Speech perception in children with speech output disorders

Research in the field of speech production pathology is dominated by describing deficits in output. However, perceptual problems might underlie, precede, or interact with production disorders. The present study hypothesizes that the level of the production disorders is linked to level of perception disorders, thus lower‐order production problems (such as childhood apraxia of speech; CAS) are linked to lower‐order perception problems and higher‐order production problems (phonological disorder; PD) are linked to higher‐order perception problems. For this, various perception tasks were administered (non‐word auditory discrimination task, word rhyming task, categorical classification, and discrimination task) in children with CAS, PD, or a mixture. The results show that children with PD only show higher‐order perception problems, whereas children with CAS have difficulties on both lower‐ and higher‐order perception tasks. In children with CAS, difficulties at lower‐order processes might affect the higher‐order processes in development. Furthermore, significant correlations were found between production and perception scores at different levels. Thus, a link between perception and production seems to be evident.     

Prevalence of celiac antibodies in children with neurologic disorders

Neurologic complications are a recognized but unusual manifestation of celiac disease (CD) in adults and children. The use of antigliadin and antiendomysial antibodies in screening has revealed the frequency of CD among symptom-free individuals to be high. Recently, a high frequency (57%) of antigliadin antibodies was demonstrated in adult patients with neurologic dysfunctions of unknown cause. We investigated the yield of screening for CD in children with common neurologic disorders. One hundred sixty-seven children, 1-16 years of age, were included in the study: 41 with migraine headaches, 39 with attention-deficit disorder with or without hyperactivity, 36 with epileptic disorders, and 51 with hypotonia and motor abnormalities. Positive IgG antigliadin antibodies were evident in 22 children (13%) in the study group compared with three children (9%) in the control group. However, in all children, negative IgA and endomysial antibodies were observed; thus duodenal biopsies were not performed. Contrary to studies performed in adults, these results did not demonstrate any relationship between common neurologic disorders without a specific diagnosis during childhood and CD. Thus screening for CD does not need to be routinely included in the diagnostic evaluation of children with these disorders.     

Differentiating communication disorders and autism in children

The diagnosis of autism and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), particularly in young children has become a top priority in the fields of mental health and education. Core symptoms include rituals and stereotypies, social skills deficits, and problems in communication. Considerable overlap exists in symptoms for autism spectrum disorders and communication disorders. As a result, distinguishing between these two conditions is one of the most difficult aspects of the assessment enterprise. However, being able to differentially diagnose these two disorders has important implications for the treatment and management of these conditions. This paper provides an overview and critical analysis of these disorders, how they are differentiated, and the specific impact correct diagnosis can have on the selection and efficacy of interventions.     

Whole word measures in bilingual children with speech sound disorders

Phonological acquisition traditionally has been measured using constructs that focus on segments rather than the whole words. Findings from recent research have suggested whole-word productions be evaluated using measures such as phonological mean length of utterance (pMLU) and the proportion of whole-word proximity (PWP). These measures have been investigated mainly in typically-developing children, but their use with children with speech sound disorders has been limited. This study compares PMLU, PWP, and consonant accuracy in Spanish–English bilinguals with speech sound disorders (SSD) to age-matched monolingual peers. This study relates directly to the type of research that Adele Miccio favoured. First, it is focusing on bilingual children. For the past 5 years, she has been the principal investigator of a grant developing a comprehensive phonological assessment tool for bilingual speakers. Second, during her career, Miccio advocated using multiple analyses to gauge the phonological skills of children, especially those with speech sound disorders. Her work in stimulability is evidence of that perspective. This study examines one ‘raditional’ measure (consonant accuracy) and two newer ones (pMLU and PWP), thereby broadening the analyses of phonological skills in bilingual children with SSD and thus carrying out multiple analyses, just as Miccio recommended throughout her illustrious career.     

Auditory and phonetic perception of vowels in children with apraxic speech disorders

The aim of this study was to assess auditory and phonetic perceptual processing of vowels in children with apraxic disorders, who demonstrated clinically with only a speech output deficit. Two experiments were conducted. In the preparatory Experiment 1 series of vowels were constructed by moving formant frequencies away from the extreme values in the vowel space in the direction of a 'neutral-vowel position'. These were presented to adults and children with no speech-language involvement. Based on identification performance low-redundancy vowels were selected, which served as the end-points of two vowel continua: /i/-/i/ and /a/-/a/. In Experiment 2 these continua were used in identification and discrimination tasks, presented to 11 children with apraxic speech problems (aged 6:11 to 9:6 years) and 12 normally developing children. The results showed poorer perception of vowels for the children with apraxic speech problems than for the control children for both continua. Identification functions indicated poorer phonetic processing; discrimination functions indicated poorer auditory processing. Furthermore, a combination of perception measures (identification and discrimination) proved to have a high differential and clinical value for the assessment of children with apraxic speech problems. The results support the view that subtle (subclinical) auditory processing deficits make part of speech output disorders.     

