Understanding differing outcomes from semantic and phonological interventions with children with word-finding difficulties: A group and case series study

Preoperative word-finding difficulties in children with posterior fossa tumours: a European cross-sectional study

PURPOSE

Posterior fossa tumour surgery in children entails a high risk for severe speech and language impairments, but few studies have investigated the effect of the tumour on language prior to surgery. The current crosslinguistic study addresses this gap. We investigated the prevalence of preoperative word-finding difficulties, examined associations with medical and demographic characteristics, and analysed lexical errors.

METHODS

We included 148 children aged 5-17 years with a posterior fossa tumour. Word-finding ability was assessed by means of a picture-naming test, Wordrace, and difficulties in accuracy and speed were identified by cut-off values. A norm-based subanalysis evaluated performance in a Swedish subsample. We compared the demographic and medical characteristics of children with slow, inaccurate, or combined slow and inaccurate word finding to the characteristics of children without word-finding difficulties and conducted a lexical error analysis.

RESULTS

Thirty-seven percent (n = 55) presented with slow word finding, 24% (n = 35) with inaccurate word finding, and 16% (n = 23) with both slow and inaccurate word finding. Children with posterior fossa tumours were twice as slow as children in the norming sample. Right-hemisphere and brainstem location posed a higher risk for preoperative word-finding difficulties, relative to left-hemisphere location, and difficulties were more prevalent in boys than in girls. The most frequent errors were lack of response and semantically related sideordinated words.

CONCLUSION

Word-finding difficulties are frequent in children with posterior fossa tumours, especially in boys and in children with right-hemisphere and brainstem tumours. Errors resemble those observed in typical development and children with word-finding difficulties.

The Cerebellar Mutism Syndrome: Risk Assessment, Prevention and Treatment

Cerebellar mutism syndrome (CMS) has received increasing attention over the last decades as a complication of posterior fossa tumour surgery in children. Risk factors, aetiological aspects, and treatment measures of the syndrome have been investigated, yet the incidence of CMS remains unchanged. Overall, we are currently able to identify patients at risk, but we are unable to prevent it from occurring.Once CMS sets in, several symptomatic pharmacological treatments have been suggested, but only in smaller case series and not in randomized controlled trials, and it is not clear whether the treatment or time itself had a helpful effect.Within weeks to months, most patients regain their ability to speak after a phase with mutism or severely reduced speech; however, many patients continue to have speech and language deficits. At this point, anti-cancer treatment with chemotherapy and radiotherapy may be of focus more than the prognosis of CMS; however, many patients continue to have speech and language problems for months and years to come, and they are at high risk of other neurocognitive sequelae as well.Without reliable measures to prevent or treat the syndrome, we may look towards improving the prognosis of speech and neurocognitive functioning in these patients. As speech and language impairment is the cardinal symptom and late effect of CMS, the effect of intense and early-onset speech and language therapy as a standard of care in these patients should be investigated in relation to its effect on regaining speech capacity.

Word-finding behaviours in narration for typically developing French speakers of school age

BACKGROUND

Research in word-finding difficulties is sparse, especially in languages other than English. As a result, the factors associated with the frequency of word-finding behaviours are poorly understood, particularly in discourse.

AIMS

This exploratory study is the first to collect data relative to the expected frequency of word-finding behaviours in narration for French speakers aged 7-12 years old with typical development; and (2) to identify the factors associated with the frequency of word-finding behaviours in narration. We hypothesized that sociodemographic characteristics, language abilities and characteristics of the spoken productions could be linked to word-finding behaviours.

METHODS & PROCEDURES

The participants consisted of 61 French-speaking children aged 7-12 years old (M = 9;09 years, SD = 1;06 years) with typical development. Children were asked to complete a receptive vocabulary task, a non-word-repetition task and two narrative tasks. The children's narrative samples were coded using a discourse analysis of word-finding behaviours, as described by Diane J. German.

OUTCOMES & RESULTS

Participants produced 39% of T-units with least one word-finding behaviour, which included relatively frequent use of repetitions and word reformulations. Regression analyses revealed that the participants' gender was the only significant variable associated with the frequency of word-finding behaviours in narration. Boys produced a higher percentage of T-units with at least one word-finding behaviour. Post-hoc analyses suggested that gender differences reflected differences in repetitions and word reformulations. Boys and girls did not differ on any other language measures collected.

CONCLUSIONS & IMPLICATIONS

Speech-language pathologists may want to take into account a child's gender when assessing word-finding difficulties in narration. Additional studies are needed to understand whether this finding extends to other word-finding tasks and to children with word-finding difficulties.

WHAT THIS PAPER ADDS

What is already known on the subject Studies in English have identified that analyses of word-finding behaviours in discourse can be used to correctly identify children with word-finding difficulties. Studies are needed in other languages to determine if this observation holds true across languages. Moreover, the factors associated with the frequency of word-finding behaviours in discourse are poorly understood. What this paper adds to existing knowledge The frequency of word-finding difficulties in narration was higher in our study of French-speaking children than in previous studies of English. Gender was the only factor associated with the frequency of word-finding difficulties. What are the potential or actual clinical implications of this work? The language and task used to assess word-finding skills as well as the child's gender may be important to take into account when assessing word-finding difficulties based on word-finding behaviours.