Specific Developmental Language Disorder Research Articles

Trastorno específico del desarrollo del lenguaje: problema selectivo o generalizado de la cognición

Specific developmental language disorder (SDLD) is a diagnostic entity in which language is expected to be the only cognitive function that is affected. Nevertheless, difficulties in other cognitive functions may also appear, either because the language disorder is an expression of an underlying condition or because the retarded language development gives rise to cognitive deficits in general. To determine whether there are any differences in the cognitive performance of children with SDLD and that of children who have developed normally. The study involved a sample of 51 children with SDLD, aged between 6 and 16 years, and 49 children in a control group, who were paired by chronological age, sex and socioeconomic level. Verbal cognitive capacity, attention, memory, visual-constructional and executive functioning were all evaluated. Statistically and clinically significant differences were found in the verbal-type skills, such as language comprehension and verbal cognitive capacity, which showed effect sizes of -1.31 and -1.33, respectively. In the other functions that were assessed, the performance of the SDLD group was slightly lower than that of the control group, but with no clinically significant differences. These findings show that the group of children with SDLD was well selected, since the only differences between the two groups involve linguistic aspects; moreover, this evidence supports the idea that language and other cognitive functions are relatively independent and that a language disorder would only generate an unspecific general effect in the other cognitive functions.

7. Language disorders and autism

Early diagnosis of language disorders and autism is important, and early intervention for autism and some language disorders makes a difference. Developmental surveillance of children to detect these disorders should be a routine part of medical practice. The persistence and pervasiveness of communication and socialising deficits differentiate children with autism from those with specific developmental language disorders. Hearing and vision assessment is essential in any communication disorder. Interventions, targeted to identified areas of need, should encompass communication enhancement, behavioural therapy, educational modification, parent education and family support. Pharmacological interventions have an important but discrete role in autism, but there are no magic bullets. It is important to remember that the normal childhood illnesses occur in children with developmental disorders. Parents should be directed to reliable websites on the Internet, and given information and books to read as well as phone numbers of relevant services (eg, autism associations). There is a need for increased government financial support for early intervention programs.

Are specific developmental language disorders caused by deficits in auditory perception?

Specific language impairment is assumed to be caused by deficits in auditory perception and therefore the training of auditory abilities is recommended as a treatment. Our study focussed on the question of whether a correlation between language disorders and auditory perception abilities can be proven empirically. 23 language impaired children and 52 controls aged 7 to 11 years were examined. Auditory abilities were measured by means of a battery of nonverbal and verbal tests. The children had to identify tones of different frequencies, loudness, duration or patterns as well as every day sounds and mixtures of such sounds. Noise-overlaid, time-compressed and frequency-limited speech tasks, and binaural summation tasks were also used. In addition, phoneme discrimination ability and auditory memory were assessed. Language impaired children scored low on phoneme discrimination and auditory memory tests but not on nonverbal or verbal auditory perception tasks. There are significant correlations between their expressive language ability and their scores on phoneme discrimination, auditory memory and sound duration identification tests. The results do not support the assumption that developmental language disorders are associated with auditory perception deficits. However, there are indications that auditory memory and time processing are deficient. Thus, training of auditory perception does not appear to be a suitable treatment for language impaired children.

Epidemiology and prognosis of specific disorders of language and scholastic skills.

Data from a prospective longitudinal study on the development of children born at biological and psychosocial risk were utilised to examine language and learning abilities of 320 children at ages 4.5 and 8 years. Following the research criteria of the ICD-10, specific developmental disorders of speech and language and specific developmental disorders of scholastic skills were diagnosed. Data were also provided for a clinical and general low achievement group according to less stringent criteria. Frequencies in the risk population were low for specific disorders (ICD-10) (0.6%-3.7% depending on age and type of disorder). Higher frequencies were found when a clinical definition (0.6%-13.6%) or overall low achievement score (0.6%-18.6%) was chosen. The impact of well-documented organic and psychosocial risks was analysed. Organic risk affected language abilities at 4.5 years of age but neither language nor learning abilities at 8 years of age. Psychosocial aspects of a child's environment proved to be associated with both specific language and learning abilities. Stability of language disorders, association between language and reading/spelling disorders as well as gender effects were investigated.

