Comparison of diadochokinetic rate between deaf children and normal children

BACKGROUND: Diadochokinetic rate reflects the motion state and synergic level of oral, lingual and speech muscle group, and it is an important index to judge the speech articulation, it is also very significant in the training and evaluation of vocal ability and the correction and treatment of speech. OBJECTIVE: To compare the diadochokinetic rate between deaf children and normal children. DESIGN: A comparative observation. SETTING: College of Hearing and Speech Sciences, Zhejiang University of Traditional Chinese Medicine. PARTICIPANTS: Twenty deaf children and 20 normal children of 6-7 years old, half boys and half girls, were selected from Hangzhou Rehabilitation Center for Deaf Children and Hangzhou Fuxing Kindergarten between January and March, 2006. The influences of organic dysarthria on our study had been eliminated, including intellectual and oral diseases, etc. Informed consents were obtained from the guardians of all the enrolled children. METHODS: ① The deaf children all cooperated with the study after proper communication with them. They practiced to pronounce /pa/, /ta/, /ka/ clearly in order, then pronounced them together, that was /pataka/. They should slow down at first in order to pronounce clearly and cohere them together, then speeded up to practice, so that the results could not be affected by the unfamiliar pronunciation. After practice, the deaf children were tested by pronouncing /pataka/ for five time continuously, and they were asked to pronounce clearly and correctly with uniform intensity, loudness, speed, etc. They were tested for three times by the same methods, and the durations of the three times were recorded to obtain the average value, then the velocity was calculated. The tests for the normal children were the same as those mentioned above. ② The differences of the measurement data were compared by the t test. MAIN OUTCOME MEASURES: Results of diadochokinetic rate compared between deaf children and normal children. RESULTS: All the 20 normal children and 20 deaf children were involved in the analysis of results. The diadochokinetic rate was obviously lower in the deaf children than in the normal children [(0.64±0.18), (2.41±0.47) times/s, P < 0.01]. CONCLUSION: The diadochokinetic rate is lower in deaf children than in normal children. It is also suggested that the training of diadochokinetic function should be enhanced in the speech training of deaf children to improve their lingual and oral flexibility and speech articulation.     

“Borderline” children

Sixteen children said to be "borderline" were referred for comprehensive evaluation. None met DSM III criteria for borderline personality disorder. Referring psychiatrists and psychologists seemed to base their impressions on the child's disorganized thinking and irrational, erratic behavior, problems that were better understood and treated from a developmental perspective. The borderline label had a negative impact on some children, and was not helpful for treatment planning or disposition. Clear guidelines for the application of this ambiguous and controversial diagnostic term in child psychiatry are nonexistent.     

Guillain-Barré syndrome in children

In industrialized nations with widespread immunization programs, Guillain-Barré syndrome is the most common cause of acute paralytic illness in children and adults. The incidence of the disease has been estimated to range from 0.5 to 1.5 in 100,000 in individuals less than 18 years of age. Approximately 15% of children with Guillain-Barré syndrome develop respiratory failure and require mechanical ventilatory support. Prospective randomized treatment trials in childhood Guillain-Barré syndrome are wanting; however, smaller case series studies using historical controls suggest that both plasmapheresis and administration of human immunoglobulin could be helpful in reducing morbidity in children with Guillain-Barré syndrome. The prognosis for recovery in children is generally excellent, with the majority of children achieving a complete functional recovery within 6 months from the onset of illness. Studies using an animal model of human Guillain-Barré syndrome, experimental allergic neuritis, have expanded our understanding of the pathogenesis of the disease and suggest new directions for exploration in the treatment of this disorder.     

Factors affecting nightmares in children: parents’ vs. children’s ratings

Objective  The present study investigated the relationship between daytime symptomatology and nightmare frequency in school-aged children by eliciting daytime symptoms and nightmare frequency from children directly in addition to questionnaires completed by their parents. Methods  A sample of 4,834 parents and 4,531 of their children (age range: 8–11 years) completed each a sleep questionnaire and the strengths and difficulties questionnaire (SDQ). Results  The results of the study clearly indicate that there is an underestimation of nightmare frequency in the parents’ ratings compared to the children’s data (effect size: d = 0.30) and the closeness between influencing factors and nightmare frequency is considerably higher for the data based on the children’s responses; the proportion of explained variance was twice as high. Conclusions  Therefore, it seems important for research and clinical practice to not to rely on parents’ information but to ask the children about the occurrence of nightmares.     

