for children with NLD and children with SLI. Second, both children with NLD and those with SLI were more likely to reject pseudowords resulting from a modification affecting the number of syllables of a word than pseudowords resulting from a slight modification with the number of syllables unchanged. This difference, however, was greater for the children with SLI, who appeared to have much difficulty rejecting pseudowords resulting from slight modifications. Finally, the performance of children with SLI was particularly poor when presented with pseudowords resulting from a slight modification at the beginning or the end of a word. These findings are interpreted as supporting the hypothesis of an under-specification of phonological representations in children with SLI.

Articulation Disorders↗

Symbolic gesture versus word: is there a modality advantage for onset of symbol use?

Researchers have hypothesized in the past that children learning sign languages develop signs at an earlier age than is typically expected for vocal words. This assumption, however, has recently been questioned on the grounds that researchers have not always guaranteed that words and gestures are being used in a comparable fashion. The present study was designed to shed light on this controversy by comparing the onset of symbolic use of signs and words in a group of 22 hearing children exposed to symbolic gestures from 11 months onward. Bimonthly interviews emphasizing contexts of use of gestures and vocal words indicated a smaller modality difference than early research had predicted, thus providing support for the hypothesis that strides in cognitive abilities such as memory, categorization, and symbolization underlie this milestone in both modalities. At the same time, however, the data also indicated that the small difference in onset time was reliable, thus providing support for the notion that the gestural modality is, in fact, easier for many infants to master once the requisite cognitive skills are in place.

Age Factors↗

What is known about autism: genes, brain, and behavior.

Autism is a neurodevelopmental disorder of genetic origins, with a heritability of about 90%. Autistic disorder is classed within the broad domain of pervasive developmental disorders (PDD) that also includes Rett syndrome, childhood disintegrative disorder, Asperger syndrome, and PDD not otherwise specified (PDD-NOS). Prevalence estimates suggest a rate of 0.1-0.2% for autism and 0.6% for the range of PDD disorders. There is considerable phenotypic heterogeneity within this class of disorders as well as continued debate regarding their clinical boundaries. Autism is the prototypical PDD, and is characterized by impairments in three core domains: social interaction, language development, and patterns of behavior (restricted and stereotyped). Clinical pattern and severity of impairment vary along these dimensions, and the level of cognitive functioning of individuals with autism spans the entire range, from profound mental retardation to superior intellect. There is no single biological or clinical marker for autism, nor is it expected that a single gene is responsible for its expression; as many as 15+ genes may be involved. However, environmental influences are also important, as concordance in monozygotic twins is less than 100% and the phenotypic expression of the disorder varies widely, even within monozygotic twins. Multiple susceptibility factors are being explored using varied methodologies, including genome-wide linkage studies, and family- and case-control candidate gene association studies. This paper reviews what is currently known about the genetic and environmental risk factors, neuropathology, and psychopharmacology of autism. Discussion of genetic factors focuses on the findings from linkage and association studies, the results of which have implicated the involvement of nearly every chromosome in the human genome. However, the most consistently replicated linkage findings have been on chromosome 7q, 2q, and 15q. The positive associations from candidate gene studies are largely unreplicated, with the possible exceptions of the GABRB3 and serotonin transporter genes. No single region of the brain or pathophysiological mechanism has yet been identified as being associated with autism. Postmortem findings, animal models, and neuroimaging studies have focused on the cerebellum, frontal cortex, hippocampus, and especially the amygdala. The cerebello-thalamo-cortical circuit may also be influential in autism. There is evidence that overall brain size is increased in some individuals with autism. Presently there are no drugs that produce major improvements in the core social or pragmatic language deficits in autism, although several have limited effects on associated behavioral features. The application of new techniques in autism research is being proposed, including the investigation of abnormal regulation of gene expression, proteomics, and the use of MRI and postmortem analysis of the brain.

Animals↗

The twin condition and the couple effects on personality development.

Twin psychology has been studied to a very limited extent. Only few remarkable peculiarities of the twins' development are known for sure, such as delayed intellectual development, language retardation with frequent cryptophasia, difficulties and fragility of self consciousness, reduced sociability. These and other peculiarities may result from a number of different factors: biological, peculiar parental attitude, and especially the twin situation itself, the psychology of the twin as an individual being a function of the psychology of the twin pair. Twin peculiarities have for a long time been ignored. On the one hand, psychology ignored the couple reality (it was a "one-body" psychology), and on the other, the twin method classically postulated that twins are not atypical and may therefore be used as a test for the general population. As a matter of fact, twin psychology opens a new way to science. The twin situation may serve as a paradigm for the general study of the couple effect, namely, for the objective analysis of personality as a consequence of the relations between self and others. For certain traits of personality, it is already known that MZ twins brought-up together are significantly less similar than MZ twins brought-up apart. In fact, couple effects may mask or considerably reduce genetic factors.