Pragmatic comprehension in secondary school-aged students with specific developmental language disorder.

This study explores the hypothesis that there may be particular difficulties for secondary school students with specific developmental language disorder (SDLD) in understanding contextual, pragmatic meaning. Sixty-four SDLD students aged 11+ to 14+ years are compared with chronological-age-matched and language-age-matched non-impaired students. New procedures are used to examine comprehension of two types of ambiguity where the context determines speaker intention: inconsistent messages of emotion and multiple meanings in context. These types of ambiguity are evident in a range of communicative intent, e.g. sarcasm, idiomatic expression, deceit and humour. Preliminary study into adolescent language suggests that at this age there is a growing expectation for students to understand these kinds of communication, both in the classroom and socially. The study finds that the SDLD students were less able than both comparison groups to use context to understand implied meanings. Non-impaired children were also more able to rule out literal interpretations when they did not know the non-literal meaning. These findings were statistically significant. The implications for research and practice are discussed, including those of diagnostic assessment, in the light of the literature survey revealing that many currently available do not assess pragmatic meaning comprehension. There is a challenge to the view that disorders in the semantic and pragmatic domains necessarily co-occur, as suggested by the diagnostic category semantic-pragmatic disorder.

EEG, cognitive and psychopathological abnormalities in children irradiated in utero

Computerised EEG, a clinical neuropsychiatric examination, and IQ tests were examined in 50 randomly selected prenatally irradiated 9–10-year-old children and compared with 50 randomly selected non-exposed control children of the same age. In the prenatally irradiated children a disorganised EEG-pattern with slow and paroxysmal activity (acute and high-voltage δ-waves, sometimes: spike-waves) in the left fronto-temporal region was disclosed. There was also a significant predominance of δ- and β (dominant frequency: 20 Hz)-power in the frontal lobe, particularly, in the left fronto-temporal region, together with depressed spectral θ-power. The more disorganised EEG-patterns were observed in those children exposed at 8–15 weeks of prenatal development, while left-hemisphere abnormalities were more typical for those exposed later at 16–25 weeks of gestation. There was also a significant increase of borderline and low range (70–90) IQ scores and a significant decrease of high verbal (>110) IQ scores. Disorders of psychological development, particularly specific developmental disorders of speech, language, and scholastic skills were more common and correlated with left-sided slow- and fast-wave activity. Behavioural and emotional disorders (social estrangement, exhaustion, emotional lability, tearfulness, apathy) were also more common and associated with a L>R imbalance in arousal. We hypothesise that the cerebral basis of mental disorders in the prenatally irradiated children is the malfunction of the left hemisphere limbic-reticular structures, particularly in those exposed at the most critical period of cerebrogenesis (16–25 weeks of gestation). We propose that the left hemisphere is more vulnerable to prenatal irradiation than the right.

Applicability of the Child Behavior Checklist in developmentally delayed children

The Child Behavior Checklist is used to assess behavioral problems in a large unselected sample of children. In the present study we assess the usefulness of the CBCL in the evaluation of the typical behavioral problems usually reported in children with developmental disorders. We examined two groups of children which both had language or communication problems. The first group consisted of 34 children with infantile autism, the second group consisted of 34 age-, sex- and IQ-matched children with a specific developmental speech and language disorder. The CBCL was filled out by the parents in both groups as part of the routine diagnostic procedures. Half of the language-impaired children have Total Behavioral Problem scores within the clinical range. Problems are mainly reported on the scales: "Attention Problems", "Social Problems" and "Withdrawn". Two-thirds of the autistic children have deviant scores on the syndrome scales mentioned above. 32 out of 34 autistic children score within the clinical range on the scale "Thought Problems", whereas only one language-impaired child does so. Single item analysis shows a high prevalence of developmental problems (speech problems, enuresis ...) in both groups. The CBCL records characteristic behavioral problems in children with developmental disorders. The problematic behaviors are shown on the syndrome scale level as well as on the single item level. Children with developmental disorders and high scores on the "Thought Problems" scale of the CBCL should be evaluated for the presence of a possible pervasive developmental disorder.