Prevalence of headache and its association with sleep disorders in children

An association between headache and sleep disturbances has been reported in previous studies, but there is a lack of research examining this relationship in a community sample of children in order to reveal the magnitude of the problem. Among 32 District Educational Directorates in Istanbul, nine school districts and within each district eight schools were randomly selected. A questionnaire consisting of sociodemographic variables and evaluating headache and sleep disturbances was sent to students' homes to be completed by their parents. The prevalence of headache was 31.4% (95% confidence interval: 29.5-33.4%). Migraine prevalence was 3.3%, whereas nonmigraine headache prevalence was 28.1%. The prevalence of headache was similar between males and females (29.6% vs 33.3%, P > 0.05). The frequency of headache increased with age for both sexes. Snoring, parasomnias, sweating during sleep, and daytime sleepiness were more common among children with migraine compared with nonmigraine and no headache groups. Headaches are common among schoolchildren. Because children with migraine headaches have a high prevalence of sleep disturbances, they should always be evaluated for the presence of sleep problems.     

Specificity and developmental consequences of speech loss in children with pervasive developmental disorders

Speech loss (SL) was compared in 276 children who had pervasive developmental disorders (PDD) with 62 children with intellectual disabilities without PDD. Speech loss seems relatively specific to PDD because it is significantly more common in children with PDD (26.1%, 72/276) than in those with intellectual disabilities (1.6%, 1/62). In three PDD categories, speech loss occurred in all the 12 children with disintegrative psychosis, 35/149 (23.5%) children with infantile autism and 25/115 (21.7%) children with other PDD. Children with pervasive developmental disorders and speech loss had spoken significantly earlier yet developed less satisfactorily after speech loss than those without it. Speech loss seems fairly specific to PDD and is indicative of unfavorable intellectual development in children with PDD.     

Intervocalic consonants in the speech of English-speaking Canadian children with phonological disorders

Acquisition of intervocalic consonants has been insufficiently studied, both in terms of subject numbers, and in terms of differentiating syllabification patterns from those involving vowel feature assimilation. The question has remained: are English intervocalic consonants syllable-initial (onsets), syllable-final (codas) or ambisyllabic? This study addresses these issues in the speech of 44 English-speaking Canadian children with phonological disorders. Intervocalic consonants resembled word-initial onsets in that they were deleted less often than word-final consonants. When there was no deletion, intervocalic consonants were more likely to be segmentally unique (ambisyllabic?) than like onsets or codas. In segmental inventories, segments rarely appeared only in intervocalic position, and showed an equal affinity to onsets and codas, with two exceptions. Sonorant continuants and, to a lesser extent, fricatives showed patterns in intervocalic position that may have reflected assimilation. For children with less severe disorders, velars and fricatives occurred intervocalically only if they also occurred in codas, suggesting a coda-like (ambisyllabic?) status.     

Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability

Background There have been very few population‐based studies of the prevalence of psychiatric disorders among children and adolescents with and without intellectual disability (ID). Methods Secondary analysis of the 1999 Office for National Statistics survey of the Mental Health of Children and Adolescents in Great Britain was performed. This survey collected information on a multistage, stratified, random sample of 10 438 children between 5 and 15 years of age across 475 postcode sectors in England, Scotland and Wales. Results The prevalence of any diagnosed ICD‐10 disorder, conduct disorder, anxiety disorder, hyperkinesis and pervasive developmental disorders were significantly greater among children with ID than among their non‐ID peers. There were no statistically significant differences between children with and without ID with regard to the prevalence of depressive disorders, eating disorders or psychosis. Factors associated with an increased risk of psychopathology among children and adolescents with ID included age, gender, social deprivation, family composition, number of potentially stressful life events, the mental health of the child's primary carer, family functioning and child management practices. Conclusions Children and adolescents with ID are at significantly increased risk of certain forms of psychiatric disorder. Careful consideration of the social and economic adversity facing such families will be necessary to ensure that support services are responsive to both the needs of child as well as the needs of the family in which they are living.     

EPG therapy for children with long-standing speech disorders: predictions and outcomes

This paper reports on a project using a series of single subjects to investigate the effectiveness of using electropalatography (EPG) in treating ten children with persisting speech difficulties of no known organic aetiology. The aims of the project were two-fold, firstly to assess whether the subjects selected benefited from this treatment, and secondly to investigate whether it was possible to predict which children would make maximum improvement. A number of factors were identified as possible predictors for successful EPG therapy and subjects were then ranked according to these predictions. Baseline measures of each subject's speech were taken using word lists. Scores reflected the correct number of realizations of consonants produced by each subject. Subjects received the same number of therapy sessions and were then re-tested. Scores before and after therapy were compared and found to be significantly different although the initial predictions as to the magnitude of improvement for each subject were not verified. The selection of appropriate candidates for therapy and the need for objective means of establishing effectiveness are discussed.