Cognition↗

The pattern of auditory brainstem response wave V maturation in cochlear-implanted children.

OBJECTIVE: Maturation of acoustically evoked brainstem responses (ABR) in hearing children is not complete at birth but rather continues over the first two years of life. In particular, it has been established that the decrease in ABR wave V latency can be modeled as the sum of two decaying exponential functions with respective time-constants of 4 and 50 weeks [Eggermont, J.J., Salamy, A., 1988a. Maturational time-course for the ABR in preterm and full term infants. Hear Res 33, 35-47; Eggermont, J.J., Salamy, A., 1988b. Development of ABR parameters in a preterm and a term born population. Ear Hear 9, 283-9]. Here, we investigated the maturation of electrically evoked auditory brainstem responses (EABR) in 55 deaf children who recovered hearing after cochlear implantation, and proposed a predictive model of EABR maturation depending on the onset of deafness. The pattern of EABR maturation over the first 2 years of cochlear implant use was compared with the normal pattern of ABR maturation in hearing children. METHODS: Changes in EABR wave V latency over the 2 years following cochlear implant connection were analyzed in two groups of children. The first group (n=41) consisted of children with early-onset of deafness (mostly congenital), and the second (n=14) of children who had become profoundly deaf after 1 year of age. The modeling of changes in EABR wave V latency with time was based on the mean values from each of the two groups, allowing comparison of the rates of EABR maturation between groups. Differences between EABRs elicited at the basal and apical ends of the implant electrode array were also tested. RESULTS: There was no influence of age at implantation on the rate of wave V latency change. The main factor for EABR changes was the time in sound. Indeed, significant maturation was observed over the first 2 years of implant use only in the group with early-onset deafness. In this group maturation of wave V progressed as in the ABR model of [Eggermont, J.J., Salamy, A., 1988a. Maturational time-course for the ABR in preterm and full term infants. Hear Res 33, 35-47; Eggermont, J.J., Salamy, A., 1988b. Development of ABR parameters in a preterm and a term born population. Ear Hear 9, 283-9] of normal hearing children: a sum of two decaying exponential functions, one showing an early rapid decrease in latency and the other a slower decrease. Remarkably, the time-constants fell well within the ranges described by Eggermont and Salamy (i.e., 3.9 and 68 weeks), consistent with the time-course of the neurophysiological mechanisms presumably involved in auditory pathway maturation during the first 2 years of life: i.e., myelination and increased synaptic efficacy. In contrast, relatively little change in wave V was evident in children with late-onset deafness. In agreement with the notion that EABR maturation follows an apex-to-base gradient as described for ABR, we observed that wave V latencies were longer for the basal than the apical end of the implant electrode array and remained so throughout the study period, whatever the time of onset of deafness. CONCLUSIONS: The findings in the early-onset of deafness group support the theory that auditory pathways remain "frozen" during the period of sensory deprivation until cochlear implant rehabilitation restores the normal chronology of maturational processes. In children with late-onset deafness, however, some maturational processes may occur before the onset of deafness, and thus less additional maturation is required during the first two years of implant use resulting in no significant EABR latency changes being observed in this period. The results suggest that the rehabilitation-induced plasticity of the auditory pathways is, in case of late auditory deprivation, unlikely to result in neurophysiological outcomes similar to those observed in children with early auditory deprivation. SIGNIFICANCE: Changes in EABR wave V latency over the first 2 years of cochlear implant use were found to be well fitted by the sum of two decaying exponential functions in children with early-onset deafness. This is in line with the maturation of ABR wave V latency in normal-hearing children over the first two years of life. Further studies are needed to assess whether the differences observed in terms of auditory pathways maturation are associated with consistent differences in terms of language development.

Adolescent↗

[Voice--mood: psycholinguistic therapy with psychiatric patients].