“Occult” hydrocephalus in children

The authors describe 32 children between 2 and 15 years of age who had hydrocephalus that was only clinically manifest late in life. The clinical picture of these children did not suggest an obvious increase in intracranial pressure; instead, the presenting signs were rather nonspecific and included macrocrania, mild psychomotor retardation, unsteady gait, increased muscle tone and deep tendon reflexes in the lower limbs, impaired ocular movement, epilepsy, and endocrine dysfunction. Their histories suggest the possible causes of the ventricular dilation in about one third of the cases were: perinatal hemorrhage, leptomeningitis, neurofibromatosis, and untreated aneurysm of the great vein of Galen. In 20 patients, however, no positive anamnestic findings were reported. CT scan revealed triventricular dilation in more than half of the cases; tetraventricular dilation was present in 6 patients, and biventricular dilation in the remaining subjects. All children underwent CSF shunting, which resulted in complete recovery in all but 2 cases. The most frequently recorded surgical complication was postoperative subdural effusion (7 subjects), which required surgical treatment in only 2 cases.Presented at the 15th Annual Scientific Meeting of the International Society for Pediatric Neurosurgery, New York, 1987     

Are children with imaginary playmates and children said to remember previous lives cross-culturally comparable categories?

Some 15-66% of children in western countries talk about imaginary playmates; in India only 0.2% of children are said to remember a previous life. Both phenomena occur from the age of 30 months to 60-90 months. This article explores whether the two phenomena are cross-culturally comparable categories. The article describes a study of the psychological characteristics of a sample of 15 children said to remember a previous life in India, compared with a matched sample; and compares it with a sample of 15 children with imaginary playmates and a matched sample from Charlottesville, Virginia. No significant differences between the target group and the comparison group were found in either culture, suggesting that both phenomena are normal. One case of an American child with an imaginary playmate and one case of a child in India who is said to remember a previous life are described, using a video-recording of the child's dialogue.     

Can listeners hear the difference between children with normal hearing and children with a hearing impairment?

Acoustic measurements have shown that the speech of hearing-impaired (HI) children differs from that of normally hearing (NH) children, even after several years of device use. This study focuses on the perception of HI speech in comparison to NH children’s speech. The purpose of this study was to investigate whether adult listeners can identify the speech of NH and HI children. Moreover, it is studied whether listeners’ experience and the children’s length of device use play a role in that assessment. For this study, short utterances of 7 children with a cochlear implant (CI), 7 children with an acoustic hearing aid (HA) and 7 children with NH were presented to 90 listeners who were required to specify the hearing status of each speech sample. The judges had different degrees of familiarity with hearing disorders: there were 30 audiologists, 30 primary schoolteachers and 30 inexperienced listeners. The results show that the speech of children with NH and HI can reliably be identified. However, listeners do not manage to distinguish between children with CI and HA. Children with CI are increasingly identified as NH with increasing length of device use. For children with HA, there is no similar change with longer device use. Also, experienced listeners seem to display a more lenient attitude towards atypical speech, whereas inexperienced listeners are stricter and generally consider more utterances to be produced by children with HI.     

Does the speech of Turkish-speaking phonologically disordered children differ from that of children speaking other languages?

How phonological disorders should be categorized in Turkish children remained vague for a long period of time due to a lack of normative studies. This paper reports the phonological systems of 70 phonologically disordered children, aged 4;0-8;0, in comparison with the results of a normative study of 665 Turkish-speaking children, aged 1;3-8;0. The current focus is on two aspects of development, mainly the differences between disordered and normal consonant acquisition and phonological error patterns from both longitudinal and cross-sectional data. The second concern of the paper is to sub-classify phonological disorders as proposed in the existing literature by examining the applicability of these proposals to Turkish, a typologically different language. It has been indicated that similar developmental trends occur across languages but consonant acquisition is more rapid and developmental errors are more predictable in Turkish. There is evidence for ambient language influence. Mostly, the sub-classifications of phonological disorders are valid for Turkish-speaking children with apparent saliency to language.     

Influence of two different sitting positions on postural adjustments in children with spastic diplegia

The present study addressed the question whether the deviant postural adjustments in children with spastic diplegia can be attributed to their crouched sitting position or primarily to their neural deficit. Postural adjustments during sitting in an erect and in a crouched position on a movable platform were assessed in 10 children, aged 3 to 7 years 6 months, with mild-to-severe forms of spastic diplegia and 10 age- and sex-matched control children. Multiple surface EMGs of neck, trunk, and leg muscles and kinematics of head, body sway, and pelvis were recorded during forward and backward translations. The children with normal motor development showed a distinct adaptation of postural adjustments to sitting position. The children with cerebral palsy (CP) had a deficient adaptational capacity which was more pronounced in the erect than in the crouched position. Thus, the crouched sitting position did not induce postural deficiency but seemed to offer a solution to the sensory-motor problem of the instability experienced. Children with severe diplegia exhibited a lack of direction specificity in the leg muscles during backward body sway, which points to a basic deficit in postural control. In addition, these children showed marked dysfunctions in the precise tuning of the postural adjustments to task-specific conditions. In the children with mild-to-moderate forms of CP the basic level of control was intact.     