The Psychological Development of Children from Belarus Exposed in the Prenatal Period to Radiation from the Chernobyl Atomic Power Plant

This study examined psychological development in 138 children at the age of 6-7 and 10-11 years, who had suffered prenatal radiation exposure at the time of the Chernobyl accident in 1986. These children were compared to a control group of 122 children of the same age from noncontaminated areas of Belarus. The examination included neurological and psychiatric examination, intellectual assessment, and clinical psychological investigation of parents as well as the estimation of thyroid exposure in utero. The exposed group manifested a relative increase in psychological impairment compared with the control group, with increased prevalence in cases of specific developmental speech-language disorders (18.1% vs. 8.2% at 6-7 years; 10.1% vs. 3.3% at 10-11 years) and emotional disorders (20.3% vs. 7.4% at 6-7 years; 18.1 vs. 7.4% at 10-11 years). The mean IQ of the exposed group was lower than that of the control group, and there were more cases of borderline IQ (IQ = 70-79) (15.9% vs. 5.7% at 6-7 years; and 10.1% vs. 3.3% at 10-11 years). The mean value of thyroid doses from 131I 0.4 Gy was estimated for children exposed in utero. No correlation was found between individual thyroid doses and IQ at age 6-7 years or 10-11 years. We notice a positive moderate correlation between IQ of children and the educational level of their parents. There was a moderate correlation between high personal anxiety in parents and emotional disorders in children. We conclude that a significant role in the genesis of borderline intellectual functioning, specific developmental disorders of speech, language and scholastic skills, as well as emotional disorders in the exposed group of children was played by unfavourable social-psychological and social-cultural factors such as a low educational level of parents, the break of microsocial contacts, and adaptational difficulties, which appear following the evacuation and relocation from the contaminated areas.

353 Specific developmental language disorders and electroencephalographic abnormalities

353 Specific developmental language disorders and electroencephalographic abnormalities

At risk for language disorders? Correlates and course of language disorders in preschool children born at risk.

The language abilities of 324 children of an at-risk population were investigated at age 2 and 4.5 y. Modified research criteria of the ICD-10 for specific developmental disorders of speech and language were applied. Frequencies between 4% and 7%, depending on age and type of disorder, were diagnosed among children whose performance on the language measure was only 1 instead of ICD-10's 2 SD below group mean, but the discrepancy measure of 1 SD between non-verbal language score and language measure was retained. Psychosocial aspects of a child's environment proved to be better predictors of later language disorders than obstetric complications. Stability of specific language disorders was on the whole fairly low, but children who perform below age level on language measures remained at risk. Gender differences are almost compensated by the age 4.5 y.

At risk for language disorders? Correlates and course of language disorders in preschool children born at risk

The language abilities of 324 children of an at‐risk population were investigated at age 2 and 4.5 y. Modified research criteria of the ICD‐10 for specific developmental disorders of speech and language were applied. Frequencies between 4% and 7%, depending on age and type of disorder, were diagnosed among children whose performance on the language measure was only 1 instead of ICD‐10′s 2 SD below group mean, but the discrepancy measure of 1 SD between non‐verbal language score and language measure was retained. Psychosocial aspects of a child's environment proved to be better predictors of later language disorders than obstetric complications. Stability of specific language disorders was on the whole fairly low, but children who perform below age level on language measures remained at risk. Gender differences are almost compensated by the age 4.5 y.

Elective mutism--associated with developmental disorder/delay. Two case studies.

Elective mutism (EM) is not regarded as a separate diagnostic category in the ICD-9, but is included under the heading "313: Disturbance of emotions specific to childhood and adolescence." In the ICD-10 EM is acknowledged as a separate diagnosis defined as "a marked, emotionally determined lack of speech in certain situations in a child with a normal or near normal speech/language ability." The diagnosis excludes pervasive developmental disorder and specific developmental disorders of speech and language. Two patients referred for EM to a child and adolescent psychiatry outpatient clinic, showed specific developmental delays and assessment indicated slight mental retardation in one of them. The question arose regarding how extensively EM is reported in the literature as associated with developmental disorder/delay. A search was carried out in four data-bases where most references were listed under the keyword "mutism". This paper presents the two case studies, and the results of the literature inventory. It concludes that EM may be associated with developmental disorder/delay and suggests that this could be a predisposing factor for an emotionally determined lack of speech in certain situations.

