The early lexical development and its predictive value to language skills at 2 years in very-low-birth-weight children

The aim of this longitudinal study was to obtain information on the early lexical development and its predictive value to language skills in very-low-birth-weight (VLBW) children. The MacArthur Communicative Development Inventory was used to collect data of the early receptive and expressive lexicon of the 32 VLBW children. This information was compared to the data of 35 full-term controls. The children's language skills were tested using Reynell Developmental Language Scales at 2 years. The growth of the receptive lexicon was slower, and the language skills poorer in VLBW children. The early receptive lexicon growth was strongly associated with the performance in Reynell's test in VLBW children. The findings indicate that the small receptive lexicon size is an early predictor of delayed language development in VLBW children. The results also emphasise the need to assess the language development of the VLBW children in detail at an early age.Learning outcomes: The reader becomes aware of the receptive and expressive lexical development of the VLBW children, and learns about the predictive value of early vocabulary growth to the language skills at 2 years of corrected age in this group of children.     

Children's history of speech-language difficulties: genetic influences and associations with reading-related measures.

PURPOSE: This study examined (a) the extent of genetic and environmental influences on children's articulation and language difficulties and (b) the phenotypic associations between such difficulties and direct assessments of reading-related skills during early school-age years. METHOD: Behavioral genetic analyses focused on parent-report data regarding the speech-language skills of 248 twin pairs (M = 6.08 years) from the Western Reserve Reading Project. In addition, phenotypic associations between children's speech-language status and direct assessments of early reading-related abilities were examined through hierarchical linear modeling (HLM). RESULTS: Probandwise concordance rates and intraclass tetrachoric correlations indicated high heritability for children's difficulties in expressive language and articulation, with estimates of .54 and .97 accordingly. HLM results indicated that children with histories of speech-language difficulties scored significantly lower than unaffected children on various measures of early reading-related abilities. CONCLUSIONS: Results from the parent-report survey provided converging evidence of genetic effects on children's speech and language difficulties and suggest that children with a history of speech-language difficulties are at risk for lower performance on early reading-related measures. The extent of risk differed across measures and appeared greatest for children who demonstrated a history of difficulties across articulation, expressive language, and receptive language. Implications for future genetic research and clinical practice are discussed.     

Speech-language evaluation and rehabilitation treatment in Floating-Harbor syndrome: A case study

Floating-Harbor syndrome is a rare congenital disorder characterized by specific facial features, short stature associated with significantly delayed bone age and language impairment. Although language delay is a cardinal manifestation of this syndrome, few reports describe the specific language difficulties of these patients, particularly the development of language abilities in the long run. This paper reports on an Italian boy with Floating-Harbor syndrome and discusses his language evaluation at presentation (age 48 months) and development and progress of his language abilities after 4 years of rehabilitation treatment. At presentation he exhibited borderline mental retardation, with verbal abilities lower than performance abilities. He showed significant impairment of both expressive and receptive language, and also exhibited phonologic and articulations problems that lowered speech intelligibility. Neuropsychological assessment revealed cognitive problems. After speech-language rehabilitation treatment, he achieved significant improvement in language function.Learning outcomesThe reader will learn about (1) the distinctive clinical characteristics and (2) the speech-language abilities and their development after speech-language therapy in Floating-Harbor syndrome.     

Language and motor speech skills in children with cerebral palsy

The aim of the study was to investigate associations between the severity of motor limitations, cognitive difficulties, language and motor speech problems in children with cerebral palsy. Also, the predictive power of neonatal cranial ultrasound findings on later outcome was investigated. For this purpose, 36 children (age range 1 year 10 months to 9 years 0 months) with cerebral palsy due to premature birth and white-matter damage (periventricular leukomalacia) participated in the study. Twenty-two children (62%) had an intelligence level above 70. One-half of this group exhibited motor speech problems. Children with an intelligence level below 70 (n=14, 38%) showed problems in motor speech skills as well as in verbal expressive and comprehensive skills. Neonatal cranial ultrasonography findings were moderately associated with the severity of functional motor limitations. LEARNING OUTCOMES: Readers will be able to: (1) describe different hypotheses regarding the relationship between language, speech, intelligence level and severity of cerebral palsy, (2) discuss how intelligence and functional motor limitations impact language and speech performance for children with cerebral palsy and (3) discuss the predictability of the ultrasound methodology.     

Very-low-birthweight children and speech and language development.