The voice is the result of a complex network between mental condition, mood and cognition of a person. The voice not only serves as a means of communication, it has also an effect on the person who is uttering the sounds. Language development phases and the emotional development phases form the theoretical base for therapeutic interventions. The way the therapist proceeds depends on the momentary mental state the patient is in. The structuring of the intervention levels depends on the degree of the disorder. In patients with pronounced inhibitions the therapist tries to activate the patient's feelings by means of passive breathing exercises and kinaesthetic awareness exercises which are accompanied by low music (awareness phase). Once a patient is successfully activated, she/he is asked to actively breathe and use her/his voice for reading and reciting purposes. The texts are accompanied by appropriate music (instrumental phase). This intervention is meant to lead the patient away from his/her egocentric state towards social interaction. After an amelioration and/or stabilisation of the psycho-pathological state, therapeutic activities are continued in the setting of group work. Patients with disorders primarily in the social area take part in this group work right from the start of therapy. The patients learn social strategies in that they get practice in creatively working with texts in the form of readings and theatre performances. They also learn how to throw a party together. In this phase they realise their abilities but also their limits (communicational phase). Due to the playful character of the work in the group the patients experience themselves independently; they leave the passive role of the patient and become active human beings. That way this form of therapy provides a bridge between the "biotope" of the stationary area and everyday life.

Affect↗

Speech acoustic-cue discrimination abilities of normally developing and language-impaired children.

The ability of 35 language impaired (LI) and 38 normally developing children between the ages of 5 and 8 1/2 yr to discriminate between speech stimuli, using an operantly conditioned, nonverbal motor response, was investigated. Six syllable contrasts ([ba] versus [da], [da] versus [ta], [epsilon] versus [ae], [dab] versus [daeb], [sa] versus [sta] and [sa] versus [integral a]) were selected to investigate discrimination of various temporal and spectral cues. Results demonstrated that the LI group made most errors discriminating syllables which were differentiated by consonants and fewest errors on those differentiated by vowels. The normal group made most errors discriminating between syllables including fricatives and brief vowels and fewest errors on stimuli differentiated by stop consonants or vowels in context. The LI group was significantly poorer than the normal in discriminating all syllables that incorporated brief temporal cues followed rapidly in succession by other acoustic cues. They also were impaired in discriminating [sa] versus [integral a]. They were unimpaired discriminating stimuli differentiated by vowels. It is suggested that the particular constraints demonstrated by LI children in their nonverbal and speech processing abilities may be attributed to abnormalities in mechanisms involved in auditory masking.

Child↗

Aphasic victim as investigator.

The author (a classics professor) suffered a cerebrovascular accident, resulting in aphasia. In order to learn whether speech therapy helps aphasic patients to recover, the patient worked on Greek vocabulary and grammar and ignored Latin. (Both languages were equally well-known before the accident; skills in both languages had been totally lost afterward.) This case demonstrates the value of retraining an aphasic. After three years, testing demonstrated a professorial level of the Greek language, but Latin was essentially still missing.

Aphasia↗

Bone-anchored hearing aids in infants and children younger than 5 years.

OBJECTIVE: While bone-anchored hearing aids (BAHAs) are currently indicated for rehabilitation in children older than 5 years with bilateral maximal conductive hearing loss, our objective was to capitalize on potentially important stages of auditory and speech-language development by providing BAHAs to children younger than 5 years. DESIGN: A retrospective review of surgical data of children receiving BAHA implants over a 10-year period. SETTING: The Hospital for Sick Children, Toronto, Ontario. PATIENTS: Twenty children 5 years or younger (mean +/- SD age, 3.21 +/- 1.65 years) served as the study group, while 20 older children (mean +/- SD age, 7.63 +/- 1.55 years) served as the comparison group. INTERVENTIONS: All patients received BAHA implants. Children with cortical bone thickness less than 2.5 mm underwent a 2-stage procedure; children with cortical bone thickness greater than 4 mm underwent a single-stage procedure. MAIN OUTCOME MEASURES: Traumatic and skin revision complication rates and implantation interstage intervals were compared between groups. RESULTS: The mean +/- SD interstage interval was 7.72 +/- 3.81 months for the younger children, which was significantly longer than for the older children (4.41 +/- 2.51 months) (P<.003). Two traumatic fixture losses occurred in the younger children, while 4 occurred in the older children. Skin site revision was required in 3 younger children. All children are currently wearing their BAHAs. CONCLUSION: Two-stage BAHA implantation with a prolonged interval between stages yields surgical success in younger children comparable to that routinely observed in older children.

Child, Preschool↗