Neuropsychological and neuroimaging findings of developmental dysphasia: A longitudinal case study

This article presents an unusual and interesting neuropsychological and neuroimaging longitudinal study of a child who showed a relatively specific developmental language disorder in the absence of any other significant cognitive, emotional or neurological disturbance. The neuropsychological assessment included tests of intelligence, memory, language and frontal lobe functions. Our patient had a marked developmental language disorder characterized by severe impairment of oral and written language and a restricted vocabulary, even though the comprehension of both spoken and written language was relatively preserved. Moreover, his non-verbal intellectual ability was normal and he showed superior visuoconstructive and visuospatial abilities which suggested good development of right temporoparietal functions. On computerized tomography and magnetic resonance imaging there were no structural abnormalities in those cerebral areas concerned with language, although both neuroimaging studies did show a feasible reversed asymmetry or further atrophy on the left sylvian. It is noticeable that at age 17 a severe deficit in the expressive aspects of language remains. In contrast, visuo-constructive functions have improved. These results suggest a functional reorganization of the brain by increasing non-verbal capabilities. The prognosis in dysphasic syndromes is worse than in acquired aphasia in children, since despite speech therapy, an important language impairment persists during adulthood.

Neuropsychological and neuroimaging findings of developmental dysphasia: A longitudinal case study

This article presents an unusual and interesting neuropsychological and neuroimaging longitudinal study of a child who showed a relatively specific developmental language disorder in the absence of any other significant cognitive, emotional or neurological disturbance. The neuropsychological assessment included tests of intelligence, memory, language and frontal lobe functions. Our patient had a marked developmental language disorder characterized by severe impairment of oral and written language and a restricted vocabulary, even though the comprehension of both spoken and written language was relatively preserved. Moreover, his non-verbal intellectual ability was normal and he showed superior visuoconstructive and visuospatial abilities which suggested good development of right temporoparietal functions. On computerized tomography and magnetic resonance imaging there were no structural abnormalities in those cerebral areas concerned with language, although both neuroimaging studies did show a feasible reversed asymmetry or further atrophy on the left sylvian. It is noticeable that at age 17 a severe deficit in the expressive aspects of language remains. In contrast, visuo-constructive functions have improved. These results suggest a functional reorganization of the brain by increasing non-verbal capabilities. The prognosis in dysphasic syndromes is worse than in acquired aphasia in children, since despite speech therapy, an important language impairment persists during adulthood.

Children with severe language disorder six years later: A follow-up study from language preschool to grade 4 and 5

Nine children with specific and severe developmental language disorder (DLD) were assessed on language, reading and spelling tasks in grades four and five. The DLD children had earlier attended a language preschool program. Four children performed within normal limits on a standardized reading test but only one child reached a normal performance on a spelling test. The best readers and spellers in the group were the most proficient on semantic measures in the present investigation and in preschool. Their language production (phonology and grammar) at age 5 was also more developed than in the other children (with one exception). Our results further strengthens the concept of “hierarchical vulnerability of language” in children (Bishop and Edmundsson, 1987).

Language impaired teenagers' comprehension of pragmatic meaning: a focus on ambiguity, implications for practice

ABSTRACT In her work as a speech and language therapist with secondary school‐aged pupils, the author became increasingly aware that aspects concerned with the pragmatic domain of language were particularly difficult for this group of youngsters. These aspects concerned not only the use of language but also the comprehension of meaning implied by context (pragmatic meaning). In her PhD research study, currently supervised by the London University Institute of Education, the author set out to explore how well secondary school students with specific developmental language disorders are able to use a pragmatic, contextual strategy to resolve ambiguous communication. She compared this group of youngsters with chronologically aged‐matched and language age‐matched control groups. The two types of ambiguity explored in this study are: (1) Inconsistent messages of emotion (for example, ‘I'm perfectly happy thank you’, said with a facial expression and the voice to convey anger); (2) Multiple meanings in context (for example, ‘I'm sorry I'm late, the road was jammed solid this morning’). Over a two‐year period, 207 youngsters were assessed, by use of new procedures involving audio‐ and videotaped samples and requiring picture selection responses. The results of the pilot study and a preliminary view of the main study data indicated that the language‐disordered youngsters, as a group, have particular difficulty in using meaning conveyed by context to help them resolve ambiguous communication. Statistical analysis applied to the pilot study data (Kruskal‐Wallis analysis of variance) revealed a significantly greater difference comparing the language‐disordered group with both control groups (p>0.01). Observing the types of responses made, there were a number of very interesting findings. For example, there were several instances where language‐impaired youngsters understood the two possible alternative meanings, but were not able to use a pragmatic strategy to ascertain which was the speaker's intended meaning, given the context. The results of this study and the presenter's review of the literature will be used as a basis for discussing the following: (1) What is meant by the term ‘pragmatics’ and ‘pragmatic language disorder’; (2) The notion of pragmatic language ‘at the interface of linguistic, social and cognitive development’; (3) The validity of the semantic‐pragmatic distinction; (4) The usefulness of the term ‘pragmatic language disorder’ as an alternative or an addition to the terms ‘high level autism’/‘autism at the upper end of the continuum’ and ‘Asperger's syndrome’.