Very low birthweight (VLBW) is often considered to be a risk factor for speech and language disorders, yet data are equivocal. The present study compared speech and language comprehension and production between 249 very-low-birthweight (VLBW: less than 1.5 kg) and 363 normal-birthweight 8-year-olds, randomly sampled in a geographic area. Mean performance for the entire group of VLBW children and for the group when 24 VLBW children with major neurologic abnormalities were excluded, was significantly lower than for controls on the majority of speech and language measures. Further analyses addressed the clinical significance of these statistically significant differences. Test scores were converted to standard scores and grouped according to standard deviation intervals, thus portraying each child's performance in terms of the magnitude of discrepancy from each test's mean. When the 24 children with major neurological abnormalities were excluded, no significant differences between the VLBW and control children were observed. Using discrepancy between WISC-R performance IQ and language to define specific language impairment (SLI), a higher percentage of control than VLBW children were identified as having SLI. Neonatal risk factors did not differentiate between VLBW children with or without SLI. A higher proportion of VLBW than control children did present subnormal language associated with IQ less than 85, hearing deficits, and/or major neurological impairments. Thus, SLI is not more common among VLBW than control children. Language deficits accompanied by more general developmental problems, however, are more frequent.     

Evaluation of communication competence in patients with closed head injury

Twenty closed head injured (CHI) and 15 control subjects (non-CHI) were selected from a hospital population and evaluated after all CHI subjects were alert and conscious. The test battery included an audiometric evaluation and 21 subtests of intelligence, verbal expressive and receptive language, articulation, auditory and visual short-term memory, oral agility, automatic speech, writing, reading, and simple mathematics. The CHI subjects performed significantly less well than the control group on all subtests except articulation and five of the subtests of reading, writing, and mathematics. Additionally, the less severely involved CHI subjects performed significantly better than the more severely involved CHI subjects on the subtest, Automatized Sequences, and, to a lesser degree, Oral Agility. The implications are that CHI has an immediate generalized effect upon the cerebral mechanisms subserving intelligence, speech, language, memory, and specific writing, reading, and arithmetic skills and that the differences seen in automatic speech and oral-motor skills appear to be dependent upon the severity of the traumatic head injury. I recommend that all CHI patients undergo assessment for communication competence regardless of the level of severity of the trauma.     

Efficacy of auditory-verbal therapy in children with hearing impairment: A systematic review from 1993 to 2015

ObjectivesAuditory verbal therapy (AVT) is one of the primary treatment approaches for developing spoken language in children with hearing impairment (HI), but its outcomes have not been thoroughly investigated. The current study aimed to systematically review past studies investigating AVT outcomes in children with HI.MethodsA systematic search was conducted in six databases. Fourteen articles that met the final inclusion criteria were grouped under three categories based on the outcome measures: receptive and expressive language development, auditory/speech perception and mainstreaming.ResultsArticles under “receptive and expressive language development” category indicated AVT can even help children with HI beyond three years of age to develop age appropriate language skills and catch up with their hearing peers. Articles under “auditory /speech perception” category suggested that children receiving AVT can learn to recognize words accurately even in the presence of background noise. Articles grouped under “mainstreaming” category indicated that children receiving AVT can be successfully mainstreamed.ConclusionAlthough studies suggest that AVT can have a positive impact on developing speech and language skills in children with HI, it is difficult to generalize these findings due to limited evidence. Future studies should utilize well-controlled group designs to minimize the role of external variables as well as strengthen the evidence-base for AVT.     

Divergence of fine and gross motor skills in prelingually deaf children: implications for cochlear implantation

OBJECTIVE: The objective of this study was to assess relations between fine and gross motor development and spoken language processing skills in pediatric cochlear implant users. STUDY DESIGN: The authors conducted a retrospective analysis of longitudinal data. METHODS: Prelingually deaf children who received a cochlear implant before age 5 and had no known developmental delay or cognitive impairment were included in the study. Fine and gross motor development were assessed before implantation using the Vineland Adaptive Behavioral Scales, a standardized parental report of adaptive behavior. Fine and gross motor scores reflected a given child's motor functioning with respect to a normative sample of typically developing, normal-hearing children. Relations between these preimplant scores and postimplant spoken language outcomes were assessed. RESULTS: In general, gross motor scores were found to be positively related to chronologic age, whereas the opposite trend was observed for fine motor scores. Fine motor scores were more strongly correlated with postimplant expressive and receptive language scores than gross motor scores. CONCLUSIONS: Our findings suggest a disassociation between fine and gross motor development in prelingually deaf children: fine motor skills, in contrast to gross motor skills, tend to be delayed as the prelingually deaf children get older. These findings provide new knowledge about the links between motor and spoken language development and suggest that auditory deprivation may lead to atypical development of certain motor and language skills that share common cortical processing resources.     

Receptive and expressive prosodic ability in children with high-functioning autism.