Development of postural adjustments in sitting position during the first half year of life

Little is known about the development of postural adjustments during early ontogeny. We examined postural adjustments due to sudden perturbations during sitting in 40 healthy term infants (28 males, 12 females) assessed in groups of eight at 1, 2, 3, 4, and 5 months of age. Surface electromyograms of neck, trunk, and leg muscles were recorded while the infants were exposed to a random series of horizontal forward and backward displacements of the surface of support. Video recordings of spontaneous motor behaviour were analyzed. For part of the analyses, previously collected data on 26 infants aged 6 to 10 months were included. In general, postural adjustments at all ages were direction specific and showed large variation. Within the variation developmental changes could be observed, revealing a transient decrease in postural activity at 3 months of age. After this transition, direction-specific postural activity was correlated with spontaneous motor behaviour. This was true, in particular, for dorsal postural activity. The clinical relevance of these findings is discussed.     

Development of postural adjustments during reaching in infants with CP

The development of postural adjustments during reaching movements was longitudinally studied in seven infants with cerebral palsy (CP) between 4 and 18 months of age. Five infants developed spastic hemiplegia, one spastic tetraplegia, and one spastic tetraplegia with athetosis. Each assessment consisted of a simultaneous recording of video data and surface EMGs of arm, neck, trunk, and leg muscles during reaching in various lying and sitting positions. The basic organization of postural adjustments of the children developing spastic CP was intact. Their main problem was a deficient capacity to modulate the postural adjustments to task-specific constraints - a deficit which was attributed to a combination of an impaired motor coordination and deficits in sensory integration. The child with spastic-dyskinetic CP showed distinct abnormalities in the basic organization of postural adjustments.     

Postural adjustments during sitting at preschool age: presence of a transient toddling phase

The present study investigated developmental changes in postural adjustments during preschool age. Postural responses during sitting on a moveable platform were assessed in 21 healthy children aged 1% to 4% years. Multiple surface EMGstof neck, trunk, and leg muscles were recorded during forward and backward translations. Comparable data were available for 11 infants seen three times between the ages of 5 and 10 months. The data revealed the existence of a transient period between the ages of 9 to 10 months and 21/2 to 3 years, during which perturbations in a sitting position are accompanied by high activity in the direction-specific agonist muscles and in the antagonist muscles. After this period, agonist activity became more variable, particularly so during backward translations, and antagonist activity disappeared. These changes could be attributed to biomechanical factors and to maturation of the nervous system.     

Postural adjustments during spontaneous and goal-directed arm movements in the first half year of life

We studied the development of postural control during goal-directed reaching and spontaneous arm movements in early infancy. Two groups of infants participated. The first group consisted of 10 healthy infants, who were assessed four times at the ages of 3, 4, 5 and 6 months. Each assessment consisted of simultaneous recording of video-data and surface EMGs of arm, neck, trunk, and leg muscles in various lying and sitting positions. Additionally, postural adjustments during spontaneous arm movements were studied in a second group of five infants aged 1-3 months. Already before the onset of successful reaching, which occurred at 4 5 months, both spontaneous and goal-directed arm movements were accompanied by a high amount of postural activity. During the goal-directed arm movements a preference for neck muscle activation and a direction specific organisation (dorsal postural muscles activated before the ventral antagonists) prevailed, whereas during spontaneous arm movements such a specific postural organisation was absent. With increasing age and concurrent with successful reaching, the amount of postural activity decreased. Still, the persisting postural activity continued to become more organised with increasing age. Position affected the postural adjustments accompanying goal-directed arm movements at all ages.     

Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: a meta-analysis

Aim This research review and meta‐analysis presents an overview of the effects of hippotherapy and therapeutic horseback riding (THR) on postural control or balance in children with cerebral palsy (CP). Method To synthesize previous research findings, a systematic review and meta‐analysis were undertaken. Relevant studies were identified by systematic searches of multiple online databases from the inception of the database through to May 2010. Studies were included if they fulfilled the following criteria: (1) quantitative study design, (2) investigation of the effect of hippotherapy or THR on postural control or balance, and (3) the study group comprised children and adults with CP. The selected articles were rated for methodological quality. The treatment effect was coded as a dichotomous outcome (positive effect or no effect) and quantified by odds ratio (OR). The pooled treatment effect was calculated using a random‐effects model. Meta‐regression of the effect size was performed against study covariates, including study size, publication date, and methodological quality score. Results From 77 identified studies, 10 met the inclusion criteria. Two were excluded because they did not include a comparison group. Therapy was found to be effective in 76 out of 84 children with CP included in the intervention groups. The comparison groups comprised 89 children: 50 non‐disabled and 39 with CP. A positive effect was shown in 21 of the children with CP in the comparison group regardless of the activity undertaken (i.e. physiotherapy, occupational therapy, sitting on a barrel or in an artificial saddle). The pooled effect size estimate was positive (OR 25.41, 95% CI 4.35, 148.53), demonstrating a statistically significant effectiveness of hippotherapy or THR in children with CP (p<0.001). Meta‐regression of study characteristics revealed no study‐specific factors. Interpretation The eight studies found that postural control and balance were improved during hippotherapy and THR. Although the generalization of our findings may be restricted by the relatively small sample size, the results clearly demonstrate that riding therapy is indicated to improve postural control and balance in children with CP.     

Impaired visually guided weight-shifting ability in children with cerebral palsy

The ability to control voluntary weight shifting is crucial in many functional tasks. To our knowledge, weight shifting ability in response to a visual stimulus has never been evaluated in children with cerebral palsy (CP). The aim of the study was (1) to propose a new method to assess visually guided medio-lateral (M/L) weight shifting ability and (2) to compare weight-shifting ability in children with CP and typically developing (TD) children. Ten children with spastic diplegic CP (Gross Motor Function Classification System level I and II; age 7–12 years) and 10 TD age-matched children were tested. Participants played with the skiing game on the Wii Fit game console. Center of pressure (COP) displacements, trunk and lower-limb movements were recorded during the last virtual slalom. Maximal isometric lower limb strength and postural control during quiet standing were also assessed. Lower-limb muscle strength was reduced in children with CP compared to TD children and postural control during quiet standing was impaired in children with CP. As expected, the skiing game mainly resulted in M/L COP displacements. Children with CP showed lower M/L COP range and velocity as compared to TD children but larger trunk movements. Trunk and lower extremity movements were less in phase in children with CP compared to TD children. Commercially available active video games can be used to assess visually guided weight shifting ability. Children with spastic diplegic CP showed impaired visually guided weight shifting which can be explained by non-optimal coordination of postural movement and reduced muscular strength.     

Children with moderate to severe cerebral palsy may not benefit from stochastic vibration when developing independent sitting

Purpose: Determine sitting postural control changes for children with cerebral palsy (CP), using a perceptual-motor intervention and the same intervention plus stochastic vibration through the sitting surface. Methods: Two groups of children with moderate or severe CP participated in the 12 week interventions. The primary outcome measure was center of pressure data from which linear and nonlinear variables were extracted and the gross motor function measure (GMFM). Results: There were no significant main effects of intervention or time or an interaction. Both treatment groups increased the Lyapunov exponent values in the medial–lateral direction three months after the start of treatment as well as their GMFM scores in comparison with baseline. Conclusions: The stochastic vibration did not seem to advance the development of sitting postural control in children between the ages of 2 and 6 years. However, perceptual-motor intervention was found beneficial in advancing sitting behavior.     

Aquatic exercise for children with cerebral palsy

Exercise for children with cerebral palsy (CP) is gaining popularity among pediatric physical therapists as an intervention choice. Exercise in water appeals to children with CP because of the unique quality of buoyancy of water that reduces joint loading and impact, and decreases the negative influences of poor balance and poor postural control. In this paper, research of land-based exercise and aquatic exercise for children with CP is reviewed. Clinically relevant considerations for aquatic exercise programming for children with CP are discussed.     

Assessment of postural control in children with cerebral palsy: A review

This paper aimed to review studies that assessed postural control (PC) in children with cerebral palsy (CP) and describe the methods used to investigate postural control in this population. It also intended to describe the performance of children with CP in postural control. An extensive database search was performed using the keywords: postural control, cerebral palsy, children, balance and functionality. A total of 1065 papers were identified and 25 met the inclusion criteria. The survey showed that PC is widely studied in children with CP, with reliable methods. The link between postural control and functionality was also evident. However, a lack of studies was observed assessing postural control in these children by means of scales and functional tests, as well as exploring postural control during daily functional activities. Thus research addressing these issues can be a promising field for further research on postural control.