A longitudinal study of ten children with severe developmental language disorders

On the basis of a neurolinguistic assessment procedure (Holmberg and Sahlen, 1986) ten children with severe and specific developmental language disorders (DLD) were studied over a four-year period. Initially they all showed global language problems which, in the course of development, became more specific. Although there were considerable differences in the neurolinguistic profiles, some general patterns were hypothesized. The linguistic analysis revealed some speech production correlates to these patterns. The results of the segmental phonological analysis and the grammatical analysis, however, did not reflect the differences between the neurolinguistic patterns. We argue that other, more dynamic aspects of language production, i.e. sentence prosody and speech rate, may better discriminate between children with different neurolinguistic patterns. A process-oriented approach to grammatical error analysis and the concept of linguistic levels are discussed.

Retraso del lenguaje y adquisición de la morfología

The present study deals with specific developmental language disorder. It focuses on a longitudinal analysis of samples of language of four children aged 4 to 7 obtained throughout the speech and language therapy. The same children later on were tested again in their adolescence.As a conclusion we point out the fact that, compared to normal children, our subjects adquisition of the article the noun morfology and the verbal tenses is delayed in relation to; a) age, as it as been elsewhere wideley proved, and b) L.M.U. which being higher in the case of the children under study allows more mistakes to be made.Besides the retest carried out in their adolescence shows a positive socialization, occasional speech troubles such as light stuttering and finally some problematic lexical choices. As far as our subjects school performance is concerned we verify, that it is affected by the intensity of the disorder, the I.Q. and the early beginning of the speech and language therapy.

Patterns of vulnerability of language in children with severe developmental language disorders

Language disordered children with receptive language problems have worse outcome and also more severe problems in other areas of language than children with isolated expressive problems according to “the hypothesis of hierarchical vulnerability” formulated by Bishop and Edmundson (1987). We studied ten children with specific and severe developmental language disorders (DLD) longitudinally and found that the hypothesis was tenable with regard to the predictions about outcome. We also found that among children in the phonologic-syntactic subgroup (Rapin and Allen, 1983), children with poor comprehension and poor lexical-semantic ability had the most severe problems of syntax. Phonological production at ages 5 or 6 was not correlated to phonological production at age 8. Oral motor function, however, turned out to be an important prognostic factor for phonological outcome. The present findings call for revised methodological routines and therapeutical priorities regarding children with severe DLD.

CAUSES AND ASSOCIATIONS OF SEVERE AND PERSISTENT SPECIFIC SPEECH AND LANGUAGE DISORDERS IN CHILDREN

Eighty-two school-age children with severe and persistent specific speech and language disorders were studied. 71 had specific developmental language disorders, three had structural malformations (cleft palate) and eight had disorders acquired after a period of normal language development, including five with Landau-Kleffner syndrome. The sex ratio was 3.8 boys to one girl. Nearly half had a family history of speech-language disorder, with one in 5.2 affected siblings. Aetiological factors were found in 26 per cent: 11 per cent prenatal, 3 per cent perinatal and 12 per cent postnatal. 21 per cent had had a seizure and 7 per cent had had seizures after the age of eight. 29 per cent were left-handed, 90 per cent were clumsy and 22 per cent first walked after 18 months. The complex origins of specific speech and language disorders are discussed.