PURPOSE: This study aimed to identify the nature and extent of receptive and expressive prosodic deficits in children with high-functioning autism (HFA). METHOD: Thirty-one children with HFA, 72 typically developing controls matched on verbal mental age, and 33 adults with normal speech completed the prosody assessment procedure, Profiling Elements of Prosodic Systems in Children. RESULTS: Children with HFA performed significantly less well than controls on 11 of 12 prosody tasks (p < .005). Receptive prosodic skills showed a strong correlation (p < .01) with verbal mental age in both groups, and to a lesser extent with expressive prosodic skills. Receptive prosodic scores also correlated with expressive prosody scores, particularly in grammatical prosodic functions. Prosodic development in the HFA group appeared to be delayed in many aspects of prosody and deviant in some. Adults showed near-ceiling scores in all tasks. CONCLUSIONS: The study demonstrates that receptive and expressive prosodic skills are closely associated in HFA. Receptive prosodic skills would be an appropriate focus for clinical intervention, and further investigation of prosody and the relationship between prosody and social skills is warranted.     

Language evaluation in children with pre-lingual hearing loss and cochlear implant

IntroductionThe cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development.ObjectiveThe aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language.MethodsThis was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody picture vocabulary test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months.ResultsThe longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study.ConclusionThe longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.     

Behavioral inhibition and clinical outcomes in children with cochlear implants

OBJECTIVES/HYPOTHESIS: Individual speech and language outcomes of deaf children with cochlear implants (CIs) are quite varied. Individual differences in underlying cognitive functions may explain some of this variance. The current study investigated whether behavioral inhibition skills of deaf children were related to performance on a range of audiologic outcome measures. DESIGN: Retrospective analysis of longitudinal data collected from prelingually and profoundly deaf children who used CIs. METHODS: Behavioral inhibition skills were measured using a visual response delay task that did not require hearing. Speech and language measures were obtained from behavioral tests administered at 1-year intervals of CI use. RESULTS: Female subjects showed higher response delay scores than males. Performance increased with length of CI use. Younger children showed greater improvement in performance as a function of device use than older children. No other subject variable had a significant effect on response delay score. A series of multiple regression analyses revealed several significant relations between delay task performance and open set word recognition, vocabulary, receptive language, and expressive language scores. CONCLUSIONS: The present results suggest that CI experience affects visual information processing skills of prelingually deaf children. Furthermore, the observed pattern of relations suggests that speech and language processing skills are closely related to the development of response delay skills in prelingually deaf children with CIs. These relations may reflect underlying verbal encoding skills, subvocal rehearsal skills, and verbally mediated self-regulatory skills. Clinically, visual response delay tasks may be useful in assessing behavioral and cognitive development in deaf children after implantation.     

Predicting outcomes of children referred for autism using the MacArthur-Bates Communicative Development Inventory.

PURPOSE: Autism spectrum disorders (ASD) are characterized by early impairments in language and related social communication skills. This investigation explored whether scores on the MacArthur-Bates Communicative Development Inventory (CDI) at ages 2 and 3 years predict outcome at age 9 years in children with ASD and developmental delay (DD). METHOD: Sixty-two children referred for possible autism at age 2 years, and 19 children with DD, were followed to age 9 years. Vocabulary, prespeech, and gestures scores on CDIs administered at ages 2 and 3 years were used to predict follow-up IQ, language, adaptive skills, and scores on diagnostic measures. RESULTS: CDI scores at ages 2 and 3 did not predict outcome for the DD group. For the ASD sample, CDI receptive and expressive language and late gestures at ages 2 and 3 years predicted a number of follow-up variables, although scores at age 3 years were generally more predictive than scores at age 2 years. CONCLUSIONS: The CDI yielded scores that were predictive of outcome, suggesting that this parent report measure may be a quick and informative assessment of early verbal and nonverbal skills in children with ASD.     

Diagnostik und Differenzierung sprachentwicklungsgestörter Kinder?

BACKGROUND: Specific language impairment (SLI) is defined as a developmental disorder in which language comprehension and the child's ability to use expressive spoken language is markedly below the appropriate level for his or her mental age. The intelligence of SLI children is in the normal range, while their language abilities are impaired. "Normal intelligence", the defining feature of SLI is questioned in this study. PATIENTS AND METHODS: Using IDIS (an inventory of diagnostic information in language impairment), we examined 138 children aged 5 and 6 years with severe language impairment; 108 SLI and 30 LI children. Various indicators of speech and language such as articulation, the ability to discriminate sounds, lexicon, grammar and pragmatic abilities but also auditory and visual perception, auditory and visual memory, fine and gross motor function were assessed. RESULTS: The performance of the SLI children was significantly higher in most of the tests than that of the LI children. Factor analysis showed that the two groups also differed in the structure of performance. Auditory short-term memory was reduced in most children irrespective of intelligence. CONCLUSIONS: We propose the retention of the differentiation of subgroups of developmental speech and language disorders depending on the level of intelligence.     

Pediatric cochlear implantation in Taiwan: long-term communication outcomes

OBJECTIVES/HYPOTHESIS: Cochlear implantation is an established method of auditory rehabilitation for severely and profoundly hearing impaired individuals. Although numerous studies have examined communication outcomes in pediatric cochlear implant (CI) recipients, data concerning the benefits of cochlear implantation in children who speak Mandarin Chinese are lacking. This study examined communication outcomes in 29 Mandarin-speaking children implanted at Chung Gung Memorial Hospital. DESIGN: A prospective between-groups design was used to compare communication outcomes as a function of age at time of implantation. METHODS: Children in the Younger group were implanted before 3 years of age, whereas children in the Older group were implanted after 3 years of age. Outcome measures assessed auditory thresholds, speech perception, speech intelligibility, receptive and expressive language skills, communication barriers, and communication mode. Correlation analysis was used to examine the relationship between communication outcome and age at implantation. RESULTS: Children in the Younger group demonstrated a significant level of difference on Mandarin vowels, consonants, tones, and open-set speech perception compared with the children in the Older group. Between-group differences were also shown on receptive and expressive language skills. But, no significant differences were noted on speech intelligibility or in self-ratings of communication barriers. A larger proportion of children in the Younger group used oral communication and were educated in mainstream classrooms. Communication mode change of the Younger group reached a significant level after cochlear implant. Speech perception performance was negatively correlated with age at implantation as well as chronological age. Mandarin-speaking children can obtain substantial communication benefits from cochlear implantation, with earlier implantation yielding superior results.     

Language development and symbolic play in children with and without familial risk for dyslexia.

The purposes of this study were to investigate (a) whether children in families with a positive history of dyslexia were more likely to show delays in language development than children without family risk and (b) whether a delayed onset of expressive language (late talking) predicted later language development. We analyzed the language development of 200 children longitudinally at 14, 24, 30, and 42 months and assessed their symbolic play at 14 months. Half of the children (N = 106) were from families with a history of dyslexia (the Dyslexia Risk [DR] group), and other children served as age-matched controls. Parental reports and structured tests were used to assess children's receptive and expressive language and symbolic play. No differences emerged between the two groups in receptive language, symbolic play, or on the Bayley MDI. The groups, however, diverged in expressive language measures. The maximum sentence length at 2 years and object naming and inflectional morphology skills at 3.5 years were higher for the control group than for the DR group. Reynell receptive score at 2.5 years provided the greatest unique contribution to the prediction of the children's receptive and expressive language. Children's risk status did not contribute to receptive language, but provided a significant contribution to their expressive language at 3.5 years, even after the variance associated with parental education and children's previous language skills was controlled. Late talkers in the DR group differed from the other members of the DR group in both receptive and expressive language at 3.5 years, although in the control group children with a late-talking history performed at age-level expectations. The findings suggest that children with a familial risk for dyslexia and with a history of late talking are at higher risk for delays in language acquisition than children without the familial risk for dyslexia.     

Development of receptive vocabulary and verbal intelligence in Japanese children with unilateral hearing loss

ObjectiveIn the past, it was believed that unilateral hearing loss has a minimal impact on the speech and language development in children. However, several studies have suggested that some school-age children with unilateral hearing loss have learning impairments in language. In the present study, we first examined whether preschool-age children with unilateral severe-to-profound hearing loss (UHL) have delays in the development of receptive vocabulary and verbal intelligence. In the follow-up study, we tested the children again after school admission. The objective of the present study was to reveal the development of receptive vocabulary and verbal intelligence from preschool to school years in children with UHL.MethodsFifteen Japanese preschool-age children with UHL and a control group of 20 age-matched Japanese children with bilateral normal hearing (NH), who were examined because articulation disorder was suspected, were enrolled in this study. The development of receptive vocabulary and verbal intelligence was evaluated using the Picture Vocabulary Test-Revised (PVT-R) and the Wechsler Intelligence Scale, respectively. The present retrospective study was approved by the Committee for Medical Ethics of Tokushima University Hospital (#3801).ResultsThe scaled score (SS) of the PVT-R and verbal intelligence quotient (VIQ)/verbal comprehension index (VCI), but not performance intelligence quotient/perceptual reasoning index in children with UHL were significantly lower than those in the control children with NH at preschool-age. The SS of the PVT-R and VIQ/VCI in children with UHL significantly improved after school admission. In the subgroup analysis, the SS of the PVT-R in the lower receptive vocabulary group of children with UHL at preschool-age was significantly increased after school admission, but the SS in the normal and higher receptive vocabulary group of children with UHL at preschool-age were still around the standardized mean of SS after school admission.ConclusionThese findings suggest that the development of receptive vocabulary and verbal intelligence was delayed in preschool-age children with UHL and that most of them caught up to exhibit normal language ability after school admission.     

Semantic deficits in children with language impairments: issues for clinical assessment

Children with language impairments demonstrate a broad range of semantic difficulties, including problems with new word acquisition, storage and organization of known words, and lexical access/ retrieval. Unfortunately, assessments of children's semantic skills are often limited to measures of receptive and expressive vocabulary size. As a result, the semantic deficits of these children may not receive the attention they need. This article explores the word-learning, lexical storage, and lexical access skills of children with language impairments and the theories that account for their performance. Our review culminates with specific recommendations for speech-language pathologists to improve the breadth of their semantic assessments.     

Early Otitis Media and Phonological Development at Age 2 Years

The effect of early otitis media on phonology and articulation in the presence of expressive language delay was investigated in 16 2-year-olds followed prospectively from birth. Eight of the children were designated otitis-positive and 8 were considered otitis-negative as determined by bilateral pneumatic otoscopy outcomes during year 1 of life. The groups differed significantly on measures of expressive, not receptive, language development. All members of the otitis-positive group were expressive language delayed. Phonological analyses were completed on spoken language samples elicited from each child at age 24 months. Results showed similar developmental tendencies in speech sound acquisition between the groups, but the otitis-positive group had established significantly fewer initial consonant phones and produced them less accurately than the otitis-negative subject group. The otitis-positive group acquired significantly fewer consonants with back place of articulation. Similar phonological error patterns of deletion and phoneme class deficiency were used by the groups, but the otitis-positive group used the error patterns more frequently. Findings here lend support to the otitis media effect as one of interaction among risk factors.     

A 28-year follow-up of adults with a history of moderate phonological disorder: linguistic and personality results.

The present investigation is a follow-up to a longitudinal speech and academic study involving approximately 400 normally developing children begun in 1960 by Mildred Templin. From this large data base, the present project invited the participation of two groups of subjects (now aged 32 to 34): (a) 24 adults with a documented history of moderately severe phonological disorder that persisted at least through the end of first grade (probands) and (b) 28 adults from the same birth cohort and schools who were known to have had at least average articulation skills over the same period (controls). Results of follow-up testing revealed that the proband adults performed significantly more poorly than the control adults on all of the administered measures of articulation, expressive language, and receptive language. Results obtained from a screening of nonverbal reasoning ability were equivocal. On a questionnaire measure of personality, both groups scored well within the normal range for the dimensions of extroversion and neuroticism when compared to the test's normative sample. These results have been interpreted as suggesting that although many adults with a childhood history of delayed phonological development will continue to experience linguistic outcomes that are less favorable than those of controls, their performance in selected nonlanguage domains (e.g., nonverbal reasoning, personality) will be far more typical of the general population.     

Short-term auditory memory in children using cochlear implants and its relevance to receptive language.

The aim of this study was to assess auditory sequential, short-term-memory (SSTM) performance in young children using cochlear implants (CI group) and to examine the relationship of this performance to receptive language performance. Twenty-four children, 5 to 11 years old, using the Nucleus 22-electrode cochlear implant, were tested on a number of auditory and visual tasks of SSTM. The auditory memory tasks were designed to minimize the effect of auditory discrimination ability. Stimuli were chosen that children with cochlear implants could accurately identify with a reaction time similar to that of a control group of children with normal hearing (NH group). All children were also assessed on a receptive language test and on a nonverbal intelligence scale. As expected, children using cochlear implants demonstrated poorer auditory and visual SSTM skills than their hearing peers when the stimuli were verbal or were pictures that could be readily labeled. They did not differ from their peers with normal hearing on tasks where the stimuli were less likely to be verbally encoded. An important finding was that the CI group did not appear to have a sequential memory deficit specific to the auditory modality. The difference scores (auditory minus visual memory performance) for the CI group were not significantly different from those for the NH group. SSTM performance accounted for significant variance in the receptive language performance of the CI group. However, a forward stepwise regression analysis revealed that visual spatial memory (one of the subtests of the nonverbal IQ test) was the main predictor of variance in the language scores of the children using cochlear implants.